Speech Pathology

Yesterday we took Sam to meet with a speech pathologist for evaluation. As mentioned in my previous post, Sam has delayed speech, though he seems to understand objects by names, can follow simple instructions, and has his own way of showing you what he wants. He just isn't verbalizing them.

It's difficult to sit in an evaluation and answer "no" to so many questions. Does he hum or sing? No. Does he point to thing he sees? No. Does he look at you and babble like he wants to tell you something? No. Does he pretend or make action sounds when he plays? Not really. (But he does bring me his shoes when I ask! He can take an object to Daddy if I ask him! He knows what shoes are and swing and outside!)

It saddens me that he is not developing normally at this age and I can't help but wonder if we have failed him by not teaching him properly or exposed to concepts or given him the individual attention he needs. I have never had the nagging fear that something is neurologically wrong with him. However, he spends a lot of time on his own, and is content to do so, but I am starting to think that maybe we haven't given him the stimulation he requires.

Our speech pathologist was wonderful. She didn't give a true diagnosis, but did say that across the board he is developing but hasn't hit all of the milestones for each category. She recommends that we begin weekly speech therapy sessions where he will receive individual therapy through play. She also recommended a federal program called Help Me Grow.

Next week we have an appointment with Development and Behavioral Pediatrics to assess a broader picture of potential reasons for the delay. Any therapy will begin after that evaluation. They may also require a hearing test for him. While he passed his newborn screening and we've never questioned his ability to hear, it's easy to check and possibly rule out.

In the meantime, you can be assured that Sam is getting all our extra attention! I realized, that being the second kid, I have always just lumped him in with Adam or let him play on his own. Recently I've started bathing him separately and using that time to sing songs and point out words. Bed time stories and diaper changes are now more opportunities for learning. Now that it's warm we are spending more time outside and interacting with the sights and textures of the outdoors. We are making a more conscious effort to stimulate and expose and identify and sing and interact.

We're praying that this work at home, combined with the therapy and other resources, will help flip the switch in him to want to speak.

Reds vs Rockies

We made our first trip of the season to Great American Ball Park for a Friday night baseball game, Reds vs the Rockies. It was Star Wars weekend ("May the Fourth" be with you), and the ball park was roaming with all the characters. (I have to admit, I was a little starstruck by R2D2.)

We saw R2D2, R5D2, C3PO, Luke, Chewbacca, stormtroopers, Anakin, and of course, Darth Vader.

Oh, and we saw a little Baseball, too...

With our own cast of characters...

Adam mostly just enjoys the food.  

While Sam enjoyed some snuggle time with Grandpa.

The Reds didn't bring home the win, but afterwards there were fireworks, all to Star Wars music.

Fun night!

Sam I Am, 18 Months

We took Sam to the doctor this morning for his 18 month check-up. We were a little nervous going in because we knew we'd have to have a hard talk about Sam's development. Sam is happy and active, understands and learns new concepts, lets us know what he wants, is social and interactive with other kids, and has strong physical and gross motor skills. He just doesn't say much.

Sam, actually, only says one word routinely: "Good". And, gosh, it's the cutest thing! He really emphasizes the "duh' at the end. One day he discovered these sounds and put them together, and to us, it sounded like 'Good'. We can ask him to say it, and he'll happily repeat it. It's the first word he says on command, and we love watching Adam ask him, "Sam, can you say 'Good'?" and he does. (Then Adam will say, "Mom, ask me if I can say 'Good'!) And we all cheer.  We ask him to say other things -- Mamma, Dadda, Car, Ball, etc., and often we just get "Good". But I love when I tell him 'Good Morning' and he replies, "Good!"

But that's all he says. By a year and a half, children should have a minimum of 8 words. Sure, he'll stumble across a Mamma or Dadda in his verbal ramblings (and he talks a lot), but doesn't use them to refer to us specifically. This is difficult for us because Adam was advanced for his age, so it's hard to make the comparison. Sam is adept at showing us what he needs by running to the door or the swing when he wants those, bringing us the remote control for the tv, reaching up to us to be held, or leading us to the refrigerator when he wants a drink.

I say he's just the Strong Silent Type.

But to rule out any further concerns and to help jump-start his verbal skills, we are making an appointment at the Children's Hospital to have him evaluated. It sounds like it will be a longer appointment where the specialists will observe his interactions with us and others, see how he plays, and get a better idea of his capabilities (versus a quick office visit). From there we will determine the next step. My gut tells me he's just a little behind, and I am all for aiding him through routine appointments with specialists and learning the techniques to help him at home. We had been harboring a fear that his bronchiolitis last year, where his oxygen intake was diminished for days, could have caused some long-term effects, and we were reassured that that is not the case.

So, aside from his these concerns (and we really have nothing to be overly concerned about at this point), Sam is a healthy, happy boy.

Weight: 24 lbs, 5 oz (55%)
Height: 33.5" (85%)
Head: 49 cm (89%)

He's long and lean (with a big head). And, oh, how I adore him! Here are a few things that he does at 18 months:

• Crawls up and down stairs now (loves sliding down backwards fast on his belly)
• Still gets a kick out of peek-a-boo
• Loves to mirror your actions
• RUNS everywhere
• Plays by himself well, particularly rolling and spinning his cups
• Gives kisses (our favorite!) and working on hugs
• Loves being outside and will run to the door whenever it is opened. (He can actually open the lever himself, so we must keep it locked!)
• Loves to watch cars go by (when we're outside he darts to the corner to better observe)
• Loves his swing
• Throws things -- food off his tray, balls down the stairs, toys when he's done with them
• Plays the Up/Down game (standing up, sitting down)
• Still takes 2 naps on most days but sometimes only 1. Heading towards dropping that first nap.
• Not a fan of baths, but it's getting better. We had been putting him in the bigger tub and deeper water with Adam. Lately I've been bathing him in the smaller tub with shallow water alone and he does much better sitting there.
• Enjoys pushing cars around, especially setting them up on a table and pushing them back and forth
• Completely on the sippy cup now. This boy was not a fan of most of the cup spouts and we had trouble switching from the bottle. We finally found the Nuk Active Cup and that made a difference.
• Wearing 18m to 2T clothes
• Loves to sit and flip pages in a board books, which I love, too
• Smiles and laughs when he looks at family pictures. (Hey, I know those people!)
• Knows his tongue, head and sometimes mouth and belly
• And, by the way, his eyes finally changed to brown. I miss the gray.

I must confess, part of me doesn't mind that he isn't developing quickly because that way he can stay my sweet little one a little longer. But it will be so adorable to start to hear him use words, tell us things, sing little songs and not be frustrated by an inability to communicate. 

I feel some guilt about not giving him the attention he deserves. With Adam I was home for all this time with him and working with him daily. With Sam, we are working full time and Sam is so content to play quietly on his own. Plus, our attention is divided with Adam, who at 4, is often more demanding of our focus. It may be time consider a daycare where he can be in an environment with more interaction and stimulation. I'm hoping the specialists can give us some activities and techniques to implement at home to get this boy talking. We are anxious to hear what he has to say!

Take Your Nephew to School Day

That's an official occasion on the calendar, right? Right up there with Take Your Child to Work Day. Whether official or not, Aunt Angie loves to show off her nephews wherever possible, and as an elementary school teacher, her classroom is a fun place to show him off and have him benefit from the experience, too. It's a win-win!

A couple weeks ago Adam stayed over at Aunt Angie's house so he could be ready to wake up early and drive to school with her. (He loved sleeping on Kyle's top bunk, way up high.) Doesn't he already look like a Kindergartener? He was so excited to go to school! (May that always be the case!)

First on the agenda was a bus evacuation drill. He was thrilled to get on the bus! And Angie said all the third graders loved helping him.

He spent much of the day in Ms Grieme's first grade room. They had library class where Adam read aloud to the other students, followed by reading groups.

I hear he held his own, though we need to work on writing, especially lower case letters. (Advice from a first grade teacher -- teach lower case letters first. It makes it much easier down the road.)

He spent a little time in Math class, too.

After lunch he had a little physical education with Aunt Angie as the teacher. We've been teaching Adam how to play baseball, so it was perfect that they were playing t-ball in class.

At the end of the day he got to tag along to a special animal presentation.

Notice those glassy eyes? This kid was pooped from such a full and interesting day! He fell asleep immediately in the car and slept for almost 2 hours when he got home.

Thanks, Angie (and Ms Grieme) for allowing Adam to tag along with you all day!