Receptive Language (Understanding) Difficulties
Negation: examples “Which person is NOT eating?” “Who is NOT sleeping?”
Functional relationship: “Which [picture] is heavier/bigger/etc.?”
Descriptive concepts: “Which [picture] is long/short/curly/straight?”
Quantity: “Which picture shows half a cookie/a whole cookie?”
Time/Sequence: “Who is first/last in line?”
Expressive Language (Talking) Difficulties
Answering questions: “What do you do when you are hungry?”
“When do you eat breakfast?”
“Tell me about your pets.”
Repeating sentences: Sentences with more than 4 words.
One interesting thing I noticed is that her understanding was more delayed than her talking. For most children this is usually the opposite. Most typically developing children understand much more than they actually say, as do many children with speech/language delays.
The most obvious problem was her inability to answer questions. We were not able to have the “back-and-forth” conversation that you might expect to have with a child who is older than 2 to 2 ½. She could answer a very concrete, factual question (such as “What is that?, What is his name?, Where are we going?”) but nothing more complex. She often would go off on a tangential topic (with some of her phrases making sense and others more like babbling/jargon) rather than stay on topic for more than one question/answer. Although she seemed very “talkative” at home (although much of this was random, stream-of-conciousness self-talk), she was not talking at preschool. This surprised me, considering how social and outgoing she was at home and with friends, and this was a big reason I contacted a Speech-Language Pathologist.
Many people (none of whom knew her diagnosis) asked me why didn’t I just do the speech therapy. There were several reasons. . . .
Number 1: Every moment of my day with her is speech therapy. I am constantly encouraging her to “say it in a sentence,” modeling appropriate social skills, correcting glaring grammatical errors, testing her understanding, etc., etc., etc., and I needed another “teacher” to impose a more formal structure, give homework with deadlines, and establish a "school teacher"-type relationship.
Number 2: I work in Early Intervention, also known as “Birth to Three.” Once a child turns three I don’t see him or her anymore. (FYI if the child still qualifies for services, they are provided by the local public school district.) I used to work with children of all ages, but it had been a while and I didn’t feel like my knowledge of preschool language therapy was as strong as it could have been.
Number 3: I knew that insurance should cover the therapy because she had a medical diagnosis. I also knew that other issues probably would arise and I would need a good team of professionals, especially as we prepared for Kindergarten. For example, many kids with FXS have social, psychological, sensory and/or attention problems as well as language delays. No parent can be social worker, psychologist, occupational therapist, teacher, doctor and speech therapist to their child, and still have time left over for FUN!! (At least not this parent.)
Have you ever considered home-schooling your child and then realized that you and your child may not have the ability to separate the “parent-child” roles from the “teacher-student” roles? I needed a separate professional for this challenge!
My next post will begin to discuss the types of activities we worked on to address these areas of difficulty.
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