Tuesday, May 13, 2008

Therapy Week 3 Day 1

Let's start with therapy since this is why I started blogging in the first place...

Today went rather well. Zach was very excited to see Ms. Kristin. We all went back into the room and played. Zach had a really good day. He once again tried as hard as he could to get some sounds out. He is following directions so well now it is almost unbelievable considering just a couple weeks ago he really had not much of an understanding. I can't wait until the day where he won't try to redirect everyone when something gets too hard -- he gives up very easy. Kristin thinks his receptive speech is just up to par with his age. This is great news - since at the beginning it was at 9-12 month range. I believe this has all to do with how bad his hearing was. Of course his expressive speech is still at 6-9 month age range. I asked Kristin again what symptoms he had that would lead her to believe he has apraxia of speech and they are as follows (I couldn't remember her exact words so I found these to copy and paste - but they are what she said) We also talked a little about the probability that he also may have an oral apraxia too.

Oral apraxia is an inability to make voluntary, non-speech oral movements. A person with this problem would be unable to stick out his tongue if told to do so, but could perform this action without struggle if given an icecream bar to eat. As the auditory comprehension sections of some aphasia batteries include commands involving oral structures like "lick your lips," oral apraxia may also be mistaken for aphasia.

  • Limited or little babbling as an infant (void of many consonants). First words may not appear at all, pointing and “grunting” may be all that is heard.
  • The child is able to open and close mouth, lick lips, protrude, retract and lateralize tongue while eating, but not when directed to do so.
  • Oral scanning or groping may occur with attempts at speaking.
  • Lack of a significant consonant repertoire: child may only use / b , m , p , t , d , h /. (he only uses M, B, and D sounds -- mainly B)
  • Receptive language (comprehension) appears to be better than attempts at expressive language (verbal output).
  • Verbal perseveration: getting “stuck” on a previously uttered word, or bringing oral motor elements from a previous word into the next word uttered.

Although he is 4 months away from being 2 - so he still has time to prove her wrong he already does the following....

  • First word approximations occurring beyond the age of 18 months, without developing into understandable simple vocabulary words by age 2.
  • Continuous grunting and pointing beyond age 2.
  • One syllable or word is favored and used to convey all or many words beyond age 2. (Zachary uses B for theses last two points)
  • A word (may be a real word or a nonsensical utterance) is used to convey other words beyond age 2.

The good news...While Zach and I were at therapy our EI coordinator called and approved Zach for his 3rd day of ST. In a couple weeks it will be upped to 4 days a week. This is GREAT news -- the more help we have now the better for Zachary's progress in the future.

Zach will go back to OT on Thursday.

Now, on to the rest......Zoe is still sick, sick, sick! She has been complaining about her tummy but everything is staying down. She still has a fever - so it looks like we will be back at the doctor tomorrow for her. Doug has also caught the bug and spent the day home again - being taken care of by me - my how the tables turn ;-)

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