Speech Pathologist

Today was the first of all the ear, nose, throat appointments.  I loved her.  She, E, was very informative and kind and, above all else, impressed!  She really was impressed with Dania's stages of speech development considering she had only known Russian up until 3 months ago!  She went over how cleft pallet kids are delayed in sounds or make other sounds for compensation but had expected Dania to be further behind because of the second language.  She said for a child who stared English 3 months ago Dania was pretty much at par with most stages of typical speech development. 

She did tests to see if she recognized her name, ie would stop her present activity and acknowledge the name prompt.  She gave simple commands, put in box, give to Mama.  Tested how much she could do without a physical gesture to prompt her, ie. saying hug without opening your arms.  She gave her objects to see how she would interact with them and wanting her to use them in conjunction with each other even though they might not be a set of toys normally used together, ie. clapping them together, putting one inside the other.  She then progressed farther to commands like 'throw the ball to mama,' which we haven't done with her.  She also would show her two objects, or pictures of objects, and ask her to point to a specific one, which we have just started with animal pictures.  I told E that Dania loves books and loves animals so E got a book and a bag of toy animals that correspond with the pictures.  Well, Dania was RIGHT into that game!  She asked about what sounds Dania makes and we explained all front of the mouth or back of the throat, with the exception of 'la la la,' and she was happy that she was bringing her tongue forward to make a sound.  We then showed E how Dania recognized the parts of the body without us gesturing and she was impressed with that! 

She gave us some suggestions for work at home, more work in front of a mirror to get her to use her lips more, we need to stop saying "can you" when we ask her to do something and make it more simple and direct, start giving her two objects and getting her to identify a particular one to hand to us, place objects out of reach for her to gesture to them and then we can say the object and try and get her to say it too - even if it is just a vowel sound, and always reinforce what we are doing with simple dialogue.  She said she loves what we have been doing because clearly we are doing stuff right for her!  That felt great!  We just need to simplify and work on the front of the mouth more.  She said that even once she has the pallet repaired, if she is using compensation sounds now she will most likely continue to use them.  Basically, a cleft kid doesn't have the glottis at the back of the throat that cuts off the airway to make a difference between nasal sounds and non-nasal sounds.  If she is using the back of her throat to simulate a sound she will continue to so we will need to follow with E even after the surgery. 

She wants to see us again in about a month to see development, go over in more detail things we can do, and set us up in a cleft pallet workshop as well as an early language development workshop.  She had gone over with us the physicality of her throat and nose and even said that cleft kids are often prone to ear infections because of fluid drainage issues so it is great we are going to get her ears and hearing looked at in detail next week.  Also, if there is an issue with the inner ears, the cleft kid may not be hearing the sounds properly to mimic them! 

We spent almost two hours going over different tests and strategies.  It was awesome.  She was laughing that I was all over the difference between speech and language and developmental stages and then I told her I learned a lot of that in teacher's college. 

It was just such a good visit and I look forward to the next and the workshops!