Anyone who reads this blog regularly will know that SALT has left a bit of a bitter taste in our mouth at times. Boo was first referred for Speech and Language Therapy in January 2013 aged only 9 months. That’s rather early, you might think, but the consultant knew only too well how long the waiting lists were. And then there were the brain scans. It was almost inconceivable looking at all the little black dots where there should be white matter on Boo’s CT images that he wouldn’t have speech problems and early intervention, as in all things, promises the best outcomes.
But nothing is straightforward is it? First of all, we got put on the wrong waiting list in error. When I received a letter saying I would be given a parenting class – as clearly I didn’t know what I was doing – to teach my child how to speak at some point in the next 12 months (but not until then as his age meant he wasn’t a priority) I sobbed for 30 minutes before phoning the consultant who realised we’d been put on the wrong list and got us put on the right one.
And then in late September 2013 we met his speech therapist. She is lovely. But it has taken her a while to get to know Boo and us. Many of the things she asked him to do involved complex physical skills, such as sitting on the floor and picking up and posting objects – ‘He has quadripledgic CP and has limited voluntary arm movement’, I screamed internally – and they used up all his concentration. For the first 3 meetings, he barely said a thing. He was working too hard in the wrong ways.
The upshot of all this was that I felt that she, along with the consultant who can’t be named and we only have to see once more (thank God) before being discharged from his prematurity clinic, had written Boo off in the speaking stakes. All of the nameless consultant’s grimmest pronouncements, that Boo wouldn’t be able to do ‘much at all in life’, that he would be ‘immobile’ and non-verbal rang around my head. I dreaded SALT appointments.
But we did our homework anyway, because we’re good like that (and I like to prove people wrong). I even bought a laminator and registered for the TES website, where I have found lots of helpful resources like flashcards and so forth. I have coloured in phonics cards in the middle of the night. I have made exaggerated facial movements and animal sounds in the mirror until my face hurt. I have learned bits of makaton, despite knowing Boo is unlikely to be able to move his arms with sufficient dexterity to sign back at me.
At times, I have been so sad about it all. So sad that I might never be able to have a conventional conversation with my son. I wrote a post about it at my lowest point, and was really buoyed by the kindness and wisdom of blog readers, who reminded me that there is more than one way to communicate. And I knew this, of course. I never feel like I don’t know what Boo wants or needs. He tells me in various ways and his sister, his dad and I know how to read those signs.
But there were the noises, too. I just found it difficult to believe that Boo wouldn’t ever speak at all, although I am quite prepared to believe that speech won’t come easily to him and that his speech will probably never be entirely distinct. You see, he has always vocalised. A lot. He has an impressive range of sounds – m, n, oof, an, ug, ag, w, y, I could go on and on… And he has had some words for some time: ‘dad’, ‘hiya’, ‘yeah’ and a version of his sister’s name for starters.
I found it so frustrating that people weren’t hearing me when I said that he could speak, if only a bit and with difficulty. But as the months have gone on, we have all (including me) come to understand a lot more about Boo and what he can and what he struggles to do. He learned to use a straw in a matter of weeks (this has helped enormously with his speech development). He has been given endless flashcards to look at and had to prove he can find named objects from a choice of 2. (Where’s the ball when showing a card with a ball and a card with a doll on, for instance.) When he had that down pat (which he did very quickly) we moved to asking him to make choices from 3 or 4 objects (find the ball while also showing him a doll, a teddy and drum) and we introduced a simple communication board with 4 activities on so he had to choose what he wanted to do next by looking and pointing at the appropriate symbol and confirming with his now totally reliable ‘yeah’ that that’s what he wanted to do. He proved through all this that he could understand symbols and language at the abstract level. Then we moved onto line drawings of verbs. He has 30 he can identify and find when presented with a choice of three.
All of this proves what I have always known. He understands us. And more than that, he seems cognitively age appropriate. His speech delay, it’s pretty clear now, is an oral motor issue. Placing his tongue and his mouth is as hard for Boo as getting his arms and hands to do what he wants them to when his intractable brain is not co-operating.
And in that realisation I see hope. Boo’s arm and hand placement is still not reliable, but at the age of 2 it is much better than some people ever thought it would be. This is the little boy who once couldn’t lift his arms or unclench his fists at all. Daily physio for 24 months and he can. If he can get over those hurdles to have more control over his limbs, we must be able to do something similar with his speech.
Now having the confidence of his speech therapist and aided by my new enthusiasm for laminating things, we have done a lot of speech therapy in the last few weeks. Since our last appointment, we have been working on 6 phonics cards (he recognises them all) and can say ‘a’, ‘m’, ‘b’ and ‘d’ now. (‘F’ and ‘g’ are harder although he can say them in the words ‘woof’ and ‘egg’). He can also recognise about 95 per cent reliably the colours blue, red, yellow and green (on flashcards or in matching games) and he tries to say ‘red’ and ‘yellow’ when prompted. He has just acquired the word ‘more’, which we have been working on for months. At his speech appointment yesterday, his therapist was impressed by all his hard work.
I left on a bit of a high. It was working. I was helping him. And we got the paperwork to refer Boo for a service that will assess him for a communication device, which I think he will respond to very well.
But little did I know what was to come…Later that day, I got the best surprise ever.
Because for all I love hearing him say ‘hiya’ and his cute ‘yeahs’ or, very recently ‘o’ for ‘no’, there is a word that I have secretly wanted Boo to say more than anything. I didn’t mind that Boo could say ‘dad’ at 18 months. Kids always do say ‘dad’ first, in my experience. I loved the fact he had a version of his sister’s complicated name early on. I didn’t mind he couldn’t say ‘Mum’ and told myself it didn’t matter if he never said it. It’s just a word. I know he knows how to get my attention. I know he loves me.
But it didn’t stop the tears welling up later that day when we were sat down reading stories. I felt Boo’s body tense a little (a sure sign he is trying to achieve some movement that doesn’t come naturally). I wondered what was about to happen. Filling a nappy, maybe? No it wasn’t. For the first time I heard ‘Muuuuum’.
I felt a shiver. ‘Pardon, baby’ I said hopefully, telling myself not to get too excited. ‘Muuuuuuum’ he said. ‘Did you say, Mum, Boo?’ I said. ‘Yeah,’ he replied. And then a tear fell down my cheek and Boo got a fit of the giggles and tried to give himself a round of applause. And then he made like a tap you couldn’t turn off. ‘Mum’, ‘Mum’, ‘Mum’, ‘Mum’.
It is so hard to explain to you all how much this means. All that hard work he’s done. All the time I’ve spent trying to help him. The way he’s flipped the metaphorical ‘v’ again to the consultant who said not to expect him to make any sounds at all or to even respond to us. And you know what? Boo knew what it meant. His smile, his giggles showed that.
Those three little letters spoke volumes about Boo. About his determination, his potential and how much he loves and is loved by us all. Mum is not just a word. It’s another bloody miracle.
(Oh and yes: I look exactly like the woman in the card below.)