Tuesday, March 10, 2015

Speech Therapy

Audrey has been going to speech therapy for about a month now. We've seen some progress but have only been going once a week because their schedule was full. This week we will start going twice a week and I hope that the higher frequency, along with being more comfortable with the therapist, will bring about more progress.

It was hard for me to finally get her in for an evaluation; I had been dragging my feet a bit. Partly because our past experiences with therapy, although it was feeding therapy and not speech, were pretty awful and partly because I just kept hoping she would start talking on her own. Now I'm really glad we've started to go though! She loves her therapist and the place we're going does all play based therapy at her age, not the rewards and consequences they were wanting to do at feeding therapy. And of course she's in a totally different situation now. We're not in the middle of a medical crisis where no one knows what's wrong and I'm not having to spend a bazillion hours on the phone fighting with insurance companies and clinics trying to get them to cover the astronomically high bills. Audrey is still on Minnesota Medical Assistance and I'm SO thankful because they will cover her therapy expenses 100%. Based on friends' experiences with school district provided therapy and our own experience with Gillette, I believe the private practice we're going to is the best fit for her.

Her first session was an evaluation which yielded interesting results! She was officially diagnosed with "Mixed Receptive and Expressive Language Disorder" which usually means both her understanding of language and her ability to communicate are low. But Audrey actually tested very high in receptive areas!

First the therapist asked me questions about her abilities and based on my answers she scored about 20 months in receptive language (what she understands) and 14 months in expressive language (how she communicates back). Apparently I vastly underestimated Audrey in both areas because after testing Audrey directly the therapist found she was actually at about 2 years and 8 months in Auditory Comprehension and 1 year and 7 months in Expressive Communication! (The tests given to me and Audrey were different, thus the different labels for the understanding and the expressing, but it's the same thing). So there is a significant discrepancy between what she understands and what she can verbalize.

I watched Audrey able to follow directions, identify clothing, body parts, and colors; and recognize the function of objects. She had trouble with analogies, following directions with negation (no, not), and following directions with spatial concepts (under, behind, over). Those are usually above a 2 year old's ability though.

The therapist also mentioned that Audrey uses 7 different phonemes (sounds) and heard a verbal approximation for "ball," "that,"  and "spoon." To me it just sounded like more of the nonsensical babbling she's been doing forever, but I think part of it is we're just so used to her not saying words that we don't recognize when she is. Today at therapy, for example, she said "duck," and tried to say "elephant" and "dolphin"!

Right now it's unclear if her inability to verbalize is because she has expressive language delays (slow to talk) or if she has something physically wrong and has speech production difficulties as well. The therapist said we will know more as time goes on. She put in an initial recommendation of therapy sessions twice a week for 30 minutes for one year, which can be adjusted accordingly as needed. We also get activities to work on at home. Right now we are working on teaching Audrey more signs and demonstrating different sounds (like oh, "hu" like in hot, and "b" in boat).