In late August, we had our little guy’s speech assessed through Early Intervention (EI). We knew he would likely have problems in this area, and the assessment did show delays which qualified him for speech. While I expected him to qualify for EI, the details of the results were surprising to me in some ways, and underscore his atypical development because of his health issues.
The assessment indicated his receptive areas of speech (understanding speech) were strong, testing above two years old, but his expressive language (producing sounds and words) was low. Overall, his speech was assessed as a 14-month-old. I assumed this meant he had all the skills a child needs to develop speech skills through 14 months- old, and we simply needed to build from there. Nope, this is not the case.
His expressive speech skills are scattered. He lacks some basic speech skills a 12 month-old should have, but already has some speech skills a two-year-old may have. The speech therapist explained it best in that his development is like a puzzle with missing puzzle pieces scattered throughout, rather than a set of stairs with skills to master at each step. With her help, we have been able to isolate the skills he is missing, and start adding them into his development.
Some of his speech difficulties stem from low muscle tone in his mouth. We worked on low tone issues during feeding therapy last winter, but it’s time to work hard on these skills again. Often I see him struggle to form sounds, and it reminds me of trying to talk after a dentist’s visit when your mouth is still numb. It has to be so frustrating, to not have the muscles in his mouth cooperate with his desire to form words. To help with this, I recently got him to eat foods like granola bars and apples (not cut up), which are difficult to chew and can help build up muscle tone. And, as much as he and I both disliked feeding therapy, we are revisiting some of the old tools and techniques.
The most important skill we are encouraging him to do is repeat after us. The therapist showed us how to encourage him to request an item and by asking him to repeat after us. We give him three attempts, before we give him the item. We don’t want him to become frustrated, but we do want to him encourage him to talk. While, our little guy is not bursting with new sounds and words yet, I do see his confidence rising. The few words he does know, he says in a loud voice instead of a whisper. Most importantly, he attempts to repeat sounds.
Another speech technique we are using is singing. Our little guy loves to dance to music, but not sing. I just assumed he didn’t like it, so I stopped. His speech therapist explained, he likely lacks confidence in his skills to sing and that’s why he doesn’t participate or hides. We are working on incorporating singing into his daily routines. He loves kicking and throwing balls, so often I will play soccer with him while singing. I never coax him to sing, but lately I notice he will chime in.
What is challenging and encouraging for him, is that his receptive speech is so high. This will help him later. Our little guy will have a vast “word bank” to pull from when it’s time to talk. However, it makes producing words more difficult for him now, because he is attempting to use harder, more complex words for his age that he does not yet have the skills to produce. I think of it as attempting to bench press weights that are significantly heavier than your muscles can lift.
Overall, therapy is going well because he is motivated and not defensive like he was with feeding therapy. Truthfully, the thought of more feeding therapy makes me want to hide, but hopefully it will only be a minor part of the therapy. I hope his language skills take off soon; I’m eager to hear his wants, likes, and his little voice, but we are being patient with our little guy. He tends to hit milestones on his own schedule and likes to surprise us.