There's always something...

So, I haven't updated in a long while. That's getting to be a habit of mine. We've been pretty busy in the five months since my last update, but let's see how much I can recount of that time.

So we finally did get in contact with a Speech Language Pathologist, who was running a home practice as well as working out of an office. She gave us a few tips and tricks to try but ultimately said that we might see better results going with an Occupational Therapist. An OT, at least for small children, focuses on play since that is the bulk of what a toddler will be doing. Normally, children develop through their play, and it was the SLP's thought that Fox wasn't really ready for Speech therapy. She also worried that he had developmental problems that was hampering his growth. In any case, she was closing down her home practice and hadn't decided whether or not she would keep Fox on as a client. So we stopped seeing her in August.

On August 2oth, we brought Fox in to see a pediatrician, who diagnosed him with autism. He scheduled a CT scan and some blood work, and we have the follow up appointment in the next couple of weeks. Kidsability was informed, and Fox was taken off the wait list for speech, and put on the wait list for Autism.

The blood work didn't turn up anything untoward, but the CT scan showed that his brain was "underdeveloped" (not sure precisely what that means, hopefully in the follow up we'll clear all that up).

Now, the prevailing treatment for autsim is Intensive Behavioural Intervention, or IBI, which is based off the principles of Applied Behavioural Analysis, ABA. As I understand it, it is based on modifying behaviour through positive reinforcement. The government provides IBI treatment to autistic children in our region through Erinoak. Unfortunately, the waitlist is 2 to 3 years :(. We had our intake meeting with the folks from Erinoak on November 6th, and we get the strong feeling that Fox won't qualify as having a severe enough form of Autism Spectrum Disorder and thus won't get access to it. However it's still up in the air and would be two to three years out in any case. In the meantime, we're paying out of pocket for IBI-therapists to see Fox 3 times a week for 2 hours at a time.

We also had an OT do several sessions with Fox and she had a few suggestions as well. She also pointed us to the direction of Relationship Development Intervention, or RDI. So we met with the local consultant and are interested in that as well. I ended up going to a conference which featured the developer of RDI, Dr. Steve Gutstein, and it looks promising.

Now with the bad news out of the way, there's also some good news: on the spectrum of Autism, it seems Fox will have a very mild form (what they call a "High functioning" autistic). While it means we get hammered in the bank account more (since the government only pays for therapy for more severe forms), it's a good starting place and hopefully means the treatments will be more effective. We've also caught it pretty early, earlier than most (a lot of the stories I hear are kids getting diagnosed around 4. That saves us two years on the waiting list :). The IBI therapy that he's been doing for the last three months or so, while it hasn't got him any more vocal, he did finally master a few signs (open, more, all done) and he's good with a shape sorter.

On November 7th, Fox's sister Ruby was born, and while he at first didn't want to have anything to do with her at all, he's at least touched her and tried interacting with her.

So in all, there's still a long way to go there, but it's progress.

Enter the Terrible Twos

So I haven't updated in a long while, even though there has been news to report. Bad Daddy! So from latest to newest:

We celebrated Fox's 2nd birthday yesterday. Since he's still not talking, we figure he doesn't understand a lot of what's going, so we haven't bothered to make too big a thing out of it. Of course that didn't stop us from buying half a dozen different toys (all of which had to be assembled by me, the assembler extraordinaire) and a big chocolate cake from Sobey's. As expected, he really enjoyed the cake! We even let him have an extra big portion.

Presents included the new green wagon for two with the cup holder from his grandparents, an Elmo tricycle with handle so we can push him around while he gets used to the idea of tricycling, a Fisher Price parking garage with spiral ramp, 3 or 4 books, a train, a sand and water play set and a Playskool Busy Basics Poppin' Pals, which we've recently discovered he likes a lot. We also measured the boy and he's 3 feet right now. According to folk wisdom we've heard, you double the height at 2 years of age and that's around how tall he'll be as an adult. So right now the guess is just shy of 6 feet, which is unsurprising. If I hear what a big boy he is for his age one more time...

Also today, we have Fox's 2 year checkup. No concerns except for the speech and language delays.

On that front, we've noticed that he's back to babbling a bit, unfortunately still just a string of one sound. "G-g-g-g-g-g" or "B-b-b-b-b" seem to be the popular ones. But I suppose it's progress, right?

We also attended the Child Health fair a couple of weeks ago and got lots of helpful information. According to the nice and helpful lady by the name of Michelle we talked with there, Fox probably should have been on their list of babies at-risk for developmental delays because of his Preemie status. Likely he was missed because he didn't need to go to the Neonatal Intensive Care Unit; we had a heat lamp in our room at the hospital and he was under that most of the time. In any case, she also did a little more of an assessment, and put us on the waiting list for her group, which was much smaller than Kidsabilty's. In the meantime, we had also contacted Community Rehab, in an attempt to pay for assessment and bypass the 5 month wait at Kidsability. We also had an assessment with someone from Kidsability, which is where we found that Fox had a love for the Poppin' Pals, type of toy.

Michelle later had a home visit and went through longer tests with Fox. Her diagnosis was that he's developmentally delayed (no surprises there). She also got our permission to contact Kidsability about adding him to get assessed for Occupational development, which has to due with "appropriate play". For example, whether you use a toy car by pushing it along. Not quite as concerned with that, but it never hurts to be sure and it's better than finding out when we finally do get our appointment and then have to be scheduled for another one in 4-5 more months.

Unfortunately, our experience with Community Rehab hasn't been a good one. We haven't heard back from them as of the writing of this post. Lisa gave them a call and we found out a week ago someone had been assigned to our case, but we still haven't heard from them. Lisa called to enquire about it again and was just directed to voice mail, which still hasn't been returned. It's quite frustrating to not get any response from a place we intend to pay, so we're looking at other options. The website for Ontario Association for Speech-Language Pathologists and Audiologists gave us a few more leads that we'll give a try, and hopefully we'll have better luck there.

General Suggestions for Language Development

Things to Remember:

1) Get down to the child's level - Try to maintain eye contact if possible. This allows the child to see your mouth and also see that you are communicating with him or her.

2) Follow the child's lead - Initiate communication while doing something the child is interested in.

3) Repeat, Repeat, Repeat - This brings up the "Five Times Rule", where you use situations that arise during the day to teach and reinforce words and use it 5 times in three different situations a day, over a period of 10 days to two weeks.

4) Label, Expand, Imitate, Self-Talk - Labelling is just giving a name to an object. For example, when eating dinner, point at the cereal and say, "this is cereal."

Expanding is used in response to a child's interaction with you. Generally you add extra words to make the meaning of the sentence clearer. For example,
Child: Daddy. Parent: Daddy help.
Child: Doggie run. Parent: The doggie is running.

By imitating what your child has said, you are showing your interest. It is also a way of confirming that you understand what he/she said. When imitating, repeat back the sentence using the correct grammar and pronunciations. This will let your child hear the correct form without saying that he/she was wrong.

Talking about experiences as they are happening, since this is when they are most meaningful.

5) Pause - Count to 5 to allow the child a chance to respond.

6) Create a need for the child to communicate - You need to enable situations where to get what they want, they need to communicate. Some children don't see the need to communicate and so won't make and effort to. Clearly, you want to give them a reason to try.

7) Use your voice and facial expression to communicate to the child that you are interested - If you are enthusiastic and entertaining it makes communication more fun and keeps your child interested in the topic. Use facial expressions (e.g., smiling, nodding) and vary intonation in your voice.

Typical Language Development

So here's a summary of the information we picked up on typical language development.

10-12 Months:
- The child says his/her first word. The child's first words may not sound perfect or may not be used correctly. For example, the child may use "dog" to refer to any four-legged animal. With practice, this production will become clearer and will be used appropriately.

- The child follows simple commands. For example, the child responds appropriately to "Put that down", "Come to Mommy", and "Give it to Daddy"

- The child seems to understand simple questions. The child may respond to questions such as: "Where's the ball?" and "What is that?"

- The child gestures and/or vocalizes to indicate wants and needs. For example, he/she may ask for very common objects such as a ball by name and/or may gesture toward the object.

- The child starts speech gesture games. For example, the child tries to involve the caregiver in "peek -a-boo" or "patty-cake".

1 1/2 Years:
- The child uses up to 20 words.

- The child uses connected sounds (i.e., jargon) that sound like sentences in a foreign language. Jargon is often accompanied by gestures. The child will often point to objects and make up names for them.

- The child recognizes the names of 1 to 3 body parts.

- The child begins to understand such categories as food, animals, and clothing.

- The child uses common expressions. The child may say "What's that?", "All gone" or "Oh no."

2 Years:
- The child uses 2-word sentences. For example, the child may use: agent + object (e.g., "Mommy sock"), agent + action (e.g., "Tommy go"). At this stage, a child expresses meaning through the tone of his/her voice and the ordering of words in his/her sentences. The child may use word combinations that adults do not use (e.g., "allgone juice", "more up", "no down").

- The child has a vocabulary of approximately 50 words.

- The child follows 2-step commands that are accompanied by gestures. For example, the child understands the request: "Pick up your toys and put them in the toy box" as Mom points to the toys and toy box.

- The child uses such pronouns as "me", "mine", "my", and "you". These pronouns are not always used appropriately.

- The child uses negative forms such as "not" and "no" in combination with another word. For example, the child may say: "No shoe" when he/she expects his/her shoes to be in a place where they are not; "Not go" when he/she does not want to leave.

2 1/2 Years:
- The child understands such prepositions as "in", "on", and "under". For example, when the caregiver says: "The ball in under the couch", the child will go to get the ball from the appropriate place.

- The child produces 2- to 3-word sentences. For example, the child may say: "Daddy go car", "Bruno drink juice", or "Me hit ball".

- The child understands the concepts of "one" and "all".

- The child uses approximately 150 to 500 words.

- The child recites rhymes and songs. The child may recite or sing rhymes or songs such as "Twinkly, Twinkle Little Star", "Itsy Bitsy Spider" and "Old MacDonald Had a Farm".

Keep in mind that this is just average; some kids will start earlier and some later.

:Duan

Introductions

Where to begin? My name is Duan, and I'm the father of Fox. Fox will be two years old in June, and he doesn't speak a word. Needless to say, we were becoming a little concerned. We contacted the good people at Kidsability and they put us on their 4-5 month (!) waiting list for assessment, but in the meantime we attended a session intended to give parents some information on speech development.

One of the things we were told to do was keep a log of our child's speech development. And being a big geek, I of course decided to make a blog.

So, I'm starting this blog for a couple of reasons:

1) Primarily, as a record of Fox's development.
2) Allow family and friends to follow along in the peanut gallery.
3) Disseminate some of the information that comes our way on developmental issues. If it helps someone then my work here is done.

So the homework given us at the session was to make a log every day of the words Fox uses and what they sound like when he says them. So right now, I can say he's made sounds, but can't say that he says anything with any consistency. So zilch on the list so far.

In the meantime, we've stumbled on to the CHILD Health Fair here in Waterloo region, where they have professionals who do assessments free of charge. Hopefully that'll let us know if we're dealing with a late bloomer, or something more serious. We've also borrowed It Takes Two to Talk from the Kidsability library. Let's see where that gets us.

:Duan