Picture this (PCS in action)

Here’s one way we got started on our journey to speech stimulation and development: PCS – picture communication system. I found the nearest education store and spent hours just looking at what was available. In another post we’ll talk about how not to go overboard with the spending. You know when you want to find stuff that will help and you pick up one of everything? Then you discover some of it just doesn’t work for you? Been there, done that. Will sell the tee-shirt soon.

Anyway, I found this delightful set of flash cards. The pictures are vibrant. Nice colors and you get simple introduction to the concepts. Naming words – hat, chair, spoon. Action words – run, jump, skip, walk. Remember, the child is a blank slate. Who decided that run was the word for moving the legs one way and walk was the word for moving the same legs differently? Doesn’t really matter who decided. The real issue is that my child, with a speech delay, needed to see these actions in pictures so that she could comprehend the distinction between the meaning of the WALK word and the RUN word. So, here are the pictures from my box of flash cards – brand name TREND.

The box came with a host of action words which I simply put all around the house. Kitchen still has - cook, bake, wash on the stove, oven, dishwasher respectively. Front door has the lock and bathroom has wash, brush (teeth). As you can see, it takes a little work but once you’ve done it once, they just stay there doing their thing. The flash cards posted here were used in the basement since we used the basement door to go outside. These are many of the things you could do outside. Inside and outside were equally challenging. What is ‘inside’? And who decided that outside was outside? With each new concept, I had to be creative and as another blogger (Woozle) says – patient. The biggest part of this journey for me has been developing patience and detective skills to determine what’s the missing piece of the puzzle for her.

And what about all of those things that we say, routinely, and assume that they have meaning. Good morning. Good night. It’s bedtime. Yup.  I created my own flashcards for these concepts. Look, the research and the educational product market is just catching up but the number of things we need, I certainly would go bankrupt if I bought everything that they made. Making some things for myself gave me a sense of involvement.  I’m doing this as my gift 2 my child. I could just as easily buy them but there’s a sense of joy, fulfillment, satisfaction – like baking bread or rebuilding a car – this is the work of my hands coming from my heart for the child of my heart.

I found a picture dictionary – there are lots of really good ones. Then I simply selected the pictures that I needed and copied them. Cut. Paste. And voila – my own flash card.  You can do the same.

Greetings came to life once I had the homemade flash cards. Four years after I created these, you can now find more photos created into flash cards. That’s what speech therapists have been using. Now they are available for purchase…I can’t afford to buy everything and there’s a lot to learn. This is just the beginning.  You’ll have to decide which things you will make (or even have friends and family make for you). Some things you buy, some things you make. Picture this – you need pictures to stimulate language development – some concepts are easier than others. Some take longer to grasp than others. My challenge was to make them as I needed – most times I didn’t figure out what I needed in advance but once I knew what I needed to make, the rest was easy.

Made it myself tip: Locate a good education store or office supplies store. Acquire some basic supplies: glue stick, markers, flash cards (pre-printed and blank), scissors, push pins, double-sided tape. With these basic supplies, you can make your own flash cards from pre-school up. I’m still making flash cards in 1st grade. They provide simple manipulatives that help her acquire, manipulate language and language concepts. Try it and see if it works for you.

Picture this – PCS (picture communication system) - either the official version or your own homemade version is a great way to introduce your child (with or without a speech delay) to language and language concepts. A picture really was worth a thousand words.  The pictures got us off to a helpful start and we are better off for having tried them.

Seen and Unseen (development milestones)

Remember when it was almost time for the baby to arrive? The doctor went through the delivery process including the APGAR score (appearance, pulse, grimace, activity, respiration). You knew what to expect. You were probably also advised about what action the doctor would take if the score was low. Then they sent you home with the baby – no book, no notes, no tip sheet. Some things we know from common sense. Other things we’ve learned from the experiences of our parents, friends, colleagues and the abundance of literature out there.


The baby had 10 fingers and 10 toes. She ate; she cried; she pooped. Things looked good. What I didn’t know was that there was growth and development that could be seen and growth and development that was unseen. Physical development – is obvious and seen. Cognitive and Emotional development – they are actually happening as well. Perhaps the more enlightened parent knows what those facets look like. Sometimes, though, you’re so consumed by the daily routine and the visible signs of development, you forget that there is unseen development at work.


The good news is that with the internet and the explosion of information, there are many more accessible resources that give you robust information. I recently found two sites that I wish I had seen in those early years. While I was focused on feedings, gross motor skills, crawling, walking, and the other seen signs of development, I was unaware of the subtle signs of unseen development - in the cognitive and emotional arenas. Good news was – I have a great pediatrician. With each visit, I learned something new about the seen and unseen development milestones that my daughter was being measured against.


Lesson learned – they can’t give you all the information about every aspect of a baby's development as there is growth that is seen and unseen, known and unknown even to the scientists.


The same is true of the speech – language and cognitive development. Saying words is the starting point of the journey. The first words let you know that they have the equipment to produce the sounds and they can hear and imitate. At 2 yrs she knew over 100 words but at 3 the speech was still unintelligible. Once we visited Kennedy Krieger Institute for our developmental testing, I discovered the range of unseen skills that should have been developing.


While I wish the answers to the cure and cause question were available, I am grateful for all of the speech–language pathologists and practitioners who can administer the tests and clue me in to what is happening developmentally and what should be happening. The ability to name action and agent (what flies, runs, bites); the ability to draw a picture; the ability to repeat a sentence or the ability to repeat a string of numbers - these are just some of the tasks in the assessment that tell the practitioner what cognitive strengths and challenges we face. You can’t study for these assessments.  You have to be developing with the right stimulation, experiences, or professional guidance.
 

Enjoy your child’s development.  Remember, however, that while you can’t see what’s happening in the brain something should be happening. If your child is normally developing then the notion of seen and unseen development perhaps didn’t even register for you. For me, once I discovered that weight, height and knowing 100+ words weren’t enough of an indication of development, I wanted to know more about the seen and unseen development that should be occurring. Check out these websites if you’re interested in learning more about the development phases of children. They are just milestones but they are a guide that can be helpful to parents who want to know what should come next.


Development milestones

PBS child development tracker

If your child isn't growing (weight or height), you would want to know what you could do.  Same goes for developing speech, language, and thinking skills.  If there's a delay, you should learn what it is and what you can do to address it.  Weight and height are development milestones that you can see easily.  There are other areas of development that are unseen but these also deserve your attention and support.  Development includes aspects that are both seen and unseen.  Visible or not, all aspects need our nurturing.

Why are you reading to me?

In recent years, they have translated the research findings into practical help tips for parents. We’ve all heard the familiar ‘reading is fundamental’ and read to your child every night guidance. I heard the public service announcements about reading to your child and even the information package that came from my chosen baby formula. Of course, I wanted my child to be off to a good start so I too read every night.

Then, at some point, perhaps between 18 months and 24 months, I distinctly remember her losing interest in the reading activity. I ignored it briefly and kept up the routine but then it became clearer that there was absolutely no interest. That however, was followed by the “I’ll turn pages and read to myself” phase. Again, with no desk reference or google option, I had no idea what that was about. Sometimes we get cues and clues that something could be amiss. Sometimes it’s not a clue it is a real development phase – developing independence and a love of reading - “Why are you reading to me? I can do it myself.” (Some things have deep meaning; some have little meaning. Pray that you’ll be on guard to recognize the difference.)

Fast forward 3 years: Between the Lions on PBS is a highly rated and nationally recognized reading program. If there was ever a program that facilitated this visual thinker’s understanding of the reading process – this was it!! We had been watching every morning since she was 8 – 9 months. In the early days, it was the sound of the different voices and the lions that seemed to enthrall her. As she got older, some of the books she heard at school were also featured on the program. Abiyoyo was one such. I won’t forget the absolute delight on her face when she saw the book at the library. Now, it was, "Read this one to me!!"

During her first year of pre-school,  they wore hats of every kind in honor of Dr. Seuss' birthday. Though the speech was still limited, it was clear from her eyes and excitement, she enjoyed the book [The Cat in the Hat] and the idea of wearing a hat to school was fun. With her love of song and music, we created a Sound of Music hat that featured music notes and other elements that she loved from the movie.

In her second year of pre-school, while others were learning the letter names and sounds, she was already reading simple words. We were fortunate. The earlier disinterest in reading was replaced by an earnest love for reading.  I didn’t have to push her to read – didn’t have to force the reading activity. It was something that she wanted to do. Now, the reading activity was voluntary, full of enthusiasm, and shared. By the time we got to the second year of pre-school, she was 4+ and could read basic CVC words (consonant vowel consonant).

That was quickly and seemingly ludicrously followed by this inexplicable ability to READ and decode words like crazy. I remember going to the kindergarten classroom where we saw the bright poster with the classroom rules. At 5+, she was among the oldest in the class, but she could read the whole poster. I heard a parent behind us whisper “she read that whole thing”. Again, with no manual for a reference point, I didn’t realize that she was reading well above grade level. Development is a process with ups – downs – highs – lows – and plateaus.

So my lesson learned, she went through a phase where reading to her held no interest. Perhaps her inability to understand the words and a need for good visuals made the activity difficult. Whatever the reason, that phase was followed by a desire to read, learning to read from Between the Lions, reading CVC (consonant vowel consonant - CAT) words at 4+, full sentences at 5+, and at the 2nd grade level at the beginning of 1st grade.

But let’s not get too excited,  reading is made up of multiple skills and phases. Identifying the letters and sounds is just the beginning. There’s also the business of comprehending – we’ll talk about that discovery in another blog. With gentle prodding and external stimulus such as library visits, good PBS programming like Between the Lions, and quiet patience, the ‘why are you reading to me?’ phase has turned into a love of reading and words. The cognitive challenges associated with reading I’ll tackle in a future post.

Reading is not only fun, it REALLY is fundamental.  Accessing the content in the curriculum, even at 1st grade requires the ability to identify the letters, read the words, follow the instructions, and complete the tasks assigned.  If you find yourself in the 'why are you reading to me?' phase - give it some time - not too much - try different types of reading material.  Ask your librarian.  He/she will know the various levels of the reading material.  You want to develop and build interest - not create anxiety and dislike for the one skill that will open (or close) doors throughout life.

April is Autism Awareness Month

April is Autism Awareness month.  My commitment to myself, my child, and others on this Autism Spectrum Disorder (ASD) journey is to start posting more regularly.  But more than that, while the scientists and the dietitians work on causes and cures, I continue to work on supporting academic success and cognitive development.

Going forward I won't only talk about the challenges and triumphs of the journey.  I've learned alot about language and language development.  Oh, there's a whole lot more to know and I leave that to the speech language pathologists and academics who will do research on how the brain works etc.  While they do that, I still have to support my child as she navigates the academic demands of school  Inclusion works for us but there's stuff that I have to do to ensure success and minimal frustration (parent, child, and teacher).  To that end, I'll start sharing some of the tips and techniques we used to learn some of the obvious stuff that just wasn't obvious to us.

With an undergraduate degree in linguistics, I know the basic elements of language, how English came to its present form.  I even know something about the history of the Spanish language.  Then there's all those years I spend in graduate school learning how to design, develop, and create instructional programs.  Who knew that there would come a point in my life when the two would come together for a purpose outside of my job?  Well, that time has come.
 
In order to support her learning, I had to (1) understand what she needed to learn everything.  They come knowing nothing and our job is to introduce them to the world  and (2) I had to figure out what the gaps were and how to guide her in filling them.  Item (1) was a challenge all by itself.  Item (2) involved the detective work that allowed me to use my program design skills and my graduate study research to create resources and activities that helped us when the off-the-shelf products didn't.  The other thing I learned was that most books aren't designed with us in mind.  I determined that if the books don't have what I need, I'll have to create them.  And that's exactly what I've done and am doing.

So, April is Autism Awareness month.  I'm committed to posting and sharing.  What's your commitment - to a parent, to a child, the teachers, the researchers, or yourself?  Everybody loves to say it takes a village to raise a child...if you're in the village, you'll need to know a little something about the people who make up your village.  With current statistics at 1 in 150 diagnosed with an autism spectrum disorder, here's your chance to learn something about us and our journey. 

Awareness is the first step.  The next is action.  However small the action you take, I say thanks in advance for your commitment to the cause of parents like me.

Form - Content - Use

In an earlier post, I suggested that the assessments themselves are like games. I remember shortly after her 3rd birthday, we went for our first assessment - speech and hearing. On that day, I watched as the practitioner gently encouraged, cajoled, made requests, and affirmed my daughter. Nothing in her voice or body language hinted at the performance gaps. And me, the doting parent, what did I know? What I learned that day was the first of many child development concepts – language consists of content, form, and use.

“Content is the meaning of the message. It is also semantics. Form is the structural aspect that includes attaching some symbol to the meaning. The symbol can include a spoken word, picture or a sign. The form/symbol is effective as long as both the communicator and listener both agree on the meaning. Another part of form is the length and word order that includes syntax. Use is the purpose, function, or reason for the communication. It includes pragmatics and social communication.  When one of the areas is missing, a communicative attempt has been made but most likely was ineffective. If the listener and speaker are familiar, then the message may be translated.” (Taken from Speech language assessment)

She played games but didn’t follow the instructions, her eyes followed the specialist closely but in the end it was apparent, even to the doting parent that there were gaps. The specialist started with the good news (we always need the good news first – it affirms the strengths of our child). My daughter’s development was like a star. If you spread your fingers open, you’ll see the finger tips give you the height and the flesh that joins the fingers makes the low points – like a star. My daughter’s speech and language development had high points (and low points).

There were areas where she performed solidly. Then there was the other reality – in many areas, she simply could not respond. The good news was that she didn’t have an obvious hearing problem but there was clearly a problem of some kind.

The initial recommendation was to contact my local infant and toddler program for early childhood intervention services. The other recommendation seemed dorky but it made sense – get flash cards and put them around the house.  Also, she recommended that I use the flash cards or pictures to lay out the schedule. (I didn’t know then that transitioning from one activity to another was a problem….there’s so much you don’t know; and so much they can’t tell you when you get the diagnosis).

This is where I began my learning – the visual cues coupled with slow, deliberate use of the language provided stimulation. First, I got the naming words (nouns) and I put those around the house – table, chair, bed, door, sofa and things like that. Then, I got the action words - verbs - the easy ones to put up were cook, knock, wash, bathe. These I put up in the places where those action verbs were most used. The fun ones were a bit of a challenge. All of the flash cards related to outdoor activity, I put up on the wall in the basement. We’d use that exit to go out to the yard. That way, we could look at the pictures and I could talk about what we were about to do and she would see the pictures as we prepared for the activity.

I hated art and I still can’t draw, but here’s what I realized: I may not be a gifted artist with ability to draw, but my gift is the ability to turn language concepts and processes into visuals that would facilitate my daughter’s language acquisition. Many months later, I learned that speech pathologists and early childhood educators have that gift, so I could learn from them or from resources that they use.

When she started pre-school at 4, I needed to explain that she would do circle time, music, and other activities at one school and then the bus would come and take her to speech therapy. I wouldn’t be there to explain the activity while it occurred so it was important to have those pictures in her head so that when the time came to board the bus, she would remember that we’d talked about it.  Remember, she wasn’t deaf – just delayed in the acquisition of  speech.

The assessment experience also revealed that my daughter was kinesthetic – motor-oriented. That meant, if you did activities with language and movement it was easier for her to grasp meaning. Who knew?

As a student of linguistics, I understood syntax, grammar, and semantics. I knew how English had evolved from Latin to its modern day form. As a parent, all I knew was that she wasn’t speaking. Three days after her third birthday, I learned something else about language that language is not just words. It is form, use, and content and that all three elements need to be present for communication to be effective.