SPEAK Week 2

It has been an awesome two weeks.  Check out the previous post to learn more about the things we learned if you're interested.  Today's post is mainly for celebrating the people that loved on Kiddo and helped both of us learn so very much, as well as final thoughts Nancy had about Kiddo and his future.

Nancy Kaufman:

First of all, a collage, comparing Kiddo working with Nancy in 2014, and just this past few weeks.  Seriously, this lady is amazing.  She knows her stuff, and she is happy to teach it to parents so they can reinforce what the kiddos have been learning at home.  She is passionate and dedicated to these kids and her methods, and they really do work.  

Nancy's Final Thoughts:

In our final meeting with Nancy, Nancy told me how smart Kiddo was, how much progress he's made, and how she's convinced he'll do great and be resolved soon.  I was surprised by this, and so I asked her where she thought Kiddo was on the apraxia spectrum.  He has been stuck in the severe to moderate severe range for so long I thought it would just be awesome to hear we were in the moderate range.  But what she told me, blew me away.  She said she thinks he has mild apraxia!  

During one of his sessions she had told me he sounded very nasal.  I asked her what that meant exactly and she said he sounds very nasal and congested and that we should get an ENT (Ear, Nose, Throat) appointment as soon as we get back.  (I already set up the appointment for August 17, haha).  She told me it could be something simple, like allergies or congestion that could be treated with medicine, or possibly some form of an obstruction that might require a medical procedure or surgery to fix. She explained that when you hear someone talking with a pinched nose it's much harder to understand what they're saying, that generally the vowels are the same, but the consonant sounds are distorted or left out all together, and so getting that fixed will do wonders for his clarity.

She thinks in another year or so, he shouldn't need speech anymore which would be awesome.  I really hope she is right about the nasal thing, because getting that corrected sounds a lot easier than several more years of intensive speech therapy.  Praying he doesn't require surgery, but if it will help him, then we'll do whatever he needs.

I asked her why she thought his language was so far below his peers.  She thinks it's because he has some red flags for autism (which we've had him tested for, he just doesn't have enough flags to be considered on the spectrum), and this is just one of those flags.  She thinks he needs a social skills therapist moreso than a speech therapist, and we should look for social skills groups in our area when we get home.  Also, the fact that he hasn't really had opportunities to practice using language could be a factor, and so she recommends we spend more time encouraging him to use longer sentences and correct grammar, then we do working on his articulation, and we should see his language really take off.  A language take off sounds great to me. :)

So overall, I feel reassured with this news, though if the ENT doesn't find anything then I don't know what we'll do except to continue with the intensive speech therapy until he doesn't need it anymore.  But, anyway, Kiddo with the amazing Nancy Kaufman.

Lessons I'm Learning from Nancy Kaufman

People have asked me if going to see Nancy Kaufman is worth the money.  It is expensive, add in the travel expenses and family sacrifices to make it work and it is costly.

But it's worth every penny.  Every new word, new phrase, new lesson learned is worth it.  I've seen her methods before.  I've attended her sessions at conferences.  I've purchased and watched her DVDs teaching her methods.  I watched her work with Kiddo for four days in 2014.  I've put into practice what I've learned from her.  But watching her work with your own child, determine what your child needs to work on and is capable of, and then teach you how to do it yourself is invaluable.  

The top three lessons I've learned from Nancy Kaufman during our time at SPEAK:

1) Push for more, because he is capable of more. 

I've watched speech therapists work with my son and drill him on two and three syllable words, trying to mold those words into perfection before moving onto longer words and phrases.  Because the more words he says, the harder it is to understand.  I've done it myself with him.

But according to Nancy Kaufman, this is wrong.  Instead of focusing on making sure a child can say bunny correctly (how often do kiddos say bunny every day, anyway?) focus on getting them to functional speech.  "I want bunny", even if it doesn't sound clear, is better than a child being able to say just bunny perfectly clear.

I had learned this last time we were with Nancy Kaufman in 2014, but I'm seeing just how much she expects of Kiddo, and he is meeting her expectations!  I would try and add one word to the length of his sentences, she is adding anywhere from 2-5 words to his phrases.

On Monday (the first day) she showed him three pictures of a boy in sequence, first of him chewing bubble gum, then of blowing a bubble, and then of it popping.  She asked him what was happening in the pictures and he said "Boy blow bubble."  Last Thursday, she was having him say "He is blowing a bubble.  It popped."  And today during his sessions she was having him say "He is chewing bubble gum.  He is blowing a bubble.  It popped on his face.  He needs to wipe it off."

Can you believe that?!  From a three word phrase to four complete sentences..  Amazing!!  Sure, it wasn't perfectly clear.  Sure he needed prompting for quite a bit of those four sentences.  But we're working on that, while teaching him how to use language he's heard for years but has never had the opportunity to use himself.  Because he needs...

2) Scripting, scripting, and more scripting.

Again, I've learned about scripting from her before.  It simply means telling your child what you want them to say, because they don't know how to say it themselves.  It is something that you need to do continuously to help your child grow in language.  So for example, if Kiddo goes up to our hotel elevator and tells me "Push button," I now correct him and say, "I'm.." and pause to let him correct himself and finish the sentence with proper grammar, giving him the opportunity to say "I'm pushing the button."  If he were to leave off the 'the' then I say, "I'm pushing the..." and he will say "I'm pushing the button".  It's a constant process of teaching proper language, but one that he is picking up quickly with the constant practice and the push that he needs.  Because, like above, he is capable of it.  He can handle it.  I cannot accept two or three-word phrases from him when I know he can do more.

And finally,

3) Cueing before the mistake is made

Cueing speech means giving either a verbal, visual, or tactile indication of what or how something is supposed to be said.  For example, Kiddo has a hard time saying m and n if it is at the end of a word.  The cue for m is to put two fingers across your lips to indicate your lips are closed for the m sound.  The cue for n is to touch the side of your nose, because the n sound is nasal and vibrates in your nose, and that way the child can feel if they made the sound properly.  

So, since we know Kiddo tends to leave off the m and the n, we cue him as he is saying the word to remind him to add that sound.  

For example, if we want him to say "I'm eating," we say "I'm'' while putting our fingers across our lips to remind him of the final m.  And 9 times out of 10 he does it. But if we forget to cue him, he reverts back to what he's used to, which is simply to say I since the m is hard for him and the motor planning for the m is not wired into his brain yet.  We want to erase the old pattern of leaving off the m and n and so we are working to create a new pattern that overrides the old one, if that makes sense.

It may all sound exhausting or overwhelming, but honestly, I'm finding it exciting because I'm hearing and seeing the growth right before my eyes.  He is saying things that are blowing me away, and I am beyond thrilled to be learning how to help both my kiddos share their thoughts with the world.  

SPEAK Week 1

We made it to the Kaufman Children's Center!!!  I've been waiting for this for years (seriously!) and FINALLY, Kiddo and I are in Michigan for two weeks of intensive therapy with the amazing Nancy Kaufman in her SPEAK program.  We just finished the first week and both Kiddo and I have learned a lot and we still have one week to go.  :)

We started off with an evaluation, in which Nancy was very impressed with how far he has come in the two years since she last saw him, but we still have quite a ways to go.  Here are the goals we are working on while we're here:

Articulation goals:

• Final and medial (middle) m (ex: tummy and game)
• Final and medial (middle) n (ex: bunny and on) 
• S blends (ex: sleep, sweater, stop, snack, scoop, etc.)
• Th (ex: three, Ethan, with)
• Medial L (Ex: yellow, hello)

Language goals:

• Using appropriate verb tenses
• Using proper pronouns (he/she)
• Using proper grammar (a, an, the, to, is, are, etc)
• Using longer sentences with all of the above goals (ex: "She is kicking the ball."  Before he would just say "girl kick ball")

He is working with Nancy and two other therapists, and they are all awesome and enthusiastic and I don't know what I'll do without them when we go back, haha.  Kiddo is a champ, cooperating really hard and though he mentions he's tired to me from time to time, he just keeps working.  I am sooo proud of him.

Each day he also gets a one-hour speech session with three other kids who are participating in the summer SPEAK program to work on social language skills.  It begins with Lisa, an awesome music therapist singing a few songs with opportunities for the kiddos to practice speech.  Then Nancy leads them in a fun game or activity that requires the kiddos to let her know who's turn it is, what they want to do, etc.  And then they end with a craft project, that the mommies and daddies come out and help with, and encourage our kiddos to ask the therapists for the materials they need.  Lots of good stuff.  We've also been enjoying getting to know the other people here for SPEAK.  In fact, we're all going to meet at the Detroit Zoo on Sunday which should be lots of fun. :)

After each day's hard work, we go somewhere fun to celebrate Kiddo's hard work, such as Chuck E Cheese's, to a playground with some of our new friends from SPEAK, to the movies to see Secret Life of Pets, swimming in our hotel pool, and playing at the McDonald's play place and trying to collect all the Secret Life of Pets toys they have in Happy Meals.  I've been reinforcing what he's been learning in his sessions and it seems to be sticking. :)  For example, he gave me a big hug the other day and told me "Mommy, I'm squeezing you!"  Another time, we went to the playground and I was pushing him on the swings.  Normally he would just request "Higher!" but this time he told me "I want to go higher!"  And when we went to the pool he told me "Look my legs float like a stick!  Not like a rock."  I was blown away by the proper grammar in that statement. :)

Proudly showing off the visor he decorated in one of his speech sessions. :)

Can't wait for week 2, but then I also don't want it to end. :)

Plans for Summer 2015

Within the same week, I learned that Kiddo had been accepted to both Nancy Kaufman's summer SPEAK program, and to a three day mini speech intensive with Jodi Kumar at George Washington University.  We've experienced progress at both places, and I really really wanted to go back to see Nancy Kaufman.  Her SPEAK program is two weeks long, and we went for four days and we saw improvement, so I cannot imagine the improvement we would see after two weeks of working with her and other speech therapists at her clinic.

Jodi's grad student Katie, me, Kiddo checking out the medal he earned (age 3) and Jodi Kumar--July 2013

Kiddo (age 4) working with Nancy Kaufman--Oct 2014

But, when it came down to logistics and finances, seeing Jodi at GWU is much more within our budget, my in-laws can watch Little Brother while we're there since they live nearby, Hubster can still work since he works with a company in the area (plus they'll pay for our hotel since he'll be working, score!), and we can visit with family and friends in the area.

So, sadly, I turned down the Nancy Kaufman experience, though we are planning on taking him back sometime.  Maybe next summer if he's accepted again?  Maybe for another four day intensive during the school year?

But I am excited about seeing Jodi Kumar again, she is amazing, and I'm excited to see what progress Kiddo will make and what I'll learn with Kiddo having speech 3x/day for three days with her.  We will see her in July, and I can't wait to see Jodi again and show off how much improvement Kiddo has made in the two years since she last saw him when he only said about 10-20 word approximations.  :)

Kaufman Day 4

Last day went great!

Speech: During our speech session Nancy and I both worked with Kiddo on his words/phrases, and Nancy gave me excellent feedback on working with him.  She gave me the list of words she's been working on with him and when I get home I'll make flashcards of each of the words so we can keep working on them.  She'll send us her eval and the list of goals to work on for the next 6 months or so soon, so I look forward to that.  I got the DVDs of each of the sessions, and I look forward to watching them with Hubster and sharing them with Kiddo's speech therapists.  Nancy says he has moderate-severe apraxia of speech, but she sees so much potential in him and would love for him to come back for another session.  Hubster and I are already talking about how to make that happen, we saw so much good come from this week.

She gave Kiddo a ziplock baggie full of cars as his prize for working so hard, as you can kind of see in the pic of the two of them below.  He was smiling like crazy about these cars until I snapped this pic, thanks Kiddo. Not the greatest pic ever, but better than nothing. ;)

OT: Kiddo did some fun work on a scooter board, working on his core and arm/shoulder strength.  Poor kid was grunting after a while, it was so hard for him to propel and steer himself using his arms while lying on the scooter, but he did like the game.

We did some more oral motor work, and Ms. Jessica had me do each of the exercises, so that I'd know how to continue the exercises at home.  She gave me a huge stack of papers to read with different exercises to work on with him, and some ideas of things we could buy to help him with his various sensory and oral-motor challenges.

All in all, an absolutely wonderful week.  God answered each of my prayers about this week: safe travels, health, that Kiddo would cooperate, that our therapists would have wisdom in how to best work with Kiddo, etc.  God is so very good, and blessed our trip abundantly more than I could have asked for or imagined.

*     *     *

Kiddo has been saying new things this weekend, that have just blow me away.  My favorites:

• After going to the bathroom on a cushioned toilet he declared it a "sof poppy" (soft potty). 
• I asked the barefoot Kiddo if he wanted to put his socks on.  "No.  Fee ha!"  (Feet hot).  
• When I was telling him we were going to have pizza for dinner but he had to wait for it, he told me over and over again, (the tears and crying didn't help with my translation)"No wait.  Pizza now."   
• After going to the bathroom at a rest stop on our drive home, he told me "I dee, I go poppy" (I drink, I go potty).  I was blown away not only that he knew that, but it is his first 5 word phrase, whoo hoo!!  Actually, that's more than just a phrase, it's a whole sentence!!  Oh, and the lady in the bathroom with us washing her hands heard him say that and giggled and commented on how smart he was.  A total stranger was able to interpret what he said.  :)

When Hubster got to see Kiddo again, he was just grinning at all Kiddo had to say, and he told me "You brought me home a different kid.  I'm so proud of him."  

We can't wait to hear what else Kiddo has to say and I pray that we can get another opportunity (or several) to work with Nancy again.  She's pretty awesome, and so is our God who truly and abundantly blessed our trip.

Kaufman Day 3

Speech:  Kiddo had a fabulous first session with Nancy, where again he said so many words and phrases it filled an entire notebook page, two columns wide.  Way to go Kiddo!

I must admit, she's tough on these kids.  She expects lots of sounds and words and good behavior out of them.  I think it's what gives her such amazing results, but I have to be honest, sometimes it makes me wince.  Like when she'll push Kiddo's hand away from his mouth so she can hear him better.  I understand why she does it, but we've taught Kiddo hand cues, and so he uses them to remind himself of how to make the sound.  Nancy told me she doesn't think the cues are actually helping him, but I disagree.  Some of the sounds he can't make unless he's using the cues, such as his "t"s and sometimes his "m"s.  Also when Kiddo doesn't understand what she's asking him to do, or he gets distracted, you can see her get a little frustrated with him.  But I think that's because she's so eager to get him talking again, working on his sounds and words and so I understand where she's coming from.  Nancy isn't this perfect apraxia goddess, but she sure does get the job done and has amazing results!  She gets more words and phrases out of him in a 30 minute session as I think I get out of him in a few days.  Seriously.

For his second session of the day, I was armed with notebook and pen for another round, but Nancy told me to come in for this session, and to prompt him with some of the phrases.  I must admit, it's intimidating to be trying to do what the so called "Queen of Apraxia" does so effortlessly, but her feedback was so very helpful and will be what will stick with me best when we get home and are Nancy Kaufmanless.  She wants to do the same thing for our last session tomorrow.

Taking a break between speech sessions.  He loves this little car cushion. :)

OT: In OT today he got to swing in this awesome swing that has a small ball pit in the bottom to work on his vestibular system.  He loved it.  He got to do some crawling through tunnels to work on his proprioception, and then we worked on his oral motor stuff.  Jessica showed me tools to use to strengthen Kiddo's jaw, and the Z-Vibe, a vibrating tool that encourages the tongue to follow it.  She put some Pixie Stix dust on the Z-Vibe and put it on the roof of his mouth, and we finally had success with him getting his tongue to the roof of his mouth every single time.  We need his tongue to go there for him to be able to say t, d, and n's properly.  Something tells me I'll need to invest in a Z-Vibe. ;)  We also were working on his blowing without puffing out his cheeks using a whistle and blowing bubbles, and he is getting much better with it.

*           *          *

Little Brother's adventures of the day with Grandma included going to an indoor play place/coffee shop called Jungle Java, where he made a new friend.  He also had fun exploring the hotel grounds and this little playground on our hotel's property.

After all Kiddo's hard work, I took him to the hotel pool for some chill time, where he had a blast, and every time I'd ask him if he was all done or wanted more pool, the response was always "more pool".  Finally, fingers all prunified, I told him it was time to go back to our hotel room, where he asked me without any prompting "Go to elevator?"  Uh, yeah kid, we can ride the elevator as many times as you want if you use words and phrases like that!!!!

Can't believe tomorrow is our last day at the Kaufman Children's Center. We have learned so much, but still have so much more to learn.

Kaufman-Day 2

Speech:  Uh, can I just go ahead and say that yes, Nancy Kaufman is truly amazing.  I want her to relocate to our neck of the woods so we can work with her every week.  Her energy and intensity is amazing, and a million cups of coffee would still not get me anywhere near the level of energy and enthusiasm and intensity she has.  She pushes the kiddos hard, yet knows their limits and makes sure they have moments of fun while they are working.  And she really does make it fun and keeps them engaged and motivated.  She reminds me of a loving drill sergeant. ;)  She got Kiddo to say more words and phrases in a half hour session, then I think I've gotten him to say in the past week.

They worked on lots of his favorite words (pizza, banana, puzzle, shoe, water, sticker, monkey) as well as a lot of the words on her Kaufman cards.  And lots of phrases, such as:

• Put on/off
• Put away
• I want to pick
• Up high
• Oh no!
• Stand up
• Go down

and lots of phrases using verbs, which can also be used as requests:

• pet puppy
• throw ball
• read book
• eat apple
• open bag
• turn on/off
• hug baby
• blow/pop bubbles
• sleep bed
• ride bus/boat
• put on hat

She also has been working on those final consonants (such as hat, boat, bed, up, want, book, yes, pick) and he's doing so much better with them with the help of hand cues.  

She's also getting him to say "yes" with the final "s" sound, instead of his usual "yeah," and to say "again" instead of his usual "more" when he wants something to happen again.

I have pages of notes I've taken, and Nancy records each session, so I can't wait to watch the DVD sessions again and share them with his speech therapists when we get home.

I'm so proud of how hard he's been working for Nancy.  We've prayed hard that he would cooperate with Nancy and her methods that he would learn a lot, and we see God answering our prayers and blessing our time here. :)

OT:  Oh my goodness, their sensory gym is amazing and I wish I could get a pic of Kiddo working/playing in it, but sadly they don't allow pictures in it, though I'm grateful to be able to go in and watch and learn.

In OT today, he did some swinging, did an obstacle course twice that ended up in a super fun ball pit, and played in a kiddie pool of dried rice and beans.  He loved that!  He laid out on his tummy in it, his arms going up and down like he was making a snow rice angel.

Ms. Jessica did quite a bit of work on his picky eating and oral motor skills.  He got to eat some veggie straws, and had to bite it using his back molars, rather than biting it from his front teeth, to help strengthen his jaw.  He caught on quite quickly and ate several veggie straws, biting from the back molars each time and asking for more.

She then showed me strategies for introducing him to new food so he doesn't experience the anxiety/meltdowns he normally does about having to eat anything new.  Today he tried a slice of pear and a turkey burger.  He did great, taking two bites of the pear (he wasn't a huge fan) but eating about half of the turkey burger.  She believes his picky eating and anxiety about new foods stem from a texture thing, and so her strategies should help him deal with new foods and their new textures.

*          *          *

Little Brother's adventure included shopping with Grandma at Meijers, where the pony rides are only a penny.  He loved it and cried when it was time to get off.

Kiddo is so proud of all his "ticker"s he got for his hard work in each session and didn't want to take his shirt with his stickers off for bed.  He is currently sleeping in this outfit.  He was so tired that about half an hour before his usual bedtime he didn't say a word, just went to the bathroom and then climbed into bed by himself.  Within a minute, he was asleep, and about ten minutes later when I put Little Brother into his pack-n-play for the night next to where Kiddo was sleeping, Kiddo's eyes flickered open and he was immediately back asleep again.  

Kiddo is working so hard and making me so proud. :)  Stay tuned to see what we learn tomorrow!

Kaufman Evaluation Day

Well, we made it to West Bloomfield, MI!  It was a 13 hour car trip, divided over two days.  Kiddos did pretty good, thank goodness for technology!

The morning started bright and early, with Little Brother escaping from his pack and play and playing in the living area of our two bedroom suite hotel (which is awesome btw).  Anyway, after getting ready for the day we headed off to the Kaufman Children's Center.  I felt like I was headed off to the first day of school, I was nervous and excited.

But we made it!

Speech Evaluation:

I think what I've been most nervous about is how Kiddo would work with Ms. Nancy, but he was great!  I got to watch from a separate room through the window while he had fun with her toys and did his best with responding to all of her requests.  After his eval with Nancy, I went in to talk to her for a while about her observations.  She told me she sees a lot of potential in him, it just will take longer for him to resolve from apraxia since he has so many other delays and areas to focus on, in addition to the speech.

  

She told me the goals she wants to work on with him for the week and they include the following:

• Working on his t, d, n, w, and h sounds
• Working on final consonants
• Naming nouns, verbs, and functions in 2-3 word phrases
• Learning how to ask questions

And can I just say, yes it's true, Nancy Kaufman is absolutely AMAZING!  She is awesome at keeping him motivated, balancing play with lots of repetitions of speech.  I think my jaw dropped at one point at the phrases she was able to get out of this kid that no one has ever attempted to get him to say yet.  No wonder she's called the queen of apraxia and I feel so blessed to be able to work with her this week.  I can't wait to see the progress he'll make and how she'll go about working on these goals with him.  I don't know if I'll be able to sleep tonight, I'm that excited. :)

OT Evaluation:

Our OT for the week, Ms. Jessica is absolutely fabulous and I'm so excited to see her work with him.  She continually was pointing out things to me, some of which I knew or therapists had pointed out to me, some things I didn't know.  I was starting to feel a little overwhelmed with all the info, but she reassured me she'd have all this in writing for me, and would give me a plan of action as to how to work with him on all these areas after the week was over.  I was so glad to hear her say that what our OT at home is working on with him at home is exactly what Kiddo needs to be working on, so I feel we're on the right track.  Ms. Jessica is a lot more aware of other issues our OT does not know about (such as oral motor), and so for that, I'm grateful for the new insight.

Kiddo had a few moments where he freaked out about something she wanted him to do, usually oral motor related, but overall he was very cooperative and his normal cute self and had fun.

After the two hour eval, we came up with a plan.  He will have an hour of OT for the next three days, where we will work on the following areas:

• Oral-motor skills, working specifically on a stronger bite, blowing without puffing out his cheeks, using a straw or whistle without biting it for stability, putting his tongue up on the roof of his mouth, less sensitivity to certain foods/textures, and introducing him to new foods since he is such a picky eater.  
• Motor skills, specifically on building up his core strength and stability.  Ms. Jessica said once we get his core stronger and more stable while he's moving (instead of the waddling while he runs, sitting in a squat, turning sideways to go up and down steps, etc), we should see a jump in his oral and fine motor skills, as well as speech, and so she really wants to focus on this, as it's (no pun intended) core to all other areas of development.  Our OT at home works on this a lot, but I'm interested to see how Ms. Jessica will work on this with Kiddo.
• Sensory motor, working on his vestibular and proprioceptive issues.  She said his vestibular issues are very minor now, so we've obviously made great progress with our OT at home, but proprioceptive still seems to be the area we're struggling with and I'm intrigued to see what she'll work on with him to help him with that.

The Schedule:

On Tuesday and Wednesday we'll have speech with Nancy Kaufman twice a day in the morning, with a half hour break in between, have a break for lunch, and be back at 1:00 for his OT session.

On Thursday (our last day) we'll have just one speech session and a consultation, and then an OT session and a consultation and be done by noon.  I look forward to the consultations so I can learn how to implement what he's learning at home and keep the progress going forward, as well as share the info with his therapists at home.

Oh, and so I don't forget about Little Brother and Grandma (who so generously came along for the trip to help me watch Little Brother) they had a blast at the local library and story time where they got to play with a parachute.

Stay tuned for Day 2!

Verbal Behavior Therapy

Several months ago I spoke with Nancy Kaufman on the phone after she had viewed one of Kiddo's speech videos I submitted to her.  She's among the best of the best apraxia experts, and has created lots of materials for helping children with apraxia learn how to speak.  I've watched her DVD to learn her methods and use them often with Kiddo.  I met her in July when I went to the apraxia conference (read my post about it here).  And in October, Kiddo will get to work with her for FOUR days.  I'm so beyond excited to see this amazing lady in person work with Kiddo and will definitely post about our time with her. :)

Anyway, back to several months ago I spoke with Nancy Kaufman.  I was telling her that he doesn't say a lot of things spontaneously, only if it's been scripted to him over and over again.  And that he doesn't know how to answer or ask questions.  That he's been diagnosed with a mild-moderate receptive language delay, as well as the apraxia.  And she told me to get him into Verbal Behavior Therapy.  That she thought that with a year of Verbal Behavior Therapy for about an hour a week, his receptive delay should be no more.

I had never heard of it before.  As soon as I hung up the phone with her (and well, calmed down a little bit after having talked to THE Nancy Kaufman and told that she would "be delighted" to work with Kiddo for four days) I researched Verbal Behavior Therapy.  And found that it's a branch of ABA therapy (Applied Behavior Analysis), a type of therapy generally used for autistic children.  I was a little concerned and disheartened, because we've tested for autism before and Kiddo is not on the spectrum.  But the more I read about Verbal Behavior Therapy, the more I was sure that Nancy was right.

"What Is Verbal Behavior Therapy? 

Verbal Behavior Therapy teaches communication using the principles of Applied Behavior Analysis and the theories of behaviorist B.F. Skinner. By design, Verbal Behavior Therapy motivates a child, adolescent or adult to learn language by connecting words with their purposes. The student learns that words can help obtain desired objects or other results.
Therapy avoids focusing on words as mere labels (cat, car, etc.) Rather, the student learns how to use language to make requests and communicate ideas. To put it another way, this intervention focuses on understanding why we use words."  From Autismspeaks.com

The Hunt Begins 

There were only two ABA clinics nearby.  One had a 6 month waitlist, which I put Kiddo on.  The other was 1 1/2 hours away, and required that we be there at least 5 hours a week, with an hour or two a session.  Nope, sorry, no can do.

I bought a few books on Verbal Behavior Therapy, and decided to try and do it on my own.  I learned a few things, particularly what areas that Kiddo needed help in, but not really how to help him myself.
.
At the apraxia conference I attended a session that was about Verbal Behavior Therapy, given by an ABA therapist who also was a Speech Language Pathologist.  What she said made so much sense and I spoke with her for a while after the session about Kiddo and she gave me some very helpful suggestions.  I knew Kiddo needed this Verbal Behavior Therapy--and he needed it stat- if we were going to make any more progress with his communication.

So, I called back the first clinic to see where he was on the waitlist.  Another 4-5 months (after already being on the waitlist for three months).  I called the clinic 1 1/2 hours away and practically begged them to let us come for only an hour a week.  No go.  But, the director did tell me that a new ABA therapist had moved to our area and was looking for clients.  She gave me her contact info.  I called her immediately.  And she has been a godsend.  Seriously, I think God brought her to us just when we needed her the most. :)

Verbal Behavior Therapy Begins

She comes to our house once a week for an hour, right during Little Brother's naptime.  She works with Kiddo for about 50 minutes, and then gives me things to work with him for the remaining 10 minutes.  And seriously, Kiddo is making so much progress, it's incredible.  He's learning how to request for things spontaneously, rather than me prompting me every single time with "What do you want?" or "Use your words."  He's learning how to put words together on his own, not phrases we've scripted for him a gazillion times.  He's learning how to follow two step directions, when before one step was all he could handle.  He's learning how to use verbs.  And this is all with just four sessions of Verbal Behavior Therapy.

I am thrilled.  Yes, a lot of this is just natural growth and development.  A lot of it is us working on the same things with him over and over again.  But the Verbal Behavior Therapy is teaching us the strategies for doing that.  It's teaching us "he needs to be able to understand and say ___ and _____ before he will be able to start asking questions."  I'm learning a lot.  And so is Kiddo.  And that makes my heart so happy. :)

Apraxia Conference

So, this past weekend I went to the CASANA (Childhood Apraxia of Speech Association of North America) Conference.  This is a yearly conference, held in a different city each summer, in which experts in apraxia come to teach speech therapists and parents how to work with children with apraxia.  This year it was in Nashville, Tennessee and it was an awesome experience!  People from 47 states and 6 countries were there.

I shared a hotel room with one of my friends I met at CHAMP Camp last summer and it was WONDERFUL to see her again and talk about our kiddos!  I also got to meet Mary Clare, one of my fav apraxia bloggers and Facebook friends I got to meet In Real Life, and I got to meet Nancy Kaufman, an awesome apraxia expert who Kiddo and I will be going to see in October.  Nancy Kaufman will be working with Kiddo for a four day speech intensive, and I'm excited to see her methods and her ideas for working with Kiddo when we're there.  Here's the four of us all together: awesome moment!! And if that wasn't cool enough, we all went to dinner together with a few other cool people.  :)

Some of the best things I learned:

• A few strategies for working with Kiddo's social skills.  Kiddo has some issues that I've been at a loss how to work with (eye contact, anxiety, answering questions, spontaneous speech, etc).  I attended a session about ABA therapy (Applied Behavior Analysis) that gave some good ideas, and I talked to the speaker afterwards and asked two specific questions relating to Kiddo.  She gave EXCELLENT suggestions, and Hubster and I now realize we need to look into ABA therapy for Kiddo.  I always thought it was specifically for kids with autism (which Kiddo does not have) but it is for any child with behavioral, social, or communication issues and we think it will be really helpful for Kiddo.
• I (of course!) learned lots of strategies for working with Kiddo on his speech.  I learned more about cueing, scripting, articulation, prosody, and all those other terms apraxia parents and speech therapists know well and I'm not going to go into here.  I admit I need to learn a lot more of the hand cues, as they really do help Kiddo with his speech and I need to be more consistent in using them. 
• I learned a few fun activities I can do with Kiddo to get lots of speech practice in.
• I learned strategies for combining literacy and speech, and also for working on handwriting and other OT-type activities.
• The conference concluded with a panel of teens who had resolved of their apraxia, answering questions.  It was wonderful to hear them talking like any other teen would, and for them to admit that either they don't really remember speech therapy or that it wasn't a traumatic experience for them, just something that was part of their life and they found fun, and they appreciate now, as they like to be able to talk. ;)  And I loved how one of them said once she was resolved of apraxia they went to Disneyland to celebrate.  Maybe we'll need to do something like that. ;)

Honestly, I could go on and on, but the overall point is I feel more confident in what I should be working on with Kiddo and strategies to do so.  I wish I had been able to attend more sessions, as most of them sounded really good and helpful for working with Kiddo, but they offered five topics during each session and you had to pick one.  Ugh, so tough to choose, especially when they are being offered by such wonderful experts.

And it is just so wonderful to be around people who not only know what apraxia is and how to work with it, but also parents who know the journey oh so well.  

So glad I went!!  Next year it's in San Antonio, TX.