Wednesday, July 29, 2015

Speech Therapy

cute River

In my 18 month post for River I mentioned that he wasn't talking intelligibly. When he had his 18 month checkup the pediatrician recommended doing some testing and starting speech therapy since he should have been talking more than he was. I mentioned in yesterday's post that I had to reschedule River's speech therapy appointment last Monday since we were in the hospital. So obviously we did move forward with the speech therapy, but I thought I'd talk a little about the process of getting there.

The first thing we did was to have his hearing tested- it's fine.

He had an initial evaluation to see if he qualified for services - he does. In order to qualify he had to demonstrate a marked developmental delay of some sort.

He had a follow-up evaluation to identify his weaknesses and establish a therapy plan.

The results?

He's developmentally on target, or even ahead in some areas, in everything except his speech. Even though he's very good at getting his needs across, he's not using actual words to do it and he doesn't try to imitate words we use. He's about 9-12 months behind on his speech.  I knew he was behind, but hadn't realized he was that far behind. He's so good at communicating without words that it's easy to forget that it's not normal for him to do be doing so.

He uses a few single syllable sounds, but no two syllable words, and even the single syllable sounds aren't really words. So the initial goal is to have him start using actual words, focusing on family names and words surrounding meal times (done, more, specific food names, etc).

The speech therapist comes to our house once a week to work with him.  Mostly this means observing him as he plays and looking for opportunities to emphasize certain sounds or signs. She also gives ideas of things we can do to encourage him or things to practice with him. At the end of each session we decide on a few things to work on during the coming week. At the next session we discuss what worked or didn't work and any progress he made in the past week.

We're about two months into the therapy, with mixed results. If we push things too much in a particular week, River will stop using it altogether. This has happened with specific signs and sounds that he used to use, but has stopped. On the other hand, we've introduced more signs and are using them successfully. He still won't imitate sounds that we make or words that we use, but some of his babbling is becoming more intelligible. He's not using actual words yet, but he's starting to use almost-words that we are able to recognize. So that's definite progress.

How much of his progress is linked to the therapy and how much is just because he wasn't ready to talk earlier is unclear. I suspect the latter, but since we went into this with the idea of "better safe than sorry", it's fine. We'd rather do the therapy and have some progress that might or might not be a result of it than not do the therapy and have problems later on when he's older.

One other thing we've done was to stop using the white noise machine in River's room. We'd been using it to mask other noises so he'd sleep better, but after reading this article we re-thought our continued use of the white noise machine. Since River does have delayed speech, we didn't want to risk making it worse by continuing to use the machine. We don't know how much of an effect it can have/has had on River, but this is again a case of "better safe than sorry." We did have a week or so of lighter sleep/more waking, but he adjusted fairly quickly and seems to be sleeping just as well without the white noise as he was with it. We still have to be careful of making too much noise since he's still a light sleeper, but it's manageable.

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