Saturday, June 27, 2009

Isaiah's Speech Update + list of words

Here is where Isaiah's at right now (a couple weeks shy of age 3), speech-wise.

* At his last evaluation (at 30m), his receptive skills were at the 28m level, and expressive skills at 12-15m.

* When he first started EI at 17m, he was evaluated to have a receptive skills at the 15m level, and the expressive skills at the 6m level, so we've definitely made some progress!

* He currently has 50-60 word approximations, although he only uses a handful of them on a regular basis.

* About 15 of those words are actually animal sounds or sound effects. To this day, he has never said "cat" or "dog" or "car", but always uses the appropriate sound effect instead.

* The majority of his words are pretty vague. I would say strangers would understand him less than 25% of the time. He uses mostly vowel sounds, even though he can say a large variety of consonant sounds on their own. Also, some inconsistencies in how he pronounces them from one time to another. (See list below)

* No 2 word sentences or phrases.

* He can be very vocal, especially in high-energy situations (such as when him and Abbie are running in circles around the kitchen table, bathtime) lots of non-specific yelling/sounds. Not always, but usually.

* During lower-energy situations (mealtimes, car rides, playing with trains), he is on the quieter side, using one-word sentences to request something he needs/wants, or maybe point out something (like a cat walking by the window). Not a lot of extraneous babble or chatter.

* Every few days, he'll get in a "no talking at ALL" mood, which lasts a few minutes to a few hours, where he doesn't make any sounds, and won't even respond to me, just very withdrawn. (I hate these)

* He NEVER imitated on command ("This is a X, can you say X?") up until a couple months ago. Even now, he *rarely* does it, and when he does, it's a very, very vague attempt (again, mostly vowels).

* He does request, although due to his limited vocabulary (and my limited comprehension of what he's saying), we still have LOTS of frustration, LOTS of tears, LOTS of meltdowns because he's not able to fully communicate his wants and needs.

A few weeks ago, out of curiosity, I wrote down every single word that he said that whole day, including how he said it (and if he said it multiple ways). This is what I came up with:

mama : mama
juice : ee-uu
butterfly : aw-aw
two : toooo / ooh
bacon : eh / deh
yellow : eh-woh
meow (word for cat) : meow
pee-pee : tee-tee
teeth : eeee
bubble (word for soap) : bu-bu
cartoons : tooos
Oswald : aw-aw
splash (?) : ta--sch
booboo : boo-boo
more : ma
ham : hey
hat : hai
strong : aww
eww : eww
eat : ee-um
cereal : ah-aw
light : iii
bye : bye
dada : dada
fish : eee
baby : bebe / meme / dede
wet : eh
off : aww
cheese : dee / nee
turtle : toe
shirt : ee-ur
brush : da
blanket : nee
broken : bu-bu
straw : taw

(It looks like a long list, but when you keep in mind that other than a handful of them, most were only said once. Spread it over a whole day, and he's still very quiet the majority of the time.)

His speech therapist has recently mentioned apraxia, which looking at the symptoms, it does seem to be a possibility. Unfortunately, this past week was our last session, so we'll be ST-less until next fall. Which sucks, because I felt like we may have been on to something. If anyone has any experience with apraxia, does the ^^ seem to resonant with what you know? I'd love to chat with others who are dealing with apraxia, especially in younger children.


Mandi said...

My DS is 4, and started speech therapy for severe delays at the age of 1. I would say about 6 months ago he was diagnosed with apraxia, but now that he has an outside of school therapist again, she is thinking it's a severe phonological disorder.

Our first sign (I had already done reading about apraxia) was that he used a LOT of vowels, never really moved his tongue around while talking, and would change how he said things (ahm ahm->ahmma->ahmmy->wahmmy->momma->mommy)

We haven't had official apraxia testing (therapist thinks he won't sit still and focus long enough), but we are going ahead and using apraxia specific treatment techniques, including Kaufman cards.

mandi @ mandimindingmoney . com if you ever want to talk!

Anonymous said...

Egg is tongue tied, possibly. I may have mentioned to you before. The line under his tongue is too long, and to fix this they doc would have to cut my baby, so I said NO!!!! I think it makes some letters tricky to say.

Also the fact that he i pointing stuff ,likes cats out to you, YAY!!!

rainbowmummy, to tired to sign in!


ps I am glad you got the diaper cake thing sorted, I put up a wee post about it, and have just found out the other day that there was a woman posting pics of other people activites, on her child minding blog!!! One blogger, Melissa from Chasing Cheerios had pictures OF HER CHILD used, tht woman has deleted all her things. GAH!!

House of Krause said...

Hi April, I know it's so confusing there are so many different speech diagnoses. Some are so similar it's hard to tell. One way to rule out Apraxia is to get your hands on the "Kaufman speech Praxis test". This will simply tell you yes or no to Apraxia. I'm sure you would need a speech path to give your son this test. Or seriously call Nancy Kaufman and tell her what is going on. She is so nice and will take the time to direct you in the right path. She is the Apraxia expert. (248) 737-3430.
I was looking through your blog. What Mt.s do you live in?? I saw the pictures of the bears. That is so crazy and so cool!Good luck, Jen (House of Krause)

~ April ~ EnchantedDandelions said...

Thanks everyone.

RM- His pedi. did check him for being tongue-tied, so not anything physical. Also, thanks for the support re: the cake thief. *muah*

Interesting Mandi. I haven't paid much attention to his tongue, really. He does change how he says things, even when he repeats himself immediately afterward. Not all the time, but definitely sometimes.

Hi Jen! We wouldn't have anyone to administer the test right now. I will definitely ask if the ST at the school can do it this fall (if they have it).

I didn't mention it in the OP, but was thinking of ordering the Apraxia Treatment Kit to work on this summer, just to see if it helps any.

But, I see that on Nancy Kaufman's site she offers a DVD evaluation. I might look into that, as well as definitely email her.

Thanks everyone! <3

Amy @ Six Flower Mom said...

My nephew had apraxia and he now does very well, he just turned 11. When he was little, to alleviate frustration we used a lot of sign language or picture cards on a key ring. This opened his communication for every day objects and action.

Loree Inman said...

My daughter is 3 1/2 yrs old. She has been getting ST since age 2. The therapist was knowledgable about apraxia and showed me many ways to work with her at home.
The birth-3 program she was in had computers for the children. I was able to get a touch screen and programs free of charge. A. loves it and learned how to make animal sounds, language followed.
She started public school (special ed. here in IL. I'm sure she'll be integrated in reg. ed. once she's in kindergarten). I am not satisfied with the services she is getting, but I still have to find out what she SHOULD be doing.
My biggest tip for you is to find an augmentative communication system for him. When A. was 9 months old, I began teaching her sign language. (This was before I knew she had apraxia.) I am fairly fluent due to having worked with people with hearing disabilities. Little Einsteins has some good videos for children and you can learn from them as well. * The motor skills for planning speech originate in the left side of the brain. The planning occurs on the right. Sign language helps develop the planning because it is done in the same area.
Another option is PEC (picture exchange system.) This has individual little pictures the child can give you to tell you what he wants. A. started with snacks. I had about 20 pics of snacks (laminated and backed with velcro). I would offer 3-4 pics for her to choose from (20 would be overwhelming) and she would choose which one she wanted.
Another tool I use is an activity shelf. These are all things A. enjoys doing but needs supervision. Playdough, paints, markers, markers (crayons, colored pencils), puzzles, crafts, etc. When we started this, she would grunt and point. Now she approximates the word for what she wants to do.
Most importantly, total communication is the key! (Total communication is using every means possible to promote communication.) He is probably a very intelligent child and becomes very frustrated trying to communicate but not being able to get the words out. I think A. was helped by the sign language because she began to replace signs with words and the sign faded out.
I am still learning a lot and it seems to help to speak to other parents, although it can also be frustrating if your child has not made as much progress as theirs. You may want to visit if you already haven't. There is much good information and links to other resources. One more thing I'd like to mention, intensive speech therapy (3-5x a week)seems to be the key to progress. UNfortunately, parents have to work very hard to get it, problems with insurance, lack of services, etc. However, A. is on break from ST due to being out of school and her language has blossomed this summer. AS you know, every child develops in their own time.
Know your rights as a parent. Find out as much as you can, go into those IEP's armed to get what you want! You are your child's advocate and you know what is going to work, what won't. (Don't be close minded to suggestions)
Question for you: many children with apraxia exhibit gross or fine motor delays as well. Have you noticed any problems with Isaiah?
Believe me, I do not know it all, but I am learning as much as I can to give A. the best start she can get!