At the end of June, I shared my story about how many people misunderstand my daughter Alicia because she’s introverted. It was amazing hearing from many other parents, some whose children were introverted like mine, and some whose children had been in need of early intervention for a variety of reasons. A common thread in these comments, and something I had already been thinking about, was the possibility of speech therapy. At the time, many of Alicia’s speech sounds weren’t right – “gwocks” instead of “blocks”, “pour” instead of “four.” And it seemed to me that this was making her harder to understand than many other three-year-olds.
I couldn’t judge by the example of her older brother, who is among the most verbal kids around. (Sometimes that’s a blessing, sometimes that’s a curse!) Ben always wants to tell everyone about everything all the time – and how do you talk about Skylanders or dragons or pirates if the people around you can’t understand what you’re saying? At Alicia’s age, Ben was talking like some five year olds; he was NOT the example to use of typical language development.
Meanwhile, Alicia’s talk was almost all self-directed. She would tell incredible stories – but only to herself, which meant there was never a need for her to clarify what she was saying. I kept wondering if her mispronunciations were the result of a lack of practice, or if there was something else going on. So I was pleased that a referral for a speech evaluation came out of her screening, even if I anticipated a lengthy wait before we’d get the phone call.
The first step was an audiology appointment to ensure her hearing was normal. As I had expected, that all checked out. And then, to my great surprise, I got a call from the local speech program – with people away over the summer, we had the opportunity to come in for an evaluation in mid-July. Was I interested? You bet! And I am so glad we were able to accept.
We headed in for our initial playgroup and evaluation. Alicia and I went into a communal play space, and she got to settle in and play with some of the toys while Erin, the speech language pathologist, talked to me about what I was noticing about Alicia’s speech. To my delight (and, I will admit, relief) Erin immediately understood what I was talking about when I said that Alicia was introverted, and said that she had experience modifying her approach accordingly.
We went through some questions about how Alicia talked. They started with the basics – what were my concerns – and then got into the nitty-gritty: did she know the names of people in the family, could she follow two-part directions, could she tell a story? She even asked about very specific grammar and syntax issues: did Alicia use pronouns? Did she seem to understand the difference between past and present tense?
Then it was time for some one-on-one: Erin sat down with Alicia in a separate space, and they played with a bag of toys, carefully selected to encourage her to say a wide variety of sounds. Alicia had enough time to warm up to Erin that she got comfortable (and even chatty), talking about all sorts of things while Erin jotted notes about errors she was hearing.
The official result was that Alicia’s language usage was right on par, but her articulations needed some work, likely as a result of her open bite, which allows her tongue to slip forward in her mouth. Would it go away on its own? Possibly, but if it didn’t, Alicia would have two or more years' worth of bad habits to break. We went home with our first assignment: practice “s” and “f” sounds for about five minutes a day, and see Erin again in two weeks. Fortunately, with a little encouragement in the form of a bottle of bubble fluid, Alicia was happy to practice. It didn’t take long for her to get the gist of what we were trying to do, and while she couldn’t always make the sounds correctly on the first try, she got to be able to do the correct version several times in a row after being prompted.
Her first longer appointment with Erin was fascinating to watch. Many speech language pathologists use games, both as a reward for practicing a sound (“Say ‘s’ again and then you can take your turn!”) and to encourage the social aspects of language (like taking turns and making eye contact while speaking.) Erin had noticed how hands-on and high-energy Alicia was, so she brought games that involved lots of action – pick this up, put that here, push this button. And in between each action, they practiced a sound.
At that first appointment, Alicia had improved enough to start adding vowels to her initial sounds. Two weeks later, she started practicing single-syllable worlds beginning with “s.” The progress is slow, but steady, and while she gets bored and frustrated with the practice sometimes, I am already noticing a difference in the clarity of her speech.
The speech therapy clearly came at a good time – she’s also going through a big vocabulary increase, so language is obviously at the top of her mind right now – but to me, there’s more to it than that. Working with Erin, along with the exercises we do at home, has taught Alicia that you can practice talking. Increasingly, she notices, and sometimes even corrects, her own “s” and “f” sounds – recently, for the first time, she counted my fingers with a clear and triumphant “F-our, f-ive!” at the end. And other sounds, ones that we haven’t started working on yet, are clearing up too.
But what I’m noticing more is a change to her willingness to speak. Suddenly, much more of her speech is directed at other people – me, her brother, even people we meet at the store. She was always willing to talk when prompted, but now she’s speaking on her own. It’s like she’s suddenly come to a realization: I can get better if I practice. If I talk to people, they want to talk back to me. And when I can make myself understood, I can share my thoughts and ideas with other people.
After her second appointment, we went to a large playground near our house, where a family with a little girl about twice Alicia’s age was already playing. The two girls gravitated to one another, and the other girl and Alicia went off to play. And ten minutes later, I heard the most startling and wonderful thing: a seven-year-old voice calling out, “Alicia! Alicia? Where are you?”
She had just met my daughter, and I had never told her Alicia’s name. My little girl, for the first time, had introduced herself. I’m not a hugely emotional person, but I will cheerfully admit that I had a lump in my throat. Who would have guessed that just a few minutes a day, plus the realization that speech, like anything else, can be practiced, would have made such a change so fast?
Two years from now, I’m betting no one will guess that Alicia went to speech therapy for a while. And maybe, without the therapy, these changes would have come anyway – when she starts preschool in a few weeks, she’ll have lots of encouragement to clear up her speech even more. In fact, I’m sure the day will come far sooner than I’m expecting where I’m wishing she would want to STOP talking. But that moment on the playground, and others that have shown my daughter’s dawning realization that expressing herself is well worth a little effort, have told me all I need to know about speech therapy: we made the right call.