Jamie has had his speech assessment. For the benefit of anyone who’s interested in what happens at a toddler speech assessment (um, that would be me), here’s an account of it.
When we arrived, we were shown into a large, fairly bare waiting room with rows of plastic chairs and a playhouse in the corner. Jamie made a beeline for the playhouse and started checking it out with great enthusiasm while we waited. It was fascinating to watch him, because he doesn’t have much interest in pretend play normally – he’s far too busy with finding buttons to press or books to read or trying to have a go on the computer – but he certainly loved the playhouse. He pretended to drink out of the little plastic cup, and then he pretended to eat the corn-on-the-cob. As he was pretending the corn-on-a-cob was a drinking straw for drinking out of the cup, Tracey (the nursery nurse doing the assessment) arrived.
We extracted Jamie from the playhouse with some difficulty, and brought him through to her room. She got him to sit down at a little table, and asked us if he had any speech at all, and we told her that he had a few words and had picked up quite a lot more in recent weeks since the daytime relinquishment of the dummy. Meanwhile, Jamie, never one to settle for sitting quietly when there were interesting-looking items in view, was busy trying to get to the bag of toys he could see just behind her. We persuaded him, with a little difficulty, to sit down at the table again, while Tracey put out one of those puzzles for small children with pieces that slot into holes. She handed him the pieces one by one – a teddy, a house, a boat, a car, a lorry – asking him "What’s this?" as she gave him each piece and then getting him to put it in its hole. After he’d put a few in, she tried asking him where each object was to see whether he’d point to it. In amongst this, she asked us about what words he could say and how he pronounced them, making some notes about them on a piece of paper.
As we could have predicted, Jamie managed to fit the pieces into their slots with a bit of difficulty (the puzzle had more slots than he was used to, so finding the right one was a bit tricky, but he did it with a bit of prompting), and had no problems at all pointing to them when asked, but he couldn’t name any of them. Tracey tried showing him the picture of the ball since I told her that was one of the few words he could say, and then tried showing him a real ball, but he didn’t name either of those either, although, when she asked him where the ball was (it had rolled under a chair during proceedings) he understood and found it straight away.
Tracey told us that she thinks he might have dyspraxia. This surprised me a bit, as, from what I’d heard of dyspraxia, it affected physical co-ordination, but Tracey told us there was a form affecting speech. Of course, at this stage it’s quite possible that he may be just developing in his own time. However, she wants him to have a formal assessment by the speech therapist to decide on the best way to proceed.
Jamie, meanwhile, was getting into quite a paddy over the fact that, whatever we’d promised him, the toys in here weren’t nearly as interesting as that playhouse, so eventually we let him go back out with Barry keeping an eye on him while I finished talking to Tracey about the plans at this point.
She’s going to refer him to the speech therapist and also ask the
health visitor to do some sort of Schedule Of Something-or-other on him
(I forget the name, but it’s a sort of general assessment for
children’s development). While we’re waiting for the speech therapist assessment, she wants us to encourage him to use his voice more by
offering him choices and insisting on him making some sort of sound to
indicate what he wants instead of just pointing – an approach that I can
see being potentially frustrating. She also recommended this website, although I think she it’s a fair bet that she actually meant this one (which was actually not that helpful either – it’s a website for an association for parents of children with speech problems, but doesn’t have much information on specific conditions such as speech dyspraxia, which is what I was really after at this stage).
Having once again torn Jamie away from the playhouse, where he was having a great time cooking the plastic corn-on-the-cob in the toy microwave and was not in the least impressed by having to leave, we went home. This of course meant that I could look up ‘speech dyspraxia’ on Google, so here’s what I’ve learned about it:
Dyspraxia is a dysfunction in the motor autopilots that enable us to perform activities such as walking or writing or talking without ever having to think in detail about which muscle has to move next and how far. Just as stored programmes in our computer tell the computer to make
particular letters appear on the screen when we type that letter on the
keyboard so that we don’t have to draw each letter individually by hand, stored programmes in our brain tell our muscles to perform particular series of actions when we want to do a familiar activity. People with dyspraxia can’t store these programmes properly, so they don’t have the same smooth and effortless transition between wanting to do a familiar basic activity and actually doing it. In the case of motor dyspraxia, this leads to clumsiness. In the case of speech dyspraxia (which can, of course, co-exist), the problems are with talking. People with speech dyspraxia just can’t easily tell their mouths and throats to produce a particular sound combination. This leads to delay in talking and a lot of difficulty with fluent verbal expression.
Children with speech dyspraxia need speech therapy over a period of several years in order to give them a chance of ever talking properly. However, with this therapy, the prognosis is excellent.
It’ll be really interesting to see whether this does turn out to be the diagnosis. It would explain quite a few little things – such as why he mastered the word ‘three’, yet can’t yet say ‘one’ or ‘two’ even though those should be much easier words. He can’t seem to transfer sounds he knows in the context of one word into the production of other words he knows (hence the continued non-appearance of ‘Mummy’ despite the fact that he has long since made similar sounds to indicate ‘milk’). He loves those imitation games children play, where he makes sounds and Mummy copies them back to him; but it’s always that way round. He rarely or never copies my sounds. He often seems to freeze completely on a word he knows, like an actor blanking on a familiar line in the glare of the footlights.
However, I’m trying not to jump the gun here on the labelling. It’s still quite possible that he’s just a slow talker developing normally in his own time, because there is no doubt that he’s been making major strides since we got that dummy out. (He is definitely saying ‘blue’ (‘boo’) and ‘red’ (‘rrr’). Yesterday while I was at work, he started saying ‘book’, which he actually seems to pronounce fairly well. Yesterday evening, when I was changing him after I got in from work, he started pointing at the Bagpuss puzzle pieces scattered on the floor and announcing ‘Bah puh!’) So I’m looking forward with great interest to the speech therapy assessment.