Speech

Eating a green bean!!

Speech, Session 2

Andrew had his second session of speech this morning.  Due to a last minute schedule change, he actually got to see Ms. Dana again.  First up was a round of BINGO with "wh" questions.

Then, it was some work on negative-- which bowl is NOT full.

And finally, snack.  Green jello, tapioca pudding, animal crackers, juice and mixed fruit (with focus on the peaches in it).  Since he saw Dana last week, she wasted no time getting back into things with the jello this week.  No smelling and such first, just right to touching it to the tongue.

It seems in ST, a drink accompanies snack.  The thought being if the child doesn't like the taste of something, they can take a drink and wash it down/get rid of the taste.  Andrew just likes to drink it because he doesn't get juice boxes often.

Smelling a peach.  He didn't get it very close the first time, so Dana helped hold it to his nose to make sure he got a good whiff.

And by end of the session, touching a peach to his tongue!!!  Seems like nothing to you & me, but for Andrew that is a H-U-G-E accomplishment!

Speech, Session 1

Andrew had his first session of speech therapy today.  To save on confusion, we're making a point of referring to it as "speech" with him, since he already knows OT as "therapy."  For the next few weeks at least, he will be seeing a few different therapists until they can hopefully get the schedule worked out and get him consistently with the same one.  It doesn't thrill me, as the consistency of the same person each week to build on prior experiences is a great benefit.  But, at least we're finally being seen so we can start improving, so for now, the multiple therapists will suffice.  And, it may be good for helping him learn to be a bit more flexible.

Today, he saw Ms. Dana.  She took him right to the kitchen to pick out their snack-- chocolate pudding, animal crackers, green jello and a juice box.  They got started with snack and I got to read the formal, written review from Andrew's evaluation last week.  There were no surprises to it, as everything in it is stuff I would agree with.  He has issues understanding the negative (asked to point to the clean shoes, he does fine, but asked which shoes are NOT dirty, and he struggles).  Problems with the wh- questions (who, what, when, where, why).  Incorrect pronoun usage (he/she/etc.).  And the strong food aversions.

For now, the food aversions are getting the most attention.  Snack was very give & take.  Andrew got to pick what they were going to eat-- usually an animal cracker dipped in pudding.

Though, a few times he chose to just eat the pudding with his spoon.

After Andrew had a turn to choose, Ms. Dana got to choose.  Her choice was always the jello.  I've heard from Ms. Nikki and others about the progression typically used for kids with food aversions and the steps taken to work up to getting them to try a new food item.  Today, I got to see those steps in action.  The first few times, they just put some jello on the spoon and smelled it.  Then they touched it to their lips.  Then the teeth.  And finally, the tongue.  After a couple of times touching it to the tongue, the last time, they held it on the tongue for 3 seconds.

It sounds simple.  But, in alternating each time with Andrew's food choices, the entire progression/snack time took over half of the one-hour session.  30+ minutes to get to touching the item to the tongue.  Not taking a bite yet.  Just getting it to the tongue.  With that, I realized just how slow of a process this is likely to be!

After snack, they did some flash card type things to work on negatives.  After 5-6 of them, Andrew finally caught on and was getting most of them right.  Like with snack, they alternated turns-- she would ask him one and then he would get to ask her one.

While they were snacking & working, Noah woke from his nap.  The nice thing about being in a pediatric therapy room... there are always toys to entertain Noah while Andrew works with the therapist.  He loves this gears toy and asks to get it out every time we're in the room.

 After the cards, it was a game of wh- questions.  Each time Andrew got one of the questions right, he got to "fly" one of his rocketships to the moon, and then ask Dana a question.  He did okay answering the questions... needed some prompting at times.... but definitely needs more work when it's his turn to ask the questions.

With that, time was up and it was time to leave.  Sitting for an hour seemed to be one of the hardest parts of the session, as Andrew got pretty restless near the end.  It will certainly be interesting to see how it all progresses.

Speech Evaluation

It's been 2 months since we got the referral for OT & ST (speech therpay), but the rehab center FINALLY had an opening and Andrew had his speech evaluation today.  I'll get the written evaluation next week with all the details, but after the 1 hour evaluation, she is recommending him for weekly speech therapy.  The recommendation is for a year.  Most of it is for his food aversions, which are also being addressed in OT, so if we see substantial improvement and get to the point we feel the OT & ST are becoming too redundant, we will drop the ST.

Anyone that knows Andrew and communicates with him on any sort of regular basis, hears about a recommendation for Speech and says "Huh?"  Andrew is very verbal and communicates quite effectively, so the thought of him needing speech therapy generally confuses people.  However, ST addresses all aspects of speech & language... including how the mouth functions and food aversions.  In fact, part of the evaluation today including having Andrew stick out his tongue and move it in different directions upon request, to determine that it was working as it should.

The therapist was impressed with Andrew's vocabulary upon first meeting him, so even she questioned for a moment, why we were there.  As we talked though, she quickly understood that food aversion is our biggest concern... but a full evaluation wouldn't hurt... so the testing began.

Andrew's biggest struggle was in the section where he was to repeat what the therapist said.  She explained it to him in several different ways, but he just didn't get it.  She would say something like "The dog barked," and instead of saying "The dog barked," Andrew's response would be "Yeah. She was barking at the mailman when he was at the neighbor's house."  While the therapist was impressed with some of his rather lengthy responses, I know he didn't test high in this area since he never repeated a sentence as he was supposed to.

He struggled with pronouns and negation-- shown a picture of 2 shoes, one dirty, one clean... he could correctly answer "Which shoe is clean?" but struggled with "Which shoe is NOT dirty?"  And, he struggled with the "wh-" questions-- who, what, when, where.  However, none of this came as a surprise to me, since it is all stuff we've seen and are working on at home.  I also think his struggles in these areas are fairly age appropriate.  She did too, and said she had to keep reminding herself that he is much younger than he seems, given how well he speaks.

At one point Andrew got very restless, so stood up at the table and junped with each answer he gave.  Thankfully, the therapist caught on to this and let him take a break to go run up & down the hallway a few times.  She also took him to the kitchen so he could pick out a snack.  I was surprised when he returned with yogurt.  And even more surprised when he took a couple small bites for her!!!  He kept saying "Mmmm. Yummy." but the expression on his face certainly didn't match his words.  To look at him, you'd have expected him to spit it out or start gagging.  Still... a bite of yogurt was a big deal!  Ms. Nikki will never believe it when we tell her.

Overall, I think he did well.  We'll know more at his first official session next week.