Preschool!

Here is the promised preschool report: John had his preschool eligibility evaluation last Monday morning. An elementary school psychologist, Dan, and the same speech language pathologist we saw in May at the school, Mary Ellen, both thoroughly evaluated John.

Dan asked him to play with different kinds of toys: stringing beads, "sewing" with a thick string and fat needle, stacking blocks, jumping off a chair, etc. He also showed John objects and pictures, and then asked concept questions such as "Which one is heavier?" "Which man is taller?" "Which one is used for eating?" "Which cup is empty?"

Mary Ellen also asked questions, but she was looking for any kind of verbal response. John was true to form. He ran to play with these strangers, eagerly did everything they asked of him, answered most of the questions correctly, and was nearly silent as he did it.

His scores indicate that John is average or above-average in every area except for two. In receptive language (or "the vocabulary in his head" as I call it) he is way above average. In expressive language (or "the words he uses") he is way below average. So John qualifies for state-funded developmental preschool!

He will see a speech therapist at least once a week in the classroom. Mary Ellen also encouraged us to have John receive more speech therapy outside of the class setting, which I am pursuing. She gave John an unofficial diagnosis of Apraxia. We are going to eventually get a formal diagnosis, but are going with Apraxia for right now because it really seems to fit John.

Here's a definition:

"Developmental apraxia of speech (DAS) occurs in children and is present from birth. It appears to affect more boys than girls. This speech disorder goes by several other names, including developmental verbal apraxia, developmental verbal dyspraxia, articulatory apraxia, and childhood apraxia of speech. DAS is different from what is known as a developmental delay of speech, in which a child follows the 'typical' path of speech development but does so more slowly than normal.

"The cause or causes of DAS are not yet known. Some scientists believe that DAS is a disorder related to a child's overall language development. Others believe it is a neurological disorder that affects the brain's ability to send the proper signals to move the muscles involved in speech. However, brain imaging and other studies have not found evidence of specific brain lesions or differences in brain structure in children with DAS. Children with DAS often have family members who have a history of communication disorders or learning disabilities. This observation and recent research findings suggest that genetic factors may play a role in the disorder" (http://www.nidcd.nih.gov/health/voice/apraxia.htm).

Another website says: "The child knows what he or she wants to say, but his/her brain has difficulty coordinating the muscle movements necessary to say those words" (http://www.asha.org/public/speech/disorders/ChildhoodApraxia.htm), which certainly matches John's high receptive and low expressive language scores.

Treatment involves LOTS of speech therapy, LOTS of home speech games, coaching, encouragement, etc. and a few other more controversial or unproven methods like face massaging (and even if it didn't work, what would be lost?--but I'd have to learn how) and Omega-3 supplements which we have just started John on. Again, it's a part of a healthy diet and John doesn't eat much fish, so it's a good idea for him to have this brain food anyway. (See http://www.drsearsfamilyapproved.com/shopdisplayproducts.asp?id=1&cat=Children%27s+Omega%2D3). Most importantly, we need to make sure John is happy while we're "treating" him, or he won't be motivated to keep working. Mary Ellen stressed that we need to carefully guard his self-esteem. He presently has a great self-esteem and a perfect personality for therapy in that he loves to be praised for his hard work.

Today I was working with John on saying "meow." We were reading Green as a Bean (excellent book!) and there was a picture of a cat.

Me: John, what does a cat say?

John: [tongue goes lick, lick, lick, his universal "I can't say what this animal says" response]

Me: No! (playfully, with a small tickle) Kitties say "Meow."

John: [seems to accept my statement]

Me: Me - Ow. John say Me - Ow.

John: [random sound]

Me: Say "Me"

John: Mimi

Me: Yes, you love your grandma [she's Mimi]. John, say "Me."

John: [after a bit of trying] Me.

Me: Good! Now say "Ow" like "owie" on your finger

John: Ow

Me: Yes! [I have him say these two words maybe 15 or 20 times] Now say "Me - Ow"

John: ow

Me: Me

John: Me

Me: Ow

John: Ow

Me: Me - Ow

John: [after many more attempts] Me - Ow

Me: YEAH!! You did it John!!! [I tickle him and kiss him and holler enough to wake up Havilah]

Me: John, Me - Ow

John: Ow


Ok, you get it. Meow was based off two words he already uses, I practiced the separate words approximately 40 times each, said the combined word at least 20 times, and he said it once. Maybe twice, if I'm generous in what sounds like "Meow."

It's a long road, people...a long road ahead of us.

BUT, John actually has taken a bit leap forward in the last few weeks so I'm at least somewhat encouraged. He communicates, he's as smart as can be, and someday, someday if we work hard enough and if God answers my prayers as I would choose, he'll talk and no one he meets will guess we were here.

If you pray, pray that John's tongue is loosed. That his brain and mouth learn to work together. That Billy and I will have infinite patience and creativity as we teach our son to use those words he knows.