Thursday, January 26, 2012

Say what? Dylan's speech challenge

We are starting the process of helping our 25-month old son Dylan with some speech delays.  He is is still on the larger end of the size spectrum for his age (88th percentile) but is lagging behind a bit in speech for a two year old.

My gut (and my doctor) tell us it's nothing serious and most likely A) typical boy speech delay, and B) that he is suffering in comparison to his verbal juggernaut four year old sister Ava, who's never met a word or turn of phrase she didn't like and incorporate into her complex word flow.

And to be fair, he definitely excels in ways that she doesn't: he is very adept physically compared to where she was at the same age: he's been climbing and jumping off of stuff since he was 18-20 months old in a way that she didn't even start doing until she was nearly three.

He also is much more patient and persistant in trying to figure things out. When Ava struggles with something (a container she can't open, a toy that's stuck), it's only for a minute or two before the squeals of frustration begin and tears start welling up, followed by her throwing the thing to the groundn or across the room and/or stomping away or over to us for help.

In contrast, Dylan will sit quietly, making multiple attempts to figure out the thing that's posing a challenge. He may grunt in frustration, but he sticks to his exploration for several minutes until he figures it out or eventually brings it to me, holding it out for help with a questioning, "Ma. Ma. Ma!"

I remember Ava at a 21 months already saying the real names for me, Jason and my folks, in addition to nearly a hundred words. Dylan at 25 months only has about a dozen clearly spoken words: mama/Mommy, dada/Dad, Nana, papa, ball, bus, dog, book, cookie, no (of course), moon, Thomas (the train), sock.

Everything else gets pointed to, or he makes the sound for it rather than saying the word. Point to a duck in a book? Cack-cack (quack-quack). A cow? Moooo! A plane (engine sound).

However, as the doctor and therapist noted, he's not frustrated by his lack of expressive language (as the professionals describe it) because he clearly understands everything that's going on around him and is able to communicate his needs sufficiently through yes/no responses and pointing to get his needs met.

He also interacts with us and others in other ways. Over the summer, Ava asked me for a cheese stick but I was busy and told her she'd have to wait. A couple minutes later, I turned around to find that Dylan had heard this exchange and gone into the fridge, opened the drawer and brought his sister a cheese stick as requested. So clearly his hearing is fine, as are his comprehension skills.

We have probably enabled some of the delay. Words and communication are the lingua franca in our house, so we work hard to make sure we're really listening and hearing each other. The downside to that is that we probably communicate for him and are good at guessing what he wants and asking the right yes/no questions to quickly decipher his wants.

Seeing him opening the fridge, I ask, "What's up Dylan? Want something to drink?"
Dylan: (head shake no)
Me: "Want some yogurt?"
Dylan: (head shake no. Points to drawer.)
Me, rifling through drawer: "Want some grapes? Cheese stick? Turkey?"
Dylan: (shakes head yes at turkey and points to it.)
Me: "Okey doke. I'll put it in a bowl for you. Can you get in your seat?"

His doctor and speech therapist say we should instead play dumb and force him to articulate what he wants. Now, I get that that will help in the long run. But in the short run: how frustrating for both of us! That exchange probably takes 15 seconds. The playing dumb routine? What? 2-3 minutes? Some days, that's 2 minutes I'd rather devote to getting something else done, like dinner.

So this week we finally got in to see a speech therapist for an assessment. And it corroborated everything we've deduced: he can hear, he can understand, he's smart, we need to spend more time practicing and enunciating words with him, and he's just not ready to talk more expansively yet. But he's coming along, and we will help get him there.

Where Ava picked up language much more easily just from talking with us, interactions and books, Dylan will need a little more focused attention, which is underway by everyone in the family, including the grandparents who keep him several times each week.

Despite my earlier concerns, it's nice to have a to-do list for this challenge, a sense of a plan for overcoming it, and noticable results already. As always, I feel blessed to have the family support and medical and financial resources to give him the boost he needs to get over this small hurdle. Imagine lacking any of those things and how much stress that would create? My prayers go out to the many who face that exact reality.