Thursday, August 20, 2009

Small Steps

Nolan's receptive and expressive language is quite good. Not "good for a hard of hearing child," but simply good- for any child. He regularly puts together 3 and 4 word sentences, has far too many words to count, communicates his wants and needs (LOUDLY) and is able to follow 2 step directions.

We do have some concerns with his grammar and his verbal processing, though this may be due to age more than hearing status. Still, because he is at continual risk for language problems, I think we will definitely mention these problems in his IFSP goals this fall.

We have found a way to work with his ability to answer questions. Since Nolan will mimic the question rather than formulate an answer, our speech therapist has devised the following technique: Ask, Model, Ask (wait).

First, she asks the question, "Nolan, what is this?"

Nolan will invariably repeat, "Noh*, what is this?"

Then she'll model the answer by asking me the question:

"Mommy, what is this?"

"That is a frog!" I enthusiastically answer.

Then she asks Nolan again: "Nolan, what is this?"

He'll repeat, "Noh, what is this?"

Then comes the waiting. Instead of answering the question for him or accepting his repeated question, we simply look at him and wait. Finally, after much pause, comes the answer:

Then there is much clapping and cheering and running around in circles (Nolan's personal expression of "happy"). This process works about 25% of the time right now, so we're keeping it up and hopefully the success rate will increase with time.

His other "issue" is not uncommon for children his age. He gets his grammar backwards- instead of saying, "the bear has a ball," he'll say, "ball has a bear." Or he'll say, "Work at daddy" to mean "Daddy is at work." Right now I am simply repeating what he says, but in the correct order. If he says, "Asleep a Matt," I'll say, "Matt is asleep! Maybe he will wake up soon."

Otherwise, he continues to astound and amaze us with things we didn't know he could do. Our speech therapist told him to put a green circle on blue square, and he was a bit flummoxed. She backed the complexity of the request down a notch, and asked him to put the yellow triangle on the yellow circle. His little hand reached out and accomplished the task without hesitation. He managed to handle two shapes and one color in his auditory memory, and get them in the right order. WOW! Not bad for a kid who still hasn't turned two!

The "eating thing" is still plaguing us. His appetite varies greatly from day to day, so we never know if it will be a good eating day or a poor eating day. This morning he woke up and threw up until noon. He doesn't appear to be sick (slight temperature, but Nolan nearly always has a slight temperature). It is very similar to what he did in April, when he quit eating well. It is definitely something we will keep an eye on. He has his follow-up GI appointment on the 31st of August, and we will get our assignment to the feeding clinic at Buffalo Children's at that time. I've heard they can do wonders, so if there is no medical cause, we should be in good hands.

*Noh is what Nolan calls himself. Silly parents for giving him a name filled with low frequency sounds!


Julia said...

Wow! And I love the "pwog" approximation -- very cute! Sounds like he's doing beautifully. Since Ben has no residual high frequency hearing, we were very glad we gave him such a nice, low-frequency name -- we had considered "Seth" when I was pregnant, and we were so glad we hadn't gone with that!

Lucas'Mommy said...

That's an impressive list of things he can do! Yay Nolan!

Pattie said...

Good job, Nolan! Keep up the great work! You'll be talking Mom's ears off before you know it!

Love teh "frog" approxiamtion. Andrew would just look at it and walk away!

Herding Grasshoppers said...

Woo hoo!

He's doing great :0)

rouchi said...

He is doing grt. He is at that echo stage where kids just repeat what they hear.Make use of it . We were advised to do at least 5 new sentences everyday for echo which helps them to have continuity, intonation and is very helpful when they are asked to make longer sentences later in life.The sentences could be even any gibberish or any other language. I found it very helpful.They learn to get the syllable right, intonation is built and the rhythm helps them later.This stage is very very important and really use it to the full. I did that by constantly asking her to say things back while cooking, cleaning or driving etc.It builds their self esteem.All the best.

leah said...

Julia, that is too funny. We're lucky in that Nolan has residual hearing across all the frequencies, but that hearing in the lows/mids is rather questionable- he seems to have some distortion and misses sounds (even aided). We really noticed it with the drop from 50dB to 60dB- his "Daddy" went to "Dah-ee." And Nolan is just impossible for him!There are times we wish we had chosen a high frequency name, like Chris. He'll get it some day, though (g)!

tammy said...

Nolan is doing so wonderfully! I just love how you are so on top of everything! It seems like just yesterday that I read how you were concerned about Nolan answering a question with the question. I can't believe he's not even two yet ... he's doing a lot more than a lot of hearing two year olds do! And I think a lot of toddlers start their sentences with the verb first ... in fact, isn't this how most foreign languages are spoken and it's us in the US that put noun before verb?

leah said...

Haha, Tammy- it probably WAS yesterday! He still does it all the time, but if we try that ask, model, ask process he seems to "get it." Actually, I think that process just gives him enough time to process the question and formulate an answer! I also can't believe he is going to be TWO in six more days... they grow up too fast!


He is doing so much! That's great! William doesn't have near that vocabulary. In fact, he does well with receptive language, but very little speaking. I'm hoping that changes before too long.