Handwriting

Handwriting. Yup, handwriting was one of the two key reasons that led us to occupational therapy (OT). Yes, believe it or not, it was handwriting (or the lack of) that convinced me.

We were recommended to send Hubby-jr for an OT assessment way back when we first looked into his speech/language development delay in 2007 (he was four then). But when we received the news he had mild/moderate hearing loss in his right ear – which helped explain most of his developmental delays – we didn’t pursue the OT assessment. We thought we had it figured out, more or less.

Perhaps my judgment was clouded at that point in time by the initial shock of his hearing loss and formal confirmation of his developmental delays (social and language). Looking back I think I was simply overwhelmed and I found all of it hard to digest. So much so I couldn’t bear the thought of one more assessment. Why go through it if it was not absolutely necessary?

Well that was then, I was wrong and in hindsight I regret not going through with the OT assessment.

So what was different this time round that made me take that step? Desperation? In part I guess. But honestly – his serious difficulty with handwriting tipped the scales. It gave me a tangible reason to seek OT. To me it was the only visible symptom.

Okay, some of you may be wondering how bad could his handwriting have been. Hmmm…let me count the ways. His letters were poorly aligned, for example his “r” was as tall as “h” and “t” was as short as “a”. There were no spaces where there should be (in between words) and random gaps between letters where there shouldn’t be. This despite me having taught and drilled him in K2. It was also either too dark (too much pressure on the pencil) or too light, there was no middle ground.

I also received feedback from his class teacher (and his previous kindergarten teacher) that he was very slow in his written work. At the beginning of the year (P1) he was always the last in copying from the board and he almost never could complete any written work in time. If the teacher gave him time to complete his work, she had to ask the rest of his classmates to do some colouring while waiting.

At home, I could see for myself how labourious it was for him. It took him tremendous amount of time and effort just to write neatly. A five sentence handwriting assignment could take him 30-45 minutes just to complete!

I began to seriously wonder why it was that difficult for him to do something that shouldn’t be all that difficult. I also knew I had to do something. How on earth could he survive school if he continued writing at this rate?

Hence when I was recommended to send him for an OT check (the second time), I was very open and we just went for it. Like I said, I was desperate. I was desperate for any explanation, more importantly for any solution.

Having said that, the results of the OT wasn’t what I expected. I kept thinking it had to be his fine motor skills. Well turns out, Hubby-jr’s difficulty with handwriting had little to do with his fine motor skills. It had more to do with poor core muscle tone which probably is a result of his vestibular and proprioceptive sensory issues.

Poor core muscle tone?! I must have gaped when the occupational therapist told me that. Hubby-jr is an active boy who has amazing stamina. He climbs, runs and slides down “fireman poles” at the playground which he visits almost every evening since he was almost 2?! As a friend of mine aptly exclaimed when I told her the diagnosis, “that is SO BIZARRE!” She has often seen him at play.

Well, I guess that’s why we pay the experts. They can pick up stuff that seemingly look normal to us. For more information on the basic skills needed for handwriting check out this link.

The occupational therapist was right (in case you were skeptical). Since we started OT in March, Hubby-jr’s handwriting has improved signficantly. His pencil control is much better, he can write neatly (when he wants to) and quickly now. In school, he can now complete his work in time! Amazing.

But he is not done with OT. He still needs it. Handwriting was only the tip of the iceberg.

Writing again, at last

Has it only been more than 2 months since I last wrote? Somehow it seems like decades ago to me. Yes in part it is because I enjoy writing and have missed doing so but mainly because SO much has happened during that time. 

In early February 2010, I brought Hubby-jr to a speech therapist for an assessment. Why? Well, even though I was hoping – hoping so badly I almost convinced myself Hubby-jr was doing alright – my gut told me he wasn’t. I knew in my gut that he wasn’t socialising or expressing himself as well as his peers and in a sea of primary school students it became more obvious. So I brought him for a speech assessment just in case (I was still hoping my gut was wrong). 

As it turned out, he not only needed to start speech therapy again (weekly for at least a year) I was also advised to send him for an occupational therapy check. Which we (hubby and I) did and bingo, he needed weekly occupational therapy as well. Apparently my son has sensory issues as well, perhaps due to his hearing problem (hard of hearing in his right ear). He has… here goes… vestibular and proprioceptive sensory issues. If you’re going WHAT?! Yup, sensory integration was a whole new world to me too. I’ll try to elaborate more in my next post. Promise. But for now, you’re stuck with just the jargons as I’m writing an as brief as possible update. 

At the same time I also came across some blogs and articles about children with mild to moderate hearing loss. It made me question if Hubby-jr seriously needed a hearing aid. So I emailed his audiologist and asked for a review of his records and asked for a recommendation. Guess what? They called me and said… yes, with his hearing profile his right ear should be fitted with a hearing aid! So my son has been wearing a hearing aid since 30 March 2010. Thankfully he adjusted to it very well right from get go and he told me it helps him hear better in school. 

So there, that is all (well not ALL but the more significant events) that’s happened over here in my home since I last posted. 

I battled through a wide spectrum of emotions as each news came. It has not been easy or painless. I grappled with God and tears accompanied quite a number of my prayers. But through it all I could see His faithfulness and feel His love. I may elaborate in my future posts. 

These days, I am hopeful (in the Lord) and… plain exhausted at the end of most days. Besides bringing him for the therapy sessions, I have to do follow up exercises (speech AND occupational) at home with him as much as I can. On top of that I’ve to help him with school work (homework, spelling). Not forgetting I DO have another child who still needs a fair amount of my attention. Yes, there’s also laundry, dinners to prepare… 

But by the grace of God I am coping, some days rather well and some days, not. All in all a whole lot better than I expected. I am learning to let go and let God. He is the source of my strength. 

Isa 40:28-31

²⁸ Do you not know?
       Have you not heard?
       The LORD is the everlasting God,
       the Creator of the ends of the earth.
       He will not grow tired or weary,
       and his understanding no one can fathom.

 ²⁹ He gives strength to the weary
       and increases the power of the weak.

 ³⁰ Even youths grow tired and weary,
       and young men stumble and fall;

 ³¹ but those who hope in the LORD
       will renew their strength.
       They will soar on wings like eagles;
       they will run and not grow weary,
       they will walk and not be faint.

My Best Christmas Present

I received a wonderful, wonderful Christmas present yesterday.

It is official. Hubby-jr no longer has to go for speech therapy. His speech therapist “discharged” him after doing a formal review. (He has been attending fortnightly one-hour sessions since Nov last year.) Hallelujah!

His current language is now average for a kid his age. Yes, he has acquired age appropriate language skills. Hallelujah!

I will still have to work on a few concepts with him at home (just for reinforcement). Four concepts to be exact. But that’s it. Hallelujah!

He may or may not need a review in a year’s time, depending on his progress in the year ahead. That translate’s to me as NO speech therapy sessions for one whole year minimum! Hallelujah!

This is the best Christmas present.

Thank. You. Jesus.

(For those of you who are new to my blog, you can read about my journey with Hubby-jr’s speech delay/mild hearing loss by clicking on the Speech Delay category on the left hand column).

Teaching Who, What, Where.

A while ago, Hubby-jr started asking “what” questions and that was followed by “where” questions. I was absolutely thrilled then as he picked it up on his own and not from speech therapy sessions. However he had problems distinguishing one “W-question” from another. This became more apparent when we (speech therapist and I) started introducing “Who” questions to him.

For example he would ask me, “Who is that?” while pointing to a bus. And when I asked him a question, it seemed to be more of a guessing game for him. If his first answer was wrong he’d proceed to give me different answers. He knew it was a question, he just couldn’t tell what kind of question it was.

To help him with this problem, I modified one of the therapist’s ideas into a game and it worked! After playing this with him twice, he got it!

1. I drew 3 rooms of our house on a large piece of paper (mahjong paper).

To pique his interest, I got his input while drawing (I didn’t ask him to help me draw as I knew he wasn’t interested in this type of thing). I told him that they were PLACEs and for that we use WHERE questions. Then I pointed to each block and asked him, “Where is this?”

2. I took out 3 small sesame street dolls and told him they were PERSONs and for them we use WHO questions. Following which I held the dolls one by one and asked, “Who is this?”(Yes I know technically they aren’t people but I also knew that he knew tv characters were “pretend people”. You can use photos or photo cut-outs of familiar people instead.)

3. Similarly I took 3 toy-food as THINGs for the WHAT questions.

4. I placed a doll and a toy-food in each “room”.

I then pointed to a specific block and asked these questions. Who is eating? What is he eating? Where is he eating?

As advised by our speech therapist, I kept the questions as generic as I could. I didn’t ask “Who is eating the banana?” as that would give him the hint that the answer couldn’t be banana. The whole idea was to facilitate his ability to give the correct answer based solely on his understanding of who, what and where.

I moved my finger from “room” to “room” and rotated the questions as randomly as I could. Initially he had problems answering my questions. So I stopped and lifted each toy/doll and asked, “Is this a thing or a person?” When he answered correctly I then put them in the WHO and WHAT boxes respectively and reiterated to him that WHO is for persons and WHAT is for things.

After that, I went back to step four.

I must add that it worked very well for Hubby-jr as he already had a firm grasp of things, persons and places.

I am happy to say that Hubby-jr has now progressed to a stage where he understands “when” and “why” (incredibly “why” came to him intuitively right from the start!) We’re working on the “how” now (…hmmm, how now brown cow? Jeeps, I’m so corny). As I was saying… even with “how” questions, he’s been displaying signs that he has grasp that too.

I can’t tell you the relief I felt feel with each of his progress. It was is utterly indescribable.

P/S: I spoke with his speech therapist and she says he may be able to do without speech therapy sessions before the end of the year. She’ll make an assessment again soon. I’m praying, I’m praying.

To read my previous posts on speech therapy ideas click here.

A Year On…

Mid July we met up with Hubby-jr’s class teacher for the kindergarten’s bi-annual parents’-teacher meeting. It was at such a meeting a year ago that his class teacher (then) was concerned with his lack of socializing and delay in speech. She (the teacher then) prompted us to have him checked and that led us to discover his hearing loss.I can’t believe it was just one year ago. Somehow it seems much longer. Maybe it is because we’ve gone through so much since then.

Looking back, I am very amazed at the progress I he we’ve made. (It’s great to look back once in a while to see where we started just to see how far we’ve come!)

His present class teacher reported he is doing well academically (even without me having to go through lesson plans with him). His written work is improving and he participates well in class activities. PLUS he’s interacting well with his classmates. Her only complaint was that he’s restless in class and often dozes off when she’s teaching! (Of which she has since rectified simply by changing his sitting position!)

He met one of his “buddies” while we were waiting that day and it was such a joy seeing him laugh and play with his friend. Just knowing he has made friends is huge enough on my happy indicator as it is. To be able to see him interacting and his friend reciprocating, it blew me away! Indeed he is such a different boy now, much more confident, friendly and talkative!

A year ago I went home with such a heavy heart. That day, I went home smiling (BIG smile) and extremely grateful (tearing grateful).

It’s Mine!

“It’s mine!”

That’s what I’ve been hearing a lot lately from both my kids. Yup, the usual siblings’ squabble.

It’s amazing isn’t it, how a (once upon a time, not too long ago, sorely neglected) toy’s appeal increases exponentially the very second one child picks it up and decides to play with it. Before you know it, the other child wants to play with it too. Yah, and just as suddenly, the toy that they were playing with earlier is no longer “current”.

The grass is just always greener on the other side.

Anyhoo, the tussle over toys isn’t new at all. It started way back. What’s new though is that now my son (almost 5, speech delay) can declare, “it’s mine!” (It used to be just, “No, Mei-Mei, No!”) And my two year old Little Missy can counter that with, “no, it’s mine!” (Hurray! Her speech development’s “normal”).

Of course the “it’s mine” goes back and forth, back and forth, back and forth…
Add this, “Mei-mei (sister), you play with this (another toy).”
And this “No!!” Scream!
Then back to, “it’s mine” banter.

It is quite a racket. It can and does drive me nuts. Yet at the same time…
It is so good to hear those two words come out of my son’s mouth (and my daughter’s).
It. Is. Good.

Teaching “My” and “Your”

Even as Hubby-jr speech development is progressing well, he still lags behind his peers. One key problem area is in using “I”, “You”, “My”, “Your”. He frequently mixes them up or just refers to himself by name.

To address this, his speech therapist introduced these two activities. The second is a progression of the first.

First Speech Activity

She played a simple game in which she and Hubby-jr had to take turns. After playing for a while and Hubby-jr understood the rules of the game, she stopped and asked, “Whose turn is it now?” His natural reply was “his name” (if it was his turn) or “teacher” (if it was the speech therapist’s turn). She’d then intervene and teach him to say, “It’s Hubby-jr, MY turn” or “It’s teacher’s, YOUR turn”. She’d ask the question, “Whose turn is it now?” at every “turn” requiring my son to reply correctly each time before the game could proceed.

After he got the hang of this, he was taught to drop the name and just say, “It’s MY turn” or “It’s YOUR turn”. But she was the one always asking the question and all answers came from Hubby-jr. Back home I did this exercise with him too but with different games.

Second Speech Activity

As a progression, she played this very simple game with Hubby-jr. Sitting face to face, it’d start with her giving specific commands to which my son had to respond. “Touch my nose” (he’d have to touch the therapist’s nose), “Touch your nose”, “Touch my shoulder”, “Touch your lips” and so on (you get the idea). If he made a mistake, she’d repeat the command and guide his hand to the correct place.

After he got the hang of this, he’d get his turn to give the commands and the speech therapist would respond. The game then became one where both of them would alternate in giving the commands and always required the use of “my” and “your“.

This is quite a fun game which my son enjoys. I’ve played it a few times with him at home too.

Since the above exercises he is using “my” and “your” more although he still mixes them up at times and he still prefers to use names rather than pronouns.

Through the process of teaching him “my” and “your”, I discovered that unknowingly I’ve acquired the habit of using “mommy” instead of “I” or “my” when talking to him. Slowly I’m undoing this and when I consciously change my sentences to use pronouns I can see that he too makes an effort to respond using pronouns!

Music to My Ears

Finding out that my son has mild hearing loss in his right ear was difficult for me. And after some “grieving” I’ve come to terms with it. I no longer quietly wish somewhere in a corner of my heart that things would be different, that he would be “normal”. I’ve accepted that it is what it is. The hearing problem is not going away and that we’ll just manage it.

Having said that, I’m not above feeling pangs in my heart every now and then especially when I see (hear?) other boys his age rattling off stories to their moms. It’s worse when I observe younger boys with amazing speech ability. This “pain” (I think) is only something moms of “different” kids know of and struggle with. 

At such moments I tell myself to NOT compare but to focus instead on Hubby-jr’s progress.

And I am so thankful that he IS progressing.

“What are you doing mommy?” he asked me several times this week. It’s the first real question he’s ever asked me. Yeah sure he’s been asking me for stuff like water, food, tv, etc. for the longest time now. But this, this was a real wanting-to-know question. Not a request.

Today he even asked me, “What are you eating mommy?”

Let me tell you these questions are music to my ears.

A year ago, his language ability was so delayed he couldn’t even answer me when I asked him what he did in school. These days he can tell me a thing or two about what he did in school. And now he’s starting to ask me questions. For a speech delayed child this IS progress people!

To top it off, he told me sometime this week, “Mommy I enjoyed talking to friends on the school bus.”

Friends? Talking? Wow! A year ago he wasn’t even socializing well!

Hallelujah! Just keep the music coming. Sweet music to my ears.

Brown Bear, Brown Bear

Since Hubby-jr started speech therapy one of the things I’ve to do with him at home is “shadow reading”. Basically he has to repeat after me word for word and imitate the tone and rhythm as I read a storybook to him. This is to improve his articulation. According to the speech therapist he’s too nasal and speaks without really pausing between each word. His sentence could sound like one long word with many, many syllables!

Shadow reading was a tough assignment. I had to correct his pronunciation and rhythm more often than he liked. It made storytime grueling. I got quite disheartened. Thankfully I wised up and tried using his favourite nursery rhymes. It worked a lot better as they were much shorter.

Then recently I discovered a couple of wonderful short videos of storybooks on YouTube and that helped tremendously. You see Hubby-jr loves almost anything that moves on the computer! (I seriously think it’s the male genes, my daughter takes to computers too but at a much lesser degree.) And these videos were perfect because they were basically close up shots of the books (of which I had borrowed or bought), moving page by page as someone narrated the story.

After he watched the videos he was hooked. He watched it again, again and again memorizing not only the words but the tone and rhythm of the narration as well. So much so he could read the book (the real book with the computer off) to me and all I had to do was correct some of his pronunciation!

Here are the videos. The first is Brown Bear, Brown Bear, What Do You See? The children’s classic by Bill Martin Jr and Eric Carle. He loved this one so much that he’d recite the story to himself every now and then!

(The YouTube link is http://www.youtube.com/watch?v=pdHCYgO9zh8)

The second is Digger Man by Andrea Zimmerman & David Clemesha.

(The YouTube link is http://www.youtube.com/watch?v=0OOz_dz0vf4)

I have noticed that Hubby-jr has since started speaking slower and clearer. It works!

Another wonderful site

At Hubby-jr’s last hearing test I found a brochure on this wonderful website I’m about to introduce to you.

It’s called the Listening Room at www.HearingJourney.com. It’s Fabulous! In their own words, it’s a web resource full of (re)habilitation activities and ideas to support the development of listening and language skills in children, adolescents and adults.

So far they’ve only stuff for kids but they’re working on activities for infants, toddlers and adults too.They’ve great game ideas for speech therapy that comes with DIY downloadable pdf files complete with instructions. They even have online video instructions. What’s fantastic is that they feature weekly activities. Yes! They introduce a new activity each week! And guess what? The resources are absolutely free!! Isn’t that just Fantabulous?!

Alrighty mommyfied, now get your act together and get them printed and do them! (Me pysching my “reluctant to add on more to my daily to-do list of things” self.)