Thursday, May 5, 2011

Diagnosis: Language Impaired, Developmentally Delayed

What next? What happened after Language Delay diagnosis.

Little Taz just turned three and has been diagnosed with language impairment and some developmental delays. It has only been a few weeks since his evaluation and I wanted to share what I have experienced so far, for those who are simply interested or are handling a diagnosis for their own children.

Taz is such a wonderful little boy. So happy and loving, he is my sweet little cuddler. We call him Taz because he loves to climb and explore and in doing so leaves a path of destruction in his wake! He loves the alphabet and puzzles and has such a huge appetite that we call him a bottomless pit! As far as physical abilities go, Little Taz is right on track. He can do anything and everything any other three year old can in that respect. But, by age two, he rarely said anything and when he did it was only one of three or four words. For the next year I told myself he must just be a "late talker" and I didn't worry too much. Not wanting to push him to conform to older brother Bug's milestones, I stressed to myself that my boys were two different individuals and they would develop differently too. A few months before his third birthday, his language hadn't really improved and the communication frustration he was experiencing was more than noticeable. I decided to have him evaluated by Early Steps Intervention.

Early Steps is a state program designed to provide early intervention for children with special needs. Now, I don't know about you, but the term "special needs" certainly didn't describe my Taz. It was abrasive, offensive and ugly. It made me immediately defensive. No mother wants her child treated as if they are not "normal". If it wasn't for my mom, I probably wouldn't have ever contacted them. My mom works in the school system and is very familiar with Early Steps and what they offer. She urged me to take Taz in, just to "see what they would say". I had other family members urging me to have him evaluated as well. And I think it needs to be said that sometimes you just want to smack your relatives. I heard everything from he's "autistic" to he's not "normal" to he's such a "bad kid". If you are experiencing others judging and diagnosing your child, then you have probably had the urge to smack them too. I'm not saying to ignore them, because sometimes it does come from true concern and they just do not have the ability to express their concern properly. However, as a parent you know your child better than ANYONE! Don't let outside influences change what you know to be true. Trust your instinct.

Simply put if you have any concerns about your child's development, having him evaluated will either put our mind at ease or provide you with options for encouraging his progress. The Early Steps Program will test physical, cognitive, gross & fine motor, communication, social & emotional and adaptive development skills. Should your child exhibit delays in any of these areas, they can provide information and services to help. And the earlier your child receives help, the better off he will be. You can also consult your pediatrician, a developmental pediatrician, a SLP (Speech Language Pathologist) or an Occupational Therapist to name a few. After Little Taz's diagnosis, speech therapy was suggested. A speech therapist came to our home on Monday mornings for one hour and worked with myself and Taz. She showed me ways to encourage him to use language and offered many suggestions. It was really important for me to grasp these concepts because I was with Taz most of the time, so it was up to me to continually reinforce the techniques we learned.

One of the ways I got Taz to start using words was to refuse to respond to any form of communication unless it was spoken. For example, when Taz wanted to go outside, he would come to me, take my finger and walk me to the door, quietly showing me what he wanted. So, when he did this, I said "Oh you want to go outside?" Tell Mommy "Outside". Say "Outside". I would then wait for him to say "Outside", verbally expressing his want. Well, let me just tell you, the first time I did this, he laid down in front of the door and pitched a fit for about 10 minutes. I then came back over and repeated "You want to go outside? Say Outside". Again, he laid down and pitched a fit. We continued this for the next hour until in a fit of tears he finally said "Outside"! That was my first indication that we were on the right track. Even though he was upset, mainly because he couldn't verbally express his anger, he understood that his want would not be met without speaking. Over the next two weeks, there were a lot of fits and a lot of crying. I held strong because I was determined for my child to succeed. And even though I was being tough on him and pushing him, it was always done with tremendous love and encouragement. It's normal to get frustrated, but if you are finding yourself getting angry with your child, obviously losing your patience or unable to maintain a normal speaking voice, please consult some outside help to deal with it. You are not helping your child if you are not maintaining your cool.

Taz was only in the Early Steps program for about two months before he turned three. Once a child turns three, he is no longer eligible for Early Steps and he is then referred to the county school system. Each county does their own evaluation to determine exactly what to recommend. So.... Little Taz was evaluated again. Diagnosis: Language Impaired, Developmentally Delayed. Even though I knew exactly what the evaluation would conclude, I still cried hearing it. In fact, I cried with the Early Steps evaluation too. I cried every time I would talk about it for almost two weeks. It was so saddening to accept that Taz would struggle and I shuddered to think how people might treat him. But I knew utilizing services and help early, would provide him the best opportunity for growth and progress and given time, he could very well be indistinguishable among his peers. After his evaluation, an IEP (Individual Education Plan) was created and formal recommendations were made. It was recommended that Taz attend a full-time language based classroom. Full-time. Monday through Friday. 8:30-2:30. This was a blow.

I had been a SAHM (Stay at home Mom) for the past five years. I had always planned on going back to work when the kids started school and I was so thankful for the opportunity to stay home with them until they did. Bug started Kindergarten this year and he was definitely ready. But, to suggest that my Little Taz go to school the same way my five year old Bug did, seemed like too much. It had always been the plan to ease him into school and just like we did with Bug, at two, Taz would attend two days a week (which he did, at a private preschool and he adjusted well). At three, three days a week. At four, Pre-K. And at five, kindergarten. There went the plan.

Taz has just turned three. He is still so little, and with language delays, seemingly smaller. But with only 6 weeks left in the school year I decided to take him full-time. As a parent, you absolutely have input on the IEP, so make sure you agree with it. Had it been the beginning of the school year, I would have probably opted for bringing Taz just three days a week. His classroom has five children (interestingly enough, all boys. I have learned that boys are much more likely than girls to have speech and language challenges). The curriculum is designed to encourage language development and Taz receives one on one speech therapy twice a week. I am happy to say that this is his 2nd week in his new classroom and he has transitioned seamlessly! No crying at all!........for Taz at least. The first morning I dropped him off was my designated "Mourning". I spent the entire day sad and miserable. But I only allowed myself that one day to mourn the loss of my "baby" boy. Then I set out determined to make the best of his time there and to educate myself on any and every way that I, as a parent, could help and encourage him.

We are utilizing the hand-over-hand technique to encourage Taz to follow through with a directive. For example, if I ask him to point to the cat and he does not point, I place my hand over his and guide him to point to the cat. This is to help reinforce his receptive language skills and then I would ask him to say "cat" to encourage his use of expressive language. We use picture cards to illustrate activities and objects. I ask Taz to look at the picture and then have him say the word associated with the picture. For example, if he takes me to the door to go outside, he will now say "outside" without prompting from me. So I show him a few pictures of things that are outside: ball, bike, garden, etc and have him show me what he wants outside. Then I have him say the word associated with the picture he has chosen in order to have his request met.

There are no services offered through the school system over the summer, so I am looking into other options. I don't want him to lose ground with three months of vacation. Most likely we will hire a private speech therapist to work with him during the summer break and of course, continue to work with him at home ourselves. I am still at the beginning stages of my research for ways to help Little Taz. Right now I am reading The Parent's Guide to Speech and Language Problems by Debbie Felt and it has been extremely helpful. I have also picked up The Verbal Behavior Approach by Mary Lynch Barbera because it looked like it would contain useful information, but I haven't started it yet. I have come across some helpful websites and resources as well. I have listed them at the end of this post. I hope you can relate to this post or might know someone who can and if you have experiences that might help me on my journey, please share them with me! I will continue to update on Taz's progress and our experience.

American Family Physician: Evaluation and Management of a Child with a Speech Delay
Bright Tots: Receptive-Expressive Language Disorder
Keep Kids Healthy: Speech Delay
Baby Bumblebee DVDs: Help for Kids with Language Delays
Laureate Software Games: Expressive Language Training

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