Thursday, April 26, 2012

Speech Therapy

My three-year-old, SB, didn't start really speaking until he was about 17 months old, old enough for a little concern from most people. However, NJ, the oldest, also didn't start really talking until that age, and he went from a few signs and pointing to complex sentences in the space of about six months, maybe less; I figured SB would follow a similar pattern, so I didn't worry. At his 18-month well checkup, the doctor asked if he spoke at least 10 words. I had counted seven the day before, which is quite low for a bright 18-month-old, but I explained about NJ having been the same way and that I wasn't worried. I didn't get him evaluated by an audiologist or speech pathologist. I didn't take my doctor's referral to Regional Center. By 19 months, these were his words:

1) Moo ("What does a cow say?")
2) Moooor (More)
3) Moooooo (Moon)
4) Baa ("What does a sheep say?")
5) Mo-mo (Remote)
6) Bapa (iPod)
7) Mama
8) Derrrr (Truck, switch (as in, switch sides when nursing), train, among other things)

(Yes, one of his early words was iPod. He still loves that thing, too.)

In fact, I was right. Just a couple months after this appointment, SB suddenly started really talking, putting together two- and three-word phrases. By the time he was two years old, he was building complex sentences. There was one problem, though. His words were terribly unclear. NJ almost from the start spoke remarkably clearly. Complete strangers could have a conversation with him before he was three. There were very few words he said in a funny "learning to talk" way. (We remember a fond few, such as "battached" for "attached," but really, he spoke incredibly well.) SB not so much. I assumed it was just him still trying to figure out how to make the sounds, and surely by the time he was two or 2-1/2, he'd be speaking more clearly.

Alas, not. Some words gradually improved, or he'd suddenly begin saying something more clearly than he used to, but, for the most part, if you didn't live with him, you couldn't understand him, and even if you did live with him, you had to work pretty hard to understand him. I and NJ are the best at deciphering his speech, and other people will randomly catch words and sentences that I don't, but the faster he goes, the less clearly he speaks. I didn't know how to fix that, or if I should worry, or when I should worry, or what I should do.

At his three-year checkup, with a kid who spoke in totally unintelligible paragraphs, I expressed my concerns to his pediatrician, who referred us to an audiologist and speech pathologist. His hearing tested fine, so we went to the speech pathologist where she confirmed that his grammar, vocabulary, and syntax were quite advanced, but his enunciation problem was "severe." The good news was, it appeared he could make the various sounds, he just didn't always use them properly. Most consonants were "m", "n", or "d", and even some of his vowels were distorted. "Big" and "bridge" sounded like "buuuuh," for example. The speech therapist said we'd see her once or twice a month and she'd send us home with exercises to try to form new speech habits.

We have quite the task ahead of us. The goal is to create new habits and break the old ones. We need to get him to say the ending consonants: "ha-T," not "ha';" "Po-P" not "Po'." And so on. Then we have to fix initial "s" and initial "f" (he uses "d" for both). Then we have to work on other strident sounds, and reduce the lisp, and fix some other initial "s", and so on.

Fortunately, SB is very bright and realizes that it's hard for people to understand him. He will repeat himself over and over again in the hopes that this time you'll get it, but he doesn't know how to fix it himself. But he's getting there. A few things, he's already fixed on his own, and others he corrects when he remembers to. I can see that eventually, he'll be speaking more clearly. I just feel so bad for him, because he has so much to say and so many questions to ask and so much bubbling in his head that he wants to get out there, and he trips over his own tongue trying to express all the wonders of the world that an almost 3-1/2-year-old has discovered. And after a long descriptive paragraph, our response, more often than not, is, "I'm sorry, but I have no idea what you said."

I think it's hard to be willing to seek help when you think your child might have a problem. No one wants to think their child isn't "normal." But realizing that we could help SB to be better understood, which would improve all of our quality of life, made getting him evaluated and starting treatment totally worthwhile. I think there's a lot less stigma to various kinds of therapy than there used to be, and, in the end, when you see the change in your child when he's getting the help he needs, you know you've done the right thing.

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