A Year Ago

A year ago I wrote my last post on my old blog.  It wasn't an official last post, but a post that is worth directing you to now.

Liam's language continues to improve.  His speech therapist is pleased with his progress.  He's been better able to communicate with us his needs and wants even if his tone and cadence is off.  Also, the words he chooses to use are different.  He might say, "I need to do that," while pointing to the TV because he can't think of the phrase "watch TV" at that time. 

The other night he wanted ice cream.  He came up to me, "I want... let me show you," (to which I respond, "no, tell me.") and he runs into the kitchen and opens the freezer.  He comes back.  "I want..." (tell me where it is) "it's in the freezer..." (tell me what you do with it) "you eat it with a spoon...." (oh, you want ice _______ ) "ICE COLD MILK!  I'm just too sleepy to tell you the words."  He couldn't think of ice cream that night.  Sometimes he can and sometimes he can't.

As we're gathering information for a catastrophic insurance claim we've seen the phrase "mild aphasia" used to describe his current speech/language diagnosis. 

What's difficult for me to remember is that aphasia is not a language delay.  He knows the words he just struggles to find a pathway to say the words.  So, exposure to language that he already knows doesn't help him.  Telling him the word he wants as he's struggling doesn't help him.  What he needs is time and encouragement, strategies for describing what he wants, and clues.

When we know what he wants to say we've been encouraged by the speech therapist to use the following hierarchy of clues.  The first type is the most difficult for him and the last is the easiest.

1.  Describe the object to him.  "It's cold.  It's in the freezer.  You eat it with a spoon."
2.  Have him fill in the blank.  "You want to eat ice _______."
3.  Give a phonemic clue - the first sound of the word he's struggling with.  "You want to eat ice KR-"

For awhile now he's been excellent at figuring out the word with the phonemic clue.  He's getting better at filling in the blank.  His therapist upped his latest goal from filling in the blank of a highly predictable sentence to filling in the blank of a medium predicable sentence.  (For example, "On Christmas we open _______." is considered a highly predictable sentence.  I can't think of a medium one - she didn't give me one.) 

Besides giving him clues when we know what it is he's trying to say, we're encouraged to have him describe what he wants (as was the case for the ice cream).  When he starts off by saying something and gets stuck we can reply with the following:

• You want to......
• What do you do with it?
• Where is it?
• Describe it.  (or usually this doesn't work... so we ask questions like "Is it big? "What color is it?" etc.)

Everything about this is getting noticeably better.  I'm looking forward to when he can talk and hold conversations like he used to.  I'm holding on to the phrase his therapist said weeks ago, "We'll get there.  It will take time, but we'll get there."  According to everything I've read about aphasia he will always live with it, but the struggle will become easier and most people won't even notice.  As for now he's got his big brother explaining to the kids on the playground why he keeps saying "GAGA!" 

Aphasia is one of those disabilities that aren't visible from the outside, so when he starts to talk with his baby voice and strange phrases people are usually shocked.  I prefer the kids who just ask why over the parents who seem surprised when they ask him how old he is and he replies "five".  If only I could get him to say, "Five, but I had a stroke and now have aphasia so it takes me awhile to think of my words and my therapist says I use a different voice because it makes it easier for me."