Saturday, March 29, 2014

Speech Update

"Righty do it!"

We've now had three speech therapy sessions since our frightening speech evaluation and things are going really well.  Allie loves the therapist and has been really excited about going to visit her.  She even asked if she could bring the therapist to school to meet her friends.

Each of the sessions starts with Allie and the therapist sitting at a little table and saying words and sentences into a mirror.  When Allie gets the sounds right, she gets to take a turn playing a matching game with paper ice cream scoops.  She thinks it is awesome.  The second half of the session is spent reading books and working on verb conjugation and pronouns, but in a fun way.  All the while, I sit silently on the other side of the room and read email on my phone.

During our session yesterday, the therapist turned to me and said "I'm not really sure what to do about Allie's pronunciation.  She scored incorrectly on the evaluation but when we work on the sounds, she gets them all right."  She then went on to say that she thinks Allie's main issue is that she tries to get all of her sentence out at the same time and that she needs to slow down and make sure that she takes time for each word.  She's working on it and has been making noticeable gains; I'm really happy with it.

In other news, I'm speaking at the American Occupation Therapy Association's annual conference this Wednesday to talk about Allie's experience with constraint therapy.  I'll be part of a panel talking about parental impacts of the intensive therapy, so we shall see how it goes.  One of her OT's emailed me asking if I would participate and she said "I can't tell you how many families have come and said... oh yeah I read about your program or CIMT on Allie's blog!!"  It totally made my day.

Wednesday, March 12, 2014

Ice Skating and Speech Evaluation Results

Allie's class had a field trip to an ice rink today and she got to try ice skating for the first time.  Jonathan chaperoned the trip and, even though she was thrilled with her new helmet, elbow pads, and knee pads, she did not actually like the skating part.  However, she did love the goldfish cracker snack that they got afterward, which inspired her huge smile in the photo above.

We got the results from her speech evaluation, and they were much more negative than Jonathan, Allie's county case manager/PT, her county speech therapist, and I expected.  Here are a breakdown of her raw scores (all numbers are percentile scores, 100 being the best):

Overall Language Testing: 6 ("moderately delayed")
Sentence Structure: 25
Word Structure: 9
Expressive Vocabulary: 2

Receptive Language: 39 ("age appropriate")
Sentence Structure: 25
Concepts and Following Directions: 37
Basic Concepts: 63

Expressive Language: 4 ("moderately delayed")
Word Structure: 9
Expressive Vocabulary: 2
Recalling Sentences: 9

Language Content: 23 ("low average")
Expressive Vocabulary: 2
Concepts and Following Directions: 37
Basic Concepts: 63

Language Structure: 9 ("mild deficits")
Sentence Structure: 25
Word Structure: 9
Recalling Sentences: 9

Pragmatics (using language for different purposes): age appropriate

Articulation/Phonological Testing
Allie fell between two scoring brackets, 31-36 months and 37-42 months.  The percentile scores are shown for both age brackets.  
Oral Movement: 15 (31-36 months); 8 (37-42 months)
Simple: 8 (31-36 months); 3 (37-42 months)
Complex: 14 (31-36 months); 4 (37-42 months)
Oral motor skills: "low average to moderate deficits"
Voice/Fluency: "within functional limits for her age"

Clinical impression: "Allison is presenting with a moderate expressive language delay and moderate articulation delay."

After I received the report, I sent it to Allie's PT/county case manger and also her county speech therapist.  Her case manger said that she just didn't understand how Allie could score so low and that she's been talking with the speech therapist about potentially discharging Allie because she's doing so well.  She also relayed that the speech therapist thought the scores were "harsh" but that she's looking into it more closely and will follow up with me soon.

Allie will begin private speech therapy this Friday.

Monday, March 3, 2014

Getting ready for baby

We've started getting the house ready for the new baby (who is still 4 months away) and Allie is really excited about it.  Our plan is to have the baby stay in our room until he's sleeping reasonably and then he and Allie are going to be roommates.  We shall see how well this plan works out.

To try to spread out the transition, we moved the changing table upstairs a couple weeks ago and the crib into her room over the weekend.  I think the new stuff has really made a difference in how real the baby seems.  She keeps talking about how her brother is going to sleep in "her" crib and how she is going to teach him how to do lots of cool things, like jumping and eating macaroni and cheese. 

My growing belly, however, seems to be a source of concern for her.  The other day she asked: 

"Mommy...  Your belly bigger?  Butt bigger?  
Baby still in there?  Tummy hurting?  Your back hurt?  
My back hurts... I have a baby in there"

She has also been super affectionate with me lately.  She keeps coming up for a hug just to tell me that she loves me.  I am thoroughly enjoying all of it, but I hope it doesn't mean the shock of sharing the attention will be even harder.

We had another snow day today and, since Jonathan is out of town for the week, we had a fun day of baking and playing just the two of us.  I painted her toenails for the first time and she LOVES it.  We then went over to our friend's house and she was so excited to show off her "pretty toes" that she went around shoe and sock-less in case anyone wanted to admire them.  We also made bread and cookies, stomped around the snow, and put together a 40-piece jigsaw puzzle three times.  By the end of the day, she was so punchy that she was hilariously laughing at almost anything.  It was a cute day.