Wednesday, July 25, 2012


My four (soon to be five)-year-old daughter, Emma, battles a severe speech apraxia that reduces the intelligibility of her very complex sentences to that of an 18-month-old toddler. We have waited for her to outgrow this "speech delay," and we have given her the benefit of the standard early intervention and school system therapy programs, but these produced zero real progress in 2 1/2 years time. Finally, this March, after spending nine months on the wait list for a private group of speech-language pathologists who practice at a hospital 36 miles away, Emma received a real assessment and a diagnosis of severe speech apraxia, and I received a glimmer of hope.

Therapy didn't start in earnest until one month ago, and it is only once a week, but its major contribution has been to give me ideas for how to work with Emma myself at home each day. Coinciding with this has been another idea of mine--that if Emma could read and write it would benefit her in three ways: it would make her attend to each sound in a word instead of constantly omitting sounds that are difficult for her to produce; it would give her an alternate form of communication, writing, if she could not make her mouth produce a word; and it would supremely boost her confidence and her self esteem to able to keep up with her sisters academically.

I wasn't positive Emma would succeed at learning to read when she was still four, but I was fairly sure of it. She had spent the last school year learning to identify and write all the letters, and she'd shown her bright mind in other ways, so we gave it a try. We started in with intensive daily home speech and reading therapy for Emma one month ago, and I'm delighted to announce excellent progress!

We do tongue and lip exercises each afternoon. We practice new sounds and pairing these sounds with vowels over and over again: "Ta, Teh, Tih, Tah, Tuh, Tay, Tee, Tie, Toe, Too." I say each sound slowly and clearly, and painstakingly Emma battles her uncooperative tongue to mimic these sounds. She tries, but instead of "Tah" her tongue follows the familiar route that her brain has created for her to produce the "ah" sound, and she says, "T-gah." Tears well up in her eyes. "I gah goo ih!!" (I can't do it!!) she yells at me, pounding her fist on the table. I look at her with tough love and teach her to yell, "It's hard work!!" instead. "Ih ah wuh!!" she yells, pounding her fist again. I look at her tenderly and smile, and this time she smiles back. We both know she just needed to vent. We back the train up again to "T......aaaaahhhh." She succeeds at producing these sound separately, and I praise her. I draw an imaginary line in the air as we connect the sounds now with no "g" in the middle, "Taaaaahhhh." She swallows, focuses and succeeds again, "Taaaahhhh." And we go wild. Progress. We've both tasted it now. And we want more.

"Sa, Seh, Sih, Sah, Suh, Say, See, Sie, So, Soo," we continue. More tears, more yelling, more tough love follow. "You can do this, Emma! Keep trying, Emma! Don't give up." Slowly, more progress follows. "Okay, on to reading," I say cheerily. We move from the kitchen to the living room now: fresh room, fresh perspective. We leave the frustration in the kitchen. We open our book, "Teach Your Child to Read in 100 Easy Lessons," and spend far more time on learning to pronounce each sound properly, pay attention to each sound in a word, and blend sounds into words than a normal child would need to, but it is working.

Emma has tasted the sweet success of speaking intelligibly as well as reading small words, and suddenly she has an insatiable appetite. Words are all around her and she knows now that she has the power to decode them (with a little help). She wants me to read with her all the time now. We're still on words like "See Sam read it," but it makes sense to her, and she wants more. I don't want to hold her back or tell her things like, "You don't know how to read that yet." So I teach her the extra rules that our book hasn't addressed yet, and she soaks them up like a sponge.

Did she just say "top?" I say to myself, overhearing a conversation between Emma and Hannah. Yes, I heard it with my own ears--not "gah," but "T-AH-P" with all the sounds so crisp and intentional, with no one coaxing her, and suddenly I want to cry.

This afternoon the real miracle occurred. Emma came to me wearing some papers taped to her shirt and said, "Woo ah my gay." I recognized the first three words as "Look at my..." but Naomi, Hannah, and I were all clueless as to the last word. "Gay!!" Emma screamed at us. "Gay!! Gay!! Gayyyy!!!!!!" Out came the tears as I looked sorrowfully at her.

"Be careful,Emma," I coaxed her. "Say each sound for me. What letter does the word start with? Can you write it down for me?"

"I goh oh!" (I don't know) she yelled back, but then she paused. Her eyes brightened. "Tee" she said excitedly, and on the paper in front of her she wrote "t."

"Tee?" I asked with giddy excitement, "It starts with Tee?!"

"Yeah!" she yelled back.

"Great, Emma! Good job. Now think about the next sound. What comes next?"

"A," she said, and wrote down, "a."

"Look at my tay..." I coaxed her. "What comes next?"

"Chee," Emma said. I wondered a moment what "Tay-chee" was, but as she wrote I understood. She wrote "g."

"Look at my TAGS?!" I asked.

"Yeah," she smiled with pride.

It's almost imperceptible, like the rising of the sun, but we began last month in the dark, and today I realized we are standing in the brilliant pink and copper glow that herald's the sun's grand appearance. I don't know exactly what the daylight will look like for Emma. Just this morning I wondered to Matt if Emma would ever speak completely fluently or if it would always be obvious that she had an impediment. I guess we won't know that for several years, but I know it's growing brighter around her all the time.

No comments:

Post a Comment