Huge Leap in Expressive Language!
I have done a horrible job documenting the lives of Blue Boy and Beany and many small moments have been lost. Fortunately, much has been captured in pictures if not words. But there are also things I don’t think I will ever forget even with no pictures, no Facebook posts or bragging emails to relatives. I remember Blue Boy standing in the big, overstuffed chair looking out the front window – he was naked from the waist up because he was going through a phase where he refused to wear shirts. He was saying something that I have forgotten because as I watched him excitedly “talking” about something he saw outside I suddenly had an epiphany – those are not his words…..they are almost never his words. All that great phrase speech that I thought he had vanished in an instant.
Kids learn to talk by copying what they hear. “Look, there’s a garbage truck” might come back to you as “look, garbage truck” or “mama, garbage truck” or even “truck…garbage”. The typical child learning phrase speech will key in on the important words, remember them, and then use those words the next time they see a garbage truck. Blue Boy was remembering the entire phrase as a chunk or blob of information and whenever he saw a garbage truck he would say “Look, there’s a garbage truck” exactly as he had heard it the first time he made the association. This is echolalia, delayed echolalia to be more precise.
I began to scrutinize everything he and Beany said and compare their use of language. Beany sometimes repeated entire phrases exactly as she’d heard them, but usually she put words together to make new phrases of her own to express an idea or thought. Blue Boy understood and used lots of nouns, but very few of his word combinations were original. The amazing thing is that he largely used his “canned phrases” in entirely appropriate ways so it appeared as though he had rather advanced language abilities. He also used immediate echolalia which is when a phrase, or the last part of a phrase, is repeated as soon as it is heard. His desire and ability to communicate with us even though he was struggling and actually quite delayed in his expressive language abilities was and is impressive.
My initial instinct was to “fix” his expressive language and get rid of the echolalia. I started researching echolalia online and talking to his speech therapist and the other professionals in his life. I’m glad I tend to research first and act second because my instincts were all wrong. Echolalia can not be “fixed” and getting rid of it would deprive Blue Boy of his means to communicate; not that I think we could actually have gotten him to stop talking! Instead, the challenge was to help Blue Boy learn how to use language more flexibly.
Basically, we used one-up-man-ship. This was hard for us because we were used to just talking to Blue Boy and Beany…we had been talking to them conversationally since the day they were born. We had been told how important this was and we were actually really good at it. Now we had to take a new approach with Blue Boy – listen to him, pick out the original speech and then one up him. If he was using single, original words then we would add a second word. If he put two original words together then we would add a third. For example, playing with trains would sound like this:
Blue Boy: “train”
Me: “Blue train” and show him a blue train. “Green train” and show him a green train.
Blue Boy: holds up yellow train and says “yellow train”
Me: “Yes. Fast, yellow train” while making the yellow train move fast on the tracks. “Crash yellow train” as it falls off the tracks.
We didn’t always talk like that, but we would find times to sit down with Blue Boy and focus on breaking language down into its parts. He knew we were trying to “do something” and he was resistant at times. He has this uncanny ability to read people and knows when you are trying to elicit something specific from him. It was a real challenge to work with him like this without “tipping him off”. Blue Boy’s a pretty smart little guy and has been working really hard over the last 6 months and it has really paid off. He has gone from having moderately delayed expressive language to right on target for his age. Whether it is the therapy that helped or if he just needed a bit more time to develop more flexible and functional expressive speech we’ll never know. I’m guessing it’s been a bit of both.
It’s easier for him to communicate with canned phrases so the echolalia continues along with the flexible speech, particularly when he is tired or otherwise stressed. His flexible speech is a struggle that you can hear…he stammers and gets stuck on words. You can feel him searching for the word he wants. He wants so badly to communicate and I imagine this will get easier for him with time and practice. I really couldn’t be more proud of him.