Monday, August 23, 2010

Vocalization Frustration

My mission in life lately has been to try to get Alanna to talk.  The more reasonable part of me says that if I just let her talk on her own and give her lots of opportunity to practice (which she does during her six hours of therapy every day) she will.  But the wound up, anal part of me wants progress so badly.

Here's the funny thing.  The girl can talk.  She has had some great words, many of which are as clear as day.  Sometimes, she will echo a word clear as a bell.  The problem is that she doesn't retain anything for long.  Words that come and go (or have come and gone) include go, muffin, pretzel, bubbles, up, no, ball, sticker, playdough, juice, round and round.  She used to also try to read this book called "I Can Dress Myself".  It was cute to see.  But this was only when she read it over and over again for days.  Sometimes we get random echos back for words she hears.  It seems like it's all motivation with her.

Trying to run the standard echoic (verbal imitation) types of ABA programs don't work.  You can tell her to say "ba", but she has no idea what ba is unless you try to pair "ba" will something she may want, like "bubbles".  But she can approximate better than "ba" for bubbles, usually.  We have several words we are using Kaufman cards with - starting at a lower approximation and moving to higher ones as she masters the lower ones.  Again though I hope as we move up she retains the words.  I would much rather her be able to say /b/ whenever she wants than "bubbles" on and off.  I'll take slow and steady with retension over long phrases or even words at this point.

This week we are going to see a speech language pathologist (SLP) with some experience with PROMPT.  PROMPT is a technique used for dyspraxia of speech, which basically means a person has trouble getting their oral muscles to do the right thing.  Obviously to Alanna hearing the sound is not enough to imitate it, at least most of the time.  PROMPT is designed to help cue the child by moving their mouths into the right position to make the sound.  So far Alanna has been reasonably tolerant of manipulation of her mouth.  I hope this can help her make the right sounds!  I'm pumped! 


  1. How old is Alanna now? I cant understand half of what my neice is saying, apparently she "talks", God only knows what she says half the time to be honest. She is 2. It all sounds like variations of "da". Dada, dadi, Dado, dadyou and so on.

    Khaled is 4 but his words are still really not clear sometimes - there are no "r"'s its a w sound - so some of these things I think are typical.

    And sometimes when the motivation is real strong, a burst of language comes out.

    Today he got an ingrown toenail cut out. OH man, it was painful to watch, he was in a lot of pain, but the language - it was unbelievable.
    "Don't do that", "stop", "all done", "what you doin" - Like he was desperately scrolling for all the right things to say to end the agony of the doctor sticking a syringe in his cut toe to freeze it.

  2. Max had words on and off for about 8 months before he really started to be able to imitate sounds and retain it. She'll get it! It is so hard to wait though and I totally feel your pain. Max seems to be going through a language burst right now (started when he turned 4). From what I understand a lot of children with Autism who are delayed in speech have this burst between the ages of 4-5. Hence the need for early intervention, which you are doing for Alanna.

  3. My son's behaviorist has to keep reminding me that communication is the key, not verbal language. Words would be nice but I know I may not get them since Sam is 5 and still barely talks. We are getting an aumentative communication evaluation done right at the beginning of school this year to see if that might be helpful for him.

    Sam also gets words than loses them. He used to point out certain things in books as I read to him. Now he won't even listen to a book. I have also noticed that he over generalizes some words. For example, he will sometimes blurt out "COOKIE!". He doesn't always want a cookie when he does this. He may just want a snack of some kind or even something totally different for which he doesn't have a word.

    We took Sam to a PROMPT therapist for a while. SHe got amazing sounds out of him. As of now they have't carried over outside of the therapy room but maybe they will as he gets older. It is definitely worht a try.

  4. Thanks for the comments and encouragement, everyone!

    @Stranded - Alanna is 2 years, 9 months, and she is similar to Khaled that way; motivation makes the words come faster and easier.

    @Kat - watching your videos of Max keep me going, I love them!

    @Emma - You are right about communication - it's so much more than just vocals. We use PECS pretty well now, but will throw in some sign if her fine motor imitation improves, and if there are still no good vocals by the time she enters school, an AAC device is the way to go. Thanks for the PROMPT advice - did the SLP teach you to do the motor cues at home?

  5. Join a yahoo group called "communicating" and read some of the posts by Dr Jim (James MacDonald) about communication and talk - he's got a really nice way of explaining how that develops.

  6. Pamela (my 21yo who is still learning English as a first language because of her aphasia but is also picking up some Spanish--her dad's native language) did that for many, many years. At Alanna's age, she was silent (although she had typical infant vocal babble that disappeared) and was learning a couple of signs in sign language. Her language has really taken off in the past six years! :-)