Hooked on Phonics...

Matt turned four a month ago, and has been increasingly interested in reading. He knows many sight words, but he really wants to figure out how the sounds combine to make words. To satisfy his curiosity, I bought a set of Bob books (the beginning reader set) and set him loose. He needs help with many words, but is starting to get the idea. We still have almost two years until kindergarten, and I have a feeling he'll be reading before then. All that speech therapy helps with phonemic awareness!

Anyway, here is a video of Matt "reading" one of his Bob Books (0 to 10):

Our Favorite (Dual Purpose) Toys

Christmas is over, and we are having a great time playing with the new toys and relaxing after all the business of the season. The boys loved all of their toys this year, and I especially loved the toys that are "dual purpose"- great for both play and therapy. While the boys inevitably play with each others' toys, I will separate the toys out by the child (and thus, age) they are intended for.

Here is my list of our favorite toys for Nolan (age 2):

• GloDoodle: A drawing toy, which has the obvious fine-motor and creativity benefits. I also use it for several language activities. With the GloDoodle turned off, I draw a picture and have Nolan guess what it might be. Then I turn it on and we can see if the guess was correct. It glows, so we can use it on night drives as an in-car entertainment toy, too.

• Blocks: We got a great set of unit blocks made by Melissa and Doug years ago. This year, we received the architectural blocks add-on set. Blocks might be the greatest language toy ever created. The great set of zoo Duplos we got also falls into this category- the language opportunities are simply endless.

• Doctor kit: The ability to role play and set up a pretend animal hospital has endless language opportunities. Hopefully, this will also help alleviate his anxiety about going to the ENT's office and our pediatrician's office.

• Shake and Go Race Cars: These cars are great. They're easy enough for Nolan to operate on his own, they go really fast, and are really fun. We can also count the number of shakes needed to make the car go, set up an obstacle course with our blocks, and race the cars side by side to get the concepts of "first, second, and third."

The best toys for Matthew (age 4) are:

• Automoblox: These things are simply great. We got a three-pack of the "Automoblox Minis." To be honest, Nolan plays with these as much as Matthew. They're great for fine motor skills, spatial relationships, and that unending need for boys to take things apart. Matt doesn't have a language delay (articulation issues only), but we never pass up the opportunity to discuss positional words and to emphasize the /s/ sound on "wheels." I love these things. Simply love them.

• Marble run: Another building toy- one that requires a lot of planning, fine motor, and spatial skills. As with any open ended building toy, there is a lot of talking going on while building the run. We pretend it is a roller coaster, we try to copy the patterns from the box, we come up with our own inventions. Nolan likes to drop the marbles in and watch them swirl around, but due to the obvious choking hazard, this toy is really designed for those in the 4-and-up category. We do get some frustration, as Nolan likes to play Godzilla and destroy Matt's intricate creations.

• Tag reader: Matthew received the Tag system made by Leapfrog for Christmas. I love it, and he loves it. The computer-pen can read individual words scanned, or can read the story page-by-page. The books have games, and the pen records the child's skill progression. Currently, the books have placed Matt into the kindergarten (for reading) and first grade (for vocabulary) levels. There is an associated website that tracks your child's "learning path"- currently Matt's' vocab is off the charts (perfect scores on the games) and his decoding skills need a little work (considering that he just turned four last week, I'm not surprised). The only difficulty with this system is keeping Nolan's hands off of it. He's quite interested in it, but the system is really meant for the 4-8 year old set (meaning that 2 year olds won't quite "get it"). There is a Tag Junior system out there, but we figured we'd just wait another year and get Nolan the regular Tag system when he's old enough for it.

CPSE Meeting

Matt signs himself in- backwards "a" and all

We had our annual CPSE meeting for the Matt. The short story is we are not going to have summer services and will resume in the fall, assessing to see if he still requires speech therapy. He is becoming more intelligible over time, though still has some inappropriate errors for his age (darn those missing consonants)!

Anyhow, I'm going into complete brag mode here. Matt is starting to read- he's been sight reading words for a while. Now he is starting to decode some basic phonics (simple three letter words). He floored the special education coordinator. The meeting went something like this:

Hi, let's all introduce ourselves!

[goes around the room, people introduce themselves]

Matt: "hi, I Matt. M-A-T-T Matt."

Special Ed coordinator: "he can spell his name? That's pretty good! He's not even four until December."

Us: "Yeah."

Matt: [writes his name on a piece of paper] "that how you spell it. M-A-T-T."

Special Ed coordinator: "he can WRITE his name?????!!!!"

Us: "Yeah."

Matt: "Your name start with "D." Cyndi name Start with "C." Cyndi is C-Y-N-"

Special Ed coordinator (named Dianne): "Wow. I can hear the artic delay, but my goodness."

SLP: "Yeah, he's the first three year old I've had that uses spelling and reading to correct his speech. His cognitive level is helping us achieve our goals"

Matt: "I like read. S-T-O-P stop. U-P up. Nolan start with N. Why there five people in here? No, there six people in here."

I'm glad we got him out of there before he started showing off his flair for addition!

Summer Decisions

We are coming to the end of the school year, which is irrelevant for Nolan. For Matthew, however, the end of the school year means that services are put on hiatus. He follows the school calendar and thus receives no speech on school holidays or over school breaks.

We had a choice to make. Choice 1 is to press for summer services, because we think with a few more months he might actually declassify and no longer need speech by fall. The problem here is that we would have to prove that he would regress without services, and we haven't seen any evidence of regression. Choice 2 is to go without summer services and pick up speech therapy again in the fall.

We're going with Choice 2, since we don't think he'll regress. Our speech language pathologist isn't quite ready to let him go, either. He's about 60% intelligible to strangers, but should be at 80% or greater intelligibility. Those darn consonant deletions really make his speech difficult to understand!

A typical sentence might be, "I ree wah gee one I ree don' wah blue one I gah abou it." Very run on, and I'm sure most would need a translation:

"I really want [the] green one. I really don't want [the] blue one. I forgot about it."

He's almost 3 1/2, so most of these consonant deletions should be gone by now. We also still have a few sound substitutions, but they're not severe enough to impact intelligibility. Even if he still has some delay, he'll declassify from services because he doesn't have any other issue (like hearing loss) that guarantees the right to therapy. Once he hits the "moderate delay" category, he declassifies. We'll seek private speech therapy if his speech is still "off," of course. I do hope that his speech hits the normal range prior to kindergarten!

Official Normal Hearing

We went up to Buffalo Hearing and Speech Center yesterday to get our final "yes, he hears!" test. We were able to get a nice line of hearing results at 15dB across the board, and test each ear independently. We did have a moment of anxiety when Matt sat staring blankly while tones were playing at 35dB in his left ear. It took him about a minute or so, and then he turned and said to Michelle the audiologist, "I keep hearing that!" After that, we just ran tones at 15dB and he responded to all of them. It is nice to rule hearing out as a cause of his speech (consonant deletion and cluster reduction) issues!

Nolan was up next, for earmold impressions. I told the audiologist about our PE tube concerns, so she took a look. She couldn't visualize the left one, and the right one was located in a build-up of wax. She did a quick tympanogram, and the left ear showed a flat line with a large volume (this means a functional tube is still in place). She took another look, and finally located the tube in the top corner of his eardrum. This is a relief, because he has one tube still in place and functioning. The right tube is definitely out, but the eardrum is healed and he has no signs of fluid.

We also found the cause of his ear pain in the right ear. Nolan has been crying when I put his right hearing aid in, and I was worried it was infected. It isn't infected, but there is a lot of wax in his ear canal. The wax is getting pushed into his eardrum when we put the earmold in his ear, hence the pain. I'm going to call the pediatrician to see if they can remove the wax, in the hopes of avoiding a trip to the ENT in Buffalo.

We also discussed Nolan's hearing issues in background noise. We had the background noise suppression program turned on and we'll see if it helps over the next two weeks. If it doesn't help, then we'll simply turn it off when we go to pick up his earmolds.

The audiologist also discussed the potential for getting an FM system through the early intervention program. I am hopeful we will be able to get one, because Nolan starts a 2 year old preschool program next year and it would help him during story time and other activities. That classroom is particularly noisy (Matt is in the program now), has tile floors, and is filled with 12 excited two year olds. The FM system may help during library story hour as well, since Nolan currently wanders aimlessly during story time.

Luckily we spend most of our time in an acoustically friendly environment, and Nolan's speech is taking off. We have 2 word phrases, and the occasional 3-word phrase slips out. We're also nearing the "too many words to count" point in his speech development. He tries to say so many new words each day that I simply can't keep up with him!

IEP Meeting

We had our IEP meeting for Matthew today, which I considered great practice for when we have Nolan's in a year and a half or so. Matt only qualifies on the basis of articulation at this point in time, so we weren't too worried about the quantity of therapy sessions when we went in. On the other hand, we wanted to see exactly what we could get, since we'll be going through this again in a while and will be requesting expensive equipment (no, a sound field is not enough. We want that expensive FM system, thank you very much)!

IEP meetings are quite different than the cozy IFSP meetings we've had through early intervention. First off, the meeting is held at the middle school of our school district. Walking through the cafeteria-scented hallways with my little ones gave me a glimpse of our future- slouching adolescent boys with mullets. Yes, mullets. Have those become cool again? I shudder to think so.

There were about seven people in the room, including the school secretary. Everything was recorded and there were several forms to fill out. They had all of Matt's paperwork and his cognitive evaluation set out on the table. They say he has "superior" intelligence. Really? I mean, he does this and this . I'm just sayin'.

After talking about his history and test results, we had to come up with therapy recommendations. Once children transition to the school district, they typically get less speech therapy time (the typical is 30 minutes per week). We asked for 2 days per week, 45 minutes per session. They didn't blink an eye and granted our request- I think Nolan's recently soiled diaper may have persuaded them to make a quick decision.

He will stay in EI until December 31, then transition to the school district for services. We will have a lapse in service because the school board doesn't meet until January 13, but a 2 week break will be good for all of us. Except our wonderful speech therapist, of course- who doesn't get paid when she's not working.

Most things will stay the same as when we were in EI, but there are some important differences:

• Matt now follows the school calendar. That means if therapy falls on a holiday, he gets no services. This also means no services over the summer, during winter break, or spring break.
• Our speech therapist now gets paid less, even though she's doing the same thing.
• We have annual reviews rather than semi-annual.

Matt will probably graduate from CPSE services in the spring, just in time for us to start the process with Nolan.

Early Intervention WORKS

Yesterday morning our speech language pathologist arrived with a box full of blocks, toy utensils, a teddy bear, and a testing manual. After having Nolan take a block off the box, put the block in the box, and select various objects, he received a receptive language score of 124%. That score is ABOVE the level of his normal-hearing peers. His expressive ranked at 108%.

This is the kid who couldn't understand simple words like "kitty," "truck," or "cup" two months ago. One month ago, something clicked and he has never looked back! We did identify some language holes (he can only identify one body part and should be able to label four), but overall he is thriving in his language rich environment!

We are sans hearing aids today until we visit the pediatrician. Nolan has a nasty cold with drainage out of one ear which makes me leery of inserting the earmolds. With his hearing test only 2 days away, I want to make sure his PE tubes are open and any infection is addressed!

Yesterday evening the "lady game" (Matthew's term) came to our house to evaluate Matthew. He has already been evaluated for speech and language, so we know he still qualifies for services based on articulation. This testing was a formality to assess his general cognitive skills. We won't have the results back for a week or two, but the psychologist did tell me she's confident he's performing at age level.

The testing was interesting. There were puzzles to put together (Matt got to the five-piece puzzles and was stymied after that). Blocks to build in patterns that matched a template set up by the psychologist (he could do anything with three blocks, but four blocks were a little difficult). Lots of questions for information (he couldn't name the colors in a rainbow, for instance). There were also a lot of receptive language questions. He missed two that I thought he would get- one of a lamp (we don't have bedside lamps, so he isn't familiar with the term) and one of an iron (embarrassing, but I don't iron our clothes very often).

Matt's responses to some of the questions were rather interesting. A selection of his answers are below:

Lady Game: Matthew, can you name some animals?

Matt: Animals live at the zoo.

Lady Game: Can you name some of them?

Matt: My mommy drive me there.

Lady Game: Matt, can you name two items that have wheels?

Matt: A choo choo train!

Lady Game: Can you name a second one?

Matt: Another choo choo!

Lady Game: Matt, what is this picture?

Matt: A banana!

Lady Game: Matt, can you tell me what this is (picture of an iron).

Matt: That a plug on it.

Lady Game: Yes, but what is the whole thing called?

Matt: I go eat banana now.

Testing almost-3 year olds is a job reserved for saints!

Pre-CPSE Meeting and Hearing Test Scheduled

Matthew at Panama Rocks

We had Matthew's pre-CPSE (Committe on Preschool Special Education) meeting at the local school district last Thursday. This was not an official affair, but just a "hello" to the school district and make them aware that Matthew has a likelihood of transitioning to the local school district for speech services.



We aren't quite sure if he will be declassified when he goes through his next round of early intervention testing or not. His receptive and expressive language are age appropriate now, but his articulation is still fairly atrocious. For example, take the following phrase:


"Go leet. Die. Ge'in car. See peet in wa. Wa. Too pie wie. Go peet."

For those who can't translate Matthew-ese, that's:

"Go to the lake. Drive. Get in the car. See fish in the water. Too far away. Go to the fish."

If he comes out with a "moderate" as opposed to "severe" articulation disorder, then he will not qualify for further services. I did request that he get another audiological evaluation to verify there is no hearing loss as a cause for his articulation issues, especially if he ends up with a declassification recommendation.

Luckily we brought Nolan in for the meeting, so they could see the whole family situation. They readily agreed that we should have Matthew's hearing tested since he speaks more Klingon than English.

Nolan with Grandpa at Cook Forest

Nolan has guaranteed services due to his hearing loss, so the CPSE chair was happy to meet him and told us her TOD would be glad to be working as a TOD again (the TOD is currently working with students who need speech therapy, but there are not other kids with hearing loss in our school district).

We also saw the audiologist this week, to pick up earmolds and more dessicant (darn that humidity). Our audiologist scheduled another hearing test for August 7th, so we will be taking impressions for earmolds on July 28, doing a hearing test August 7th, and going in for the MRI (pending insurance approval) on August 11th. I am reassured our audiologist is keeping good tabs on Nolan's hearing levels, especially since he seemed to lose a small amount of high frequency hearing between his ABR and first booth test.

Oh, yeah- and Nolan took his first steps. I can't believe my little guy is starting to walk!

It looks like we are on for a busy August and September, but then things should slow down and we will get back to our normal pace of life.

We've Got Goals, Baby!

I had my IFSP meeting for Matthew, and we put goals into place for the next six months. His official diagnosis is a severe articulation disorder with a moderate receptive/expressive language delay. His receptive delay is mild, and probably registered poorly because he was not in the mood to cooperate with the examiner. He didn't show an understanding of pronouns or the correct use for objects (he fed the bear with a spoon in a cup- unfortunately I always use a spoon in my coffee mug and he imitated this. Oops!). His expressive was moderate, his pragmatic use of language was severe, and his articulation was severe. That's the bad news.

The good news? He gets speech therapy, twice per week! His goals for the next six months are:

• Increase core vocabulary


• Demonstrate understanding of pronounds and simple descriptive concepts


• Imitate words


• Produce consonant-vowel combinations


• Decrease frustration when not understood


• Increase amount of signs to match receptive language


• Add consonants to vocabulary


• Increase word approximation consistency


• Increase word clarity

The simple idea of my 2+ year old being able to imitate words has me all a-twitter. I know it is a process, but I really can't wait until he calls me "mama." I've been waiting a long time.

Passing by Failing

Matthew had his Early Intervention evaluation for speech and language. I was really worried that he would not qualify due to his receptive language skills, even though he can't talk. The speech language pathologist arrived and Matthew was in a quite "busy" mode, not really answering the questions for receptive language. This really worked in our favor, as it kept his receptive language at a 22 month level (he's almost 26 months old). That's in the normal range, but didn't kick his total language score out of the ballpark. His expressive, with 0% intelligibility to a stranger and only 6 word-like phrases (apparently "ewwww" and "oh" don't qualify as true words), registered at a 12 month level. This kicks him into the severe range for speech. With a moderate language delay and a severe expressive delay, he should qualify. The lack of progress with his receptive does keep me cautious about hearing loss with him, though I know we had him down to 20dB in a soundfield.

At least we can start getting help for him. It's really depressing when I drop him off at the 2 year old room at MOPS and all the other 2 year olds say things like, "look! Radio's broken!" and Matthew only says something that sounds like, "favahfafa!"

Toddler Signs

This isn't hearing loss related, but does involve sign language so I thought I'd post it here.

We've been working on some sign language with Matthew (not for hearing loss reasons- apraxia runs in this family and the kid simply can't talk yet). It's been alleviating a lot of frustration, though a recent "conversation" went as follows:

Mommy: "Matthew, what do you want for breakfast?"
Matthew (signs): Candy.
Mommy: "No candy for breakfast. What ELSE do you want?"
Matthew (signs): Cookies.
Mommy: "No cookies before lunch. Do you want pancakes?"
Matthew: "Aaahhh!" (his version of yes).
Matthew (signs): Cup.
Mommy: "What do you want in your cup? Juice or milk?"
Matthew (signs with a big grin): Candy!!

Sigh...

The amazing thing is that three days ago this conversation wouldn't have been possible. At two years old the kid can only say about 4 words (monosyllabic and not clearly, but he does have four words). The only thing I can hope for is that Nolan skips the apraxia so we don't have to deal with that AND hearing loss. We'll deal with whatever comes our way, though!

I'll post a video of Matthew signing if I can get him to cooperate. Two is generally not a good age for cooperation!

Update: I got a video, but he is in constant motion. He is a bit like a hurricane- as evidenced by the toys strewn around our family room (grin):