Living with Speech and Language Difficulties

As I was driving Little Bear home from preschool today we had a very frustrating conversation. It went like this:

Little Bear: I want that one Mum

Me: That what?

LB: That button.

Me: Ok. Which button?

LB: That one (pointing)

Me: I can’t see matey.

LB: That one (pointing).

Me: I’m driving. I can’t see. Which one?

LB: THAT ONE!!!

Me: Try to use a word to tell me

LB: That button.

Me: (Trying a different approach) ok. Is it on the steering wheel?

LB: No.

Me: Is it the radio?

LB: Yes

I switch from CD to radio.

LB: Not that!!

Me: You didn’t mean the radio?

I switch back to CD.

LB: I want that one.

Me: That what?

LB: That button (pointing)

Me: (Trying not to sound annoyed) we’re nearly home. When we stop you can show me.

It was the skip button. He wanted a different track on the CD.

It’s very frustrating because he knows what he means; he just really struggles to find the right words to explain himself. I think in this case he was struggling to understand why I couldn’t just look at where he was pointing (I had sneaked a peak but there are a lot of buttons in a car, all in a very similar place) and why I didn’t just know by the powers of telepathy.

Sometimes, Little Bear does know the word he needs but I still struggle to understand him because his speech is unclear too. The evening before the CD incident, we had experienced one such struggle. My brother and I had picked Little Bear up and he was very excitedly trying to tell us what he had been up to. “I find dasha” he said. “You found a dinosaur?” “no, da sha” “erm, dancer? Dasher?” “DA SHA!”. I’m not sure how many times he repeated it. In the end I had to say that my ears weren’t working properly and then e-mail his keyworker to try to get to the bottom of it.

Treasure! The word was “treasure”. As soon as we had figured it out it was obvious. I couldn’t believe I hadn’t clicked at the time. The trouble is that in the early days, Little Bear had so few words that I knew exactly how each one sounded. Once I had tuned in, I could understand probably 95% of what he said. However, since then, he has had such an exponential growth in his vocabulary that it’s impossible to keep up. His longer sentences and myriad of words mean that his speech sound difficulties have become more apparent. Consequently I can now probably only decipher 80 to 85% of what he tries to say, bless him.

I must clarify that last paragraph though because obviously the improvement in his language is a good thing. Back at the start of life with Little Bear I had a few shock moments when I realised how profound Little Bear’s lack of life experience was and what a huge impact this had had on his language development. At 3 and a half years old, even with a recognised language delay, I still expected him to know basic vocabulary e.g. cow. But he didn’t. We saw a cow and he said “horse”. We saw a horse and he said “horse”. We had to teach him that they were two different animals with different names. We talked about a cow making milk. It was quite a revelation for him. We saw a train and he said “bus”. Every vehicle on the building site was a “digger”. I looked back to when Big Bear was a similar age and could reel off “dumper truck”, “bale fork”, “roller”, “teleporter” and I saw a word mountain towering in front of Little Bear.

The mountain wasn’t just made of nouns but verbs, concept words (big, same, hot etc), connectives, pronouns. And not just words on their own but words waiting expectantly to be ordered into sentences, preferably with some consideration for grammar. It was a big mountain.

Well, Little Bear would have said it was “bik” and he didn’t know “mountain”. In those days, everything was bik. “Bik” could mean “I want A LOT of ketchup” or “I want my water pistol FULL” or “that water is DEEP” or HUGE or MASSIVE or TALL. But Little Bear only had the one word for size or quantity so “bik” it was. “Bik” shows me how Little Bear has scaled that forbidding mountain, how he has clawed his way up it against all odds. “Bik” has gone now, replaced with its correct counterpart “big” and all the words in capitals are now part of Little Bear’s every day vocabulary.

Back when we were still in the foothills of vocabulary mountain, I found it hard to tell whether we were making progress or not. People would say “isn’t his language coming on?” and I would say “is it?!” and feel mildly ridiculous that as a Speech and Language Therapist I wasn’t a bit clearer about this. However, after a while it was patently obvious that we were climbing fairly rapidly upwards. Sometimes I’d leave him for a couple of hours (with grandparents or at preschool) and feel as though he had more language when I came back than I had left him with. The length of his sentences is increasing all the time, he is continuing to grow his vocabulary and I can see signs of change in his speech.

However, the mountain we are scaling is massive and as the CD example shows, there is some way to go yet. Amongst other things, we need to work on auditory memory. Like many children with Speech and Language Difficulties, Little Bear is much quicker to learn through his visual channel than any other way. He has a good sense of direction; he can remember where he has seen items so is good at finding things; he can learn a visual sequence e.g. the I pad code; he can solve visual problems e.g. how to open a lock. In comparison, his auditory skills are much weaker. It’s not really a surprise seeing as though less than a year ago he wasn’t really tuned in to language at all. He wasn’t used to paying attention or listening to the spoken word. Consequently his comprehension of language is also delayed. We have always needed to simplify instructions and be prepared to repeat them again and again to give Little Bear chance to process them. He has made enormous progress with this too but I am becoming aware that his auditory memory is not really providing him with the support it should. Auditory memory is meant to be a kind of holding pen for words that come into your brain from your ears. It should sit the words down on a virtual bench, all in the right order and keep them there for a few seconds until other parts of the brain have had chance to make sense of them. Little Bear’s bench is a bit wonky though, maybe it has a leg or two missing and the words can’t sit on it. They keep falling off before he’s had chance to figure them out and some of the words probably don’t even make it onto the bench at all. Repetition is crucial for him: it maximises the chances of the words getting onto the bench.

I think Little Bear’s difficulties with learning to count could be due to this faulty auditory bench. He has learned a few number names but he just can’t hold them on his bench for long enough or in the correct order to be able to retain the sequence.

Luckily, auditory memory is a bit like a muscle and can get stronger with exercise. This strengthening is hanging above us on the language mountain.

We also need to work on Little Bear’s sound awareness system. He finds longer words a bit tricky and misses syllables out so that “guitar” and “car” end up sounding the same. He needs to begin to understand that words start with different sounds. He needs to learn to make a “l” sound and that sharp and map end with ‘p’, not ‘k’ or ‘t’. He needs to learn that some sounds are noisy and some are quiet. He needs to learn how to say his name so that people can understand it. He needs to learn that “4” is not the answer to “what’s your name?”. That answer goes with “how old are you?”. “How old are you?” is not the same as “how are you?”.

It’s a big mountain.

Most of all, we want him to be able to express all of those thoughts and ideas and wishes that are currently held captive in his brain. We know they are there, clamouring to get out but the exits are currently blocked by inadequate language skills. It is upsetting to see him get frustrated and to try to chat with his peers but often fail at this because they cannot understand him.

We continue to scale the sheer rock faces though – so far there has thankfully been no plateau to wait around on. I cannot help but turn every activity into a language learning opportunity and I’m probably modelling words in my sleep! It’s a big mountain but we will reach the top. One day.

 

 

If you have any concerns about your child’s communication skills, or want to know more about the role of the Speech and Language Therapist, check out my Guide to Speech and Language Therapy on the Adoption Social: http://theadoptionsocial.com/blogless-blogging/speech-and-language-therapy-a-guide/

 

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