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speech therapy

Matan said “snow”

Broke his arm at gan this week, awwww, baby

The good news is that Matan’s speech is improving, but not quickly enough. He was evaluated to determine the best pre-school special education program he will need next year. In addition to speech and emotional development, he also needs help with fine motor skills and general development. While we believe he was in a “better” orphanage, but he was still one of 12 children who lived in a very small room with almost no stimulation except their interactions with each other. Even today when he is in a new space he likes to go around and touch everything in the room.

During the two years that have flown by since we adopted him he’s been in speech and occupational therapy on a regular basis. But apparently this hasn’t been enough. We don’t have a prognosis of how he’s expected to do next year, with the full support of a special education staff, but I’m sure the small group of only 10 children, and rigorous occupational and speech therapies on site will help him vastly improve on his current delays. At least I hope so.

He continues to be a charming and adorable little boy. Everyone loves him, and he’s friendly and generous. But he can play with his trucks and tractors all day, and dislikes being challenged by other activities. We are so lucky that he has Karen. She plays with him, talks to him, and in general acts as a guide. He adores her and I can’t imagine how much more delayed he would have been without a big sister.

Yes, after drafting the above post, I got a call from Matan’s pre-school that he appears to have injured his arm and should see a doctor right away. Turned out to be a double fracture above the wrist. Poor kid didn’t understand why I wouldn’t remove his cast at night so he could go to sleep. He’s getting used to it now.

Blessed breathing space, kind of

Kiftzuba This week the kids seem to be on an even keel. Almost a sense of normalcy even with all the work we’re doing to help K, and with her stuff at schhool going on in the background. Both kids are in the process of getting all their evaluations so we know what direction to aim for in the coming school year.

Matan is continuing with psychological and speech evaluations to present to the municipality so he can get into speech school next year. He just restarted his speech therapy after a short break. He’s really come a long way but the benefits of the speech school go beyond just speech, and should help him close the gaps in his overall understanding of the world so he’s ready to rejoin his peers in kindergarten or first grade.

We’re now halfway thru the process of finally getting a full psych work-up on K to rule out any serious issues. The school wants it, and frankly, so do we. We need some advice “from above” about whether her therapy is doing enough good or whether we should change focus somewhat. Maybe we need to direct more attention, as so many have advised, to sensory integration treatment along with her existing therapy to work on emotional issues. K’s really an excellent student, and takes her homework responsibilities seriously. Her report card was excellent, except for behavior. We have no room to complain at all. That’s why it’s so hard for all the “professionals”, from school to private therapists, to understand why her behavior is so extreme. She’s going to incredible lengths to moderate her behavior during class time, but still loses it during “down” times like breaks and those small spaces before class starts. She also has few, if any, behavioral issues during the after school sports she loves. The coaches are tough and gruff women. K clearly responds well to a caring, but very structured environment. School is often neither.

Yakking away

While there may seem to have been much focus on Karen this month, Matan too has made great strides in language and play while we navigate the complex municipal procedures to have Matan in a speech school next year. The Center for Childhood Development has helped guide us through the circuitous process, but even with their backing, the municipality is a law unto themselves. We were supposed to have a review board that decides whether to admit Matan by end of February, but due to “internal problems at the municipality”, this is now pushed to April, at which time I’m sure it will be pushed again for Passover.

Matan’s vocabulary is improving almost daily, but he still shies away from using verbs. Most of the work I do with him focuses on using verbs and helping him become more independent, something he is also eager to increase. He’s unambiguous about stating what he wants and doesn’t want, which is great in terms of communication, and development. He enjoys playing with peers, but prefers being with me over most anything else. He’s become much more strident in his “NO”, and bawls when he doesn’t get his way. This is frustrating for me, but I understand how important it is for him to find his sense of self in this way.

The most beautiful part of having both children is seeing the two of them playing together, watching over each other and falling asleep together. True, they do fight, but it’s so limited compared to the amount of time they are happy together. Karen really loves feeling like she takes care of him. If he cries because I told him “no” to something, she will immediately come to his defense. She even makes breakfast (cereal and milk) for him some mornings. She’s learned that if she wants to eat cereal in peace and quiet, then she’ll have to make him a small bowl too.

Speech Therapy #FAIL

I’ve noticed that a lot of people arrive at this blog after searching for “speech therapy”, so I guess it’s time to update with M’s situation. He’s had speech and occupational therapy for over a year, and still has a lot of trouble expressing himself verbally.

Experts believe that children adopted as toddlers have an emotional age that begins as if born at adoption. One game I play is to project that since this is the guideline for emotional development then it can also apply to speech. If that were the case, then M is really only just under 2 years old, not his biological 3.6. His speech is on target for a 2 year old boy, but no where near where it should be for M, who will soon be 4.

I had considered getting a private speech therapist who could work with him more than the once a week we get from our provider. We’ve consulted with his whole team at the Machon Lehitpatchut HaYeled” (Child Development Center). The team includes a speech therapist, occupational therapist and developmental physician. They’ve recommended that he attend a speech school next year instead of the regular municipal pre-school. The speech school is also run by the municipality, but instead of having some 35 students to a class, there are only 10, and the children spend much of their time with different therapies aimed at improving their verbal and emotional skills. Matan doesn’t really have any emotional issues so far as we know, but the lack of speech itself at this age causes increasing levels of frustration.

F-ck! locked myself out of the apartment, without a cell phone and without car keys and I’ve got to pick up the kids in 15 minutes. Oh, and it’s pouring. Ever so grateful to our dear neigbors who let me use their cell phone, picked my kids up with theirs and took us back to their apartment until DH could get home to let us in with his key.

More about Matan, later.

If it’s not one child, it’s the other

Now that Karen seems fairly well squared away for the school year, my worries move to Matan. He’s just past 3.5 yo. and still has serious speech issues. I came face to face with his problem on Yom Kippur at the playground. He was playing with another child who was smaller, but had excellent speech. When I asked, his mother told me he was 2 yo. A year and a half younger than Matan, and with much better speech.

Speech worries me on two counts. First, the inability to communicate causes him frustrations. He is usually a very easygoing little boy, but he’s been acting out a lot lately and I think much of it is due to frustration over his inability to express himself.

The second concern is that speech is just a symptom of a wider issue. Although he socializes well with children of his age, and even older, he is very passive when it comes to something that he needs to make any effort towards. Maybe it’s wrong to say about a toddler, but he seems like a lazy thinker. Either that, or else he has difficulty holding a train of thought.

On the other hand, I remind myself that I have read many sources that claim that children adopted as toddlers only begin their emotional development once they are with their forever family. This went a long way in explaining why Karen, who in many ways is developed beyond her age, still often has the emotional reactions of a 4 yo.

When we adopted Matan, he seemed like an infant in many ways. He had absolutely NO speech, only grunts. He could barely walk more than a few steps. He clearly wanted to be held and cuddled like a baby and he ate only soft or blended foods. For me, this indicates that maybe his speech, like emotional development, should be measured from the time of adoption, and not in chronological age. Matan has been with us for less than 2 years. His speech is about normal for a 2 yo boy, so if speech is similar to emotional development, then he’s fairly on target. I get these thoughts to quiet my fears for him. But it doesn’t mean I don’t take action.

Sometimes I think he almost wants to remain a baby in many ways. Lately he meows like a cat. A happy meow indicates he’s satisfied, and angry one has me asking him what’s wrong. Talking like a cat may be a creative way for him to maintain a baby’s repertoire of happy/sad sounds. He also often cleaves to me like an infant, so I know he still needs a the emotional security he never had as a baby. Language is probably mixed in with all the emotional stuff he’s dealing with in his barely-verbal brain.

He’s been in speech therapy for almost a year, and I don’t think it’s doing enough for him. I am considering checking out some private speech therapy options which may include a more intensive treatment plan or just a speech therapist who clicks better with Matan. He doesn’t have the greatest chemistry with his current speech therapist who is treating him via our health insurance and as part of the Child Development Center where he’s also gotten excellent occupational therapy and developmental diagnosis.

At least now Matan wants to speak. A year ago, he showed zero interest in even trying.

About time for a post

Has it really been almost two weeks without a new post? Ouch.
Work is kicking my ass, and so are my two lovelies. Matan has been home sick for two days with a high fever, but luckily, no other major symptoms. He’s now saying new words all the time, but we have trouble understanding him. He’s been getting in more fights at pre-school, so I think his lack of language is frustrating him a bit. He’s still very social and plays with many different children. But he’s also one of the least verbal in his class, so we’ve decided to keep him at the same school for another year instead of registering him for municipal pre-school.

Karen began municipal pre-school at his age. She was more verbal than Matan, but still had a very hard time and suffered a lot of frustration because her language skills were significantly behind those of the girls in her class. Matan has more verbal delays than she did, and I want to keep him in a “younger” environment. By staying at his current school, he’ll be with children born in 2007, like him, but he’ll be the oldest, with his April birthday.

Municipal pre-school has several problems for us. First, he’ll have to be completely potty trained. He’s doing well, and I’m sure by September he will only be wearing night diapers, but we were advised by his occupational therapist not to push him so I allow him to choose whether he wants underwear or a diaper at home and when we’re outside playing on the lawn or at the nearby playground. When we ride in the car, or visit other people, I usually have him in diapers. The second problem with municipal schools is that there is no nap time. Matan still really needs a brief nap. And finally, many of the kindergartens mix two age groups in one class. Karen spent her first two years with half a class a year older than her, and this year she has half a class which is a year younger than her. I certainly don’t want him to be in a class where half the children are a year older than him.

Matan says, “iPad”!

The past few weeks have been action packed. Among other things, Matan has finally started really speaking. Not just Abba, Ima (Daddy, Mommy), but real words! He’s still hard to understand much of the time, but he’s actually interested in trying to repeat sounds and words after me. In the past, he showed absolutely no interest in even trying.

I don’t know if we can claim it’s due exclusively to our work with the iPad, after all, he has also been going to speech therapy for months. But it can’t be denied he’s finally really begun to speak, and it’s after he began using some of the free iPad talking animal games like “Talking Tom”. His word repertoire has grown so much that I can’t list all the words he now says, but one word he says very clearly, is of course, iPad :-)

Ready for speech therapy?

Since first posting about using our iPad to help Matan with speech therapy, this blog has been inundated with readers searching for different variations of “iPad” and “speech therapy”. It appears I’m not the only one interested in using this tool that’s so much fun for the kids.

I’m no expert, but I can affirm that since we began playing with the iPad application characters that repeat what you say to them, Matan has been adding vocabulary at the rate of almost one new word a day. It may not sound impressive to some, but from a child who did little more than grunt and say “na, na” for the first year, it is a huge improvement.

Of course, part of his interest in the iPad game is based on his readiness to speak. Earlier in the year, when we were working intensively with our occupational therapist, she advised that he was not yet really ready to begin speaking. His level of play was at a very infantile stage. But with her help and the wonderful caretakers at his pre-school, his play has evolved into something much more sophisticated than the passive wheel spinning, swing set riding and button-pushing-for-music that he thought was the end-all of fun when we first brought him home.

It was especially disconcerting to see him sit and spin wheels, whether on cars, stroller, or anything else for as long as he was left to do so. We put a lot of effort into working with him on less passive play, and today, while he still enjoys those things, especially when he’s tired, his play, overall, is a lot more active.

When we first met him, he was a 20 month old child with the development level of a 6-9 month old. Today he is still delayed, but much less so. We are hoping to continue closing the gap. He’s no where near the level that our daughter was at his age, but he’s made huge improvements in year+ that he’s been with us.

iPad for speech therapy

My iPad has become the fav device of both children. Karen loves to play games and puzzles on it, and Matan likes the talking kitty cat “Talking Tom” application. This talking app seems to offer better speech therapy than any of the tips our speech therapist has recommended. Matan loves petting the cat and hearing it purr, but his favorite is to screech at it just to hear it playback what he said. Luckily, the yelling is only for venting during more than 10 minutes of “iPad therapy”. I sit with him and clearly enunciate some of the words he already knows, and a few that he should be working on. The cat repeats after me, and then I try prompting Matan. Although we haven’t significant speech improvements yet, he’s still fairly new to the application and it already maintains his interest and has him repeating sounds, something he didn’t enjoy doing before.

For Karen, the puzzles are great for brain development, and she absolutely loves playing all kinds of games and puzzles that DH downloads for her.

The iPad that DH lovingly bought me for my last birthday is almost exclusively used by the children at this point. I hope DH doesn’t run out to buy the new iPad. We have enough gadgets and I really want to invest in a bigger apartment……

25th percentile!

In just over a year, Matan has jumped from being under the bell curve to 25th percentile in height, weight and circumference. He’s also showing significant improvement in both gross and fine motor skills, and age appropriate play. But we’re stuck with speech. The speech therapist is now working with him every week, but I sense a lack of chemistry between her and Matan. I’ve asked to be transferred…

Yesterday we had our appointment with the developmental pediatrician at the clinic for child development. That is where Matan gets his occupational and speech therapies. We were originally referred there because when we first brought him home, his muscles were weak and he could barely walk a few steps before tiring and reverting to a crawl. Amazingly, after only a few visits to the physical therapist, mostly to train me, he graduated and no longer required phys. therapy. But since we were already in the system, they did a full work up which led us to the occupational and speech therapists.

I’ll know more once we get the full physician’s report. She said it was hard to make a determination since he was uncooperative with her during our 1.5 hour appointment so she’ll be relying on a report that his pre-school is submitting next week.