Sunday, April 28, 2013

Speech Delay: Pre-Diagnosis

This is a video of Bradley at Christmas time 2010. Bradley was about 2 years, 9 months. I have included a transcript at the bottom of this post. Watch the video first and see if you can understand what Bradley is saying. Then check out the transcript to see what I now know Bradley was saying. The audio volume is very weak, so you'll need to turn your volume up pretty loud and/or use headphones. If I can figure out how to edit the original movie to enhance the sound I'll re-post with improved sound quality.


"He's not autistic. He just has a speech delay." That's what I remember telling myself and others countless times prior to Bradley's PDD-NOS diagnosis at age 3.  At times I even had a hard time admitting Bradley had a speech delay. I was a talkative child... and I'm a talkative adult. I was an award winning speaker in high school- winning state medals in both cross-examination debate and informative extemporaneous speaking. As a psychology instructor, I speak for a living.  How could my child have a speech delay?  My mother-in-law told me that my husband had a speech delay as a child and didn't consistently use effective, understandable speech until he was two or three. This was comforting to me, but the longer the "speech delay" went on, the more I realized Bradley was falling behind his peers with his speech.

I remember Bradley saying "Momma" and "Dada" before he was one year old. He cooed (produced "aaahhh" and "ooohhh" sounds) as a baby within the average developmental time frame. I think he did a little babbling (vowel-consonant sounds like babababa), but now I realize it was not as much as my younger son babbled. After his first birthday Bradley wasn't adding many new words to his speaking vocabulary. I didn't worry at first, because I knew boys are sometimes slower in adding to their vocabulary than girls.  A few more months went by and at 17 months Bradley entered public daycare in August 2009.  At first Bradley didn't seem significantly behind his peers in the daycare class, but by Christmas time the daycare director suggested I allow an Early Childhood Intervention (ECI) diagnostician assess Bradley's speech.  It hurts to hear someone tell you they think your child is not developing appropriately... really hurts.  I know the suggestion for assessment was made because the daycare director cared for my child. I know that early intervention is the best treatment for just about any and EVERY physical and psychological concern.  Diagnosticians know the benefits of early intervention, but they don't know the hurt.

After an assessment with ECI, Bradley was recommended to participate in speech therapy treatment and began receiving services.  I don't remember the frequency of his initial speech therapy, but I think it was one 30 minute session per week.  Bradley's first speech therapist was a woman named Kori. She was very energetic, nice, and positive. Kori gave me a lot of hope and Bradley seemed to like her.  However, I didn't think I was learning how I could help Bradley.  I guess I was expecting to have a pragmatic treatment plan for me to follow.  Bradley participated in the ECI speech therapy, but I wasn't seeing significant improvement in his speech.  I don't know if my expectations of improvement were too high, but I grew rather impatient with the quality of speech therapy (specifically about the lack of resources and direction given to me as the parent).  While Bradley's two and a half year old class mates were now speaking in sentences and carrying on conversations with their parents, we were getting only 1-2 words at a time with lots of unintelligible talk. Bradley also had excessive saliva that would dribble down his mouth. We would notice this excessive saliva pretty consistently- almost on a daily basis. Meanwhile- speech therapy included blowing bubbles and playing with whistles, and I was growing impatient.

Video Transcript
Mom: Jingle Bells. Jingle Bells. Jingle all the way. Oh what fun it is to ride in a one horse open sleigh.
Bradley: Hey
Mom: Hey- What does Santa Claus say?
Bradley: Clan Saus say (Santa Claus say)
Mom: Ho ho ho
Bradley: Ho Ho. Chris (Ho Ho. Merry Christmas)
Mom: Ho Ho Ho.
Bradley: May mis (Merry Christmas)
Mom: M&Ms??? (at the time I thought he was saying M&Ms)
Bradley: M&Ms
Mom: Can you say Jingle Bells?
Bradley: Ho Ho. Tick a tick. Tick a tick. Tick a tick (Bradley would frequently say "tick a tick" or something along that lines rather than meaningful speech)
Mom: Sing Jingle Bells
Bradley: Tick a tick. Tick a tick. Tick AHH. Tick a tick! (I think he was trying to sing Jingle Bells)
Mom: Jingle Bells. Jingle Bells. Somebody's here. Say, "Who is it?"
Bradley: (whispers) Who's it
Mom: Who is it?
Bradley: Dada
Mom: You think that's Daddy? Let's see. Who is it?
Dad walks in...

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