Speech Therapy Evaluation

To be honest, I was dreading Sunshine’s speech therapy evaluation on Thursday.  After her less-than-enthusiastic approach to physical therapy, I was pretty well convinced that speech would be the same.  The 7 months of PT was just not a likable experience despite our amazing and thoughtful therapist.  Sunshine doesn’t take well to new people … she hasn’t since we brought her home.  And I’m 100% ok with that, even though it makes many situations uncomfortable.  But she’s 3 months palate repair post-op now and I knew that at this point, I was simply dragging my feet on scheduling it.  It was definitely time for it.  So the evaluation was scheduled.  During nap time, naturally.

Although timid and not willing to “perform” at first, I was happily shocked to see that Sunshine began opening up and interacting with the therapists.  She had a speech therapist and a special needs educator here to evaluate her and both brought lots of fun toys to keep her interest.  Before we knew it, Sunshine was very interested in what cool tricks the therapists had up their sleeves.  She easily answered their questions and passed many of their tests with flying colors, despite her non-verbal communication.  She was even able to demonstrate mastery of a few 3-year-old level skills!  They said multiple times, “Oh, she’s very smart.”  Of course we know that already, but it’s nice to hear that reinforcement.  They also commented that she had a large attention span (read: she is very determined and doesn’t stop until she “gets it”), based on how long she stuck with one task.  She’s still hasn’t mastered several other “younger” skills though, so she qualified as over 25% delayed in several categories.  She also automatically qualified for services because of her cleft.

After 90 minutes of “playing” and questions, here is the breakdown of her assessment at 28 months old:

Cognitive (playing, thinking, and exploring): 26 months
Communication (understanding others and expressing herself): 20 months
Social or Emotional (emotions, feelings, interacting with others): 22 months
Adaptive (eating, drinking, toileting, and doing for herself): 19 months
Fine Motor (using my hands for play, feeding or other activity): 22 months
Gross Motor (moving her body to change position or location): 22 months

They assessed her at 20 months for communication (which was much older than I thought she’d score) because of how good her receptive language is (what she understands) in combination with her expressive communication through sign.  They said that without these 2 factors, her assessment would have been much lower.  They also said that her receptive language and ASL knowledge were so significant, that they just couldn’t ignore it for the assessment. (Yay for ASL!)  Some of their reasoning for other parts of the assessment I question a little, simply because I know that all children learn and master new skills at their own pace … so I have a difficult time with boxing Sunshine into certain categories.  But either way, extra help is always a good thing!

So we worked up a bunch of goals and someone will be in touch with me to start scheduling therapy!  We’ll most likely have speech therapy once a week and then meet with a special needs educator about once a month to help with the non-verbal stuff.  I also want to share another suggestion they gave me:

Because she can successfully use the consonant “m” (seriously, ask anyone who is around her for more than 5 minutes … mama, mama, MAAMAAA, maaaa, MA!!!!), they suggested working with her to use the “m” sound to make more words … any kind of words.  “Mooo” for cow, “more,” “me” … anything with a “m” that makes a sound.  They said that repetition is absolutely key here.  So that’s what we’ve been working on for the last few days, and we’ve had some very positive results!  She has a difficult time putting the “m” sound and the next sound together to make one fluid word, but she is creating the sounds separately.  I’ll take that progress for now!  Right now, I am focusing on “me” and “more” … she is responding positively, so I’ll continue on that track.

This speech therapy thing is all new territory for me, so if any other BTDT mamas have any advice, I am all ears!  I would love any suggestions you could offer.

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  • October 21, 2012 - 6:46 pm

    Amy - Our Milo qualified for speech (I think this is hilarious- he qualified because of his amputated arm! ???). He also scored higher than he probably should have due to his receptive language. We had in-home speech therapy that lasted for about 6 months. Although I really liked our assigned therapist, we just didn’t see much progress in all that time. We worked on the same exact concept the entire time she visited, each & every time, for 6 months. We saw small advances, which was enough to qualify for continuation. But we were really disappointed.

    When we enrolled him in daycare, however, we were blown away with the advances. Peer pressure can have some positive aspects, apparently. 🙂 Once Milo turned 3 (this past summer), he no longer qualified for the in-home visits run through our county. Now he’s part of a program through our local school system. He has appointments once a week that we take him to (no more in-home stuff – boo! but we were previously only seeing the therapist once every 2 weeks), and a supervisor visits his daycare once a month to work with his teachers so everyone is on the same page in working with him. Whereas we had been seeing Milo only use words when prompted, only 1-2 words here & there, and lots of frustration; now we see unprompted, spontaneous usage, 3-5 word answers to questions, and he’s even started learning some of his emotions (so so helpful with frustration & temper tantrums!).

    Anyway, all that to say: if for any reason, you don’t feel that it’s quite right, make sure you ask for a change. I really liked our first therapist on a personal level, but she just wasn’t getting all of Milo’s potential out of him. I was nervous & embarrassed to admit that, and didn’t complain. That probably set Milo back by a few months. Hindsight is 20/20, so I try not to dwell on it, but make sure you have your “mommy radar” going to get the most of your sessions. Also, something I wish I’d done more of & am trying to rectify it now- take videos of where she is now, and keep them going so you can see just how far she comes. Sometimes it’s not easy to put into words exactly how they’re growing, but when you see videos of “then” & “now”- it’s very exciting! Good luck!!ReplyCancel

  • October 21, 2012 - 10:35 pm

    Wife of the Prez - Our DD never qualified for in-home therapy b/c she came home at 35 months. Our son either b/c he came home at 5 years, 0 months.

    I agree with Amy, though, to push back if you don’t think it is working for your child.

    The once weekly ST our DD received through early intervention at a nearby school (b/c she was older than 3 so no one-on-one in the home) was a TOTAL.WASTE.OF.TIME.

    She was in a room with two other children younger than her who were both non-verbal. She is very verbal; people just couldn’t understand anything she was saying. But she talked in complete sentences.

    So, the therapist spent the entire 30 minutes working with the other 2 children who were non-verbal, while our daughter colored worksheets. We finally dropped out and told them we were going somewhere else.

    Now we pay our private, in-home ST $90 an hour, but it is so worth it. Would never go back to ST through the school system. I feel like Amy that we wasted a lot of precious time doing that route, but I’ve heard others who had great success with it. Just didn’t work out for us.

    Our DD, btw, just turned 7 years old and will be singing a solo in our church’s Christmas Musical in front of at least 500 people. I NEVER imagined more than a year ago, certainly not 4 years ago when we brought her home with unrepaired cl/cp at 35 months old, that she would ever be able to do anything like that. I am SO VERY PROUD of her her!!!ReplyCancel

  • October 21, 2012 - 10:35 pm

    Ruthie - She is PRECIOUS. I can’t even get over it.ReplyCancel

  • October 22, 2012 - 4:53 am

    scooping it up - just hopped over from Sunday Snapshot and wanted to say these shots are adorable. I’ve had three kids in EI for speech, OT PT, Developmental Therapy and it has been life changing for us and our kids. I hope things continue to go well for her and that she loves it. It can be an awesome pillar of support. Right now we are at seven EI appointments a week, and it benefits my kiddos in a profound way. I hope you find the same experience.ReplyCancel

  • October 22, 2012 - 8:04 am

    Whimsy - Popped on over from Sunday Snapshot – I love her facial expressions!ReplyCancel

  • October 23, 2012 - 9:16 pm

    kim - Hi there, I’m a mom to a six-year old China BOY with cleft-lip/palate. I second the recommendation for private speech. Also, look into your insurance company. I was able to get 35 visits a year covered (albeit copay) when I lived in the States. Now that we’re in Canada, I’m sifting my way through a whole new system… looking for a CLP support group here, in fact.
    Good luck to you. You’re daughter is absolutely precious.

  • October 24, 2012 - 2:47 pm

    anything but LoKEY - Just catching up a little and saw your post. I just posted a recent speech update for Lily. Making progress, but some days it seems slow. One suggestion is to get her to say “mmmhmm” about her meals. Lily had a difficult time at first really pressing her lips together for the “m” sound because of all the scar tissue from her lip surgery. Everything was very stiff. So, just licking her lips off and things of this nature were slow going. We used a harmonica to help her get more lip flexibility and to practice blowing. It works wonders! Also, you will be so amazed at how quickly she begins to make progress. It is truly astounding and it gives them so much confidence. 🙂ReplyCancel

  • October 24, 2012 - 5:44 pm

    Jerusha - Shu has been in twice-weekly ST for…I can’t even remember when he started. Not for CL/CP, of course, but his issues are surprisingly similar, and I am working as hard as he is at it. 😉 Good progress, and very necessary, but not easy. Let me know if I can answer anything specifically. We adore our ST…thank God!ReplyCancel

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