He had his music class today. Just 2 students including my son.
What struck me was that he was talking beyond the usual "thank you", "good morning", "bye, see you next week" and what he said, he said without needing me to prompt him.
Why was I so very happy:
- he vocalised his desires to the teacher (not just using body language)
- it came out so naturally (no prompting)
- it was sufficiently loud (not whispering)
- intelligible (in the past if it was loud enough for me to hear, no one else would understand).
Expressing himself
What he said to his teacher:
- that one (in repsonse to the teacher asking which sticker he wanted)
- I like that one (when he ran up to teacher the second time he brought out the sticker sheet. This was said very quickly, without the teacher asking which one he wanted. No prompting. It's also a "long" phrase to a non-immediate family member which was intelligible)
- big (in response to teacher asking if that's a big or small sticker)
- I'm dizzy (after spinning round & round with the other boy during circle time. No one else heard this though)
I'm happy to see the progress in his communication. It's vital that he is able to vocalise his needs and wants, to avoid unnecessary frustrations and to avoid lowering his self esteem. This is especially so when he's about to start kindergarten.
It's only been in the last 3 weeks or so that he's begun to frequently express his needs & wants & feelings.
Examples of words he's used to expressing his feelings:
- I'm cold
- I'm hungry
- I'm full now
- I'm happy
- I'm angry now
I'm relieved that I've been on the right track in developing him to this stage. There have been various things that I do.
I think the main thing that worked was that I helped him identify his emotions, needs and wants. It's got to be done repeatedly, over and over again.
By this I mean catching him there and then in that situation and giving him a "label" for the emotion or modelling for him the words to use.
For e.g. when he's mad, I'd say "I know you are mad, but..." or "Why are you mad?". In the latter case, I would not necessarily expect an answer because he's not achieved that level yet. I do ask it anyway because it reinforcing that emotion (mad) with the word "mad". I also ask it anyway because I want him to think what made him mad (emotional intelligence).
Another example is for the feeling/word "cold". In the past he used body language to indicate cold (arms crossed over his chest & using his hands to rub his arms). I'd then say "Oh dear, is it cold? Are you feeling cold? Oh no, you're cold! Let's get a jumper on you because you're cold. How are you feeling now? Are you still cold? Here, let me rub your chest to warm you up. Better now? Not cold anymore?". "Cold" was mentioned 6 times in that one incident. Repetition is important.
Often (but not always) as a mom, I'd already know what he wants and it's far easier to just respond to his emotions, needs and wants instead of taking that extra few minutes to "label" it for him or "model" it for him. But repetition is important when learning something new. Often it meant exercising my patience. Often it meant taking the longer route instead of a short cut, in spending that extra time. It meant not giving up.
Intelligibility
Being able to identify your feelings, wants and needs using words is one thing. Being able to vocalise them with clarity is another thing when he has dysarthria.
It's still hard to fully understand him. Most of the time I am eventually able to understand him because I can guess what he said (if it wasn't clear) based on the context it was said in or simply because I'm familiar with him.
For e.g. "tat ohh" means "Trucks roll", referring to the title of his current favourite story book. He cant pronounce the "k" or "c" sound. He cant do "r" either. He can't purse his lips to make the "o" sound as in "roll". He has difficulty with "l" as it requires his tongue to touch the top of his mouth.
I still have a long way to go in helping him.
Here's a reference to Caroline Bowen's website where she's written a useful article on speech intelligibility:
Bowen, C. (2006). Speech Intelligibility from 12 to 48 months.
Retrieved from www.speech-language-therapy.com/intelligibility.htm on 17/10/09.
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