Tag Archives: functional language

Christmas is coming

I met a friend at the weekend who told me that her four year old had rushed home from school on the 27th November, yelling “Three days ’til Christmas Mummy! Three days ’til Christmas!” Her class had been talking about Advent and she took a great deal of convincing that she would in fact have to wait three weeks until the big day. Henry has never shown any anticipation of Christmas, nor any special enjoyment of the day itself. He likes looking at photos of Christmas lunches and has a particular fondness for the song ‘When Santa Got Stuck Down the Chimney’ because he likes the sneezing at the end. I suspect if it was called ‘When Simon Got Stuck Down the Chimney’ his joy would be undiminished.

This year things are slightly more confused. When Henry was younger, he used to call ‘crisps’ ‘creemas’- the ‘s’ sound followed by a consonant has always been difficult for him. If asked to identify the fat man in the red suit or a pointy tree with lights he would also say ‘ Creemas’. We could always work out which one he meant, basically because if he said it spontaneously it was always the potato snack. We’ve been working on the ‘s’+ consonant sound over the last year in speech therapy and he’s been saying ‘crisp’ for quite a while. However, in the last two weeks he’s reverted to ‘creemas’ – and this time it’s harder to work out which one he means, because, for the first time ever, he is showing a smattering of interest in the festive season. We went on our regular Monday trip to Sainsburys yesterday – more about life skills than actually needing to do any shopping – and I found myself being pulled towards the Christmas display in the foyer, where there was one of those things you can put your head through and be photographed. There was a lot of ‘creemas, creemas’ going on – but as the only thing that makes the supermarket bearable for Henry is the fact it is home to a large and tempting array of crisps, it could just as easily have been those he was referring to. I decided to risk it.
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And thanks to a woman who was selling RAC membership opposite, we even got a photo, of sorts, of the two of us.
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Happy Creemas everyone!

Talking

We had a visit from a new speech therapist last week. One of the purposes of her visit was to assess Henry for an AAC device (an electronic talker). It’s something we’ve been considering for a while, ever since a friend of mine started blogging about her son’s amazing progress using a device called a Vantage Lite, which uses a system called LAMP (Language Acquisition Through Motor Planning). Even though Henry has some speech, there are a number of  reasons why he might benefit from such a device: it could make his speech clearer to others, help him with word retrieval and possibly also help him to sequence  words into longer phrases and sentences.

Henry was on talkative form that day, grabbing the speech therapist’s hand as soon as she came through the door, pulling her into the sitting room and demanding tickles and ‘fast running’. She was obviously quite surprised, saying at one point that she had ‘ been expecting a non-verbal child ‘ and commenting positively about his intonation, imitation skills and obvious desire to communicate. For someone whose child had been described by one teacher at school as having ‘no functional language’ you can imagine this was music to my ears. Her advice was to delay a decision about an AAC device for six months, as she felt Henry may be on the verge of a ‘language explosion’ ( more music, a full symphony orchestra this time). We agreed that there are barriers that he has to overcome: difficulties with word retrieval, some consonant blends and sequencing (syllables and words) but that the main hurdle of old, his motivation to speak, is gradually being overcome by Intensive Interaction. I’ve written before about how his speech is confined to requests, but II is helping to extend those requests and also seems to be encouraging him to comment. We’ve had many repeats of the descriptive  ‘noisy’ I wrote about a few weeks ago and we now also get a running commentary at meal times – ‘chips….drink….sausage….chips’. When he started doing this we responded with a slightly irritated  ‘yes, look, your chips are there’, assuming that he was requesting as usual, but quickly realised that he was telling us, not asking. We now say ‘ Mmm chips, yummy’ and he repeats ‘yummy’ and carries on tucking in.

The speech therapist gave us some ideas for how to further extend Henry’s vocabulary and length of utterance within his narrow range of interests. Some of it we already knew, but had become lazy about: not letting him get away with using ‘toast’ to mean both toast and bread, insisting on the phrase ‘I want X please’ instead of just running to fulfil his single barked commands. Other ideas we had never used, for example, the use of scripts to accompany favourite games and other requests, the labeling (with a named picture) of items around the house. She advised us to ban questions that demand unmastered vocabulary as much as possible, concentrating on giving choices instead.  ‘Is this a sofa or a chair?’ is much easier to answer than ‘What’s this?’  as the correct word can be picked, rather than dredged up from memory (when his most frequent response was not ‘sofa’ but  ‘so far away’ !) Above all, she affirmed the growing confidence I’ve been feeling about Henry’s verbal potential.  The motivation to speak is now there, and we need to work as hard as possible on giving him the tools and the practice he needs to do it.

The video below shows Ellie working on a number of scripts with Henry, attempting to turn ‘blanket’ into ‘come under the blanket’, ‘ noisy’ into ‘Ellie, be noisy’ and ‘tickle tummy’ into ‘I want you to tickle my tummy’ (we’ve since changed this to ‘ tickle my tummy please’). She does this by modelling the phrase, then giving a prompt. It’s early days, but he’s definitely getting there. Happy Christmas everyone.

Hammock

I haven’t written much about sensory integration therapy on here as yet, but it’s certainly something that benefits Henry hugely. He seems to crave swinging at the moment, in particular swinging on the hammock in our garden. The clip below shows how this seems to help enable his speech. Occupational therapists would explain this by saying that the vestibular feedback he gets from the movement helps to regulate his sensory system and organise his brain, including the speech centres. Others might say that he’s simply having fun and that this is motivating him to speak. Whatever the reason, he’s certainly having a good time ordering me around!

Half term reflections

Last day of the half term holiday today and time to look back on the first eight weeks of home schooling. What have I learnt, and what, more importantly, has Henry?

First of all, ignoring everything I learnt as a teacher, I set far too many targets. According to my home-grown IEP, he should now be able to dress and undress independently, swim a few strokes without armbands and be able to read his own name and those of family members, as well as about twenty other things, none of which he can do consistently enough to justify ticking them off. None of the targets were unrealistic, but what I didn’t take into account was the huge effect of  the environment on Henry’s learning. So even though he was beginning to swim without floats in the open-air pool in the summer, changing to the covered pool with all its echoes and humidity meant that even getting him into the water was difficult for a few weeks. Dressing and undressing skills? I’d forgotten the annual challenge of  wearing long sleeves. We’ve got past that one now, but it meant that independent dressing has had to be abandoned for a routine of coaxing, cajoling and massage to reduce skin sensitivity. I had always known that he doesn’t make progress in a linear fashion but being with him all the time has made me aware of just how erratic his learning can be. One day he can read all our names without difficulty; the next he struggles to pick out his own.

Despite this, there have been some huge successes. One of the areas in which Henry has made real, definable progress has been in speech and communication. He is now using two and three word phrases to request some activities (name+activity+ please if you’re lucky). He is much more demanding of adult attention (sometimes a mixed blessing) and actively seeks out play even at times when he could be watching his beloved YouTube clips on the iPad. His ability to read  facial expressions and gestures has improved too. Sensory defensiveness has lessened, in particular his ability to tolerate the sound of crying. He is much more able to wait patiently for the computer to load, and to cope with frustration when it goes wrong.

And so I’ve come to recognise that targets have to arise organically, out of what actually happens, rather than what I want to happen. His new communication skills and love of play have developed as a direct result of Intensive Interaction, or rather our peculiar II/ABA mash-up, which involves getting him engaged and involved through II type play, then throwing in short bursts of learning activity which are rewarded with more II (and sometimes crisps). Sensory play (in particular the’noisy’ game) has helped to regulate his ability to process sensation. The child-led nature of the school day has made both of us calmer – I am more prepared to take time, to wait for him to follow an instruction or engage in an activity, and Henry, as a result, is much more compliant and less likely to hit out when things don’t go his way. Our targets for the next half term are fewer and build on the progress he has already made. It would be great if, by Christmas, he could be using the ‘name+activity+please’  phrase to discriminate between different people. At the moment he has a tendency to rattle off ‘Ellie sit down’ or  ‘Ellie tickle tummy please’ no matter who he’s addressing ( a bit like a toddler calling all animals ‘doggie’) although he often uses the correct name when prompted.

Finally, I have learnt that home-schooling is bloody hard work. It came home to me a few weeks ago, when Justin and I had a rare child-free weekend away. It’s always odd to be without Henry – the absence of the feeling of being constantly vigilant has tended, in the past, to make me feel slightly uneasy, as if I’ve forgotten something. But walking along the Cobb in Lyme Regis made me realise that the hyper-aware feeling is something I now experience nearly all the time – and it wasn’t until I felt its absence that I understood that fully. Being tuned into someone else all day is exhausting and, despite the fact we have a huge amount of fun I don’t always do it well – there are days when I’ve been driven to distraction by his refusal to wear a particular T-shirt, bored silly by endless demands for tickles. Thank goodness for the wonderful Ellie, who never seems to tire of tickling, running around the garden ‘fast’ or shouting at the top of her voice, for Jackie, our lovely respite worker, who gives me two hours on a Wednesday afternoon, and for Justin, who takes over the role of playmate at evenings and weekends. I’m aware that I always write ‘I’ in this blog and that this is unfair – I couldn’t possibly do it on my own.

Noisy – Part 2

We were in the car this morning when a rubbish truck rattled past.   ” Noisy!” Henry said. If you have watched the video attached to my last post, you will understand how happy this made me.

Henry has been speaking to request things since he was four. But that is all he has ever done with words. For him, it seems, language is a tool to get the things he wants – food, DVDs, games. We’re working on extending the barked commands – ‘ Toast! Thomas! Tickle! ‘ – to a more complex (and socially acceptable) ‘More X please’, which works because of the built in reward factor: you can withhold the request until the whole phrase has been said. But encouraging comments is much, much harder because it has no immediate pay-off. We can point at stuff when we’re out and sometimes, if he’s in a good mood, he’ll tell us what it is. But unprompted speech to comment on a sight, an experience, to share attention? Never. It’s a problem that’s been occupying me for some time – he has a very basic level of functional language, sure, but without comments it’s difficult to develop it into conversational speech. Yet the fact that he’s happy to engage in the gestural back and forth of Intensive Interaction, with all its characteristics of conversation – listening, responding, turn-taking – makes me think that it’s not lack of motivation and interest that’s stopping him making comments, as I had previously thought, but just not knowing how to do it. And maybe, just maybe, this is another way in which Intensive Interaction will help. I can’t wait.