DLD & Education

Today there has been a web chat run by @DLDandMe all about the impact having a language disorder has on a child’s education. It is part of their wider work to raise awareness of Developmental Language Disorder  (DLD) and to spread the word to a broader audience, about what DLD is, how to recognise it etc. I joined in a little, although late, but I thought it might be useful to share more detail about this topic, from our own personal experience.

As most readers already know, I am both a speech and language therapist and Mum to our seven year old son – LB – who has DLD. There is a complication to our story, which is that LB experienced early neglect and didn’t come into our lives until he was three and half. It is pretty impossible to pick apart the different impacts of neglect and DLD, with both having made their mark. However, it was clear from fairly early on that the communication difficulties LB experienced were more significant than delay alone and where progress was quite quick in some areas, speech and language has always proved more challenging for him. As much as possible in this post, I’m going to focus on the specific ways DLD has affected LB’s educational progress, notwithstanding the separate effects trauma has had.

LB’s DLD impacted on all areas of his communication development when we first met him – including his ability to understand language (comprehension), his auditory memory, his ability to use words and make sentences (expressive language), his ability to listen and pay attention, his ability to speak clearly and his social communication. When I talk about his presentation back then, in workshops and the like, I can see that it shocks people. And it was shocking, because LB’s language system just couldn’t do what he needed it to – not one part of the complicated whole functioned as it should have. He was very much trapped inside of himself and he wasn’t left with many options other than to express himself through his behaviour.

In the early stages of his pre-school education, this impacted him in a myriad different ways. He was certainly delayed in learning concept words such as his colours, size words, same/different etc. which meant he just couldn’t follow much of the teaching or express answers to what nursery staff would likely consider easy or every day questions. That said, with specific teaching of one concept at a time and plenty of reinforcement in everyday activities and play, LB was able to close the gap pretty quickly. It isn’t that LB can’t learn, because he has developed phenomenally quickly, it’s just that he couldn’t pick these concepts up from the ether, as children with typical language skills would. He required specific teaching, repetition and showing, to get them to stick.

Obviously, struggling with comprehension made it even harder for LB to learn new things. There must have been much of what went on in Nursery that he couldn’t follow. This no doubt exacerbated his difficulties with listening and attention, because it is extremely hard work for anybody to focus on language they don’t comprehend. Imagine having to listen to French or Urdu or Finnish or any other language you aren’t familiar with, for large swathes of each day. It would be exhausting and it wouldn’t take long until you stopped listening. Therefore, in some ways, LB’s DLD exacerbated his DLD. He certainly coped better on a 1:1 and thankfully we were able to provide him with this because I was on adoption leave and he just went to pre-school for a few sessions (and now he has TA support). Keeping distraction levels down and matching our language to the level LB could cope with, was imperative. It meant we could keep language accessible for him most of the time and choose which concepts or structures we wanted to stretch him with. I guess this is where my professional background came in – I suspect creating these ideal learning conditions would be much more difficult for a child whose parents are new to the idea of DLD and whose pre-school setting don’t get it.

Certainly as LB’s comprehension developed, so too did his ability to learn. I know it sounds a bit ridiculous but he did appear to be growing cleverer. I maintain that had he have had a cognitive assessment at the beginning, and one a couple of years later, he would have climbed the percentiles. This is because learning and education is generally acquired through the currency of language. As he acquired more words, he knew what more things were. He was able to express how things work. He was able to enquire and find more information out. The more language you have, the better you become at gaining it. Initially, we just couldn’t have talked about complex ideas such as electricity or natural disasters or endangered animals or health conditions. LB didn’t have the vocabulary to access a discussion or explanation about such things so he essentially wasn’t able to learn about them. It was only when he had gained sufficient depth and breadth of vocabulary and could listen to and follow longer structures, that he was able to develop his knowledge of the world around him. And when this did happen, it was amazing to witness the world opening up to him.

Vocabulary acquisition was a huge ongoing challenge for LB (and me) for a long time. Initially, even though we used lots and lots of modelling strategies, he didn’t seem to be growing a larger vocabulary. Again, like with other aspects of his language system, the more he heard a word used and the more times he managed to store a new one, the better his language processing system got. He has certainly got quicker at acquiring new words, even if this continues to be hard for him. Evidently LB’s language processing system (the bit of our brains that hears words, de-codes them, decides what sounds are in them, and their meaning, and stores them in an organised way, ready to be spoken) was not well-developed. It was laborious for him to use it, meaning that getting his vocabulary as big as he needed it to be must have been an exhausting task for him.

Where LB would once have needed to hear a word used around him for several months, with a high level of repetition, before being able to store and use it, he can now store a new word almost immediately. This has had a huge impact on his ability to be able to keep up with the curriculum. Each new topic brings a cornucopia of new words, which children are expected to immediately absorb in order to follow teaching. If you can’t understand the new words, it’s extremely difficult to follow the new lessons.

Although speedier, LB’s processing system remains inaccurate – he struggles to de-code words so that, without help, he might store ‘Corvette’ as “courgette” or ‘submarine’ as “subramine”. He is aware of this so often requests help – just having someone break a word down into bite-size syllables is a huge help to him and allows him to store a new word correctly. At school he has word webs for new words and is building up a personalised dictionary with his TA.

Despite all the hurdles, LB’s comprehension skills have caught up. He seems able to access the vast majority of teaching in his year 2 classroom without too much difficulty. He does cope better with multi-sensory teaching and visual supports (such as narrative grids, Mind Maps etc.), not least because they help to hold his attention. When LB is tired, his skills in this area do diminish a little and he might need a bit more repetition but overall I think his progress underlines what the right speech and language therapy input can achieve for children with DLD.

LB’s difficulties with auditory memory have impacted in several ways – most notably on his ability to blend sounds together and to learn listed information. Literacy acquisition was always going to be a challenge for LB, as his speech continued to be unintelligible well into year 1, with vowel distortions, and his sound awareness skills (identifying the first sound in words, rhyme, syllables etc) were poor. Even the pre-reading task of describing what’s happening in a picture was ridiculously difficult, because LB didn’t have the sentence structures or vocabulary he needed in his expressive language – something else we taught specifically.

We worked hard on sound awareness in a stepwise manner – identifying the first sound of short words then longer words, then the last sound of short words etc., alongside attending speech and language therapy. Again, I feel that good phonological awareness skills are something LB wouldn’t have been able to acquire organically, but he was very much capable of achieving on a 1:1 basis with a personalised approach.

We stumbled at the point of blending sounds together – a critical final step before literacy could be gained. The difficulty it turned out, after a bit of ‘diagnostic therapy’ (again, thank goodness for my career) was the blasted auditory memory which was struggling to hold three sounds, let alone stick them together. Once more, practise paid off and eventually LB could blend. Which, having already learned his letter shapes – pretty easily, it was a visual task – meant he could read. Progress has been steady since that point, with him progressing through the reading levels as you’d expect. In my opinion, a good phonics approach is essential for a child with DLD. It was a challenge to establish that strong foundation but once it was in place, it served LB well. He is not yet meeting the expectations of the curriculum but his reading is good; he understands text and he can apply his phonic skills to decipher most words. Crucially, he loves books and listening to stories. Keeping things as fun and engaging as possible is another essential tool in encouraging a child with DLD.

However, LB is not yet ready to apply his phonic skills to writing, finding this laborious. The addition of SPAG requirements such as including a noun phrase, or adverbial, pretty much renders writing the very worst aspect of school life for LB and, in my humble opinion, totally takes the fun and imagination out of it for all children.

It is hard to get LB’s teachers to understand just how many demands writing places on the language system of child with DLD. My hunch is that when his reading skills are better still and he’s had more specific phonics teaching, his ability to spell will improve. I suspect that expressing himself on paper, with appropriate grammar, will always have its challenges.

The other area auditory memory difficulties have impacted is LB’s ability to learn listed or sequential information such as the days of the weeks, months and, perhaps most crucially, how to count. Learning the numbers to ten proved extraordinarily challenging for LB so that when he started school, aged 4 and half, he couldn’t count to three in the correct order. The knock on effect of this was that Maths was pretty much impossible. How can you do sums when you haven’t the basic language for it? When “4” or “732” are just as meaningless and unquantifiable? This certainly held LB back and for the first year, perhaps two, of his education, his literacy skills appeared better than his numeracy ones, which lagged significantly behind. However, all the repetition and visual representation eventually paid off and LB learned to count to 10. And then 20. Very soon after that, probably because he could use his logic and ability to see patterns, he could get to 100. Once he had the language, Maths wasn’t so hard at all. In fact, it looks as though LB will meet the expected levels of the National Curriculum for the first time this year, which is no mean feat, given his starting point. Now that he has the language, even the reasoning SATS paper is accessible to him, despite the problems being presented in word form.

Having DLD has made every aspect of LB’s education more challenging for him. However, with the right support, LB has proved over and over again, what children with DLD can achieve and how crucial getting that support in place is. Language underlies all learning and we ignore that at the peril of children with DLD.

 

 

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Seeking the Positives

I know I promised last week that for this blog post I would write something shorter and lighter so I will endeavour to but to be honest it has been a confusing kind of day. My brain is a bit of a mangle and I’m not too sure, at this stage, how it’s going to come out.

My thoughts are around the idea that when it comes to adoptive parenting, how you feel about events really depends on how you choose to look at them. I suppose that’s true of many of life’s events but there is something specifically yin and yang about parenting a child with some behaviour challenges.

I find that in so many situations there are positives. I don’t know if my glass is half full or what, as I am very much a realist, but I do like a positive. I seek them out and collect them. The rub is that for each positive or few positives, there will be an equal and opposite negative. It’s as though when one hand gives, the other takes away.

For all the fabulous things Little Bear does, he’ll do something ridiculous and I guess it’s down to us at those moments, to decide whether we let that thing taint the good stuff or just let it go. Sometimes it’s impossible to be objective about it. Sometimes things push your buttons so much that you can’t help being irked. Sometimes you have given warnings and explained the cause and effect of an action and given ample chances and your little darling has chosen to do that thing anyway. At those points it is hard to find the positive.

At other times, I find myself dithering a bit. I find myself thinking theoretically that he shouldn’t have done x, y or z but that it hasn’t actually upset me at all and therefore should I bother making a point of it or not.

I suppose what I’m saying is that there is a lot of sifting of behaviour going on: a constant analysis of whether things have gone well or whether they haven’t, when you balance up the negatives and positives at the end of it all. This thought makes much more sense if you consider a specific event. For example, if we went to a party and Little Bear had played well with the other children and had sat for his party tea but at one point he had nicked someone’s balloon and had purposefully popped it, making them cry, is that, on balance, a successful or unsuccessful event? I could decide that the balloon popping was a big incident and therefore feel bad about the whole thing. Or, I could think that in the grand scheme of things, popping a balloon was small fry and that at parties, some incident or other is par for the course. In that scenario I can come away feeling pretty chipper and like things went as well as they should. The event is the same in both examples. The only thing that has changed is my perception of what happened.

When we became adopters (specifically of Little Bear and his particular needs), there was a natural adjustment period in which we changed our perceptions of what constituted a successful event. I suppose we made adjustments to our expectations based on his developmental level, behaviour at the time and knowledge of what he could/ could not reasonably cope with. To begin with, that was going to a place without us getting thrown out. If we achieved that and nobody ended up in A and E, it was a clear success. I think we have continued to adjust those expectations as he has developed and progressed so that now, we expect much more from him.

What’s difficult at the moment is knowing, accurately, what he really is capable of in any given situation. I think our expectations are pretty reasonable: we never demand exemplary behaviour all of the time because that’s clearly ridiculous. I think we take a lot of shenanigans in our stride. We never expect an event to go by without some sort of minor issue or three and that’s ok. We’re pretty adept at ignoring the less than perfect.

What is getting increasingly tricky are the situations when behaviour very clearly doesn’t live up to expectation; when we know Little Bear is capable of more or better. I think we are faced with a choice at these junctures: do we blame regulation/ his history/ the wind direction and allow those things to justify his behaviour? Or do we think that, actually, he is capable of more and should have tried harder? I am very much an analyser, a seeker of answers, a person who actively considers behaviour from all angles. I am very much about looking beyond behaviour, thinking about what it communicates and what may have triggered it. I do those things as a matter of course. However, I find myself occasionally wondering whether in doing so, I always find an excuse for Little Bear when, let’s be honest, all children can be little so and so’s sometimes and also that, as he grows older, he will need to take increasing responsibility for his own actions.

The reason I wonder this is because yesterday was Little Bear’s nativity. He had worked hard to learn all his lines off by heart and he delivered them perfectly. He was in all the right places at all the right times and did a sterling job. Then, as if to provide the yin to his yang, he proceeded to writhe about the front of the stage, hanging off the front and generally mucking about. He had been on the stage for approximately two minutes so even by his standards it was a remarkably short time to have got bored already. I know that he knows he shouldn’t do that. When the head teacher spoke, Little Bear was the only child who took it upon themselves to heckle him. It wasn’t cool.

I decided to speak to him about it later because there was an evening performance too. Sometimes, if there has been a problem with situational understanding or social expectations, a little chat to make things more explicit can help. I felt he was pretty clear on the behaviour expectations. However, lo and behold, in the evening performance, he pretty much repeated his antics from earlier, adding in a fracas with the other donkey and once more loudly disagreeing with the head teacher.

I couldn’t help going away feeling as though the negatives of his behaviour had outweighed the positives of line-learning and delivery. Grizzly came away feeling similarly.

As with all situations, I think we now have a choice of how to view the event. We could continue to be disappointed by his behaviour, knowing he is capable of more. We could choose to think that if only he had tried a little harder, he could have lasted the final two minutes without incident. We could consider that the other 59 children managed it, several of whom are also adoptees, as did all the children in Reception class who are two years younger than him. That line of thought could lead us to wanting to talk to him about it.

However, it’s done. No matter what we think or say, he can’t undo it. Given that, what would be the point of expressing our disappointment to him? It would only shame him.

We could choose to excuse his behaviour. We could blame it on tiredness, the anticipation of Christmas, dysregulation, the audience – a whole multitude of possible culprits. By exonerating him, would we be at risk of thinking he doesn’t have the power to control himself when he very clearly does?

Perhaps there is another way to view it. We could decide to view it from the point of view that Little Bear wouldn’t be Little Bear if there wasn’t a moment of indiscretion. We could just write the last 2 minutes off as collateral damage. We could focus on the fact that, despite having DLD, Little Bear managed to learn 52 words, arranged into 6 sentences, all off by heart and delivered it clearly and loudly. Those facts are phenomenal and fairly unbelievable given his difficulties with auditory memory, language and speech.

I don’t think it matters too much which perspective we choose to take, because none of them can change the event itself. There are no more nativities coming up that we could hope to go differently. Therefore, I think I choose the last version; the most positive. I think I seek the positives because they make everybody feel better. The negatives are difficult. The negatives draw unwanted attention to us as parents, they call into question our parenting in other people’s minds and they cause us embarrassment. It is difficult to be fighting the fight of getting school to understand your child and their behaviour then seeing them seemingly choose to clown around in front of all the parents, staff and half the school.

For one’s sanity, it is often preferable to take the positive stance.

I’m getting better at sweeping the negatives aside and letting them go. I just hope that in doing so, I’m not lowering my expectations of Little Bear unduly and I’m not finding justifications for his behaviour when I should be demanding better.

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Anyhoo, it’s nearly Christmas and I have presents to wrap. All that remains is to say I hope you all have a calm and happy Christmas and enjoy time with your loved ones. I asked the boys if they have any Christmas messages for you. Predictably, Little Bear told a rude joke and sang a song about Uncle Billy losing his willy. Big Bear says, “Merry Christmas you filthy animals”. So, you know, good luck (I might need some) and enjoy the festivities. Lots of love from all The Bears xxx

 

SaLT, EP & an Assembly

It has been a busy week at Bear HQ for meetings with professionals and thinking about Little Bear’s needs. On Wednesday we had our second session with his Speech and Language Therapist (SaLT); on Thursday Grizzly and I met with school and the Educational Psychologist (EP) and today Little Bear had an assembly and his first taste of public speaking. Each event has been thought provoking in its own way.

SaLT Session 2:

This week’s session consisted of further assessment and rapport building. The Therapist is continuing to impress me. This week she gave me the assessment findings from the previous week as she said she would. I find it is all very well professionals promising things but it is the actually doing them that earns brownie points.

The results are interesting, with scores ranging from the 5^th to 75^th percentiles. For those not familiar with percentiles, a score at the 5^th percentile means that if you took 100 children the same age as Little Bear, he would score better than only 5 of them but at the 75^th percentile, he is scoring better than ¾ of them. It is an unusual and atypical scoring profile. You would usually expect children to have a cluster of scores round about the same level across all of their skills. As all of these scores relate to his comprehension (understanding) of language it is even more unusual but nevertheless it is as I had expected for him.

Little Bear scored well on his understanding of basic concepts such as hot/cold, same/different, in/on/under. We have worked on these concepts so I would expect his knowledge to be fairly good. The longer or more complex an instruction became, the more difficult Little Bear found it to follow. Instructions containing more complex concepts such as before/after and ‘all except’ were also tricky for him. This fits with our feeling that he can understand a lot more than he used to but that we still need to simplify our language and that the more complex an idea is, the more repetition Little Bear needs.

His grasp of different sentence structures was at the lower end of the expected range and was impacted by his lack of awareness of pronouns.

Despite all that, the scores do also reflect positive progress as at first assessment (when he was seen briefly by a private provider in his pre-school) all his scores were at the 1^st percentile. That shows me that his attention and ability to be assessed has improved as well as SaLT input having being effective. Working on language really does make measurable differences in performance. It will be  interesting to see how his scores change over time, especially now that he is having formal therapy alongside the things we do at home.

The Therapist gained more brownie points as she had evidently reflected on Little Bear since our last session. She had noted the unusual quality of his speech and had suspected his vowel sounds might be distorted. This is not a typical pattern of errors and is not a part of “normal development” i.e. most children make speech errors when they are first learning to speak. The errors usually follow a pattern e.g. back sounds such as ‘k’ are made at the front of the mouth instead sounding like ‘t’. This is an expected part of development and it usually rights itself as children develop. However, making vowel distortions is not a typical developmental process. In fact it is fairly rare and neither Little Bear’s Therapist nor myself have ever tackled it in therapy before. Little Bear’s Therapist could have pretended to me that she did know what to do and could have just made up some therapy as she went along. However, she identified that she needed to know more and discussed Little Bear with a colleague who specialises in hearing impairment and would be more knowledgeable about vowels. Consequently she now has a more targeted assessment that she is going to try next week. I find this honesty and seeking of support reassuring. It is important to know when you don’t know. In my view, it makes her more competent, not less. There is nothing worse than somebody who doesn’t know that they don’t know (“unconscious incompetence”) and just blunders on anyway.

The other thing this conversation did for me was provide me with relief that finally another professional (who isn’t me) has identified that Little Bear does not have run of the mill SaLT difficulties and that between his spiky language profile and his dodgy vowels, he does have a Speech and Language Disorder not a straightforward language delay. For any SaLT’s reading, she has not used the new terminology of “Developmental Language Disorder” yet, a term which I do think applies. It will be interesting to see whether she does as we go forwards.

Meeting the EP again

We first met the EP a few weeks ago when we had a consultation meeting. You can read about it here: Seeing the Educational Psychologist

Since then he has spent a morning in class with Little Bear. He observed and played with him and took him out of class for some formal assessment. His teacher told me on the day that Little Bear had been exceptionally well behaved and she wasn’t sure the EP would have seen all the things we had been worried about.

Interestingly the first point that he raised at our feedback meeting was that he had noted Little Bear playing well and interacting appropriately but mostly minding his own business. He had observed on a number of occasions that some of the other boys were quick to blame him for various things when in fact he hadn’t done anything wrong at all. We have had our suspicions about scapegoating and other children exploiting Little Bear’s difficulties with communication but it is different to have that confirmed by a neutral professional. Obviously it is completely wrong and worrying because nobody wants their child to be victimised. I am glad that school are aware of it but I do understand their difficulty in policing everything that happens as they can’t be everywhere or see everything. We shall be keeping a very close eye though.

In general, the EP was pleased with Little Bear’s social and play development. He had carried out some assessment and that showed Little Bear’s non-verbal (cognitive) scores to be around the 10^th percentile (below average) and his verbal score to be around the 38^th (within the average range). This result is completely at odds with my hunch which is that Little Bear has good cognitive skills and significantly poorer speech and language skills. I think there are a few reasons why it may have come out this way:

• We have worked A LOT on language and Little Bear has made a lot of progress. We have probably worked on the types of activity that were used in the verbal assessment but not on the ones in the non-verbal bit so he was essentially more practised at the verbal one
• The verbal assessment used won’t be as accurate as anything used by the SaLT
• It is difficult to truly separate verbal and non-verbal abilities when so many activities intrinsically rely on language knowledge. The EP talked about picture matching activities such as bird with nest and dog with ? This type of task relies on a child’s knowledge of vocabulary and the meaning of words (semantics). It relies on them having good semantic links between words, something I suspect Little Bear doesn’t have. He does have a lot of words now but I suspect they are stored in a jumble, not nice and orderly and therefore it is hard for him to find the ones that should go together. I feel this says more about his language ability than his cognitive function.

Although the EP is lovely and I have found him very useful, this just highlighted to me how pernicious language difficulties are and how difficult it is to get even very educated professionals to truly understand the impact of them. I am so grateful that I finally have another SaLT on side who really does GET IT. I hope.

The rest of the meeting was taken up with reviewing the strategies already put in place. I was very pleased that school were able to give detailed feedback so are evidently using the strategies and they seem to be working well.

We also discussed transition to year 1. Thankfully Little Bear’s teacher is going to move up with him which assuages a lot of our concerns but it is the jump from EYFS provision to more formal learning that is worrying us all. Little Bear is certainly not ready to sit at a desk all day or to complete learning tasks independently. School are absolutely brilliant at providing him with the specific intervention he needs but we have all agreed to apply for funding in the hope that this will secure ALL the right things next year, when a TA in the classroom is not a given. Next week’s job will be completing all the paperwork…

Assembly:

During the Easter break we were tasked with helping Little Bear learn his words for today’s assembly. I was a bit concerned as only a couple of months ago, Little Bear struggled to hold 3 numbers in his auditory memory long enough to repeat them back to me. Learning words was not going to be easy for him. Yet today he stood up in front of the whole school and a load of parents, walked sensibly to the microphone and speaking loudly, without any sort of prompt, said all of his words: “Every day we are running or walking a mile and its keeping us fit and healthy”. I don’t think everyone understood what he was saying but I don’t care because it was a phenomenal achievement for him.

I have just picked him up from school and he has the dreaded take home book. I absentmindedly flicked through it when he handed it to me and was shocked to see pages of children’s handwriting. “Oh God, look at this” I said, waving it under my friend’s nose. “Don’t worry” he tried to reassure me “they’ve had that for a week”. I didn’t like to tell him that it wouldn’t matter how long we had it for, Little Bear still wouldn’t be able to write more than a copied or dictated very tiny sentence. It is SO hard not to compare and not to feel disheartened. However, I know that my gorgeous little dude is working as hard as he can with every fibre of his being and in his language disordered world, learning 16 words off by heart is incredible. Writing or no writing, he’s still incredible.

 

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/