If you’ve been reading this blog for a while or you know us personally, you know that Nola’s ears have been a source of difficulty for her (and us) since she was a tiny infant. She had tubes put in when she was only 5 months old – the earliest our ENT would put them in. Even after the tubes were put in, she continued to have infections and fluid. Her ears drained fluid repeatedly throughout the fall, winter and spring. For a while, we were at the ENT’s office to have them suctioned about every other week.
As a speech path, I’ve been concerned about Nola’s speech and language development. She doesn’t have enough words and she continues to rely on whining/yelling and pointing to get what she wants. She’ll occasionally take our hands to show us things, but most often she either gets mad or just gives up. We’ve taught her to sign “more”, but she has to be reminded after she starts whining. She has always seemed to understand what we’re saying, but she just isn’t saying what she should be. I told myself not to be too concerned until she got closer to 18 months, but that nagging feeling just kept telling me to be proactive.
I had to take her to the doctor in June because she was tugging at her ears right before we were supposed to go to St. Louis. Dr. Schaefer was out of town, so we saw Dr. Scherer. He looked at her ears and told me that it wasn’t an ear problem, but she was teething instead. Afterwards, I told him I was concerned about her speech development and asked if he would write a referral for a hearing and speech evaluation. (I wanted the hearing eval to rule that out before we did the speech eval.) He agreed and put the orders in her chart. I immediately called the ENT’s office to schedule an evaluation with the audiologist and started the process of getting scheduled for evaluation at a therapy clinic.
In the meantime, I decided to ramp up my at-home therapy. We started making a greater effort to teach her words and “make” her say things instead of giving in to whining and yelling. Everybody got on board – even Caleb. It was so cute watching him try to get her to say things and trying to teach her words.
Of course, everyone’s response is always, “Well, she’s the baby. Everyone probably talks for her. She doesn’t have to talk.” That just burns me up. I’m smarter than that. We don’t talk for her and we don’t let anyone else talk for her. Granted – as the 2nd child, we haven’t been able to spend as much one-on-one time with her, playing and reading every single day like we did with Caleb. But…it’s not like we’ve neglected her. It’s not like we don’t talk to her or talk about everything we’re doing all the time. I talk to her just like I talked to Caleb. “Look, Nola, there’s an apple. Yummy apples. The apple is red. Can you say apple?” “Oh, my goodness. I see cows. Cows say ‘moo’. Those cows are big and little. They are eating grass.” Sometimes it’s exhausting how much I talk to her about everything – just trying to teach her language.
Nola’s hearing evaluation was on July 15th. She did amazing! The audiologist, Lori, said that her right tube is still in and working perfectly. Her left tube is probably coming out, but her ear function is still good. She passed the tympanogram with no problems. We went into the booth for the sound field testing and she knocked that out of the park too. She responded to every single sound. Just to be on the safe side, Lori did an OAE and there were no problems there either. The verdict: Nola can hear. Hallelujah!
The next step was one that I’m much more familiar with. I made an appointment for her language evaluation at Imagine Pediatric Therapies. I chose Imagine because I have heard nothing but good things about it and I have known some wonderful therapists who have worked there. We went in on Monday afternoon (7/18) to meet with Mrs. Andrea. She was so welcoming and Nola took to her immediately. We spent a long time talking and she asked me lots and lots of questions from the Receptive-Expressive Emergent Language Test and we worked through the Preschool Language Scale together. Nola was much more interested in emptying out my purse and her diaper bag, playing with all of the toys and exploring the room than anything else.
She did what was asked of her, though, and I think we got a good picture of her communication skills. Her scores are very split between the tests. She scored very high on the PLS and much, much lower on the REEL. I know the scores don’t mean much to anyone but me and any other SLP who might read this, but here they are: PLS Receptive = 91, PLS Expressive = 92, REEL Receptive 88, REEL Expressive = 76. That 76 put a major lump in my throat. I never dreamed it would be that low. Actually, the 88 was a little heartbreaking too. I really thought her receptive skills were at or above age expectancy. Andrea wants to do one more test, but Nola definitely qualifies for therapy.
I’m not sure when therapy will start. It will definitely be as soon as possible. I’m ready to see if someone other than her family can convince her that talking really is beneficial. A lot of people have asked why I don’t just do her therapy myself. The honest answer is that when things are hard for kids, they tend to learn better from other people than they do from their parents. I’ve tried all of my therapy tricks and they haven’t worked. It’s time to turn this over to someone who specializes in younger kids.
It took a while for this to sink in. My sweet baby girl is delayed. I never dreamed I’d be typing those words. I never dreamed I’d have a child who didn’t talk. I mean, seriously…what are the chances of that? And, now, I worry about what we’re looking at. Is it simply a language delay because of her chronic ear problems or is it something more? I worry about apraxia and I worry that it could be a part of a bigger problem that I don’t even have a name for. However, I know that no matter what comes our way, we’ll handle it just fine. God won’t give us more than we can handle – even if He trusts us more than we trust ourselves. And, I know this for sure…this little bundle of sass and sweetness will get her point across, regardless of how she has to do it.
