Speech progress

My son is 3 and a half years old. He gets speech therapy twice a week (30min sessions) from the public school. He is also seeing a private speech therapist weekly (30min sessions).

It is great to be us these days! We see so much progress with speech and communication, it is exciting and overwhelming (in a really good way)! So, from the beginning.

We starting using sign language with my son when he was a couple of months old. The recommendation seems to be to start slow with only a few signs, but that doesn't fit my personality at all. So, as soon as we found out that our son had DS, I bought a couple of sign language books and started learning. I also took a ASL class, but that was for myself (my obsession to learning everything there is about a subject), completely  unnecessary for teaching your kid basic sign language. We immersed our son in sign language, that is we used all the signs we knew when talking to him. As soon as he was able to sit, we let him watch Signing time videos. Those were a great investment - this is how the whole family learned sign language, including grandparents! For a while nothing happened, we got no signs back and it was frustrating. The temptation to stop was there, but it helped that we were seeing older children using sign language and benefiting from it. My son started signing around 1 year old. I don't remember exactly, but he started with the usual signs (more, milk, eat, mama, daddy). He then progressed in leaps and bound. By 2, he was having a vocabulary of more than 100 signs and was correcting his EI speech therapist ("gorilla, not monkey"). Spoken words were hard to come.

In terms of therapy, he received EI speech therapy from 1 year old. We started once a month. This was ridiculously little, but we had to fight hard to get speech therapy, so we decided to take what was offered. This was changed to twice monthly when he was 18 months (we are very persistent people), and to weekly sessions when he was 24 months old. At 24 months we added weekly private speech therapy. I just want to say that we loved our EI team. All therapists were great and it really felt like a collaboration. In general, I appreciate the EI model of family centered therapy. It worked very well for us. We especially loved and appreciated the EI team in retrospect when we moved to the public school system. But this is another story!

"No". One of the first spoken words we heard. And then we kept on hearing it! Still a favorite, although these days is slowly (but surely) replaced by "mine!!!". Speech came slowly. At 3, my son was using about 50 spoken words. He started using two words phrases - combining signs and speech. His receptive language was much better than his expressive language and continues to be so. By the way, he was evaluated at 3 years old, before transitioning to the public school system and scored at 21 months in all areas of development.

Anyway, now at 44 months, he is doing great. He is using more and more 3 words phrases, although most of the communication is in one or two words phrases. It is mostly speech, but he will use signs for clarification (or emphasis!). He is making a lot of verbal requests. He is doing some commenting. He just started to respond to where, what and who questions. Speech intelligibility seems OK for where he is developmentally, but it is too soon to tell.

Last week I was reading the speech information page from the Down Syndrome Ed website. I go there often for ideas on what to do next. There were some nice statistics (see their tables) about total words (spoken and understood) per age categories. So, two days ago my husband and I spent the evening writing down all the words we heard my son say and then those words we know he understands. We only counted spoken words, so the total (which is pretty good as it is) is an underestimation. Spoken words: 171 (for his age group mean is 116.7, stdev 102.9, range 1-399). Words he understands: 320 (for his age group mean is 233.4, stdev 93, range 69-424). Not bad, I think. That was a good evening!

An issue we are having with speech and communication is that, while my son is talking a lot at home, he doesn't do the same at school. We hope he will be able to generalize the skill soon, but it is currently hard for him to interact with his peers. His mode of approaching his friends is by touching them and often times this is perceived as aggression. His teachers and therapists are working on ways to extend this interaction from physical gestures to speech or sign.

In terms of resources, I've been trying to use Libby Kumin's book, Early Communication Skills for Children With Down Syndrome: A Guide for Parents and Professionals. As with the fine motor skills book, I've found this book to be more for professionals than for parents.While I don't find if useful for practical advice, I use it to get questions for our speech therapists and to learn some terminology.

The book that I love best for speech and communication advice, is Play to talk: A practical guide to help your late-talking child join the conversation by James MacDonald and Pam Stoika. A really great title too! I've read the book twice (and I'm getting ready to do it again). My husband read the book. We tried hard to implement the ideas. It sounds simple, but it is very hard, especially for a parent with an agenda - a teaching agenda. Basic idea: you want the make your child a partner in communication. So, the most important advice, don't hijack the conversation. Research shows that parents (especially moms) of children with special needs talk too much. We need to match our children, giving just as much as receiving. The goal is to keep them in the loop for as long as possible. This applies to play interaction, non-verbal communication and finally speech. Once a solid connection and interaction is established, one can try moving to the next level - the child is using 2-word phrases, you respond with 3-word phrases. If the kid starts losing interest in interaction, go back to matching. He is not ready to move to the next step yet. The book is filled with good, specific, advice. A great read!

Baby babble DVDs. There are three DVDs available so far, and we've used the first two in the series. The DVDs are developed by two speech language pathologists. I was surprised to see that they indeed encourage sound production. Although my son was used to the visual and audio sophistication of  Signing time, he accepted the Baby babble videos and responded to them. This is not a given - he rejected many other videos (Preschool Prep, Blue's Clues, First Word Stories). We tried a lot of them, we have a good public library.