This is part of my series about our experiences in getting Early Intervention services for Phoebe’s expressive language delay. Phoebe started receiving services in January of this year, which consisted of one-on-one meetings with a speech pathologist, and weekly attendance of a parent-toddler group. For background, you can refer back to parts 1, 2 and 3. This post is a bit about the course of Phoebe’s language progress, and a bit more about what went on during the services she received.
(I should make it clear that the rapidity of Phoebe’s progress is not typical, and most likely not due solely to the EI services she received. I also can’t say how the service she received compare to those of other locations, and other kids. But here is what we experienced, for what it’s worth.)
When Phoebe started EI services in January, she would primarily use single word utterances, with occasional utterances of 2 words or longer. Through the next couple months, we would get plenty of the 2 word utterances, like “eat cake” or “candles hot”, with more and more 3-word strings.
She was getting more and more comfortable making requests (which became more and more like demands). We tried to encourage her to request using a sentence, such as “I want X,” like the more advanced speakers at the playgroup would do, but she would only produce this reluctantly. She must have been giving this a lot of thought, though, as there was one early morning in March when she was apparently practicing in her sleep. I was startled (and amused) to hear the words “I want a cookie” ringing out loudly and clearly from the baby monitor. (And then she went back to sleep.)
By April, 3- and 4-word sentences were the norm, with more and more of the adult-like grammatical elements showing up. (She would regularly produce plurals and articles, for example.) More helpful to us, though, was that we were getting to the point where Phoebe could really communicate. She could tell us not only her wants and needs, but more information about her state of being. After she had been sick, it was really thrilling for us to hear her produce the sentence “tummy feel better now.”
In spite of all this progress, it was like she was a different child at the playgroup. She would often not say a peep for the first half hour of free play, aside from occasional single word responses to questions. Then at snacktime, she would only whisper her request, which was often only a single word even after she could make longer requests at home. Over the months, she would more and more often make the full-sentence requests that she’d make so readily at home, but very very quietly. Whenever Phoebe was particularly tired, such as after we’d returned from a weekend trip, she’d get even more quiet. Likewise when a new child (and accompanying adult) started in the group, or when a substitute group leader took the place of our regular person.
Things were different with the speech pathologist, J, when we’d meet with her for our one-on-one sessions immediately after the group. Phoebe would need a few minutes to warm up, but would gladly respond to questions and use her words. Our meetings continued to be play sessions, centered around various toys, and Phoebe showed no signs of believing them to be anything other than sitting around and playing with J. I’d sit with them and watch, and play, and sometime encourage Phoebe to tell J about something we’d done since our last visit. Phoebe tended not to speak in quite as complex ways as she did at home, but even so, J never failed to hear evidence of Phoebe’s rapid progress. Each week, I’d have some new bit of language development to report, and Phoebe would usually obligingly produce that construction, if not during that session, within the next one or two. Plurals. Articles. A range of negatives. Multi-word constructions. Past tense. Then full sentences with all the right bits in place. And then, suddenly, complex sentences with subordinate clauses.
Each week, J would write up a report for us of her observations of Phoebe’s progress, and recommendations for things to work on. She’d include a few samples of Phoebe’s longer utterances, which will be nice for me to look back at. She also would give me various handouts about activities we could do to encourage speech, and information about development stages. After the first few weeks, J said that Phoebe’s progress was steady enough that weekly one-on-one sessions were no longer considered necessary. However, seeing as Phoebe enjoyed these sessions so much, and I got a chance to observe the process in action, I asked if we could keep up the weekly meetings. J was happy to continue. (I also got her assurance that there wasn’t some other child waiting in the wings for an opening in the schedule, though.)
I don’t remember when it came up first, but the speech pathologist let me know that come our next assessment, which would be scheduled 6 months from the date we started services, Phoebe would no longer qualify for services.
I’m still not done with this yet, though it’s getting closer. Next time, I’ll talk a bit more about Phoebe’s progress in the playgroup setting, and perhaps also about our 6-month assessment. I’d also like to share more about what I think that Phoebe got out of the Early Intervention services, and how it may or may not have affected her language development.