Tuesday, April 26, 2011

Listening, Language, and Speech Development: 2 Years Hearing

I haven't posted a speech sample in quite awhile, or really, even given an update on Aiden's language development in quite awhile. I don't have any "official" scores from standardized testing, BUT I do have my "mommy" thoughts, (and a video clip at the end), which I think, are actually more "official" than any test.

As any therapist or teacher starts a meeting with parents, they usually start with the strong points (and if they don't, I'd find a new one) and Aiden has many, but here are a few (or five).

1) Aiden is a genius. Seriously. Ok, maybe not a genius, and I know he's my kid, but the boy is mr.smarty.pants. He has this photographic memory that is utterly scary. He picks up on new concepts very quickly, which puts my mind more at ease because for a word to become part of a CI child's comprehensive vocabulary, they typically need to be exposed to it 100 plus times.

2) Receptively, he is doing phenomenally. He listens better than his hearing brother and sister (mainly because they choose to only have selective hearing).

3) Expressively, he's doing pretty good. His vocabulary list of what he says comprehensively is huge. I don't track it anymore because he's picking up on new words so quickly. He knows nouns, verbs, a good handful of adjectives, prepositions, articles, plurals, etc. and uses pretty much all of them in the proper context. He does a pretty good job enunciating single words or two words together. He's communicating his needs and wants and is definitely vocal. BUT .... (list of "buts" to come after all the non-worries).

4) He does a great job discriminating different environmental sounds and has great auditory comprehension skills all around.

5) his voice quality is good. There are times I worry about him sounding a bit nasally (which could mean he's getting too much high frequency input), but I keep my mind at ease through his AVT and his school teachers/therapists that tell me he has wonderful voice quality. He also has no problem imitating different sound durations (being able to hold a long sound - i.e. baaaaaaaa vs. a multi-syllabic sound ba-ba-ba. Six months ago, this was very hard for him. He could hold a long sound for a short time and only repeat up to two-syllable short sounds - ba-ba, which had a lot to do with his breath control and his low tone) and different tonal ranges (deep vs. high, whisper vs. scream - which screaming has become his newest favorite thing to do).

Now onto the "buts". Don't get me wrong, I believe Aiden is coming along WONDERFULLY. I really do. and how positive is it that he's speaking at all! BUT, in the same breath, I have my worries. This journey definitely comes with struggles and roadblocks, everyone's is different, but nothing we won't conquer.

Here are my mommy observations:

1) Aiden's just not much of a talker (except in church). While he plays, he talks to himself, as he walks around the house, he talks. So I should say, he's not much of a conversationalist (I know, it seems like a lot to ask). He's almost like his mind is constantly racing to stop and just talk. He's not one to ask questions (yet) and doesn't have a lot of conversational speech going on. He is just starting to answer simple "w" and how type questions. He's definitely mastered the "yes/no" question asking phase and has a perfect sounding "yes" and "no" (this step typically has to come before they'll start answering the "w" questions). Right now he does a lot of imitating, almost as if he's gotten too used to all of us modeling everything for him. The good thing about this though is he imitates me when I expand on his one-two word phrases. For example, he'll say, "wow truck!" and I'll say, "I see the truck. It's a big yellow dump truck!" and he'll repeat back, "see yewow dump truck!" He's getting there.

2.) Most of the time he talks in one to two word phrases, but we're starting to hear him put three and four words together more and more and speak more directly with us. The other night he asked me, "Mommy, bears please?" (he wanted to watch the three little bears on my computer) and he asked WITH the proper intonation so I knew it was a question. this was definitely a first (usually he would say, "bears mommy" or just simply, "bears.") my eyes leaked.

3) When he does combine more than two words, his articulation gets weak and jumbled, as if he's mumbling (he does this too with a word that has more than two syllables). We understand him, but a stranger walking down the street would probably only pick up on the first word or two. Our immediate family (gmas, aunts, uncles etc) is starting to understand him more though and have shared how he's come such a long way in the past six months. He sings songs, and I hear that tune in his voice (thank you God!), but it's hard to understand what it is he's singing. His speech can sometimes sound "lazy", if that makes sense.

4) He has trouble with his bilabials (/p/, /b/, /m/, /w/ (which is caused by low tone in his cheeks and lips) among a few other early sounds he should already have (like /t/ and /d/). (NOTE: I'm not including sounds that even a typical hearing three year old wouldn't quite have yet, like /f/ or /k/ etc. What's funny though is Aiden says a perfect /s/ and /sh/ and most of the other s blends.) There are times he says these perfectly - sometimes in isolation as when we do CV (consonant-vowel) syllable practice, and sometimes just in the beginning, middle, and/or end, depending on the word. For example, he says a PERFECT, clear as day, melt your heart, "mommy", but milk, is still "Nilk". He also says a PERFECT "baby", yet when he calls our dog Bella, it's "Dewa". The /p/, is usually perfect at the end of words (pop is "op", stop is "stop") but is completely absent in the beginning and middle of words (no matter how hard I try, I cannot get the boy to say apple, it's "ah-le".) We know he can repeat these sounds (so it's most likely not a mapping issue), but when paired with different sounds, it's either easy or difficult (like, "boo" and "moo" are very hard for him to say - yet he repeats a perfect "oo" or "ba" or "ma" in isolation). This not only has to do with poor lip closure, but also breath control and having to put multiple steps together (in the brain and orally) to produce these (see #5). Even in all this, he says "chocolate" pretty close to perfect. Go figure.

5) He has motor planning issues. THIS site provides brief examples of the different speech motor planning disorders. Aiden definitely fits into the "Sensory Processing and Motor Planning" and "Movement Execution" areas. I believe once we get our arms around this and his oral motor (he uses his teeth to talk a lot), he'll start taking off, which will then lead to more conversational type speech.

So yes, Aiden is definitely hearing and UNDERSTANDING us. He is also speaking, with some articulation set backs (oral motor) and some trouble putting what he knows together in order to voice his thoughts and create simple conversation (motor planning). He gets it though, and he'll get there.

Yes, I am SO PROUD of him and how far he's come.

Yes, I'm still worried, I'm sure to an extent I always will be, but I will not lower my expectations for him.

and yes, I know that one day Aiden will get there, and this is HIS journey, these are HIS steps. He gets it (he really is mr.smarty.pants) and he's WELL on his way, at HIS own pace.

Here's the latest speech sample I have.

Note: I had a lot of trouble with Overstream, so I included the video uncaptioned and captioned. I hope one or the other work. and don't forget to turn off the music!

This video was taken about a month ago, right after his third birthday (the day we were going to celebrate it though), and about two weeks after his second hearing birthday.



Anonymous said...

Hi Tammy -

Aiden sounds a lot like Ben at 3 years old. Ben would talk at home all the time and Steve and I could understand him, but when we would go places people would always have to ask what he is saying. I know it is different for Aiden, but some of it I feel is just boys. The girls started talking much sooner.

Hope to see you soon,


Naomi said...

His issues sound very similar to Matilda. She's always had issues with 'moo', but for the last few MAPing sessions the audiologist has MAPed every low frequency electrode, and now she's really improving. She does the mumbling thing when she talks in sentences too.