Thursday, June 10, 2010

Speech Therapy - 10 June 2010

Overall, the therapist was happy with his progress. In the past few months, I haven’t been closely monitoring his progress in speech (or other areas!) cos I’ve been distracted by other matters (settling into kindy, changing of helpers, his illnesses). But the therapist hadn’t seen my son for about 3 months, so she noticed a few things.


She heard him speak in a string of 4 words in a single breath. Actually, at home he can speak in a string of 7 or more words at a go, but it’s just that he doesn’t say much to outsiders.

She noticed that he is more stable on his feet. She noticed it as we were walking to the therapy room. I think she also noticed it when my son had to go to toilet 3 times during the session!

She noticed that he no longer has a wet/gurgly voice, which is good. She had wondered whether that wet voice would eventually disappear.

She noticed that his fine motor skills had improved. One of the activities was piecing together a number train jigsaw puzzle (he had to use his voice to ask for various pieces that he wants). I was a bit surprised that he was getting better at joining pieces of a puzzle. A night or two ago, I brought out a chunky large jigsaw puzzle and left him to it cos I had to cook dinner. When I got back to check on him, he had pieced 8 pieces together all by himself! That was a first!

She was also impressed that his reading skill has progressed so much in the 3 months since we last met. I was not surprised in this aspect because lately, he tries to decipher longer words (4 or 5 letter words) by his own, if he sees a leaflet lying around or on his milk tin etc. But I was surprised that instead of looking at the picture in the book to answer the therapist’s question, he tried to decipher the written word. It was a big picture book, on the A-Z of animals (e.g. “A is for anteater”). There were a lot of “I dunno” coming from him even though he knew the picture of a giraffe, a rhino etc.

My husband too noticed that lately, he says “I dunno” a lot even though it is something we know he knows. I reckon he says it cos he already knows it (as in “Hai ya, why are you asking me that la?! So boring”). Other times, he says it when he really doesn’t know.

The first thing she said to me when we met today was that he looks good. So when it came to the end of the session where both of us discuss about him, I asked whether it’s the haircut, or that he lost baby fat from his face (he lost 2kg during the H1N1 episode), or that he’s taller. She agreed that he looks matured, that he his taller (no longer needs a foot stool to stabilise him when he’s sat on that Ikea chair), that he looks more toned (fingers not chubby).

She thinks that shedding that weight might have been a good thing, and aided him in moving around better. She commented that he needs to work on strengthening his muscles. I shared that he’s doing more physio in the Neurosuit during the school holidays, and before his physiotherapist goes back to do his postgrad degree. She thinks that improvements to speech and fine motor (higher level skills) will come, when there are improvements in gross motor, balance (lower level skills) etc.

I raised my concern that he started to stutter when it comes to “st” words (stop, star, stair, understand). She explained that in his case of dysarthria, it’s not really stutter, but because it’s hard for him to plan his muscles to blend two consonants “s” and “t” with a vowel immediately after the consonant. It’ll resolve itself in due time cos he’s getting in the gross motor work. In the meantime, she suggested that I encourage him to purposefully lengthen the vowel (e.g. st-aaaaaaaaaa-r).

I was also concerned that he mispronounces the “L” by using “n” instead. She heard him say “peh-nee-sss” when it was “please”. She said it is common to use “n” for “l”. She asked if it happens with words that begin with “L” also. I said I didn’t think so but when I got home, I heard him say “nook” instead of “look” which is a common mispronunciation for him.

She isn’t too concerned about the “ck” sound cos she did hear him say it correctly at times, and at times not. She explained that so long as he can sometimes say it correctly, it means that he is able to, and we just need to remind him. She’d be worried if he couldn’t say it correctly at all.

As for the “r” sound, she says it’s ok for now as there’s a lot of other things that we need to work on. Hmm, I didn’t notice he has a problem with “r” but now that she mentioned it, it would naturally be tricky for him to curl his tongue to make the “r” sound. Perhaps I’m too exposed to Manglish to have picked it up!

We spoke about schools too. She was very helpful when I emailed her for advice a few months ago, on schools that take in special needs kids. She too thinks that Australian Int’l School is very open to taking in special needs kids. She pointed out that a private (not int’l) school in Subang takes in kids that need shadow aides. I might check it out later.

We next meet in Sept which is good news!

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