3.05.2009

Calling all SLP's.....

DS has been doing really well with SLP goals. There are still a lot of things that mommy wishes her little boy would do (speech related), but maybe they're not realistic or age appropriate... which is the problem with peer comparisons.

Jen comes today and is quite impressed with DS asking questions, varying responses, etc.. and comments that he's doing so well we're going to have to come up with new goals. And she acted stumped and asked me if there was anything else I could think of to work on and she would have to really think to come up with something. I have known for quite some time that she thinks he is 'all caught up' and working on goals above his age.

I have taken a bit of a break from 'neurosis' (Example 1 / Example 2) of constant speculation and reevaluation of how/what DS is doing - so I was tounge tied when she asked. To tell the truth, there are certainly things that still bother me, but I didn't know what they were. I don't even have a mental list right now.

Question: At age 3 - which we are only 4 months away from - what would be appropriate developmental stages of speech to have been through. Also, do you have some sort of 'list' of dev. milestones that should be reached by 3? Are there things that you know of that relate so specifically to ASD that maybe she's missing as needs IF she's not that up on 'the spectrum'?

I am totally pleased that she wants my input - I don't want this to come across as some fault of hers right now. I just feel unqualified to identify what he SHOULD be doing & so i always have this fear that if I don't know to look for it, it could go totally unnoticed b/c she doesn't dig very deep to FIND things that he needs to work on. I'm on board to do the work on my end to find answers to these questions - but I'm hoping someone will chime in and help me.

Two heads are better than one!

Oh & if your'e not an SLP, but you have some input....you're certainly welcome!

8 comments:

Jann said...

I've been following your blog, and have a lot of thoughts, but I'm not quire sure where to begin...

1st of all, it's very strange that an SLP wouldn't the next set of speech goals. There's a definite progression normally.

Second, on the OT, your son is SO young. I know a lot of 2-year-olds who can't dress themselves. My son, now 7, didn't really start dressing himself until last year. It's only this year that he can work buttons. Fine motor and speech are often very tied together. He HATES handwriting....but his is getting a lot better this year as he ages and has more control. Texture issues are also tied in with speech issues often.

Lastly, (although I could go on and on) are you really sure about your son's level of receptive language? If he doesn't understand what is being said to him, that goes a long way to explain a lot of his behaviors. Our son was "faking it" using visual cues, so were were surprised when the Vanderbilt folks gave us the actual scores, and explained that our son had NO idea what we were saying a lot of the time. No wonder he did his own thing. We were WAY overtalking and needed to bring our language to his level. Life got IMMEDIATELY better after that.

The people we work at Vanderbilt with really stay away from Dxing at such a young age. I see you stressing and pushing and taking him to all these therapies...I just wonder about the mental cost of this autism Dx, which I frankly wouldn't be surprised if it were taken off your son down the road.

I admire you. You are working so hard for your son, and he sounds SO, SO amazing. And I think the downside of an autism Dx too early is that the child gets lost in the therapies...or the parent does.

Did you get a chance to read any of The Mislabeled Child blog entries? I'm wondering if you read their book and or entries. (I've read some of their stuff online.) if you would indentify a more "differential diagnosis" that fits your son other than the broader spectrum.

A little boy just 3 years old said...

Thank you for your comment. We did a speech eval not too awful long ago and his receptive language wasn't too bad, although I don't remember any of the exacts. I will mention that she look back at that. I think her point on the 'normal' progression is that he is surpassing his age range. However, I disagree with her on that. When he is 'working' for her, he is prompted even by her presence & things are not generalizing as well as I would hope. My gut feeling is that she does not understand autism very well.

Also, as far the therapies go, the 'mental cost' is only mine. We have 4 'therapies' once a week for 45min-1 hour. He LOVES all the people who come in & it is all play based & in our home. So, while it is a great way to show ME what to work on.... I do not think for one second that he is in mental anguish.

Also, on this blog I strive to be truthful to my feelings and thoughts. It portrays some of my worst days, and 99% of it is AUTISM only, so it's not a good portrait of our lives as a whole.

As a parent, there would be mental cost no matter what.
He has challenges.
I want to help.
Here where we live if there is no Dx, there is no help.

We have had SUCH a huge progression this year - it has been the most amazing thing to watch. I do not think my son would communicate the way he is able now without all of this. But I don't want it to stop because he's a fast learner. Does that make sense?

I want to get to that point where he loses his Dx - not all children can hope for that. My hope would be that all this therapy stuff would be behind him BEFORE he gets to the age where his peers 'notice', but I'll never sit here and say that will happen either.

With something as mis-understood as Autism, it is just my job - bottom line - to make sure I know what I need to. It is obvious to me that noone cares about my son the way I do, so it is just plain sense to work hard for him.

Seems like I've been to some site about Mislabled Child. Can you send me the link?

Laura said...

Well my SLP was taking a class in Floortime when she started with Brad, and she used Brad as a subject. She even videotaped a therapy session, and was formally evaluated based on that session. So our experience is probably not the norm.

Brad's SLP focused on expanding "circles of communication." Typical toddlers tend to be rigid, and autistic toddlers tend to be more so. This plays out in behavior and play, but also speech. So when Brad became verbal, she would follow his lead and "enter his play." Then she would try to break him out of the rigidity and expand the circle of communication - mix it up a little, with varying degrees of success.

That may be out of your SLP's scope. The typical language development stuff goes from yes/no questions, to W questions, and then onto cognitive stuff like opposites, relational (big versus small) and rhyming. And then there's articulation, but I don't know where E is in that regard.

I hope that helps. And keep up the good work, mama.

A little boy just 3 years old said...

Laura, it sounds like your therapists are just so different than ours. I don't know if its location or what.... but I just don't see a lot of parallel. I'm sure its a good thing to have so many choices, but it makes it confusing as heck. Bah.

Anonymous said...

At that age, I remember making observations and asking questions was a big one that Chee was supposed to be working on.

Like driving past a pond and noticing the ducks, I might role model saying "I see a lot of ducks on the pond." Upon walking outside, I might say, "The sky is really blue, I wonder where all the clouds are."

The goal being to get her to verbally make observations about her environment.

Asking questions - focusing on the whats and wheres - was something that her SLP did with her in therapy by playing games with her. I would try to replicate that at home. I remember one being that we'd do a small puzzle together but I'd hide a piece behind my back with the goal of getting her to ask me where's the missing puzzle piece.

Hope that helps.

A little boy just 3 years old said...

OOOH. Great idea with the puzzle piece!!!!! He loves puzzles and would never stand to not finish it! Thanks a bunch. I bet your Chee and my E are very similar...

Jann said...

Re: your question.

The Mislabeled Child. This was written by two doctors, she's a neurologist. I've read some of the book online, and it's interesting stuff.

The link
http://mislabeledchild.com/

Of particular interest to me is the chapter where they detail who/why children with language difficulties are being mislabeled autistic.

Also on their blog (you'll see a link from their main site). This was an interesting link because it also included brain scans which are starting to deleniate between autism and late talking:


Monday, February 02, 2009
Late-Talking Children Confused with Autism Spectrum
Although one in five children have a language delay, it is surprising how often children are misdiagnosed as having an autism spectrum disorder or low IQ. ....

Late-talking children often can be distinguished from autism because of their normal affiliative or social drive and social mirroring ability. Their language strengths and weaknesses are also quite different been non-autistic late talking children and autistic late-talking children. Most mistakes are made when children are diagnosed with behavioral checkslists rather than a detailed professional assessments.

A little boy just 3 years old said...

*Jann*
Do you have a website that is really good at describing what a 'late-talker' is? With or without contrast to autism.

I really do think we are on the right path, who knows what the future holds. He has so many issues that are not directly 'speech' related. I do realize that communication has a direct link to some of the behaviors, but it goes beyond that for him.