Friday, January 29, 2010

2-Year Old Communication Frustration

I dare say that most if not all parents have some level of communication frustration with their 2-year old. The level of frustration is elevated when the toddler is speech-delayed. Matthew is 2 years old and is speech-delayed. It's common among kids with Down syndrome. I recently learned that the "typical" toddler takes off with speech and language between the ages 2 and 4 while speech for a child with Down syndrome takes off between ages 4 and 6.

Sign language has definitely been a good tool for us. It is our bridge to talking and allows Matthew to communicate with us since his speech has not developed yet. However, there are a few words that Matthew has no signs for. What do we do? I can teach him more signs. It's easy enough to look up signs on sites such as Signing Savvy. In the meantime however, we usually get into a guessing game. I try to guess what Matthew is trying to communicate. When I guess correctly, he'll giggle and smile. When I'm wrong, he'll shake his head "no" and/ or grunt.

Matthew knows at least 30 sign words but his vocabulary is growing and I have not taught him the sign for every word he knows. His babbling is emerging and he can make some consonant sounds like da, pa, t, sss, and ba. He said ba-ba a few times before for "bubbles" but it hasn't been consistent so we keep working at it. His latest speech-related progress is that he's vocalizing the consonant sound in some words that he is familiar with. For example, he'll say t for "cat" and "eat". And he'll say sss for "baby signing time" or "stairs".

Understanding More Than He Can Verbally Express
We ran into a problem recently and I'm sure this won't be the last time this will happen. He came to me and said "sss" with his hands positioned as if signing "baby". So naturally, I guessed, "Do you want to watch your Baby Signing Time video?" To my surprise, he shook his head "no". I tried a few other words like "stairs", "puzzle", "slide", "kiss", "eat", "music", "ball", "crackers", "cereal", (note that he can clearly sign eat, music, ball, crackers, and cereal but I guessed those words anyway) and a few other possible activities he likes.

He shook his head "no" and grunted to everything and was visibly getting frustrated and upset that I wasn't understanding him. I felt helpless not being able to understand him. Then out of desperation, I said, "Bubbles. Do you want to play with bubbles?" He finally giggled and smiled - meaning "yes!" How he meant "bubbles" out of "sss" is beyond me but I was glad we got over that hurdle.

This brings to mind something I've heard and read: "Children with Down syndrome usually understand more than they can express through talking." How very true in our case!

Verbal Apraxia
He knew what he was trying to say. He was trying very hard to tell me what he wanted. The problem was that his thought didn't translate into the speech that we readily know and understand. So maybe in his mind he was saying "ba-ba" but instead he was verbalizing "sss". I'm guessing this is an indication of verbal apraxia.

Childhood verbal apraxia affects the motor planning or programming of speech sounds which basically means (and correct me if I'm wrong) an inability for the brain to signal the right mouth muscles to move in order to make the correct sound for the word in mind. It doesn't mean he will never learn to talk. It just means he will need to learn to make the sounds individually before combining sounds.

His speech therapist thinks that Matthew may have verbal apraxia but he was probably too young to be diagnosed. Whether he has verbal apraxia or not, we've agreed to just approach his speech therapy sessions with that in mind. So far, we've been emphasizing certain strong consonant sounds during play and showing Matthew how the sounds are made. For example, "mmmm" is said with the lips together and I let Matthew put his hand on my lips so he can also "feel" the mmmm sound.

Picture Cards to Communicate
If Matthew could point to what he wanted, I think it would make things a little easier. But he doesn't point. We're still working on pointing. I encourage him to point at pictures in his books and to objects around him but it seems that pointing doesn't come naturally for him. His speech therapist has incorporated using picture cards for the different activities and toys she prepares for him. So before presenting the actual activity or toy, she shows him two picture choices and encourages him to point at what he would like to do.
picture cards
The picture cards that I made for him are great for helping label objects, activities, and people he is familiar with. Matthew is a visual learner and he also learns by doing. I made these cards with the idea that they would provide a visual for vocabulary-building and eventually learning sight words. The photos are on the front of the card and the word is on the back. He loves to babble while looking at his picture cards. Lately, his favorite card is a photo of his Grandpa. He says "pa" and signs "Grandpa" while looking at it.

However, all his picture cards are all mixed together in one bag. I think my next project is to group them by activity, family, food, and so on. I also need to add more pictures (note to self: add one for bubbles.)


Tara said...

My oldest son has speech apraxia. We did not sign with him and I so wish we would have. Now, at 4, we understand most of what he says but still have moments like you described. Sigh. His younger brother, Zak, has a speech delay and was thought to have apraxia (too young to diagnose) but, we think he was just imitating his older brother. Eon starts speech therapy next month. We asked the therapist if she wanted us to just build her a room so she could move in. :)

All that to say, I feel your pain. :)

Monica Crumley said...

Great post, Ria. I love those cards. Another idea with the cards is to match color eventually. I think the speech delay is the hardest part of Ds at this age. I know it'll get better, but we've had those trying times as well. Lucky for you Matthew shakes his head no. John Michael doesn't let me know if I'm wrong, so I'm often still guessing... I ask him to point, but that's not always clear either.

Ria said...

Thanks Tara! The room idea was pretty funny too.

Monica, great idea with the colors on cards. I'll make some of those too. Good luck to us with the speech.

Cathal's Mammy said...

If there is one thing I would tell a new parent, it is to place as much effort as possible in speech and language, and signing. We have been using Lamh (the Irish standard sign language used with all children with special needs) with Cathal from a very young age, and what a difference it makes. He signs to us, not correctly, but we know what he is saying, and along with the sound he makes, we can usually decipher what Cathal is trying to tell us.
We have also just completed the Hanen, It Takes Two to Talk course. I cannot recommend it highly enough. It gave us the tools to help Cathal communicate with us with using some very simple strategies, and it has taken a lot of that language frustration away.

The Hapa Girl said...

Speech delay...I just blogged about how it through me off of my game! I really like the card idea, we sort of use it at the house but I really need to incorporate it more! Lillian just goes to what she wants and then I know! But, there are times when she goes to the pantry and takes out the snack she wants and brings it to me! I'm working at it! I wish she knew more signs...I'm working at that too!

Far Above Rubies said...

Hello Ria,

Thanks for passing by my blog. I'm following you too. xox

I pray your pregnancy is going well.

My regards to the family, and especially little Matthew!!!

Windmills and Tulips

Unknown said...

Bill and Ria, what a great site!! Our Son has Down Syndrome and he will be 2 this March!! :) Other than his Open Heart Surgery at 3 months old, he has been healthy and strong! He is also a bit frustrated that he can't say many words. But, we're getting there!

Thank you for sharing your information!
Monte and Evelyn

Sharon said...

Definitely going to get myself together and make picture cards for Brennan. Thanks for sharing what you've learned with the rest of us!!

Angie Willey said...

I love the cards you made. I was thinking of making some like that myself. His primary service provider brought some out last week that were made with something called board maker. It is hard sometimes for me to tell what the objects are, so I know it must be confusing for my little guy. We also have issues pointing, but I am hopeing that the cards will help with that.