Wow, I didn't expect anyone to have read my novel about Nathan's speech therapy journey over the last few months. But a number of you all told me you read it and had great encouragement and information to share. Thank you all!!!
So, I figured you might want an update, since recently the Speech & Language Pathologist (SLP) & Occupational Therapist (OT) were able to meet with Nathan together at the same time a week ago.
Remember, our SLP thinks it's possible that Nathan has apraxia. She doesn't use the word, because she doesn't diagnose - very few, if any, SLPs will diagnose before the age of three. The only reason I know the word "apraxia" is because the Early Childhood Specialist has mentioned it. Our SLP does believe - whether it's full blown childhood apraxia or not, that Nathan has a motor planning problem.
And the OT believes that Nathan's problem is not motor planning. It's the fact that his fine motor skills are not as developed and his muscle mass in his neck & back is leaner than average for his age.
So what would the two ladies think as they saw Nathan together and got the opportunity to talk it all through? Two amazing professionals in their field, who adore Nathan, and whom I each deeply respect.... Well... I'll tell you:
The OT persuaded the SLP in her direction. I missed some of the conversation - while I took care of Faith and other things. But what the OT shared and pointed out completely convinced the SLP that Nathan's problem is, indeed, mostly about fine tuning his fine motor skills and developing his muscles better. Both woman agree that there is still a motor planning issue. But the fine motor skills is his primary problem.
So what do we do??
Lots of fun stuff: More playing with broken crayons. More playing with stickers (I've got cute pics to post about that tomorrow!). Lots of wheelbarrow races (where he walks on his hands and we hold his feet). Lots of pulling his sister in the wagon. And lots more milk shakes. lol Really.
The OT & SLP want to help stregthen four primary areas - Nathan's back (particularly between his shoulder blades), his neck, hands and lips. Pulling, pushing, rolling, all those things will help with his body. And things like slurping milkshakes through a straw - or yogurt or pudding - will help with fine tuning lip muscles & motor planning. They also suggessted using one of those fancy straws with lots of loops, because it also requires more resistance. The SA zoo sells a pretty cool one, so I think on our next visit the kids will get to take home a souvenir. Let's hope they don't get too use to that... lol
Another idea the therapists suggested was getting some different flavors/colors of chapstick, putting it on our lips and then making different shapes with our lips on white paper. And letting him play with different kinds of whistles at once and then interchanging them on him - like when he plays with the train whistle, switching it out for the slide whistle or harmonica - because he has to plan to shape his lips differently for each one. Those would be good for motor planning with his lips.
ALL the activities they suggested Nathan will LOVE. So that makes it easy and fun!
The OT & SLP also suggested that we start looking into private practice help for Nathan. We can only be part of this Easter Seals type program until Nathan is three. Then he no longer qualifies. He will qualify for assistance through the public schools for speech therapy, but the therapists assured me that Nathan will not qualify for OT in the schools. The schools do not accept preschool children into that program unless they cannot even hold a crayon. They don't care about handwriting, or other things. So Nathan will not qualify.
However, Nathan is going to, most likely, have a very hard time learning to write. So, instead of waiting until he's in Kindergarten to get help from the schools because he's behind his classmates, the terapists strongly suggest that we seek early intervention now. And give Nathan a big jump start on better developing his fine motor skills while he's three, and probably four.
Both ladies recommended a woman in the area that is great at what she does - and one of the only one's who incorporates sensory integration in her therapy. In fact, the SLP use to work with her - so she knows how good she is. Unfortunately, this private therapist usually has a waiting list. So I'm working to find out if our insurance will accept her. And then hope to get on that waiting list so that when Nathan turns three, hopefully he can be her patient :)
So what has caused all this?? Both ladies said that Nathan's dislike of many different textures probably has something to do with his delay in fine motor skills. Because he did not get to experience all those sensations like a normal child - and did not figure out his body as well. To me, that sounds weird... did Nathan really miss out that much by not wanting to touch dirt, grass or gooey things?? But the ladies made sense in their explanation - and I really cannot explain it anywhere as good as them, so you'll just have to trust me.
They also said that they often see a delay in fine motor skills in kids who did not crawl for long - the hands are developed alot when you crawl. But Nathan crawled for eight months, which they agree was a good amount of time. So who knows exactly all the reasons for Nathan's slight delay. But it's just that, a SLIGHT delay.
The OT told me that some OTs would laugh his problems off and insist that he does not need help - they'd tell me he's just fine. She said that his sysmptoms are so minute - and many people would overlook them or ignore them. Like I have done... even though I'm not trained, to me, Nathan has appeared to be doing things well and right for his age. But I never thought to notice or consider how he sits, or how he's quiet when he plays with a new toy, or many other things the OT picked up on. Nathan has fine motor skills, she said. He's using them appropriately. But he needs to fine tune them. When he does, he'll be absolutely fine - no long term issues. In fact, by the time he's in kindergarten, we'll not see a difference between him and other children his age. He might even be ahead of the game, because he is bright and his problem solving skills are above his age level ;-)
And the SLP told me that some SLPs would say that everything they're sharing with me is none-sense: they'd say, "speech therapy is just SPEECH therapy, not all that other stuff." But the SLP said that she's seen the benefit of treating the WHOLE issue and not just the tongue. And from day one, she has known (and been saying) that Nathan's problem is probably a combination of things and not just the fact that his mouth can't make the sounds. She also highly recommended we continue with OT after Nathan turns three and assured me that in 1-2 years, he will have caught up.
I think thats about all they shared. It was a good morning. And I got tons of new ideas and ways to play with the kids that will help Nathan (and Faith) with fine motor fine tuning :)
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