Monday, May 19, 2008


If there are any speech-language pathologists who read this blog, please know I am by no means attacking the profession. I just am mentioning this because I always seem to be writing negatively in this area. Aidan’s speech therapist is conscientious and seems to know her field well. I think probably Aidan is a particularly difficult case. He does not really have a phonological disorder. His articulation is fine for his developmental age (he still slips on “r’s” and “v’s”), his voice tone is fine, his MLU (mean length of utterance) is not too bad — she measured it as 5.9 words per sentence but it is more complex at home. His main language gaps, I sense, are conceptual ones, more difficult to deal with since they have global ramifications.

Now that I’m most likely going to be doing his therapy at home at least for a while, I’m trying to get caught up on the terminology so I ordered a few books from the library hoping to get a handle on the jargon. People generally don’t care for jargon but guess what? I’ve found again and again that it’s the key that opens the door to a discipline. If I can get the doctor or therapist to use a specialized term it is a Google “Open Sesame” to all kinds of REAL information, not the kind the professionals use for parents.

My problems with Aidan’s speech therapy in the past have been mostly that it is on the “schooly” side of the therapeutic spectrum. From some reading I did last night, though, it sounds like SLPs do try to integrate academic goals with language ones — which obviously makes sense because they are closely linked. The “school” approach though is to break goals up into micro-skills and this seems to me to be frustrating for a child who is already dealing with problems with processing. He does not get a chance to see the “big picture” and actually find personal meaning in the tasks. So this summer I want to find a way to get his IEP “goals” in line with his own personal ones. This seems to be easier with OT and PT, because they are more to do with direct concrete functioning and that is so much more where he is at right now.

Aidan’s speech teacher said that she felt one of the goals for him next year ought to be ability to sequence. Interestingly, I found when I worked with him at home that he CAN sequence verbally with concrete processes. He told me the steps in how to make a graham cracker sandwich.

First, you put peanut butter on the graham cracker
Then you put on the vanilla chips
Then you put on the chocolate chips
Then you eat it!
(What do you put the peanut butter on the cracker with? A KNIFE!)

So he definitely can do sequence. What he apparently can’t do right now is put a picture story in order. I do not really know if this is sheer lack of interest, or if there is a layer of abstraction there that is too much for him. Probably a combination. Anyway, I am planning some Montessori-type activities for him to work on during the summer.

I put some links to various resources over at Schola et Studium. What I’m seeing with him is difficulty with what they call “praxis” — motor planning. It affects him across the board. Oddly, he has little trouble with functioning on a concrete level. He is actually a better planner than I am when it’s something he’s familiar with. Where he has trouble is (1) facing a new situation and developing a strategy impromptu and (2) fine motor and visual and auditory planning, probably integrating the different areas. I wonder if the second doesn’t cause the problems with the first. When we first brought him home from the hospital at age 8 months, he took some time to even “see” the two dogs. This happened again when he first saw Paddy in the hospital isolette. He was oblivious to all appearances until he found a way to interact.

I have some issues with praxis myself. I have a lot of trouble seeing a task through in an orderly way. I think I’m going to break down the planning I have to do into discrete sections. This week I’ll focus on Aidan’s goals — the therapeutic ones. Then later I’ll pay attention to the more academic ones that he and Paddy will have in common next year. Finally, I’ll break Kieron’s Year 7 into sections and address it bit by bit.

I notice Aidan shares my love of jargon by the way, as a door into connection with a subject area. He used to always say things like “X + Y = 21″, now take away the X. Recently he has been saying things like “The subject is RAN and the verb is SQUIRREL”. He listens all the time and it’s remarkable the words he acquires, by rote. In that way his language is at two entirely different levels — one is the real, concrete everyday requests and comments, and the other is a sort of hyper-vocabulary that he repeats just for the sound and social connection, with only the vaguest idea of the actual content. It is the middle level — abstracting the universal from the particular, as they say at TAC, that he doesn’t tend to do much yet.