speech delay

Speech Therapy Diary : How to Stimulate Amirul’s Reception and Expression of Words

The session went well and Amirul was showing great improvement from the last pre-therapy session. From 8 words to under 100 words — but still have to improve on the pronunciation if we look at his age.He is now able to recognise many nouns mostly on vehicles and basic human parts and anatomy. The puzzle test, colour recognition, and other important test were evaluated during 2-hour session. Amirul was inconsistent with the reception and the expression — that what the doctor told me.

Let move on to the details of the session:

FIRST TEST
First thing Amirul had to do was to arrange the block accordingly, where there were four color of blocks — the doctor said that I can also introduce colors to him when playing this game. Then, Amirul learned about one and all. First, Amirul was asked to take one block. Then, the doctor asked Amirul to take all of them, The objective was to differentiate between one and all. For the first time, Amirul were having difficulty to interpret what is ‘all’. I had to become role model and took all block from the doctor’s hand, just to make understand what is ‘all’.

Amirul learnt one and all concept video

FLASH CARDS
The doctor took out a deck of flash cards and showed to Amirul. She asked Amirul to express what he saw on the cards. Turned out Amirul able to recognise most of the item, but sadly can’t say it. I give you one example — when the doctor showed the comb, he unable to speak but he acted like there’s an invisible comb and stroke his hair.

The doctor concluded that he recognised items but fail to express using words.

Watch Amirul Flash card Stimulation video here.

I LOOK. I SEE. I COMMENT
The communication between parent and the children is important — that was the doctor mentioned to me. So, the method that I have to do is to set a toy in front of him. Look and see what he will be doing and comment upon it. Don’t ask questions!! Just comment like a commentator has been doing — for all his life — during Manchester vs Chelsea football match.

I have to practice to become a natural commentator and not feeling awkward when I have to comment on everything what my son has been doing.

Video for I look, I see and I comment

VEHICLE RECOGNITION & BASIC PUZZZLE
Amirul passed this test. He recognize all but the ship. As usual, he unable say it but doing very well mocking the sound of train, car, plane, and so on.

Amirul was given a puzzle for him to arrange it. He was doing very well and he solve it by himself while the doctor and I were having a conversation on how to tackle the speech delay problems.

Amirul learnt vehicles and basic puzzle here

WHAT WE NEED TO DO
[1] Playtime Recordings.
The doctor said it would be excellent if I had a camera to record for Amirul learning session. Fortunately, my wife has a camera and she will not hesitate to lend his camera for the sake of our son.

[2]Practice, practice, practice.
If you want to expert at something, you have to practice. Communication is a skill and I need to practice the recommended method when communicate with my children.

[Look into the problems]
The doctor evaluated based on the information I gave to her and reviewed that we have a few problems to tackle:
[1] The lack of the routine establishment and instructions
We have routine. If there’s a waste; you should put it into the dustbin, If you finish drinking milk; put it into the sink, finish watching cartoon; closed the TV. But we treat like he was 2 years old. He should’ve been introduced to more routine such as dirty cloth; laundry bag and towel; dry it well. Consistency and Discipline are the two things we should concern about.

[2] Coding Language
The doctor said she disagreed with introducing two language in everyday life. Malay and English word against one item is so not practical and the children cannot coupe with it. He will have problem, like my son, to interpret an item because he have conflict with the coding — which one is right, Malays or English? — in his head.

[3] Failure to practice more basic nouns.
What i realized was i failed to say out loud the basic and simple nouns such as teeth, mouth, ear, and other basic human anatomy. It’s not that amirul failed to recognize them. He knows it very well. We successfully introduced and amirul recognize them. What amirul failed was to say it out loud — the pronounciations. I felt like a punch in the air when amirul unable to say anything when the doctor show the eyes to him. He knows eyes but don’t know how to say it. I felt frustrated — All this time, I was concerned about tree, cat, dog, car, and all, but overlooked with nearer and more basic things like eyes, ears, mouth and nose.

Introducing the new area – Adverbs and Adjectives
It is the right time to introduce both at the age of three. The doctor advised that I can introduce it during play time. It’s better to have a play skill for toddler as one of the essential activities.

The basic Adverbs and Adjectives

  • Slow and fast
  • Big and small
  • Tall and short.
  • Wide and narrow
  • Long and short

Conclusion.
Overall, the doctor advised that — based on the observation — Amirul’s speech delay is mild. It’s not so serious. It can be solved by doing more interactive communication between my son and both of us. Another problems that we haven’t tackle — said the doctor — were [1] the lack of the routine establishment and instructions [2] Coding language, that i have to stick with one language.

For The next session, she asked me to prepare the recorded video of the play time. She wanted to evaluate on how I interacted with Amirul.

Speech Therapy Diary: The First Appointment

To be honest, I really Don’t What He’s been building
The first appointment was all about [1] recognizing the things around him or things that interest him, and  [2] understanding one or two instructions at a time.  For the session lasted for an hour, the doctor evaluated Amirul as okay. It means he is developing speech but very slow. He recognized a lot of things and that’s good. But he needed to build up with understanding more than two instructions at a time. 

May be I got lucky or what, because I didn’t have to waste much time waiting for my session to come. The registration was fast and the appointment was on time.Usually, in public hospital, you have to wait for hours in queue just for registration and then wait in anxiety for your name to call to see the specialist.

I only had to wait for 15 minutes before a nurse calling out Amirul’s name. After that we met the doctor.

We started with small conversation, and the doctor told me what was the session all about.

These are the test that the doctor evaluated on amirul:

  1. Recognize The Pictures: what amirul didn’t recognize was flower. He is a boy, okay. What do you expect when you show him flower?
  2. Puzzle: This was his first time dealing with picture puzzle. Yes, he is familiar with puzzle game on iPad. But, he still needed my assistance to do the puzzle.
  3. Lego Imitation.
  4. Instructions.
  5. Speak a word.
At the end of the session, the doctor asked me to do some homework, in helping Amirul to improve his learning stimulation. Here’s what that I need to do:
1. Spend time with him about 30 – 60 minutes a day:
(A) Match the lego with picture.
  • One-by-One instruction - Give him 1 lego and instruct him to match the lego with picture. Spread out about 6 to 9 flash cards in front of him, and say,
“Amirul, please put Lego on ball”.
  • Two-by-Two instruction- This activity is a little bit harder at first. Give him 2 lego and instruct him to match the with two pictures. Spread out about 6 to 9 flash card in front of him and say,

“please put Lego on -

1. Ball + Car, or

2. Ball + Flower; or

3. Ball + Cat”

For this example, the ball is the control word and it must be in front, no matter what. At this stage Amirul is at learning level. He needs to do this activity more often.

(B) Puzzle. Just buy 3-4 pieces of puzzle and let him do it himself. But sometimes, he need an  assistant. The crucial part is when he finish doing puzzle, you have say it out loud, so he may follow voice.
(C) Visual Imitation. For the first stage, take three legos and build something. Instruct him to build the same like you. After that, cheer him up. It will him stimulation.

2. Speak with him frequently.
When we speak to him, the word must be sound and clear. Plus, the doctor needed me to write down before we even to start conversation with Amirul, like transcript or something. The rational behind it was he could learn quickly when the conversation is constructed and repetitive, Let me give an example:

“Amirul, this is a chicken. The chicken is a bird. The chicken has feathers”

I have to established target word that must be used often and repetitively. Chicken is the target word for the example above.

3. Buy a notebook to write down the daily acitivity.
I have to have a notebook regarding amirul activity and progress, more like a journal. In there, i should write down about

  • What activity course we have done today,
  • The list of vocabularies: even if i have to list eeuu as one of the Amirul’s vocabularies (eeuu is a digger actually)
  • The transcription of what we going the speak with amirul.

For our next session, doctor wanted to a journal. She would evaluate the activity, and the vocabulary based on the journal. Then from that, she would determine what Amirul should do next. We have another six sessions. The doctor said that she wanted to do monitoring closely the progression and it will be intensive as we would have that sessions on every week.

The conclusion.
For the time being, I should continue with the activities the doctor has instructed me to do. She said it was a homework for parents, as if my teacher assigned me a homework when I was in school.

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