Wednesday, January 25, 2012

The Boy's Speech

For as extraverted as I am, I'm a pretty private person. I don't like or feel comfortable sharing anything too personal, be it positive or negative.

Most of the stories and posts I make to blogs or Facebook are impersonal or personal in a very impersonal way (if that makes any sense).

I keep those closest to me up to date, asking for advice, prayers and help when I feel it appropriate but I rarely vent or just "talk" about certain things that are currently happening with myself or my family.

Today, however, I feel compelled to write about something that can be considered small in the grand scheme of thing but has become pretty big in our household: My son's speech.

This story really begins about a year ago, maybe more.

To put it simply, our son just didn't talk.

He smiled, he laughed, he played, but words, if any, were few and far between.

All around us I saw 2 year-olds who could speak in full sentences and had very developed language while my own 2 year-old remained silent.

When I expressed concerned I was always told, "Oh, every child is different and develops at their own rate," or "Girls talk earlier than boys," etc.

Of course there may be some truth to that but there are benchmarks that all children should be achieving and while my son was making those benchmarks they were the minimum requirements.

We were also a bit encouraged by the fact that a little boy at church who was six months older than Garrett had a more limited vocabulary than he did.

But 2 1/2 came and went and while he continued to add more words he still was not putting together even simple sentences.

I started to think it was time to stop hoping for the best and comparing him to both the best and the worst of examples and get him professionally assessed.

The final straw was, at right around his 3rd birthday, I sat with him in nursery and the little boy who was so far behind him was now talking in sentences, having genuine conversation and my own son was still limited to one or two word back-and-forths that can be considered conversation in only the most primitive of means.

"Purple sippy!"
"Do you want your sippy?"

"Blue train!"
"Do you see a blue train?"

Just after Olivia was born I talked to a mother who's developmentally delayed daughter is in speech therapy and asked her who I needed to contact about getting my son assessed. I also scheduled Garrett for an appointment with his pediatrician who tried to encourage him to converse with her and agreed that he was no longer even making the minimum benchmarks in speech for his age.

Garrett's hearing test
The first step, of course, was a hearing test that he passed that with flying colors.

I was told that the next step was a speech evaluation and that would have to wait until after Christmas.

Over the Christmas and New Years break we tried to work with him more carefully and while he made quick progress with words his language still seemed stalled.

After stalking the early education people for three weeks, they finally got back to me and scheduled Garrett for his speech evaluation.

I can honestly say I wasn't nervous. I knew he wasn't where he was "supposed" to be by the speech benchmarks laid out by people who are in the know about these things but I'd already accepted that this is where we are right now. Because I'm a research fiend I was learning that certain patterns and habits of speech (and other play behaviors) that Garrett is exhibiting can be signs of autism or other developmental delays or disabilities. Yet I wasn't going to put the cart before the horse and think the worst. I had accepted that whatever was, was and there was no point in borrowing trouble from tomorrow though it doesn't hurt to have a little bit of worst-case information just in case. We would take this a step at a time and right now, at this step, we need to find out how far behind he is and if we can identify the problem.

For one whole hour I watched the speech pathologist play and interact with Garrett. We talked about my concerns which she was able to pick up on immediately in her interactions with him.

Through her evaluation she was able to tell me that he has areas wherein he is excelling (even more so than other kids his age) but also areas wherein he is very behind.

The good:
  • He has better-than-average articulation. If given a sound to replicate he can do it and if given any sentence, broken up into one syllable parts, he can say it almost perfectly.
  • He understands simple one-step commands.
  • He can communicate his needs and wants very well through one-word statements. 
  • He can name almost anything you put in front of him and remembers the names of objects very easily.
The bad:
  • He does not understand two-step commands. The pathologist put four toys in front of him (a toy banana, drumstick, fork and french fry), she asked him for the banana and the chicken. He gave them to her but didn't stop there, he also gave her the french fry and the fork. 
  • He does not understand verbal choices such as, "Would you like an apple or banana?"
  • He cannot understand negatives. If told, "Don't touch that," or "Don't throw the ball," all he understands is "touch that," or "throw the ball." 
  • He exhibits a lot of echolalia. Echolalia is when, instead of answering a question such as, "Would you like an apple or banana?" with "apple" or "banana" he echos back part of the question by saying, "apple or banana?"
  • He can not understand the language behind identifying an object's purpose. The pathologist put four pictures in front of him (a pan, a pencil, a sock and a clock). Even though we had gone over these objects and their purposes before hand, when she asked him what Mommy cooked breakfast in he was unable to identify the pan. She asked him what item told the time and instead of pointing to the clock he just grabbed all of the pictures and threw them in the air. According to the pathologist, these are connections he should be able to make by now.
She gave me some homework assignments and some videos to watch along with a couple of books and assessment charts we are supposed to work on over the week. She's going to see him next week and see what progress (if any) he has made and go from there as far as the next step is concerned.

There is no diagnosis or prognosis at this point and according to the pathologist there won't be for another couple of weeks. We all (me, John and the pathologist) are going to need to work with him over the next several weeks to see what he is learning and what he's not and that will help her and us decide what exactly is the issue and if it is just a delay or an actual disability. It will help determine what kind of testing, therapy or work he may or may not need and how we should proceed.

I was warned that his echolalia is his way of communicating to me that he doesn't understand what I'm saying and to not punish or correct him when he starts to exhibit it. I was told to inform everyone who might watch him to be careful not to identify his acting out with "naughty behavior" when he doesn't obey because many times its just because he simply doesn't understand. She said it was very clear to her that he does not understand the language that an average 3 year-old would understand. This struck me particularly hard as there have been many times I have punished or corrected him for things and listened to sentence after sentence of his echolalia thinking it was just his way of telling me he DID understand instead of realizing that it was his way of saying he DID NOT understand.

This weekend we will go out and get some more pretend play toys. He pretend plays like crazy with trains but we're supposed to work with him with other objects and toys, too.

We read to him all the time but now we're supposed to go through the worksheets on how to get him more interactive with the stories.

I'm supposed to be very careful not to use negatives with him and find a way to somehow turn, "Don't do that," into "Do this." Turning "don't hit" into "be gentle" or "don't throw" into "put that on the floor." It's a lot harder than I thought. I'm still trying to find a positive way to say, "Don't throw things at the cats."

I'm supposed to model pronouns. "I am putting your train in the box" as I put the train in the box. "I am making you eggs" as I make him eggs. My day is going to become a series of status updates for him.

I'm supposed to work on his two-part simple commands like, "give me the spoon and the fork."

I'm glad we're finally working towards some answers with his speech. As the pathologist said, he does not have a word problem, he has a language problem.

Yeah, I feel guilty as heck that I didn't get the ball rolling on this six months ago, but I guess there's nothing I can do about that now.

This is definitely going to be a step-by-step process. Here's to taking the first steps.


  1. He couldn't have a better mommy to help him through this than you, Melody (as is evidenced by the fact that God gave him to you). I know there will be hard days and times of frustration for all of you, but it is SO evident how much you love him and want the best for him. I will be praying for you all as you work your way through this together.

  2. Melody, There are a couple of groups on facebook with mothers that go through these same things is it okay if I add you to them. They can give you some ideas also.

  3. Thanks, Helen. Yes, it's okay to add me. Any additional information and help is welcomed.