Joscelyn's Journey

A Beautiful Child's Journey Through Hemimegalencephaly

Speech Therapy Update

on April 14, 2013

Joscelyn has been receiving speech therapy at Florida Hospital’s Pediatric Rehabilitation Center, three times a week since she underwent a left hemispherectomy in July of 2012 to stop debilitating seizures. Before her surgery at 13 months of age, Joscelyn could say “ma-ma” but was not babbling or engaging in much vocal play. Over the course of the last 9 months, she has started doing much more vocal play and experimenting with many new sounds including “b”, “oo” and “ay”. She is beginning to follow simple commands such as “arms up” when she wants to be picked up. She’s also learning her body parts and can point to her belly, feet, nose, head and right arm, which we affectionately refer to as “Righty”.

(Of course, being an almost a two year old now, she follows these requests only when she feels like it!) 🙂

Here’s a video of her giving kisses and waving with Righty:

Hi, Righty!

In speech therapy, we are working on getting Joscelyn to vocalize and speak. We also sing songs, do fingerplays and practice sign language. Some of the words we’re working on teaching her to sign include the words most used by toddlers such as “more”, “eat” and “all done”.  In addition, she is learning how to use an augmentative alternative communication device or AAC device. This device has programmable buttons which “speak” words for her when pressed. Initially, you might think that signing or using the AAC device would discourage her from speaking on her own but studies have shown that both actually help children to develop spoken language and reduce frustration.

You can read more about AAC devices here: http://www.asha.org/public/speech/disorders/AAC/

Joscelyn’s AAC device is manufactured by a company called PRC. They offer a variety of AAC devices which can be activated in a number of ways depending on the abilities of the user. AAC devices such as the one Joss uses can be operated by hand but other devices utilize switches that can be activated by the head, arm or even mouth!

Joss’ device looks like this:

aac

We’ve been teaching her one word at a time. Right now, the button options are “More”, “Stop”, “Want”, “Go”, “Eat” and “Drink”. All of these options are expandable. For instance, once she selects “Eat”, the device can be programmed to switch to a different screen with her favorite food selections like “macaroni and cheese” and “applesauce”. Right now, there are many words “grayed out” or hidden on the main screen. We will reveal them one by one as the new words are learned. Currently, the device enables her to say one or two word phrases such as, “Want go” or “Want eat”. Later, we can add the pronoun “I” and she will be able to construct the phrase, “I go” or “I want eat”. In this way, she learns basic sentence construction. The grid on the front of the device forces her to isolate the use of one finger in making her selection. During her initial evaluation with the device, we found that like most babies her age, Joscelyn used a “sweeping” motion with her hand across the screen which made choosing one word over another more difficult for her.

Here’s a video of Joscelyn and I practicing with her AAC device earlier today. I was encouraging her to select either the “more” button or the “go” button in order to get more of something she wanted. She learned the word “Go” on the device first and seems to favor that over “More” right now, but we’re continuing to work on it.

As you can see, she clearly understands how to locate and activate the “Go” button in order to get what she wants: MORE music! (She’s listening to the wonderfully talented Elizabeth Mitchell sing “Shoo Lie Loo” here.)

At times, we find that she is much faster in making her selections and needs less prompting and at other times, she needs more encouragement. Sometimes, she doesn’t want to use the device at all but we’re very excited about having this additional communication tool at her disposal for when she does feel like taking advantage of it. Our goal for her is “total communication” meaning that over time, she will learn to express herself through a number of modes of communication such as signed, oral, auditory, written and visual aids depending on her preferences and needs.

In the coming weeks, I’ll be posting updates on how her occupational and physical therapies are going, as well.

As always, we thank all of you on “Team Joss” for your continuing prayers and support!

 

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4 responses to “Speech Therapy Update

  1. talbottr says:

    Thanks, Jennifer, for educating all of us Jossybean lovers on her tools and therapeutic modalities. It is all so very interesting to me and I learn something every day from you! xoxo

  2. Gary Wayne says:

    Brilliant – the devices AND Joss.

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