Tuesday, September 3, 2013

Overcoming Behavior Issues: Speech Delay

Patrick began babbling and saying "dadada," "mamama" and the usual cooing, around the same time other babies his age started. Before our kids were born, his dad and I decided that I would teach our kids Spanish and he would teach them English, and as Patrick was growing, I started to teach him a few words in Spanish. I had read somewhere that kids from bilingual homes usually are a little late on talking, so I guess I kind of expected all along that he would be a late talker. Late talker as in talking a few months after the average child.

Patrick, as of today, has the vocal skills of an average 18-20 month old baby. Patrick is 3 months short of being 3 years old. That's too "late" for what I had anticipated. While talking comes and develops naturally for most children, for other children, like Patrick, it doesn't.

I think it was until he was a little over one and a half years old, that I realized that his severe speech delay was looking like a real possibility. By then, we were all aware of his Oculomotor Apraxia and hypotonia, and the more I learned about his developmental delays, the more I realized "speech delay" was part of the bundle. When Patrick was 2 years old, his vocabulary was limited to mommy, daddy, babba (bottle), and to the sign language for the word "more." In the video below, Patrick is shy of 2 years of age.


As Patrick was growing, his frustration for his inability to talk was growing as well. The older he was getting, the more he was understanding, questioning, doing, and desiring. But he couldn't express any of that. I can only imagine how helpless one can feel in a situation like that. This was the reason number one to his screaming. You know how babies cry when are cold, scared, hungry, sleepy, thirsty, uncomfortable...? Well, Patrick, as the toddler he was, had turned that cry for a scream. He was tired? Scream. He was thirsty? Scream. He wanted to play? Scream. He didn't want something? Scream. He wanted something? Scream. Scream. Scream. Scream. The constant screaming would make me upset, which would then make him even more upset, and it would turn into a vicious circle from which I couldn't figure out how to get us out.

About five months ago, Patrick's vocabulary was limited to 6-8 word approximations, which made his therapists suggest to add more words in sign language to ease that frustration. So Patrick learned the sign language for more, I'm done/I don't want, and please. Ball. Ball. Ball. Ball. Ball. Ball... I had to repeat it dozens of times a day, while we were playing with the ball, until one day, there was finally a "ba." And that's what we had to do with many other words. Today, Patrick has about 40-50 words, most of them being mere approximations (nani = night night, tide = outside or inside, memi = Mary, nana = grandma or banana, didi = Jesus, na = Sam, pun = spoon, bapi = Patrick, pi = please...)


We had to teach him to point at things, too, to make it easier for us to know what he was talking about. Thankfully, he had finally learned to walk, so we taught him to hold our hands and take us to wherever was what he wanted (if he wanted to drink something, he would take us to the kitchen; if he wanted to go out, he would take us to the door, for example). He moved from twice a month therapies, to three times a month. Also, I attribute the improvement on his speech to the Omega 3s and the changes made in his nutrition that I talked about a few weeks ago.

Many children these days are late talkers, and I believe there shouldn't be any pressure on making them talk when they are not ready. However, Patrick was ready, he just didn't know how to. How do I know he was ready? Simple: It was affecting his daily life.  His very own self was ready to communicate, but his mouth couldn't do it, making him upset and turning aggressive towards others. I can tell that when we let him know that we understand what he is trying to tell us, it is easier for him to accept a "not right now" if it is something that he wants and we can't provide at the moment. He is more involved in making decisions of what he wants to eat or what he wants to do, letting us know when he has had enough of something... and all these moments go by without meltdowns. The screaming, throwing and hitting are very rare these days, and I'm so happy to have my happy Patrick again.

Speech (or lack of) wasn't only affecting his mood and behavior, but was affecting his learning progress as well. Let me share a fond memory from my Epistemology course when I was in college: We were asked to read a children's book called Pixie, by Matthew Lipman. The book is about a girl who, among other things, asks too many questions.  The funny thing is, that after the class read the book, I was dubbed Pixie (and I was called that for the rest of my college years!) because they said I asked way too many questions. Ha! Of all the numerous books I read during my school years, I think is a marvelous coincidence that this particular one is to this day stuck in my head, perhaps thanks to the nickname I got. But whatever the reason, the fact is that Patrick's new difficult behavior was making me think a lot about Pixie.

Pixie inquires into the connection between language and things in the world, which give meanings to everything in our daily experiences. In other words, Pixie is meant to show us how a child makes sense of the world as she learns new words. Children like Patrick, who find it difficult to express themselves verbally, will have problems learning things because of their inability to refer to them. Whether is with word approximations, sounds, sign language or pointing at objects, we taught Patrick how to refer to things (objects, emotions, people...) and ever since, he seems to be learning a great deal of things at a faster speed as he ever did.

Everyone keeps telling us that he will talk more once he starts school. I do believe this because the very first words Patrick said were during a trip we made to Mexico. My family is very talkative, and there are always a lot of children around, so there was non-stop talking all day long when we were down there, which I think got Patrick motivated. He is still unable to put two words together, however, I think it's emerging now. Couple weeks ago, he spent a few days with his very bright and talkative friend Jackie (happy 3rd Birthday, Jacqueline!) and ever since that visit, he has been making an effort to put two words together: "acusacu bobo" which means: __________ Lobo (something about our dog). Couple days ago I brought an Elmo toy into the room where he was playing, and as he saw me he said "momo, si" (Elmo, sit), as he was pointing at the floor where he was sitting.

Jackie and Patrick playing baseball
Jackie and Patrick watching the Gorilla at the Zoo

Awhile back I was anxiously awaiting for the day when I would finally hear from Patrick "I love you, mommy." I'm not anymore. I know he loves me. What I don't know is what's his favorite animal, what he wants for dinner tonight, what he wants to be when he grows, what makes him sad the most, what he thinks of his little brother. When the day comes that he talks, God knows I will let my old "Pixie" get the best of me, and will ask him a universe of questions, because I know there is so much in that brain and in that heart of my little boy, that I just can't wait to know all about him!