Friday, July 9, 2010

Speech Evaluation (Part V )

Part I, Part II, Part III (Nathan, age 2 1/2) -- Parts II and III have videos of him showing some of his sign language skills in case you are interested. :)

Part IV (age 3 1/2) - I don't think I blogged about this, so here's a quick recap:

After the age of 3, the free speech therapy must be done through the school system so that's the next route we took.

During his evaluation, he was given a hearing test with headphones and the little beeping noise and he was supposed to say if he heard it or not. Well, he didn't say anything... not because he didn't hear it, but I don't think he's understood the directions. So the therapist tried to just watch his body language for cues that he heard it. Not very conclusive as to his overall hearing, but it appeared that he could at least hear some of the tones.

He also did a lot of the same activities from his first evaluation (which he was disqualified from because he spoke more than 10 words at age 28 months). He stacked blocks, played with toys, told the therapist what pictures he saw on the paper. I answered questions about his development (which was normal).

At the end of the session, I got the same answer as before: He does have delayed speech, but he's not delayed enough for the free program due to tighter constraints on entry qualifications. Basically, they have so many children seeking help that they can only take the extreme cases. We were told that when he turns 5, he can be reevaluated in kindergarten through the school system if necessary.

And now we're at the present and PART V of his speech evaluations.

Nathan is not quite 5 and he's not in kindergarten, but his speech is still really slurred when he gets to talking fast. He misses the "r" and "th" sounds regularly. I still do a lot of interpreting for friends and family. Sometimes I just have to give up on what he's saying myself. It's very frustrating for him, but he really does a good job of trying to get his point across and repeating his words. Unfortunately, we have not kept up with the sign language with his growing vocabulary, so that is *generally* not a helpful alternative in trying to decipher his sentences.

An example of our frustration is a conversation just 2 days ago:

Nathan: "way-yah way-ee-oh"

repeating himself and changing one sound: "way-yah way-DEE-oh"

I asked if he said "radio" and he says, "yes".

Me: What kind of radio?

Nathan: "red-ah"

Me: A "red" radio?

Nathan: NO!

Nathan, again: "red-ah"

Me: ???

He tries again, screaming it: "WED- AH!!!"

So I begin to think about what it could be. Knowing his "th" sounds like a "d" I change it in my head to "weth-ah".

Quickly realizing the "ah" is actually the "er" sound, I finally get "weather".

"weather radio?" YES!!!!

This type of conversation is typical at least once a day to every other day; however, his speech is improving over time. Regarding therapy, my thoughts are that he will probably only need minimal sessions and that we'd be able to work on most of it at home. So, we signed him up for a private speech evaluation, paying for it ourselves.

Same rundown as the previous evaluations: play, chit-chat, tell the therapist what the picture is.

At the end of the session, the therapist said that for his age he's doing fine. The sounds he is having trouble with are typical for his age and even though he also initially missed the "z" sound during the evaluation, she when back over it and he was able to make it then.

She said that they could continue therapy, but all they would be working on is slowing him down and repeating the words he is missing. She suggested we just work on that at home... instead of shelling out $75 a session. (sounds good to me!)

She also said that if the "r" and "th" sound don't come by 1st - 2nd grade, to have him evaluated again through the school.

I left that day very satisfied with the answers I was given. It was no longer, "Yes, he's delayed, but not delayed enough" to "He's doing fine, he just needs to slow down". YAY!!!

{On a side note... with no other place to put this bit of info because I don't want a post all to itself... Nathan had an outer ear infection about two weeks ago. At his initial appointment, the pediatrician pulled a huge chunk of wax from his right ear. He was later referred to an ENT for the infection and was treated. At his follow-up visit, the ENT pulled a huge chunk of wax from his left ear. The left ear no longer has a tube and has healed, but there is pressure behind the drum. The right ear no longer has a tube, but there is a hole in the drum. We will follow-up in two months to see if it has healed and how the pressure is doing on the other ear.}

Now that you have that bit of side info, you can fully appreciate the following comment I got from Nathan yesterday:

"Mom, I can hee bett-ah now!" (I can hear better now!) ~ LOVE IT! :)

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1 comment:

Andrea said...

It actually surprises me that they would accept "hee bet-tah" as normal for his age? And that they can only take really bad cases in the public system - that's unfortunate because I believe the therapy is so much easier to start young, ya know?
I remember when you first posted about this and I was having Ashton evaulated through the public government system at the same time (he was 2.5 and saying about 5 to 10 words too). They took him right away and he improved with the therapy (seemed a lot like just play to me at the time). And now that we can totally understand him, my therapist does everything she can to make the paperwork work so that he will CONTINUE to get free therapy.
I guess every state is different and I haven't really heard him speak. Have you had his hearing checked again now that he's older? I have been frustrated every time with that - it's practically impossible with shy little ones - lol! I"ve also found that keeping the nasal passage clear can be key to better communication.
Hope he keeps improving!