conversations

The boys and I were driving to t-ball practice last night. We past a moving truck parked on the side of the road (not near any houses). Blake says "Mommy what kind of truck is that?" I said "it's a moving truck" Then there is a pause and he says to me "But, Mommy it's not going anywhere".

Sometimes we say things to children expecting them to know what we mean. We often forget that a lot of things in our language have many different meanings depending on the context of the situation. I have never spoken "down" to my sons. I talk to them pretty much the same way I would to any other person. This is the best way to expand a child's spoken vocabulary hence increasing their reading vocabulary. Children will often figure out what you mean by using the context of the statement. But, there are times that we have to step back and explain what we are saying. As in the story above. Blake knows that the truck isn't in motion at the time. So, even though he has seen moving vans in our neighborhood before he did not make the connection to the truck that was just parked on the side of the road. It took a minute of me explaining that it is a truck used to move people's furniture when they change houses for him to comprehend the context of a moving truck.

Often times people feel they need to simplify what they are saying in order for children to understand what is being said. When people do this on a regular basis children do not fully develop a true language pattern of speech. As adults you typically do not speak in simple sentences to your peers. If you only speak to children in simple sentences and with easily understandable words, yes your child will understand you, but are you helping to expand their knowledge?

When I give my sons directions, I use simple statements and words that I know they understand. I do this for the fact that I want them to remember what I told them to do. It also allows me to give them more than one direction at a time. But, when having a conversation with them I do not. I want them to develop a great conversation vocabulary and be able to hold their own no matter who they speak to and with.

Hope you have a great conversation with your children today. You never know what they want to share with you. Remember to check to make sure they understand all those double meaning and try to enrich their speech every day. (o:

Another milestone in our lives

Well, I just got home from Blake's IEP meeting for speech at the local elementary school. The meeting was his annual review, but it was also to put him on consultation. What does this mean? It means that Blake will no longer be receiving speech services. It means that my little boys who was barely speaking last year, now is speaking so well that he doesn't need services anymore. It means he is on/above age level in his articulation skills. At this point he only has two goals to work on: clearly speaking multi-syllabic words in sentences and clearly speaking in longer and longer sentences. A lot of this has more to do with him thinking faster than he can talk than actual articulation issues.

His speech teacher will be in contact with me monthly to check in on his progress, but for the most part we do not see a need for him to receive speech services anymore. Can you believe it? Last year at this time, I was worries that he would be speaking clearly when he entered kindergarten, and he is being released a few weeks before he turns 4.

I'm so proud of his progress!

Bittersweet Moment

Today was Blake's last session with his speech teacher that he has been using since he was 2 years 4 months old. When he began working with Jen, he hardly communicating at all. She taught him to sign and from there helped him overcome his speech issues. She was the one who encouraged us to have his tongue tie clipped which was the best thing we ever did for him verbally. She helped us help him to learn to articulate his thoughts. In the time she worked with him he learned to speak, he learned to speak clearly, and now we can't get him to stop talking. He can recite stories, he speaks in paragraphs and says multi-syllabic words.

It blows my mind how much he has improved in the last year, but to look back at where he started with her... wow!

We decided that we no longer needed to pay out of pocket for him to recieve these one-on-one services, as he goes twice a week to the public school for speech too. We have decided that he has progressed so well under her guidance that he is ready to move on. This is such a bittersweet decision... she has played a huge roll in this development and it is because she did such a good job that we no longer need her services.

Blake and I (and Colby too actually) will miss seeing Ms. Jen each week, but we know that there are other children out there who will certainly benefit from her guidance and wisdom, her love and her caring, her knowledge and the skills she will provide to help them.

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Today's goals:
-- go to the Y with the boys in the morning [check]
-- take Blake to speech at TLE (out local elementary school) [check... next time I must remember to have Blake go to the bathroom at home before we go... OOPS!]
-- menu plan (I have to move grocery day and I'm going to test out Tuesdays this week) [check, I actually did the plan on Monday night, but made the grocery list today]
-- strip the beds, wash the sheets, re-make the beds [check]

Tomorrow's goals:

-- go to the Y... not sure which class I'll go to yet

-- laundry... anyone else feel like this is an every day goal?

-- go to the grocery store

-- post my Tasty Tuesday recipe

-- make tacos for dinner

Make sure you check out the poll on my sidebar!

Unexpected Challenges

Anyone who has followed this blog for a while knows that Blake has had speech issues pretty much his whole life. He has been receiving speech therapy since he was almost 2.5 year old. After having his tongue tied clipped, he gained a great deal of progress. In September of last year, he began speaking more and more. I'm blown away with his progress and the vocabulary that he has developed in 3.5 years. I always knew that he had a strong receptive vocabulary (understanding of what he hears), but now his expressive vocabulary (what he is able to say) blows me away too.

In early March, his private speech clinician performed new testing to see his progress and assess what is really causing his speech issues. In the testing it was determined that he has verbal and oral apraxia. We had a feeling that this maybe part of his issue before the testing was even started.

"Apraxia is a neurogenic impairment involving planning, executing and sequencing motor movements. Verbal apraxia affects the programming of the articulators and rapid sequences of muscle movements for speech sounds (often associated with hypotonia and sensory integration disorder). Oral apraxia involves nonspeech movements (e.g., blowing, puckering, licking food from the lips)." Dr. Marilyn Agin

Ok... now I know you are saying... so what does that mean? It means that he has issues doing things with his mouth especially when asked. There are movements that he can't do on his own and some that he can do involuntarily, but if you ask him to do it he struggles. For example, he struggles to lick his top lip, this is something that he can not do involuntarily or when asked. Another example is he can open and close his mouth on his own, but when asked there is a pause between the two motions because he has to think about it and can't just do it.

Part of the challenge with this is the fact that Blake is very smart (and not that isn't just a mother bragging... he is) and know what he can and can't do. He gets very frustrated when asked to do something that he knows he should be able to do and can't. But, gets even more frustrated when it is something he isn't sure he can do and you expect him to do it.

This was shining in full force yesterday. I found out that Blake hasn't been drinking anything at school because he wasn't confident in drinking out of a real cup. At home he uses a sippy cup, more for the fact that Colby dumps anything he gets his hands on than any other reason. But, knowing Blake he didn't want to try to drink out of the cup at school in fear of spilling it. So yesterday for dinner we worked on him drinking out of the cup. He could do it with one hand so it is not an issue of being steady or bring the cup to his mouth. It was hard to sit there and watch him struggle with how to put his lips on the cup. To watch him take the tiniest sips of juice to be sure he got it all in his mouth. He was so proud of himself when he did it on his own. But, the challenge with apraxia is that even if he did it last night doesn't mean he will do it right today or tomorrow or the next day. Children with apraxia struggle with consistency they struggle with getting the same motion and/or sound done the right way over and over.

This is hard to wrap my brain around. I know he is smart, I know he can do these skills, but his body doesn't always communicate correctly. I worry about how this will effect him in school. This is a child who is beginning to sound out words on his own, but at the same time he can't always correctly articulate the sounds when asked. I know that he knows all the letter sounds and does a good job getting close to the correct sound, but struggles with consistency. I just fear that he will get frustrated with it all and then not want to put in the effort because it won't always be rewarded.

We will get there. He has made HUGE strides in all areas... I'm so proud of him.

Dec 4th

Today's story was Huggly's Christmas, by Tedd Arnold.  If you don't know the Huggly's series, Huggly is a cute green monster who lives in a world below ours.  Huggly and his friends come into the human world by coming up under the "peoples beds".  In this book, Huggly goes into the people house and sees the Christmas tree and has an adventure exploring and even meets Santa Claus. 

Today was a big day in Blake's life... he went to speech at our local pubic school for the first time.  He shook the teacher's hand waved to me and then went off with her, and didn't even look back.   I was so proud of him I actually got to watch him walking down the hallway with her.  I went back to pick him up after his 30 minute session and he was so excited.  He made a snowman with her and was proud to show it to me.  I am so glad that he will now be getting speech 3 times a week 30 minutes each session. 

Blake's speech

Well I haven't talked about Blake's speech in a while so I thought I'd update everyone. Blake is doing a lot better with his articulation. He is gaining more and sounds and now more words that are closer to correct articulation. We are focusing on consonant-vowel and vowel-consonant words and clearing up his long and short vowel sounds.

Over the last few weeks we have come to realize that Blake has some major oral planning issues. His mouth has trouble knowing where the lips, tongue and mouth need to be to form each letter. As an adult you take for granted saying sentences, never mind words and even individual sounds. Blake is having to learn how to move his mouth to form the sounds correctly, and this is not easy.

I get so excited when I hear him saying more words even if they are word approximations. When I can understand what he is trying to say it makes life so much easier.

I recently had a meeting with our school district about Blake. When he turns 3 he falls under the public school umbrella. In November, he will begin receiving speech at our local elementary school twice a week for 30 minutes each session. At this time, we are planning on continuing his speech with his other therapist also. Unfortunately this cost will now be out of pocket for us, but Richard and I feel that this continuity will be beneficial for Blake. It will also mean that he will have speech 3 days a week for 30 minutes a day... and that should be so worth it!

It's crazy to me that in only a few weeks Blake will be turning three. My goal for him is that he will be speaking clearly before he starts pre-K which won't be until 2011. I want him to be able to get the most of out his schooling and be able to shine and not shy away because he isn't understood... I don't think that's too much to ask... is it?

Speech development

I haven't posted about Blake's speech in a while, so I figured I'd fill you in...

First this is a slow process and we knew that going in. He is learning more and more signs and beginning to use the independently. He is also clearly saying more beginning sounds than ever. We are still working on /m/, /b/, /p/, /ee/, /oo/, /oh/ and /h/.

It is hard because he tries very hard, but still struggles to say the sounds correctly. We haven't had a chance to constant an ENT about his tongue, but that is on the top of the to-do list. We are now also working on using his upper lip... he doesn't round it when he makes sounds such as /oo/. We've noticed that he keeps it flat while drinking out of both a sippy cup or straw cup. Strange.. he does have the strength to use it correctly... now it's just a reteaching thing.

As for me... well I still struggle with trying to help him. I still struggle with trying to figure out what he needs to keep his frustration at bay. I still struggle with the feeling that I should have caught this earlier, I should have done something to eliminate this issue before it got to this point. But alas there is nothing I could have done, and nothing I can do now. We just take it one step at a time and realize that he is making progress... and he will get there.

Speech update

I haven't posted on Blake's speech in a bit, so I figured I would. Blake is still working on learning more signs and seems to be doing well with picking them up. He has mastered a few of then and is beginning to use the independently, with Richard and I. He now knows and uses: 'more', 'milk', 'please', 'open', 'all done', 'sorry', 'baby', 'go', and 'cookie'. We are working on 'bathroom', 'music', 'water', 'banana', 'drink', and 'eat'.

We are working on the sounds /m/, /p/, /b/, /ee/ and /o/. The latest thing is to have Blake look at our mouth as we form the sounds correctly so he can see how it should look. Also, when we say /b/and /p/ we have him feel the air come out of his mouth. One thing that we are noticing is that he is saying a lot of the sounds with a nasal tone to it. This very well could be connected to the fact that he is tongue tied and his tongue is interfeering with the sounds ability to escape his mouth correctly.

At this time, we are strongly considering talking to an ENT to find out how complicated this would be to correct. How envasive is this procedure? How long is the recovery time? We feel that this needs to be done. We have come to the conclusion that it will help in so much in the long run to have it corrected soon. Richard is crazy busy right now at work, but it is high on the priority list after his work quiets down a bit. I'm also thinking about asking the speech therapist to look at Colby too to see if we should consider having Colby's tongue taken care of now too.

I just hope that getting it done will help him. I just hope it will provide him the jump he needs to correct his articulation issues. I just want to be able to clearly understand my little guy... for both of us!

Sunday Speech update

I think I may post my speech updates on Sunday... well this week anyway since I haven't made a scrapbook page (o:

Blake's Speech Therapist (ST) was impressed with his progress with signing. She was glad to see that we have begun more signs with him and that he is having little confusion with them. He is still not doing them completely independently yet, but that will come I know. The other thing she was please to see was that he is trying to say the word along with the sign which is the goal.

This week's homework for us is for us to enunciate one sound/syllable with each signed word. ST suggests that with "more" we focus on the /m/ sound, "please" /ee/ sound, bye /b/.

This week we are adding the signs for "milk", "water", "drink", "eat" as well as continuing the signs we began last week.

For the most part Blake is able to reproduce the sign and say something along with it. He struggles with "help", but has created a sign of his own that is similar to the ASL sign. We will still use the ASL sign to him so knowing him he'll figure it out eventually.

Blake's speech

Blake had his first speech session on Friday. Most of the time was spent filling out the paperwork and providing a picture of his developmental levels across the spectrum of skills.

Blake was fascinated with his speech therapist, ST, and even spoke to her quite a bit. Starting this Friday his sessions will be at 9am which will be good because that is Colby's nap time. This is good for two reasons... one Colby won't be a distraction and two Blake will get the full attention of both myself and ST.

We have begun working with him on some simple signs. The first goal is to eliminate his frustration and provide him other means of communication. We will continue to encourage him to speak for as much as possible while giving him a few signs to help too. ST had suggested beginning with "more" and "open". Blake picked up on "more" very quickly. We haven't really had a lot of need for the word "open", but do use the sign when it comes up.

Richard and I decided to jump in and add a few more words. We decided that "help" was an important one for us to use with him. Blake is very strong willed and independent, and if you try to help him when he doesn't want help he gets even more frustrated. But, at the same time if you don't help him and he wants help... yep he gets even more frustrated with the situation.

We are also using the signs "milk", "yes", "no", "thank you", and "sorry". But, we aren't expecting him to master these ones first. My thinking, knowing Blake, is the more he's exposed to Richard and I using the signs the more likely it is for him to begin using them himself.

The exciting thing is he is trying to say the word while doing the sign so he seems to be making the connection between the spoken word and the sign already!

As things progress, I'll keep you posted on the things we are doing.

Blake's speech

I mentioned in my Random Weekend thoughts, that I had Blake's speech evaluated and he qualifies for speech therapy. I figured it would be worth explaining this a bit more.

When we went to Blake's 2 yr. doctor's appointment I pushed for a referral to early intervention. Early intervention for those who don't know is a federally funded service provided for children birth to 3 who have some type of developmental delay or medical condition that requires extra services (physical therapy, occupational therapy, speech and vision specialist, etc...). We have a very good working relationship with our Pediatrician and I knew if I pushed it she would agree with the evaluation. I decided to wait until after the holidays to call and set up the appointment.

When I called they did a phone evaluation. This is used to weed out the parents who are just searching for services, but the child doesn't really need them. When they evaluate the child he/she has to be two standard deviations below the norm in any one category to qualify, and/or have one sub-category that is two standard deviations below the norm. When they did the phone questionnaire, I was told that Blake did not qualify because his "communication" falls in the norm. I decided to push them to test him. I know his communication skills are in the norm as it is a combination of receptive and expressive language. Blake's receptive language (the understanding of what he hears) is very high! But, I also know that his expressive language (what he is able to say) is very low. Or should I qualify even more to say it's more an articulation problem (in my opinion, but I'm not an expert).

After talking to the Child Care Coordinator who will be following his services, she agreed that it would be worth doing the evaluation to see what is going on, and what can be done to help Blake. We then set up an appointment for the next available time... 2 months later! Yes, I realize that there are other cases that are a lot more severe than Blake's speech, but still it felt like a forever wait.

When we went to the evaluation they performed a standardized test to evaluate his development in communication, motor skills (fine and gross motor), self-help skills, social/emotional, and cognitive skills. Part of this evaluation was completed by asking Richard and me a series of questions about Blake's everyday abilities. The other part was actual tests they did with Blake in a play type format. There were two therapists performing the evaluation. A speech therapist was working with Blake and an occupational therapist was asking Richard and I the questions.

The assessment was reviewed there that day too, and services were set up (what he qualified for, not the where and when of the service). When we went through the assessments it was determined that he was average to above average in all categories including communication. But, when they looked at his expressive language skills he was below the norm in this one area. The speech therapist agreed that he needed speech therapy and that pushing to get him evaluated was the right thing to do.

I am just glad that I had enough understanding of language skills to push this evaluation. I'm also glad that they were willing to listen to my concerns and understand that I knew he needed help. The other thing that I feel having been a teacher helped me with is that I know that a speech issue is typical. I know that having a speech problem has NOTHING to do with intellect. I know that it is something that can be helped and overcome when provided the right type of help.

It still baffles me how many people think that getting any kind of service means that there is a cognitive problem. What is even sadder is how many people in the field of education do not understand that providing service earlier will help the child in the long run. That although some developmental delays are signs of learning problems to come, not all are. A developmental delay means that the ability is there... if you don't have the ability to perform the skill it isn't a delayed skill!

I can't wait for Blake to start receiving speech. I'm excited to see his speech blossom to match the rest of his abilities. I'm excited to help him. And more than anything I'm excited to know that at some point in the near future I may be able to hear him say Mommy.

What gives you the right?

One thing that really bugs me as a mother is the nerve people have! What gives people the right to question your child's abilities, personality, or any other aspect of your child and his/her development?

People often stop me when I'm out and about with the boys. Typically they ask how old they are and then I usually hear... wow you've got your hands full. Another thing I often hear are... oh they are just too cute (or something on that aspect). Yes, they are cute, but there is so much more to them than being cute.

The things that really bug me are when they ask Blake how old he is and I usually answer for him. He will occasionally say hi or something else to them, but they aren't going to understand 90% of what he says anyway. But, what gives them the right to say in front of me... doesn't he talk yet? Or people will say... he'll talk soon. Or, I bet only mommy understands you. First of all... none of these things need to be said in front of Blake. He does talk, but is very hard to understand. It has nothing to do with intellect, it has to do with developmental level of speech and speech only. He can understand anything you say to him! Blake doesn't talk to many people besides Richard and I... and my feeling is he knows they won't even try to understand him so why should he try. Blake is a smart cookie and very aware of others and their feelings. I don't want him to pick up on the fact that people expect him to talk in a way that should be understood by a stranger and know that he can't just yet.

I hate that people who know us casually and those people we've never met before have the audacity to say something so bold in front of him. I never know what to say in response. I often say he only talks when he wants to, or with people he knows. Sometimes I just ignore the fact that they said anything and go on.

At home, we praise Blake for using his words and encourage him to use them whenever we get the chance. I know he knows what he wants to say, but gets frustrated when we don't understand him. I know he thinks its easier to show us than tell us. I also know it will get better. I know he has the ability to comprehend what he's trying to express... now we just have to work on saying it clearly.

I just wish people would think before they speak!

talking

Just as I suspected now that Colby is here, Blake is starting to talk more. And, just as I suspected he is speaking in phrases not just words. I knew my guy had it in him, but why talk if I don't have to?

That is the good part, the hard part is 45% of the time I am still guessing at what he is saying. Blake is tongue tied, which interferes with his ability to speak clearly. Plus for some reason he talks with his mouth pretty much closed, which is strange to me!

I love hearing him mumble thank you and you're welcome, or I did it, or here it is. But, you really have to pay attention to hear what he is saying. And, I know that if I have a hard time others will have an even harder time. Richard is getting better at hearing/understanding some of Blake's words and phrases, but I know that people who do not spend a lot of time with him will have no clue what he is saying.

The challenge with this... Blake gets upset and frustrated when you don't understand him. He is good about trying to show you what he wants, and will keep saying things over and over, but trust me he is one frustrated little boy at times.

I plan on contacting the speech pathologist from my old school to see what he suggests. At what point should I insist he be tested for speech? At what point do I start to worry? At what point should he out grow some of these issues?

I just want my little guy to be able to communicate so he isn't so upset. I don't want him going around feeling like no one understands him. I just want to be able to help

not quite himself

Blake had a tough weekend this weekend. I don't know if he isn't feeling well? If he is sensing the changes in the house? If he realizes that all his furniture has been moved? If he was just having a few "off" days? Or what!

I know he was having some tummy troubles, but I think we got that straightened out... only time will tell! Of course I'm not sure if it was caused by a lack of fluid? Something he ate/drank? A minor bug? Stress, ok feeling mommy/daddy stress?

That is one of the challenges of dealing with a not so verbal 18 month old (and now I can actually call him an 18 month old as he turned 18 months yesterday). I just wish he could tell him what hurts or what I can do to make him feel better!

Trust me for the most part he lets you know what he wants/ needs! He is getting very good at moving people to show them what he wants from another part of the house (granted visitors don't always understand why they are being pushed around... literally!).

I keep hoping that once the new baby is here he will up his verbal skills. I will tell you that I'm very impressed with his receptive language... for the most part he understand what you say to him and can (but doesn't always) follow directions.

Well he decided to sleep in today so maybe that will help him feel more himself. I hope to get him back on track and on schedule... and feeling more Blake!

Speech development

As a kindergarten teacher, you learn a lot about speech development. It is frustrating at that age to have speech delays that are considered developmentally appropriate. The /th/ sounds are not typically mastered until age 8... but it's hard to explain that to a parent who is worried because their child says "tink" instead of "think".

Being on the other end of the spectrum I find it interesting that doctors do not explain this to parents right in the beginning of children's speech development. Children are not expected to "master" any sounds until typically 3 years of age. Also many common speech "errors" are not real errors at all in a 1 or 2 year old, but just typical developmental stepping stones.

At this time, Blake says about 20 words, but many of the words he says he drops the beginning sounds ("ilk" for milk). This makes it hard for some to understand what he is saying as "real words". The big thing parents need to understand (and should be stressed by doctors in my opinion) is at the this age children are beginning to learn that words are used for communication, and if you can understand what your child is trying to tell you and uses the word correctly... then it is a mastered word.

Speech development, like all other development at this age, happens when the child is ready. Parents need to watch out for falling into the "Oh no my child isn't doing it as fast as that child" trap. I feel that if pediatricians helped parents gain a better understanding of speech development then parents would have less to panic about in this area!

Interesting article on speech development if you are interested in the typical ages and stages of articulation development: http://members.tripod.com/Caroline_Bowen/acquisition.html

here's a list of Blake's more common words / phrases:

Momma (and many forms of that)
Daddy (and other forms of that)
Abbu (for Abby)
ilk (milk)
ook (book)
alk (walk)
up
ight (light)
nack (snack)
hi
oggies (doggies)
yummmm
mmmmmm
uck (truck or duck depending on the situation)
hey!
ake (Blake)
ank you (thank you)
all one (all done)
ead (read)
ead it (read it)
I did it
do it
ookie (cookie)
ove oo (love you)
off