Wednesday, October 26, 2011

Speech Therapy Progress - So Slow

I realized that I haven't done a speech therapy progress update in almost 5 months. I can't believe that much time has passed. I've been doing fewer progress updates because there is less progress to report.

Last time I wrote a progress update I said that we were working on final consonants and that she was using /p/ and /t/ spontaneously about 30% of the time and we had pretty much no other final consonants. Now Ava is using final /p/ and /t/ spontaneously at least 60% of the time in phrases and sentences. She's also using or approximating most of the other early emerging consonants spontaneously at least 30-50% of the time. She can imitate final /s/ and /sh/ as well, but is not using those spontaneously.

We still don't have /k/ reliably. I'd say I've seen relatively little movement on this phoneme in 5 months time. Even in direct imitation with multiple cues she will substitute /t/ for /k/ at least 3/5 times. I am frustrated with the complete lack of progress on learning a velar sound.

Right now I feel like I understand Ava at least 90% of the time in context and at least 50% of the time if I have no context. I think she is significantly less intelligible to strangers. She is speaking regularly in 3-7 word sentences, but most of those are word approximations.

She has /p, b, t, d, m, n, h, f, j, w, s, sh, ng, and vocalic /r/ in her phonemic inventory.

I feel like her language growth has been phenomenal over the past few months. Sentence length and complexity, expressive vocabulary, and morpheme use has all improved significantly (as you would expect for a child of her age).

Speech progress has slowed and is becoming difficult to track. We have shifted out of the stage where we see rapid progress from beginning therapy. Now I am beginning to see that the remaining errors are significantly more stubborn and progress will be measured in small increments rather than leaps. It is disappointing, but not unexpected.

I know slow progress is much more typical of apraxia and motor planning problems than fast or even steady progress. It's just that when things moved so quickly at first I got my hopes up. I was hoping that she would be the exception rather than the rule. Why is there always another reality check just around the corner?

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