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Update…The Boy Who Wouldn’t Talk….Yet

I wrote a few weeks ago about beginning the Early Intervention process for Callum – at almost 20 months, he still doesn’t use any words.  Since then we’ve had two screenings; one of the bad things about the EI process is that there tends to be several weeks of lag time between each step.  Even so, things are moving forward.

The first screening was a global development screening.  Our EI “case coordinator” and the child development specialist came out to the house and basically played with Callum for an hour or so.  He was asked to complete certain tasks like pointing at pictures or picking up objects and we were asked a number of questions about his behavior as well.  All of this information went onto a standardized development “test” (not even two and already being standardized tested…sigh…).  Everything – motor, social, cognitive, and receptive language was great, even above average.  But expressive language was well below average.  To qualify for services, children have to have a mild delay in two areas or a significant delay in one – Callum’s expressive language was low enough to qualify him.

The next step was a hearing screening (to rule out hearing as the cause of the speech delay) and a more thorough speech evaluation by a Speech Language Pathologist.  We met with the audiologist and SLP this past Friday.  Everyone was very friendly and worked to make Callum at ease – these folks clearly spend a lot of time working with young children!  Callum’s hearing checked out fine, so that’s not a cause for concern.

After spending an hour or so playing with Callum and asking me questions, the SLP concurred that his expressive language was significantly delayed.  His receptive language was scored as above average at 21-24 months.  But his expressive language is only at the level of a 6-9 month old overall (with a few areas where he ranks higher).  It’s not just Callum’s lack of words that are a concern.  He also doesn’t attempt to imitate sounds (despite imitating everything else we do!) and really only has a few sounds that he uses at all.  So even though he clearly knows many words, he isn’t attempting to say them at all because he doesn’t seem to have the sounds to do so.

Although Callum is still too young for a definitive diagnosis, the SLP felt that he may have some sort of motor coordination disorder such as Speech Apraxia based on the sizable gap in his receptive and expressive skills and his limited use of sounds.  If this is the case, this means his brain knows the words it wants to say but can’t send the signal to the mouth and tongue to form the sounds.    Jesse and I have thought for a while that it often seems like Callum thinks he is saying something or gets embarrassed when he knows he can’t.  Maybe we are just imagining things!?  In any case, we’ll be working with a therapist who has experience working with motor coordination issues.   As Callum progresses through therapy, it should become more clear if this is a problem for him so it’s important to have someone who knows what to look for.  The techniques used for motor coordination issues are also a bit different from those used for more typical speech delays so we may be trying different things.

So that’s where we are for now.  The next step will be choosing a therapist and then starting sessions twice a week.  I’ll keep you updated on our progress!

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Published in Health