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SLP Mommy of Apraxia: October 2014

Tuesday, October 28, 2014

A tale of two roles: navigating my role on both sides of apraxia.

I first met a fellow mommy of apraxia at the Denver Apraxia Walk.  She was pleasant with kind eyes, and said she felt her 5 year old son needed a change up in speech therapy services.

The next week her son was scheduled for therapy at the private clinic in which I work.

In most cases, I have my parents come with their child into my office.  I NEED them to see what I see.  I NEED them to do what I do.  They are with their child the most, and they are completely capable of carrying over what I am doing, as long as they know WHAT I am doing.

Normally the child might be somewhat distracted by the parent; however, this day, I was the one distracted.  Not by my client, but by his mom.  There isn't one word to describe her face, but there were multiple adjectives rolled into one: worry, anxiety, fear, hope.

These are only a few, and honestly, they killed me.

I understood more when she said she had successfully home schooled 4 other children, some even in college.  I admired her.  She not only stayed home and raised her kids, but she taught them school as well.  Their entire childhood development rested on her shoulders and she had done a good job.

But her baby.  Her last child.  This one was different.

I felt her pain.  I absorbed her worry.  I took responsibility for her hope.

I knew I could help her son.  He wasn't receiving the right therapy.  That was evident from his first session.

I was so moved, I came home and told my husband.  I described her face and how it was hard for me to take because I kept absorbing all of her emotions.

It's hard to watch a mother visibly show almost every emotion I went through with Ashlynn's dx, but then be able to turn that off and be the professional SLP I need to be.

I recently watched an initial video I took when I saw him.  Again, though I was trying my hardest to focus on him, I couldn't help but look at his mom in the background.  The worry on her face is tangible.  I just want to yell out, "I will help him mom."  "Slow down."  "Stop worrying."  "He is going to be okay."

Unfortunately, I know saying all of those things is like telling the sun not to rise.  A mother's worry cannot be extinguished.

Last week though, something was different about her demeanor.  A softness was in her face. Upon further questioning, I discovered her oldest daughter came home from college and told her she saw a difference in her little brother's speech.

That's all it took.  Outside validation from an inside source.

I'm sure that doesn't mean she's still not worried, but I hope a small weight, even if ever so tiny, was taken off her shoulders.





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Monday, October 27, 2014

Costume Character Prosody Game


While working with one of my kiddos with CAS this past week, I improvised a fun way to incorporate prosody into our lesson.  Since it's around Halloween, we said his target words in different voices like our ghost voice, monster voice, or vampire voice!  

I decided to make a game that would work really anytime of year to work on prosody.  Say it like a Costume Character has 2 sets of 16 different costume characters.  Another 8 cards include fun game directions like: "Costume Caper!  Take a character from another player."

Each player has a game board with 8 spots.  Whoever fills up their game board first with a different character occupying each space wins!

Of course, you could always just have your students draw a card and say their targets using their character imitation, or you can play Memory or Go Fish since two sets of cards are included.

Find it in my TpT store: Say it Like a Costume Character

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Monday, October 20, 2014

"Oh my goodness!!" Ashlynn turns 5!

The day started long before the AM. Preparations were in place to decorate the house after Ashlynn went to bed.

This year was different though.  When I left to leave while Cody was putting her to bed, she asked me where I was going.

"Mama?  Where you going?"

Though I tried my best to cover, she asked,

"You going for my birthday?"

Freeze time.

My daughter has ALWAYS been astute and observant, but we usually could play it off and nothing more was said.

SAID.

That's the thing.  Nothing more was said, but Ashlynn has been watching all these years.  I think, wait, I KNOW she knew what was going on.

We celebrated her birthday this morning.  My son has been getting up at 3 AM every morning for the past two weeks, so I was sleeping in a chair in his room when I heard noise outside.  I walked out and saw Ashlynn gasping for breath.  No, she wasn't in trouble, she saw the balloons in the hallway!

She's seen these before, but today, she could EXPRESS that she really SAW them.  I had my phone on me and starting rolling the film.


Me: Ashlynn, what do you see?

Ashlynn: Oh...my....GOODness. (dancing through balloons looking at her decorations)

Ashynn: Whose presents are these?

Me: Those are YOUR presents!!

Ashlynn: Who give them to me?

Me: Mommy and Daddy!

Ashlynn: Yeah?  Look!  It's my jerjay Jace (dang assimilation...if you're an SLP, you would find this fascinating, especially since she can say "birthday"

Jace: It's your birthday today?

Ashlynn; Yes, it is!

Me: How old are you Ashlynn?

Ashlynn showing ten fingers: This many!!!

Me: Say, "I'm five!"

Ashlynn in excited fashion: "I'm five!!!

A little later on,

Ashlynn: Mama, where's my cake?

The last two years I made her a cake, but this year I decided to buy her a pretty Minnie ice cream cake that we hadn't picked up yet.  I was surprised she asked where it was.

Take that apraxia!

As the morning rolled on, I was folding clothes when my husband came into the room, eyes red. Emotional. But before I explain why, it's important to know the back story.

A couple weeks ago we were discussing what to get Ashlynn for her birthday.  My husband always has it in his head to get our kids a BIG gift.  He remembers the BIG gifts from his childhood...and some he even remembers what age he was when he received them.

I don't remember my big gifts.  I remember gifts, usually practical.  I love gifts, but for example, on my list for Ashlynn's gifts I had: long sleeve shirts, winter coat, robe, socks....(follow Cody's "really?!?" face).

Ashlynn just isn't into BIG gifts.  For some reason, she loves cards.  Any cards.  Trading cards, flash cards, alphabet cards, playing cards....cards.

I told Cody, if he wanted to get her a BIG gift, he should get her cards.  Buy her a binder she could decorate and put in pocket protectors.  He did...begrudgingly.  But it's true. It's what she wants.  We took her to the toy store THREE times, and she just wasn't crazy about anything.

Okay, so back to his red eyed confession.

Cody: Ashlynn just said "thank you daddy" unprompted.

Me: Really?  For what?

Cody: Buying her cards. She's never said thank you unprompted before.

Take that apraxia!!

As the guests arrived, her Grandma and  Grandpa  were two of the first people in the door.  She excitedly ushered her grandpa to her swing where she got him to push her.  I remember a time my dad came to visit and she wasn't really talking.  She said 'hi' but that was about it.  He left that day and told my mom he wasn't sure Ashlynn knew he was.  You can read about that story here.

The thing is, Ashlynn always knew who he was.  She knew he's the guy who plays ball and boats with her. She knew, but because she couldn't say, he left feeling the way he did.

All those are distant memories now.  She asked him "you push me on the swing?"  and they were gone.

As she was opening gifts, she was telling everyone "thank you" in a big loud voice.  She opened up a box that had a hoodie in it that she saw in the store shopping with me and told me it was pretty.  This was her face opening it up.  I think she liked it ;)



Another shirt she opened had the word Princess written on it.  I asked her who calls her princess.  As she looked up and scanned the crowd, her eyes stopped on her other grandpa that was there. She smiled and pointed at him, saying his name.  He later reported what a cool moment that was.  Verbal confirmation that Ashlynn has always known all along just what has been going on.

This year, singing Happy Birthday and blowing out candles all came easy.  That milestone was met last year.  

The best came at bedtime.  I read her a bedtime story, prayed, and then kissed her goodnight.  She was holding the card book Cody gave her.  She told me, "Mommy!  These are my decorations."  (She was pointing out her room decorations that have been on her wall since basically she was born).  Yes, honey, those are you room decorations. "Yep, just like my decorations for my birthday."  

She is starting to retain, recall, and generalize higher vocabulary.  I smiled.  Then she pointed to her card book.  

Ashlynn: Daddy gave this to me

Me: Yes, he did

Ashlynn: That was nice of him.  You get him so I say thank you?

Me: You bet Ashlynn.

And that's how we are kicking apraxia's butt!

Happy 5th Birthday Ashlynn!  May you continue to find your voice and voice your thoughts, hopes, and dreams.

Love,
Mommy







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Friday, October 17, 2014

Spooky Spider Web Game For Apraxia

Since Childhood Apraxia of Speech requires a different approach to treatment, principles of motor learning theory need to be driving therapy.   You can read more about this in my two interviews: Sharon Gretz interview and Ruth Stoeckel Interview

Since getting 100-200 reps per session can be tedious and difficult to keep new and fresh, I came up with this fun Halloween game to play while you work on the child's target sounds.

Download it at my TpT store: Spooky Spiderweb game


Happy Halloween!



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Wednesday, October 15, 2014

Kids say the darndest things....unless of course they don't because they have apraxia.

What was it that Bill Cosby always said?  Kids say the darndest things or something like that.  Unless of course, you know, they don't because they have apraxia of speech and can't even say the most basic things.  Or this that I just ran across:

Unless of course, they don't because they have Apraxia 
When Ashlynn was born, I wondered what her personality would be, the funny things she would do and say.  I just expected it to happen.  She would be so witty.  She has two smart parents, and one in particular who is quite funny (I won't name names but it's not the SLP).

As time marched on, I did see her personality, and she did do funny things, but it was all so limited. It's pretty hard to say or do basic things, much less funny things when you have motor planning issues affect your entire body.

Seeing other kids her age or younger on social media or worse in person, usually broke my heart.  It got to the point I didn't want to take her around other kids her age and I had to hide friends on social media because I couldn't bear another kids say the darndest things" moment, or really any moment that a typical developing child would have:

Scenario:
My crazy kid is doing back flips off our couch
What I saw:
Ashlynn can't even jump yet

Scenario:
Look at our precious baby wearing her mom's high heels.  We're in trouble!
What I saw:
My precious baby still falls wearing her own sturdy tennis shoes

Scenario:
My son just imagined this carrot looked like an alien
What I saw:
Can my daughter even say carrot, and does she even know what an alien is?

Scenario:
Look at our big boy riding his two wheeler!
What I saw:
My big girl still can't pedal a big wheel.

Scenario:
Little girl just said she wants to be a princess for Halloween.  She sure is daddy's little princess!
What I saw:
My little princess has yet to say her name.

The list goes on. Not that I wasn't proud of all of these other kids, I was.  I was also happy for the parents, and maybe a little jealous.  How easy everything came.  All these cute little milestones taken for granted.

Worse yet, the posts about their child's annoying incessant talking.  If only there was some peace and quiet.

Really?

The quiet is our own little hell.  You can't even to begin to understand how painful that is to hear as a mother who has a nonverbal child, when every quiet moment is spent praying that they will talk.

That's why my last post was so special I guess about Ashlynn confusing "coworkers" with "construction workers."  She always comes along, just in her own time,

and your kids will too.

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Monday, October 13, 2014

The Little Old Lady Who Was Not Afraid of Anything: SLP activity pack


I made my first companion pack today to go along with the book, The Little Old Lady Who Was Not Afraid of Anything, by Linda Williams.  This book is awesome for speech.  I use it for elementary school children, but also read it to my young kids and they are spellbound.  The pack includes a sequencing, describing and following directions activity related to the book. 

The book is a repetitive book that builds on the page before.  This little old lady goes for a walk in the forest and runs into various articles of clothing and each item makes a certain sound: shoes (clomp), pants (wiggle), shirt (shake), gloves (clap), hat (nod), and a big pumpkin head (boo) at the end.  As you will learn from me, repetitive books are excellent books to use to promote language and practice speech since the children can catch on after a few repetitions.  You can read more about how to use repetitive books for apraxia in my free handout .

I always make sure to get out props as it engages the children to pay attention and participate in the book even more.  If you have my companion pack though, there are printable pictures you can also use.  For my verbal students, they have to say the sound that goes with their item each time it comes up in the book.  For my nonverbal students, I might record the sound on an assistive technology device of some sort that they must press when it is their turn. 
I usually choose which items to give the kids depending on their level of speech or language development.  Since Ashlynn has apraxia, I gave her the pumpkin head that said, "boo" when she was younger, since she was working on bilabials (b,p,m) in CV combos.  As she got older, I have her saying the more complex syllable CCVC 'l' blend shapes (i.e. clomp, clap).

Once the kids catch on to their word or phrase, as I read the book I stop at their part to have them say it.  Lots of participation and lots of fun! 

To get my activity pack that includes a sequencing and following directions activity: go to my teachers pay teachers store.

Happy Halloween!

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Friday, October 10, 2014

Working our way out of the apraxia tunnel

Ashlynn has been saying things lately that are really showing higher level thinking. You'd think this would be glaringly apparent to me, but it really IS crazy how much language gives us an idea of what is going on in their brain.
She's been VERY interested in her schedule, and where she is going the next day.  I still haven't made our visual schedule, but it's on my to do list.  She usually asks me though while she's laying in bed to go to sleep,

"Mama, what are we doing today?"
"you mean tomorrow?
"yes"
"Tell me that.  What are we doing tomorrow?"
"What are we doing, tomahyo?"

And then we talk about it.  She loves it when her grandma drops her off at school and I get to take her to her class.  This happens on Tuesday and Wednesdays.  She used to just keep asking 
"you takin me to school?"

I would reply, "Grandma will take you to school and I'll take you to class."

I've been telling her that since she started school.  This week she finally said, 

"What are we doing today mama?"
"you mean tomorrow?"
"yes"
"Say that, What are we doing tomorrow?"

Instead of repeating it back to me, she asked, "Grandma take me to school and you take me to class?"  
This may seem small, but I was sooo proud!

She also asks me who I work with almost everyday and I usually tell her my coworkers or colleagues.

Well the other night, she said, "who you go to work with, mama?  Construction workers?" 

LOL  

I love it.  It makes my heart smile, and in those moments, I know everything is going to be okay.

My last update has to do with school.  This is her third year of preschool.

The first year she came home singing (with 1-2 sounds) the melody to the baby bumblebee song.  By the end of that year, she was also telling me who her friends were in school.

The second year, she would tell me who she played with for that day, but that was usually the extent of her school reporting.

This year, her third year, she's identifying the letters of her name all over the place.  She also told me the other day when we were talking about arctic animals and that polar bears live there, 

"I live in Colorado."  

Me: "Did you just say you live in Colorado?"

Ashlynn: "Yes, my teacher tell me that."  

I sat their in awe.  This is the first time she's ever told me something she's learned at the school.  Heck, this was the first time she said something that she hadn't learned from me or that I hadn't heard her say before. 

I see the light at the end of this tunnel that is apraxia.  To be honest, I've seen it for some time now, but I feel we're getting closer to making it completely out.


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Wednesday, October 8, 2014

Back and forth book for nonverbal students

When a child starts school, a range of emotions can be present in BOTH the parent and the child. When Ashlynn started preschool at three years old, she had only ever been watched by family.  This was fortunate for us because since she was essentially nonverbal for her first three years of life, my husband and I knew we wouldn't know if someone hurt her or abused her.

Conversely, we also wouldn't know anything about her day if we relied on her to tell us.  I wouldn't know what songs she sang, what friends she made, what activity she enjoyed, what she learned, or even what she ate for snack.  Basically, it can be heartbreaking and a little terrifying.

Currently I'm working in a program in the schools for many kids with severe communication needs. Just because they are elementary level, it doesn't mean the parents still don't have those range of emotions, worries, and desire to hear about their child's day.

I came up with this cute back and forth book we've been using with some of the kids.  We printed the sheets out and laminated them.  We then put velcro on and the kids can pick the pictures and put them in the circles for that day.

For example, in the picture below, our little friend said today  he liked the jungle gym, played on the slide at recess, and went to PE.

You can also get pictures or have names of the child's classmates that can be put on with velcro or written in with dry erase marker on the bottom circle, "I played with ____."





     




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Monday, October 6, 2014

What to do when you can't say "Trick or Treat"

Ashlynn said her first "trick or treat" on command at the age of four.  At three...she had an approximation, but then she froze when we went trick or treating.

Many people were polite and kind, not demanding she say something for her candy.  Others though, sat indignantly at the door waiting for "the magic words."  Because Ashlynn's strengths lie in social skills, she was always able to charmingly muster up the word "hi" instead, and most of them would give her the candy.

However, many of my clients report anxiety around this time of year for them and for their child with apraxia.  I've heard of some creative ways around this.

One client I had said she took her daughter with older cousins who all went in a group and spoke for her, if you will.

Another client had a sign that said "Trick or Treat"

A mom I've met through the fb group, made these cute and wonderful cards that not only say "trick or treat" for the child, but also spread awareness!!  I asked if I could share and she was happy to pass them along.

So here they are!!  Thanks Shelley for your generosity!

If you are finding these hard to print, feel free to email me at lauraslpmommy@gmail.com and I will be happy to send you along the PDF.

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