Tuesday, April 23, 2013

Speech Ewaluation

Several weeks ago I called ECI to set James up with a speech evaluation because his pediatrician, our friend who is a preschool special ed teacher, Ryan, and I all agreed he was a little bit (a LOT) behind in expressive language.  Of course I was doing a million things at once, because that's what I do, and when they answered the phone at the ominously named "County Services" I said "Yes, hello, I'd like to arrange a speech ewaluation for my son."  It was an auspicious start.

They set the date for today at 9 am and sent out some paperwork and then we waited.  And during the intervening weeks Ryan and I were hyper aware of how James was talking.  Separately we started really focusing on his speech and requiring him to try to use words where before we would just, say, get him a cup of milk on autopilot when we got some for the other kids.  I started narrating our daily routine like first time parents do with their six month old babies before they realize how much more fun it is to turn up Lady Gaga and tune out the chaos in the way back.

"James, it's time to BUCKLE!  BUCKLE BUCKLE BUCKLE your seat!  Can you say BUCKLE?"

"Here we are at the store!  Let's buy BANANAS!  BA-NA-NA!  BA-NA-NA!  BA-NA-NA!"


And, you're not going to believe this.  But he started talking a LOT more.  His vocabulary has tripled in the last few weeks.  His pronunciation has improved dramatically.  The screaming and frustration has gone WAY down.

After about two weeks of this Ryan and I looked at each other and posed a difficult question.

"Do you think he's speech delayed because we never actually talk to him?!"

 I mean, Charlie, who enjoyed undivided attention from the two of us, could point out then-candidate Obama on a magazine cover when he was barely two.  He called him "Omama-Biden".

So this morning when I got James out of bed I said "Hi, James!  Today we go to SPEECH!" and he said "PEECH!" I wasn't hoping there was actually something wrong with him, but I worried that I might be taking a perfectly normal child to a speech evaluation.  Like when you take a kid to the pediatrician because you're bored and it's raining outside.

Fortunately while we were in the waiting room he spent a good five minutes telling one of the nurses that the dog puzzle piece was a "Moo moo."  And driving a toy firetruck around on a table proudly shrieking "ZZZZZRRRRRRRUCK!"

The OT led James through a series of games and activities and he had a great time.  He's never had so much attention in his LIFE.  The speech therapist listened to their interactions and also asked me lots of questions.  Questions that have no good answers.  Like "Does he play independently?"  I said yes.  The follow-up question was "Does he require supervision?" was trickier.  I mean, the answer is "No, he does not *require* supervision" but I am not going to go on the record here in the County Services building that I *don't* supervise my two year old (even though, haha, who can watch THREE children at once amiright?).

Also, "Does he exhibit negative behaviors when you ask him to do things?"  Um, yes?  A normal amount?  Like, he tries to claw at my face while I'm buckling him in sometimes but not at, like, a *clinical* level.  I'd say like, 60-40, depending on how recently he's eaten and slept.

I nearly snort-laughed when she asked "Does he use appropriate tone of voice and volume in different settings, like the grocery store and church?"  Um.  Well.  The older kids don't do that 100% of the time.  Give me a glass of of wine at girls' night and I can pretty much be counted on to overshare in the loudest voice possible.  Not really sure what you're asking for here.  So I answered vaguely "I think he's fairly normal in this area."

After all the one-on-one table work the therapist took James out in the hallway to try running, jumping, and kicking a ball.  Judging by the raucous laughter coming through the open door, I would say that he enjoyed that part of the exam, but when it was time to be back in the room he climbed into my lap and signed "all done" anytime someone tried to talk to him.  Test over.  I have had it.

He curled up with his blanket, buried his face in my chest, and sucked his thumb.  But I was so proud of him.  He had been so charming and cooperative.  He stayed on task the whole time and did what he was asked (except when he couldn't find the baby doll the OT had "hidden" on the floor behind his chair, but darn it if he didn't try as hard as he could).

He scored at or above age-level in all areas except for expressive language, which is what I was expecting.  He is 17% behind (and does not qualify for services), but I think if we'd done the test a month ago he would have been much further behind.  If he keeps going at the rate he's been going this month I think he'll catch up before long on his own.  The speech therapist suggested we get him examined by an ENT to rule out adenoid problems since he mouth-breathed and drooled through the entire hour ("Oh, I didn't realize that was an issue," I wanted to say, "His father and I are both engineers.).

So, no speech therapy for James, at least not right now, but I'm so glad we went because I'm always glad to be assured that I'm not seeing things that aren't there.  I'll continue to enjoy his gleeful "ZZZZZZZRRRUCKS!" because it looks like he will be saying "truck" before too long.  Or, you know, almost saying the "F" word like the other kids did at his age.


Brooke said...

LOL at mouth breathing and drooling being normal. Glad James is benefiting from extra conversation.

SnarkyMommy said...

My fav line: "Oh, I didn't realize that was an issue," I wanted to say, "His father and I are both engineers."

Same thing happened with Maeve. Exactly. They should have a special sliding scale of speech with calibrations for number of siblings and birth order.

Helen said...

""Oh, I didn't realize that was an issue," I wanted to say, "His father and I are both engineers.)"


Seriously, that's the funniest thing you have ever written.

Brandi said...

My MIL (retired speech therapist) mentioned to me when my oldest son was 18 months that she thought he was behind. Finally at 22 months I called the county. During the phone interview they kept asking how many words he had. 0. "What does he call you?" Nothing. He was evaluated the day before his second birthday. He had picked up 15-20 words and I thought we had this thing in the bag. He was at or above age level for everything but expressive language. They labeled him 12-15 months. He received speech therapy once a week...then was booted out of the program for being above age level after 5 months. I wondered what would have happened if we waited. Maybe he just wasn't ready? He had perfection issues in therapy and if he knew he couldn't say the word perfectly he would sign "all done" and walk away.

My youngest said he first word at 17 months and has not stopped talking since. Ever. He is now 4.My husband is an engineer:)

Sarahviz said...

Same.Exact.Thing. with my third son. He spoke NO words at age 2 so we had him evaluated. Diagnosis? Third Child Syndrome. Turns out he never spoke b/c we all spoke for him. He went from no words right to complete sentences. Needless to say, he's almost 8 now and never.shuts.up.

Kyla said...

It is ALWAYS better to check things out. If nothing else, you got a good tip on the adenoids. :)