Thursday, January 26, 2012

Speech 101: The First 24 Hours

Life is communication.

The better one can communicate the easier life will be. Of course, the opposite is true and the more difficult it is for someone to communicate the harder life will be.

I failed to realize just how hard life is for Garrett right now and to be honest (and to put more miles on my guilt trip) we have failed him in our communication with him. We've come to a place that is "comfortable" for all of us and it has left Garrett at a stalemate.

We did everything that we thought good parents do (played, interacted, played games, didn't let him watch too much TV, read him books, gave him snuggles) but until yesterday we didn't have much in the way of ideas on how to work with him and figure out whether or not he was understanding our communication with him. In honesty, our "play" with Garrett was more of us sitting on the floor and watching him play or running our trains behind his trains or tickle fights or simple interactions that don't require much language.

Armed with some new information from the pathologist John and I wasted no time diving in with our interactive play with Garrett centering more on language.

Right away when we got home I started modeling pronouns. I listened closely for his echolalia and tried to figure out new ways to phrase questions so that he understood. I also spent most of the day figuring out ways to take all of the negative commands I've given him over time into positives. Since he's also potty training, a lot of our time was spent in the bathroom communicating with words like "pee," "potty," and "YEAH!!"

When John got home we jumped right into working on his two-step commands. We got out some toys for Garrett and took turns telling him to take one or two of those toys to Mommy or Daddy. We then went on to interactive pretend play by breaking out pots and pans and setting up a makeshift kitchen in the living room.

It was then we really started to grasp how little he really is listening to us.

We brought out a cup full of colored marbles that he was "cooking" for us and I asked him to give me all of the red marbles. He didn't even register that I was talking to him. John tried to tell him to give me the red marbles and we might as well have been talking to the wall. I started to take all of the red marbles while saying, "I am taking all of the red marbles," and he finally realized that this was something that required both listening and a response and through a series of fights over whether or not I was stealing his marbles he finally started to give me marbles of specific colors or put marbles of specific colors into certain dishes or cups.

That small battle over with we did our homework by watching the "Read Together, Talk Together" video about dialogic reading and asking and responding to questions that expand language.

It was about bed time so John took the first Read Together, Talk Together book upstairs and read him his book and put him to bed.

The next morning started a new wave of challenges for me.

I'm very used to making him breakfast and letting him play on his own while I clean the kitchen and other household chores.

I started collecting laundry after the morning potty rituals and stopped in his room for some interactive play.

The pathologist said it was important for him to incorporate play that includes him having to "talk" for a toy like a doll or animal. She said not to press the issue with him but to model that kind of play for him and see what happens. So, here I am, a woman who has not "talked" for a toy in probably twenty years, on the floor in his bedroom with Woody the cowboy and a stuffed kitty trying to model both sides of a conversation. It was very awkward at first. I'll admit.

Garrett thought this was hilarious and laughed at me and threw blankets at me but I wasn't deterred. After a while I was throwing the kitty into "jail" in the laundry basket and asking Thomas the train to take Woody to the Sheriff's office. When I put the toys down to pick up my screaming 2 month-old I was so happy to see Garrett pick up where I left off and at least try to mimic my play and talk with his kitty, Woody, monkey and goofy bird.

Soon Olivia forced us downstairs for some diaper and potty time and then we were right back to pretend kitchen play in the living room. Garrett expressed to me that he wanted to cook me eggs and that they were hot!

Instead of leaving Garrett upstairs play on his own while I did laundry I let him come downstairs and help with feeding the cats while I did laundry.

Upstairs I modeled pronouns and actions by explaining and trying to get Garrett to help me fold towels.

"I am folding the towel. I fold it in half. Then I fold it in half again."

One of his issues is that it seems like he's listening but he's really only listening for key words that indicate what is going on and skipping over the rest. For instance, when I say, "I am folding the laundry," he knows this means I fold clothes up and put them in piles so if I ask him to help he just wads up clothing and puts it in piles but does not listen or understand the language behind actually folding or putting clothes in specific places.

I worked with him through those steps and then we went upstairs and I had him help me put clothes away.

"I am putting my clothes away. Garrett, where does Daddy's pants go? Daddy's pants go in the dresser. Daddy's pants go in the dresser drawer. Can you open the dresser drawer? Can you put Daddy's pants in the dresser drawer? Can you put Mommy's socks away? Where do Mommy's socks go?"

It was a long but fruitful process.

Then came lunch and the whole process started over again for cleaning the kitchen and doing dishes.

Garrett expressed to me that he wanted to help and instead of telling him no and that this was Mommy's job I figured this could be another opportunity to communicate with him.

He climbed up on a chair next to me and started going nuts. He was throwing dishes here and there and for a moment I didn't think this was a good idea.

I told him to stop and to listen and to put dishes in the water one at a time.

The pronoun modeling started and it was, "I am washing the plate. I am washing the bowl. I am washing the spoon. I am putting the plate on the drying rack. Do you want to help Mommy dry?"

Garrett said, "Yes," so I gave him a plate and he promptly threw it right back in the dish water.

"No, Garrett. That is washing the plate. What do we need to dry a plate?"

Out came his echolalia, "Dry a plate?"

"We need a towel to dry a plate."

"Towel to dry plate."

I took out a towel and started to dry.

"I am drying the plate. I am drying the plate with a towel. We need a towel to dry a plate."

I gave the plate and towel to Garrett and he did well. And step by step I directed him in putting it away.

Then he climbed back on his chair and I gave him the next plate. He promptly threw it into the dish water.

We started the whole process over again.

After about the third or forth try he was starting to realize that drying was not the same as washing and that dishes to be dried did not go in the water. I was even more encouraged when I started to ask him, "What do we need to dry the plate?" he started looking around and thinking about it and finally said, "Towel!"

And it wasn't echolalia. He understood. It was like music to my ears!

We even got to the point where he was following two-step commands like "Give me the towel and put that plate away."

The rest of the day was like this, even down to bath time where I sat there with three trains trying to come up with conversation for the three trains as I mimicked them talking to one another in the bath.

After a few minutes playing trains it was time for bed and it was sweet to have him climb up in my arms and not want to let go, asking to "Snuggle Mommy." 

For bed time I read one of the Read Together, Talk Together books and then he wanted to read his train book.

Now, we've read this book to him almost every night for probably a whole year. You would think he would know what was going on in the story. But using the Read Together, Talk Together guidelines for interaction and the pathologists guidelines for ques as to whether or not he was understanding I got a big slap in the face to how little of the book he actually understands. To him, the book is about trains and that's all that matters.

Almost every question I asked him about what was going on was answered with echolalia. It made me feel like I was being kicked in the gut. Months of reading to him and it seems as though absolutely nothing was getting through. I went through the Read Together, Talk Together guidelines through the book as though we were reading it for the first time. A book that typically took us three minutes to read took almost forty-five minutes.

To sum up my feelings of the day: I am exhausted.

I am encouraged. I am humbled. I am chastised. I am frustrated. I am hopeful. I am mad. I am unsure. I am determined. I feel bad that Olivia is kind of getting a back seat to Garrett as other than feeding and changing her I've been propping her up on pillows and putting her in the swing or just sitting her in my lap to play and interact with Garrett. I feel torn about my responsibilities to him, my daughter and my home. I'm feeling a bit overwhelmed and it's just the first day.

 And now it's off to bed to rest up for day two.


  1. For different reason, we have had to do the same thing with 3 of our children. They came to us over the age of 3 with zero language due to being deaf. Once they received the cochlear implant we have to do a lot to stimulate their brains, make new neural pathways and build vocabulary in addition to just assigning meaning to the words they were now hearing. It is exhausting and I certainly felt the pull between my younger children who needed so much from me and my older kids, who needed me, but we're more self sufficient. I don't know you well enough to give you advice, but I will say that for us it did get easier, we did see much improvement. Again, I know the situations are not the same, but I just wanted to offer some encouragement.

  2. Yes, yes, yes, I recognize this time in our life too! Took the words right out of my mouth. My youngest could not "hear" or respond to things like, "Don't run into the street", "Stop!!!", etc. Even through his teen years, and teaching him to drive, we have worked on this. I just want you to know that it DOES get better, and to keep on doing what you are doing! It works! And pleeeeeze do not beat yourself up over this. The life and the world is hard at work waiting to beat us up, be kind to yourself, and say beautiful things to your heart. Hugs.

  3. I just remember going through this some with Jeffrey, and the therapist saying we turn them on but we don't turn them off. And when he was 8 he got a T-shirt that said, "My parent's taught me to walk and talk. And now all they want me to do is sit down and shut up" That is our Jeffrey. He is never quiet now always has something to say.