Tuesday, April 13, 2010

Hearing, Seeing, Feeling

People often wonder exactly how speech therapy works for a child as young as Jonah. It can be a difficult puzzle to get a young child to understand making verbal sounds or the meanings of words and language altogether.

The majority of Jonah's speech therapy is play based. The therapist takes advantage of things that Jonah is already interested in, to capture his attention. Last week, when we entered into the "gym" Jonah noticed one of those little tykes basketball hoops right away. "BAW!" he shouted. He has become obsessed with basketball within the last month. He can recognize anything that has to do with basketball, and immediately points to it. In the past week or so, he has begun labeling it verbally. "Baw" is one of three words that he uses consistently. Since he responded to the basketball hoop, the session was mostly spent playing basketball. We presented him with verbal commands to understand and follow, such as "Put the ball IN!" and "Throw the ball to MAMA!" Understanding and following simple instructions like this, is one of our goals for Jonah in therapy. We were also using a lot of labels that we are targeting as goals. One of our goals for his language skills is to verbally identify "Mama" and "Daddy" as well as to look to us when someone else uses those labels.

Another huge part of his speech therapy, is to integrate all of the senses as much as we can. Although he cannot smell or taste the sounds we want him to produce, he can hear see and feel the sounds with our help. Certain phonemes include a release of air. The time of this release can effect the sound that we produce. The "b" and "p" sounds are identical in all of their components (position of the tongue, shape of the lips, movement of the vocal chords) except when the air is released. Go ahead and say "Ba" (I bet no one is listening.) Okay, now say "Pa" You can actually feel the similarities once they are pointed out to you, and even moreso the differences, which is that release of air.

Jonah has a hard time with the "b" sound. He has only started producing it this past week, and even now that he produces it often, he still struggles with it. He also has issues with the "t" sound. So it's no surprise that he has difficulty mimicking the word "boat." Boats are his favorite bath toy. I got his attention first by bringing his boats out and letting him play with them. Then I brought the boat up next to my face. I said "This is your BOAT. BOAT." I made sure that the boat was close to my face, so that when he was looking at the boat he could also see my mouth shape. He was seeing the sound as well as hearing it.

Jonah is used to mimicking games at this point. Ever since I suspected a speech problem (around ten months) I started playing mimicking games with him. In his therapies, these games are a big deal, and he gets rewarded with an abundance of praise for any motion towards mimicking. Jonah knew this game. I could tell he was thinking very intently on how to move his mouth. He stared at me and wiggled his lips. "P... P... Po." He whispered. He seemed aware that he was not making the same noises as I was. Phonetic awareness is something that children acquire at a very early stage of language development. I reapeated "BOAT." very slowly. He tried again, still just whispering.. "po...po.." I took his hand and put the back of his wrist so that it was almost touching my mouth. I made the sound he was making. "PA PA" I did it hard enough so that he could feel the air. Then I made "BA BA" sounds onto his wrist. I let go of his hand and put the boat back to my face "BOAT BA BA BOAT" I said. He felt the sounds, and now he is seeing and hearing the sounds.

By the end of this game, Jonah was able to mimic the word "Boap." He does not refer to his boats spontaneously as a "boap" but I was not going for a label. We were practicing how to make the sounds of the word. We do similar activities in his therapy sessions, using different objects and different sounds.

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