Childhood Apraxia of Speech

(The video has nothing to do with the post, it's just cute.)

Kaylie has been attending speech therapy for about 6 months now, so I thought it was about time for an update.  We had her hearing tested back in August (about 3 months after starting the therapy) in an effort to determine whether a hearing deficiency, however mild, might be contributing to her slow speech development.  Not only did she pass the hearing test, but she cooperated so well that the lady doing the test commented that she is rarely able to administer the whole test to children so young, and that Kaylie responded normally to all of it.  So, that pretty well ruled out a hearing deficiency as a cause for Kaylie's speech delay.  With that possibility eliminated, Jennifer became fairly sure that it is probably childhood apraxia of speech, a cognitive disorder in which there is a disconnect in the planning process of speaking.  According to the site I linked above, "children with apraxia of speech have great difficulty planning and producing the precise, highly refined and specific series of movements of the tongue, lips, jaw and palate that are necessary for intelligible speech."   In other words, her brain has a hard time telling her mouth how to form the necessary sounds for speech.  It sounds really scary, and I'd be lying if I said I wasn't a little bit freaked out when Jennifer first shared her suspicions with me.   Kaylie is really too young for an official diagnosis, but from what I've read about apraxia and what I've observed about my child, it fits.  Even if we later find that we're wrong about the core problem, then this at least gives us a plan for how to move forward with her therapy now.

In the three months since then, Elora and I have stopped going into therapy with Kaylie.  In the beginning, I think it was good for all of us to participate, because it helped Kaylie to become comfortable with Jennifer, but it had become obvious that Elora and I were just distractions.  We've also added a third therapy session each week, and the additional day seems to have flipped a switch somewhere.  She has improved so much just in the last month or two!  She's gaining consistency where she was once erratic, and is adding completely new sounds to her repertoire.  She is not only talking more and more, but she has become so much more willing to try new words!  This may seem like a small thing, but for me, this is the biggest indicator of just how far she's come.  

For my part, I cannot even begin to say how proud I am of her.  It is a little heart breaking to watch her struggle to wrap her mouth around some new sound, or combination of sounds, and sometimes I catch myself wondering why my beautiful, intelligent child must work so hard to do what comes so naturally to most other children.  But there is no "why", it just is.  So we're working with her, and encouraging her, and celebrating every victory with her.  To see her sweet little face just light up with joy and pride when she's able to say something new is just...well, there are no words.  :)

June.

A photographic sampler of the month of June.

June 1: Water Play

June 2: Chuck'E'Cheese

or, More On Potty Training  Reinforcement

Elora, while fully capable of using the potty, has consistently shown a lack of enthusiasm for doing so.  Why gt up and go to the bathroom, when it doesn't seem to bother her in the least to have wet pants?  So, we've been trying to inspire the proper enthusiasm in her, both punishing her bad choices and rewarding her good ones.  This reward chart is actually something that I made for her back in January, but that I never blogged.

Note:  I made this exclusively for our own personal use.   I do not own the rights to any of these images.

These are the counters.  

I made 3 for Chuck E Cheese, 5 for the ice cream, and 7 for the movie.  I printed it all out at home, then took them to Office Depot to have them laminated.  I cut out all of the counters, and used Velcro in the squares on the chart and on the backs of the counters so that they could easily (and repeatedly) be moved around.  Then I hung it all on the wall right next to the potty, right at her eye level, with the card board sleeve from the movie hanging over it all so that she would be able to see that, too.

Based on advice I'd received and articles I'd read, I thought it might help to give her something to work toward, and for her to be able to see it and be reminded of it every time she went to the potty.  Initially, she was really, really excited about it, but she would never go more than a day or two without an accident.  Fast forward to June, and she FINALLY got her 3 days in a row!

June 6: At the Zoo (with Aunt Bekah)

We've been zoo-ing about once a month or so, since it got warm.  By this point, it had gotten hot, and knowing that they have these awesome water fountains just inside the zoo, we dressed the kids in their bathing suits.  We ended up getting there shortly before story time, though, so we did that first.

The kids could not wait to go play in the water, but when they got there, they were super shy about getting in it.  Elora, in particular, does not like to get water in her face, so she just kept backing into the fountains.  And of course, whatever Elora does, Kaylie must also do.

And then we learned that a baby giraffe had just been born that morning.  Have I ever mentioned that giraffes are Elora's favorite animals? These pictures aren't great, because they were taken through the glass and my camera kept wanting to focus on the fence rather than the giraffes (I forgot about manual focus), but isn't he sweet? Only about 7 hours old here, and already standing and walking around.  So, so cool.

June 14: Hopscotch

It was late in the day, either just before dinner or just after.  The girls and I had been inside all day--we hadn't even changed out of our PJ's.  It was a beautiful afternoon. not too hot, and Brandon decided it would be criminal if we didn't get at least a little fresh air.   We opened the garage door, set out the blue lawn chairs, and watched the girls play.

I didn't really take any pictures of their faces.  I was fascinated by the light, the nightgowns & boots, and the chalk lines.  Is it weird that I'm kind of in love with this picture?

June 28: Farmer's Market & A Speech Therapy Update

There's a farmer's market at the local park every Wednesday and Saturday during the summer, and Rebekah and I finally got around to taking the kids to check it out.  

We ended up eating half of our strawberries right there, they were so good!  We haven't made it back yet, but I'm thinking we really ought to.  

That afternoon, Kaylie had therapy.  We're still going twice a week, and Kaylie is making great progress!  She's added lots of new words to her vocabulary, and is signing for a lot of things as well.  Jennifer has moved from just trying to get Kaylie to repeat simple words to focusing on specific letter sounds and final consonants.  For example, Kaylie says "eee" for "eat", dropping the T and speaking only the beginning of the word.  We're trying to teach her to say the whole word.  At the end of each session, Jennifer always makes suggestions for what we can do with Kaylie at home, so that she continues to learn in between visits.

Elora always goes with us, and is always very good while we're there.  Jennifer either brings something special for Elora to play with, incorporates her into the lesson, or allows her to play one of the kid's games on her tablet.  Frankly, I think that might be Elora's favorite.

And that brings us to the end of June.  Next time, I'll try to bring us up to date in July.  :)

Speech Therapy for Kaylie

When we took the girls for their annual check-ups back in March, their doctor put in a referral for Kaylie to see a speech therapist.  The office we'd initially been referred to had a giant waiting list, so we had to jump through a few insurance hoops to get the referral changed and everything settled.  We finally got her in for an evaluation last Wednesday.  When she was done, Jennifer (the therapist) reaffirmed what I've been thinking right on along:  Kaylie is on par as far as social development and comprehension levels, but that she just isn't verbalizing the way she should be. By this point, she should have a pretty impressive vocabulary, and she should be using a  lot of simple, 2- and 3-word sentences.

Her first therapy session was Monday, her second was yesterday.  Each session is only 30 minutes, and the therapy itself is all guided play.  So far, Jennifer's had a hard time getting Kaylie to cooperate.  She has an array of books, toys, games, and flash cards that she uses to try to engage Kaylie and get her to articulate certain words or sounds.  She'll hold a toy that she knows that Kaylie wants, to try to get her to name the toy.  When Kaylie does it, she gets the toy.  Unfortunately for Jennifer, Kaylie has mostly just shrugged and gone after something else, so both sessions have just been Jennifer following Kaylie from one task to another, trying to engage her, and get her to play along.

  

One thing that does seem to be going well is that Jennifer is using sign language alongside the verbal language, and Kaylie is picking up on that very quickly.  More often than not, she responds not with words or sounds, but with hand gestures.   As we were leaving on Wednesday, Jennifer told us to really focus on learning and using the sign language in conjunction with the words.   Apparently, children tend to learn words  much faster when there is kinetic activity involved, maybe because it is stimulating more of the brain?  I am not sure of the science behind it, but it does seem to be working.  I've downloaded an American Sign Language app for my phone (the first one I've ever actually bought!) and she's picking them up just as fast as I can learn them!  I'm excited to see where this is going, I just cannot wait to be able to really communicate with my Kaylie girl!