Hellobee

Juliet had her yearly Early Intervention review today. It was cutting it close since her authorization is up at the end of the month, and between bad weather and sick kids, we had to postpone the meeting several times. I met with Juliet’s case director as well as her regular developmental therapist. Since she was graduated from physical therapy in December, that therapist didn’t attend this meeting like she did the previous ones. The case director also had the notes given to her from Juliet’s speech evaluation she had earlier in the month. This meeting was to see not only about her eligibility in the program, but also the need to add a speech therapist. On paper the case director said truthfully Juliet didn’t look to really qualify for services anymore; her only true lacking these days is her speech which is delayed significantly if you ask me, but overall she passes most everything else. But since every child is more than just paperwork, we would look at her past, what the numbers and papers said, and truly assess her as a person, getting feedback from her regular therapist as well as the speech evaluation.

We talked about our past goals for Juliet: physically we wanted her to be walking and moving around which she clearly was, but our hopes for the communication haven’t panned out quite as well. When we initially made her evaluation, our hope was that she would be expressing more words, babbling, and even stringing together short sentences like “Ma ma ba ba” by this point. As we were in discussing Juliet at the table, she was wandering around between the playroom and kitchen. I think she was a bit confused at the change in routine. For a while she was amusing herself nicely and popping in now and then. We could watch her interactions and that’s when it struck me how quiet her play really is when she is by herself. Granted her play noises when Drake is around are usually screams and tears, but when left alone she is almost completely silent.

As we discussed her speech patterns more, I became more aware of how little Juliet tries to communicate with us. Most of the time when speaking words or sounds it’s due to us prompting her and asking a question. She rarely ever initiates any kind of conversation or noise of her own unprompted. As it happened Juliet was playing a toy of hers that rolled underneath the couch. We watched as she laid down trying to reach it. After some time she continued to simply lay on the ground and stare at us, not moving, which was unusual to the point that the case director asked if she was tired and going to fall asleep. Finally after almost 10 minutes like this, Juliet started to cry. It was clear she wanted that toy and possibly even wanted help retrieving it, but she simply did not make her intentions verbally clear enough for anyone to understand her needs.

That’s really what I have come to realize is so lacking in her speech. While she clearly isn’t talking in the sense of producing words or sounds, she also isn’t using gestures to communicate or even attempting to communicate with us verbally at all. Many times when she wants a bottle or a drink she runs in front of the fridge and stands there looking at me. She never says “baba” to me unless I ask her, and then she repeats it. It’s taken me some time to see this, and I have recently been trying to encourage more speech by either telling her to say something before getting her request, or sometimes not responding to her want until she initiates some kind of verbal cue to me.

Over the hour we talked about most of Juliet’s developments; cognitively, socially, and emotionally she is behaving and showing all the signs of a normal growing 21-month-old little girl. Since my largest concern was always speech, and this was clearly her hurdle even though her paperwork didn’t line up perfectly, Juliet was allowed to continue in EI with the addition of a speech therapist. Her developmental therapist whom she has been seeing since the start of EI at 9 months and the speech therapist are now close to overlapping in some areas, since we have geared mostly toward speech work for quite a while now.

Juliet is a child that is slow to adapt to new things and people. Her developmental therapist described her as very much an observer, which I think is a fair assessment. Whenever her therapists would bring new toys to show her during their sessions, it would often take her a few times to even attempt to touch and try the toy. The same was for story time, which I have been taking her to since September. For a long time Juliet would only sit on my lap during story time and not move or dance or engage like the other kids. Now though since she marches right in and joins in all the fun. At home when I sing the songs, she immediately knows the moves to copy and repeats them. Because of this pattern of behavior, the case director and her therapist both felt cutting out developmental and substituting a whole new therapist into her life would be detrimental. So in addition to adding speech therapy on, her developmental therapy was dropped back to every two weeks, allowing a more smooth transition and for us to have time to say goodbye to our developmental therapist whom we’ve all (Drake included) have become attached to. This new plan has been instated for 3 months, allowing us to make it to Juliet’s second birthday — a milestone I want very much to celebrate with her therapist who has been with her before she was one.

Overall I have been so pleased with all the progress Juliet has made in this one year. It’s hard to measure sometimes because she started so young and I would assume even without intervention she would have naturally progressed at some pace, but perhaps not as quickly had she not had the support she received. I am excited about the idea of a speech therapist, something I felt she had been lacking since her original diagnosis in the doctor’s office around 7 months of age.

It’s hard to explain how I feel at the idea of a talking Juliet, because the way she is right now is all I know. When she pronounces her words in her own way, it’s still somewhat endearing to me and I look forward to hearing them even if I know they are wrong (my favorite is when she says pop pop for hop hop when she sees a bunny). But I know she ought to be saying more as she approaches two, so I’m very thankful we have this opportunity through Early Intervention. So now we wait for a speech therapist and the start of a new journey for Juliet.