Speech

At James's last Special Infant Care Clinic (SICC) visit back at the end of June, they recommended that he continue seeing his developmental therapist but that she would shift to working more on speech. Well, that's fine in theory, but she's not trained in speech therapy, so it hasn't actually worked out in practice. So we asked our Early Intervention coordinator about getting a consultation with a speech therapist, partially to see whether he needed additional therapy, but also in case that person might have some new hints or strategies we might use. (We were influenced by the fact that the person who evaluated the boys for physical therapy way back when was so awesome -- even though they didn't end up needing PT, we felt like the suggestions she gave us for exercises to do to help with tummy time, etc., were extremely helpful. We thought maybe something similar would happen with a speech eval.)

At first the EI coordinator was going to set us up with the speech pathologist in her office, but then she had second thoughts because that person isn't trained in working with hearing loss. And, James's auditory-verbal therapist is trained in speech therapy as well (which I think we had forgotten), so instead we had a meeting today with her and with the EI coordinator to decide how to proceed.

One issue with speech evaluation with a child like James is the question of what standards to use. There's his chronological age (16 months), but with babies born this early, no one really expects them to be at their actual age developmentally yet. Then there's his adjusted age (13 months), which is a more appropriate benchmark generally, but then there's a third one for hearing loss -- his "hearing age", which starts from the time he got his hearing aids (early May). So, James is a bit delayed in speech for his adjusted age, but he's way ahead for his hearing age, and as his therapist said today, for a child with auditory neuropathy and moderate to severe hearing loss (though she misspoke there -- James has mild to moderate loss), he's doing "absolutely outstanding."

Overall, her take is that he's doing really well, and that speech therapy would not be useful at this point. What we've been doing in the therapy with her is to try to get as much language input for him as possible, and then his speech should emerge from that, which it appears to be doing.

After this discussion, our decision was to not pursue a speech eval or anything additional at this point. We're very comfortable with that, but we wanted to explore the options given the SICC recommendation.  (My impression is that the SICC doesn't really take the hearing loss into account in their evaluations, and also, I think they want to err on the conservative/negative side in their evaluations so that a child doesn't get denied any services they might need.) 

James demonstrated his "yee haw" and "ei ei oh" (Old McDonald) while they were here.  His AV therapist asked if he'd been making any other kinds of sounds, like vroom for a car or bam bam, and when he heard her say "bam bam", he banged his fists together!  So cute!  (And good listening!)

And, also today, he said "ooo" in response to "what does the cow say?" and he said "ball" ("ba") and crawled over to get his ball.  (He'd said "ball" in his ball pit the other day, but I wasn't sure if he really was saying ball or just babbling with his "ba"s -- but this time was pretty convincing.)  He also said "duck" again when he was looking at a picture of a duck in the book. 

He's also imitated "bye bye" a couple of times (in an adorable high-pitched voice), although he may be saying "di di" instead.  And he imitated "uh oh" after he threw his cup out of his high chair.  (I'm waiting until he's a bit older to explain to him that it's not really an "uh oh" if you drop it on purpose.)

With all that, I think his speaking right now is AWESOME.  Super-genius baby! 

It's also a big relief to have him actually saying some words (or, you know, the toddler version of words).  The fact that he was understanding what we said was reassuring that we weren't dealing with the worst case auditory neuropathy scenario ("never able to understand or use spoken language" -- you can imagine that booming around in the back of my mind, the monster under the bed), but now that he's using words as well, I am breathing easier.  (As usual, Mike stopped worrying about the worst case long before I did.)

The photo is from dinner tonight -- we gave the boys refried black beans (and let them eat with their hands).  Mattie loved them and just shoveled it in (and on); Jamesie didn't quite know what to make of it, and I think ended up with more of it on his legs than in his mouth.  :)