I have been meaning to write about Lily's progress for a while now. We had such a non-stop period of appointments that talking about Lily and how she is actually doing had to be put on the back burner. Lily has been in Auditory-Verbal therapy now for a little over 2 months. She is saying "me", "my", "you", "your", "I"- she has a good grasp of pronouns now. She is doing better with 2 step directions than she was initially. When we first started asking 2 step directions, like "Pick up the doll and give it to me", she would pick up the first thing she saw and it was hit or miss if she would actually give you anything. I guess this showed she was not used to really listening to what was being asked of her. She has pretty much mastered "in", "on" and "under" and on her own is demonstrating understanding of "behind". This is a good sign because it is exhausting to imagine working this hard with her on each and every abstract concept that there is in the English language. The stuff we are working on with her is the stuff that you take for granted when children acquire language naturally without any impairment. It is incredible when I think now how effortless it was for Charlotte to learn to speak. Children absorb language, from the time they are tiny, just from overhearing it. This is why hearing aids cannot be compared to eyeglasses- just because the sound is suddenly amplified does not mean that fixes the problem. There is a tremendous amount of work to be done to catch up hearing impaired kids on all that they miss from overhearing everyday conversation. We are now working on plural "s". I don't know how she is going to get this one and I think it is going to take a lot of work to get her to differentiate between "the dog" and "the dogs" when she can't even hear that final sound.
Lily's speech is somewhat clearer than it was before but you have to spend time with Lily to understand her most of the time. Here is something that you might hear her say: "Cah-leh wan wah moo-bem". Translated this means "Charlotte wants to watch a movie". So it looks like we will have to do speech therapy at some point to work on articulation with her. I think that the focus for now is to get her to expand her vocabulary as much as possible now and that cleaning up her speech will come later.
Lily's behavior is more and more trying as she gets older. She does not like to "perform" the required tasks during her therapy sessions and is getting bolder and wilder as each week passes when Janet and her student are here. Lily was very quiet and withdrawn for the first therapy sessions and fairly cooperative (as she often is in new situations with new people). And by withdrawn, I mean she buried her face into me and would have melted into my body if she could. But then, as her comfort level increased, she began to act like she does normally at home, as Chris says, like a feral child. What is difficult to do is to differentiate her behavior from her hearing loss. Would she act like she does even if she could hear or is her wild, inexplicable at times behavior soley due to her hearing loss? I can only draw on my experience with Charlotte when I try to understand Lily. Charlotte was not an easy baby/toddler by any means but I was able to figure out what she needed to be calm and comfortable and satisfied. That is something I have struggled with since Lily was a newborn- how to figure out what she needs in order for her to maintain emotional equilibrium. There seems to be something out of sync about Lily and I am searching for answers about that now too. Sensory integration dysfunction, while a controversial theory, is something I guess I have to explore at this point. It is not uncommon among children with hearing loss. Now the question is how to I pursue dealing with it....
Here is a description of kids with SID, many things sound just like Lily:
If they are oversensitive to touch sensations (tactile defensiveness), they will avoid touching and being touched and will shy away from messy play, physical contact with others, pets, certain textures of fabric, many foods, bumpy sock seams, etc. On the other hand, if they are under-responsive to touch sensations, they'll crave touching and being touched. These children will be fingerpainting their arms, stuffing their mouths with too much food, shouting indoors, turning up the volume and bumping and crashing into people and furniture.
If children are oversensitive or defensive to movement experiences, their feet will never leave the ground. They will shun playground equipment and object to riding in the car or elevator. They may refuse to be picked up. Or, if they are under-responsive, they may crave intense movement, and seem always to be in upside-down positions, swinging on the tire swing for long periods, and on-the-go constantly -- jumping, bouncing, rocking and swaying.
This will be my next focus after we find out what Lily's implant status will be...