Tuesday, 24 July 2012

Talking and Speech Delays

My daughter is learning to talk.  It's a fascinating little process, which started a few months back with: "Ma-ma." 

These days her expressive vocabulary extends to: "Mama", "Bye-bye" (with sign), "Go!" (exclamation mark required), plus signs for "again" and "no".  Arguably, she also has a sign for "I don't want you to do that," but that's hitting, so I'm not counting it.  We also have a few environmental sounds popping up as she makes select animal and vehicle noises... "Ee" for "Cheese" when we take a photograph should probably be in this category.

This is not very impressive for a child of almost eighteen months, but it's a huge novelty for me, because at this age, her brother wasn't speaking at all.  He would very intermittently come up with a word, but a week or so later, it would be gone again.  His doctor gave him a pass at fifteen months, because he plainly understood what was being said to him, but at eighteen months we were referred to a speech therapist.

Speech Therapy

I should make it clear that my son falls more into the category of late-talkers who start speaking in whole sentences at the age of three.  He didn't; he started using single words at twenty-one months, but the point is that he started talking when he was ready rather than because of an underlying issue.  I have no intention of undermining the problems that speech-delayed children can have (I've dealt with a couple at school), so I want to put that disclaimer in.

In other words, my son didn't have any communication frustration or difficulties in comprehension. He wasn't being prevented from talking by a physical defect.  His expressive (i.e. spoken) vocabulary was non-existent but his receptive vocabulary (i.e. what he could understand) was good.  An eighteen month old should be able to understand 100-200 words, and at the very least, he was safely in that range. 

Although I doubted that there was a problem, I went ahead with the early intervention programme, because it seemed silly to assume that I was right.  As it turned out, I was... but what if I hadn't been?

The first assessment was of our circumstances, and a very pleasant woman assailed me with a long list of questions about my mental state and what resources I had for support, and anything else that might be a contributing factor.  I couldn't give her much until we got into the medication during pregnancy part since I'd gone through both IVF and Ovarian Hyperstimulation Syndrome.  We ended up with a long list of drugs, which unreasonably made me feel helpful.

The second assessment actually was of my son, and involved four people, two of them playing with him and two taking notes.  They evaluated him for everything, and he was on track for his age except for expressive speech.  The other thing that bothered them was that he wasn't doing environmental sounds.  He would mimic a lion's roar and a snake's hiss if asked, but although we had a cat, he wouldn't attempt a meow.

They asked me what targets I would like to set, which I'm sure some person has established as a way to make parents feel that they are being listened to... except it also makes us feel put on the spot.  If it wasn't for my teaching experience, I would have had no idea what should be normal for a year's time.  But we hashed out a few short-term and long-term goals, which more or less ended up moot as he 'graduated' therapy by the first of our deadlines.

His speech therapy consisted of a lovely woman coming over every Friday morning to spend an hour playing with us on the rug.  Her purpose was mostly to illustrate ways to incorporate language into play.  She gave me a few direct tips about encouraging mouth muscles (play games waving cheerios about on the end of your tongues), and I noticed that she discreetly checked my son for some of the early signs of autism, e.g. she invited him to do pretend play, which is something you don't find in autistic children; my son was happy to indulge.

We both adored her, and I was quite sorry when, after a few months, my son had caught up to the low end of 'normal'.  The only problem with speech therapy was the cost, but at least that was within our means.

Baby Signs

Our speech therapist also did some signing with my son, but this was something we were doing anyway.  I had been given the Baby Signs book when I was pregnant and had, in first-time-parent fervour, eagerly perused it and drank in every 'baby conversation' in its anecdotes.  Then I discovered that in practice, I never had both my hands free and my son's attention at the same time.  To this day, I have absolutely no idea how the really successful baby signers do it.

Even so, I signed when I could, and my son's lack of signs (and, potentially my daughter's, though I've signed much less to her) was a big tip-off to his lack of interest in communicating.  I had a friend whose son couldn't talk and was frustrated about it.  When they started signing with him, it was like a switch went on in his brain.  He couldn't get everything together for the spoken word, but he could sign.

In my son's case, he did at least use and retain a few signs: "More", "All done", waving and shaking his head.  It's possible that the availability of these signed words slowed his attempts to master the spoken words, although the general consensus with baby signing is that it's more likely to speed up speech acquisition than delay it.  I see no reason to disagree with that, and even if it did have the opposite effect on my son, I'd still think he was the exception rather than the norm.

Baby signing came into its own when he did start talking though.  He started picking up more signs first, and then one day he started saying "Up."  While not technically his first word, it was the first word he both spoke and signed.  The difference between that and the ones that had gone before ("yes" "go" and "cracker") was that he immediately started saying it in a variety of different contexts--though not for "pick me up" surprisingly.  He also kept on saying it.

From that point, he surged forward picking up all kinds of words both spoken and signed, but he was more likely to say words that he could also sign.  I'm in no way trained in this, but I'd guess that the physical action helped code the speech into his brain.  Back in high school, I used to pace around a room while memorising a passage of text, which might be the same thing (or could be totally different... like I said, I'm not trained in this).

For our part, the signs were a lot easier to understand the speech, so for several months they were a comprehension aid, and I regularly referred to this website for new signs.  They phased out gradually, I'd guess by the time he was two and a half--certainly before my daughter was old enough to start observing them.

We never got the experience with signs that the book promised, but I was glad we had them as a resource.  I don't think they're essential, and as I've already admitted, I've done very little signing with my daughter.  Still, while I've not refreshed my memory on specifics like 'apple', I do try and attach gestures to certain words.  For me, it falls into the "It won't harm, and it might help," category.  But it's not something to stress over.  If you've made the decision not to sign, feel comfortable in that.  After all, every baby learns some signs, even if it's just 'bye bye' and 'shh', and finger-play songs probably provide the same mental stimulation.

But I absolutely recommend it for any speech delay... even of the "He'll talk when he's ready" variety.

Getting Used to Normal

I never really expected my daughter to have the same speech delays, since she's not nearly as laid back as my son, but I had no inkling of what normal speech acquisition is like.  After all, a twenty month old is much further advanced in mental development.  My son might not have leapt into full sentences, but he would apply the same word to different contexts comfortably--and was unlikely to say a word if he couldn't!

My daughter on the other hand, went from babbling "Mamamama" to saying "Mama."  I've never been called Mama before.  My son went straight to a Mummy/Mommy hybrid, though now he's picked up Mama from my daughter.  I can't say I had a particular interest in being called Mama, but when it actually started, when it became her first word, oh, I was an addict.  Over time, Mama has become a more general term for "I want attention," but it's still firmly attached to me.

"Bye bye" crept tentatively into her vocabulary while "Go!" I regret to say, was picked up from Go Diego Go, her brother's current favourite show, and was initially said only in reaction to seeing a picture of Diego or Dora the Explorer.  However, her brother has picked up on her exclamation with such enthusiasm, that it's getting used in many more situations--by all of us!

Beyond the words, she's been so much more focused on her babbling than my son, practicing anything she likes the sound of--including a wide variety of tongue-clicks--and when I make a sound, she'll watch my mouth closely to see what I'm doing.

On the receptive side, I think she might be a little behind where my son was, although I can't be sure of this just based on vague journal entries, but she's certainly at the level she should be.  Her favourite book right now is Bright Baby's First 100 Words which is hauled out several times a day.  Unlike her brother, she's a lot more attentive to those environmental sounds, and delights in pointing to animals or vehicles to hear the sound I attribute to them.  For some, she'll essay her own version, although it's somewhat random.  She'll say 'hoo' for owl and 'pfft' for camel but won't attempt 'moo'?

At any rate, I'm comfortable that she's coming along at the pace that's right for her, and she's showing no signs of frustration which is the important thing.  As for her brother?  He's got the typical three year old verbal diarrhoea these days, and we have no concerns about his linguistic future.

Sunday, 15 July 2012

Update on the summer

Has it really been over two weeks since I posted?  Eh.  Between heat and other things, I've not felt like writing.

My son started back at school last week.  Rather than have three full months off, which always seems too long a break to my British mindset, I decided he could do the July summer session at school.  It's generally too hot in July to make outings pleasant, I am prone to heat exhaustion so I am not much fun, and the school takes them to the pool almost every day, which is probably the best thing for them in this weather.

That said, a couple of weeks ago I was feeling quite sorry that our time at home was coming to an end.  I'd really enjoyed having both children, planning days that didn't revolve around the school run.  Every week, I took them on at least one 'adventure' that was out of our normal routine, and we generally just made the most of our freedom.  But that last week that he was off school was the week of the heatwave, and suddenly going back to our quiet routine seemed much more appealing.

Still, my project to get used to doing housework with the kids around has been a roaring success.  I don't mean to imply that we have some kind of Mary Poppins effect going on where we all sing and dance and work together as a happy team.  There is still likely to be crying and whining... but not always.  For the most part, I am staying calm and giving the children attention where needed and where possible.  I am also being firm about when they need to keep off the floor that I am mopping--the suggestion is for them to stay in one area where they can play in full sight of what I am doing.  If they don't, they get moved behind the baby gate on the stairs so they can't get to me, until I am finished (which only takes a few minutes). 

Generally, I am succeeding in enforcing this consequence calmly and without anger.  They have become accustomed to the ruleset and to seeking each other out for attention--or playing by themselves.  Indeed my son is beginning to go off to his room to play independently with his toys. I've been awaiting this particular development most impatiently, but now that he's starting it, I'm feeling a twinge of panic that soon he'll be in his room all the time and we'll never see him.

But the house is certainly tidier.  I even managed to clear off the bookshelves so that I could replace them with the nicer bookshelf we bought a couple of months ago, a project that I'd been putting off because I couldn't face the child interference.  I've said before that I'm a rollercoaster tidier, but getting such obvious results for my efforts has given me a more sustained burst of motivation, and I'm still working through those little projects that I hadn't want to deal with before.

That said, my next self-improvement quest will be to keep a closer eye on my daughter, and be ready to drop what I'm doing and help her play with her toys as needed.  She's a lot more chaotic in her play than her brother ever was, and that's because I'm too busy to sit down and play with her in a more orderly fashion (which sounds bizarre, but I'm referring to simple, repetitive activities with a clear sequence of events, which is actually very helpful for a toddler).

So when she gets out one of her toys that she can't do independently yet, e.g. a puzzle, I want to be on the ball and ready to sit down with her and play with it.  And to make sure she puts one toy away before getting the next one.  Basically, going back to having cleaning be the secondary activity, the one I do when she doesn't need my attention, rather than giving her attention when I'm not cleaning.

So that's where we are.  And despite the heat, I really am very happy right now, and feeling quite regretful at the thought of returning to work next year.