I don't think I've really posted much about Adam's speech therapy in this last year. So (I use the word 'so' a million times per post, I swear), I wanted to get some info down here for me to refer back to if I need to.
I just met with his preschool teacher, IU13 (PA governmt Child Development & Early Learning) service coordinator, and current speech therapist this past Wedns. to update his goals for this year's Individualized Education Program (IEP). So (there it is again - acckk!), here is a bit of his history:
*He didn't use his left leg properly when learning to crawl and sit
*He didn't walk, due to his strange leg use, until 18 months
*He didn't say more than 5 words (and those were not complete words with ending consonants) by the time he was 20 months old
* We kept hoping that new words will just pop up, but by 24 months we started looking for speech therapy
* His 1st evaluation with the IU13 showed more than enough delay to warrant speech therapy but we were not given OT/PT even though he showed delay in his motor skill development as well. At this point, I was still clueless about IU13 and the process for getting him services, as well as not quite ready to accept the fact that he had delays. I did not push further for OT.
*His 1st speech therapist came and "played" with him once each week at our house. He got to love her and look forward to her sessions, while she managed (miraculously in my opinion) to coax new sounds out of him. I was shocked to hear him call me "Bobby" for the first time, instead of using the hand sign. By the time she had worked with him for 9 months, he could say "I ub you, Bobby" as well as other 2-word sentences. I was amazed!
*He got a new therapist when he turned 3. She turned out to be even more amazing at her job! Through play, modeling, reading, and use of cues, she has been able to break him out of his quiet little shell and into the world of verbal communication in just 1 year!
I wish I could explain truly how much this has meant to our family, as we only had a few hand signs and much whining/fussing with which to 'talk' to him. Not speaking had locked him out of relating to other kids his age also. Since this was my primary concern at the time, I didn't focus much on his motor delays. Ms. Dria (his speech therapist), however, was skilled enough to give us many tools and clues to his speech AND motor behavior over the past year. She has explained to us how his low muscle tone (discovered by us when we were trying to figure out what was wrong with his leg) affects his speech and motor skills as well as just delaying his walking. She thinks he displays 'peripheral neglect' - a visual processing issue. Her observation is that his motor skills have not caught up to where the average 4year old should be, and she is helping us to try to get him OT. She has truly become an advocate for him and his development and we value her highly.
So where are we now? We continue with his speech therapy with some updated word usage & social goals from this year's IEP:
#1) "In order to communicate his ideas, experiences, and feelings for a variety of purposes, Adam will speak clearly enough to be understood by most listeners by using accurate sounds and all syllables expected in his words." [This goal has to do with actual physical usage of words & language rather than social communication]
Using -> auditory discrimination activities; repeated practice & modeling; reinforcing activities (playdough, crafts, motor movement games, puzzles); verbal prompts & touch cues; reading
Outcome -> measured by consistent use of target sounds in connected speech when given less than 2 cues.
#2) " In order to communicate his ideas, experiences, and feelings for a variety of purposes, Adam will use verbal and nonverbal language to interact and communicate for a variety of purposes" [This goal has to do with his new reluctance to use the words he's learning in social situations but rather resorting to fussing and not interacting with his peers]
Using ->reinforced activities [at preschool & home]; providing him with short models of things he can say to his 'peers';expanding his contribution [at preschool] to predictable routines; allowing him to respond with gestures or single words [at preschool & home] in order to reduce social demand stress
Outcome ->measured by his communication skills (questioning, responding, commenting, interacting) with his peers and family.
I really don't get how they try to quantify such things as speech and lack of communication, (although I understand that they must). But if I read it all slowly (and I talk through it with Ms. Dria), I can understand where we are headed with Adam. Although his progress in the last year has been huge, he still has trouble with quite a few sounds and cannot always be understood by other adults or peers. His teacher at preschool will help us to move him away from his 'demand' stress (refuses to communicate when directly questioned or 'put on the spot', even with grandparents). As far as getting his some OT, I've filled out my evaluation of his skills and his preschool teacher gave her opinion. Now we just have to wait to see if that, along with Ms. Dria's experience with his motor skills, is enough to earn him an OT evaluation.
Hopefully, another year of speech therapy (and OT?) will bring Adam along far enough for us to begin Kindergarten on track! Until then, we keep working one session at a time... And any advice from others on these therapies or your journeys with them would be welcomed as well!