Sammie is currently 29 months old, and a very cheerful, happy, well-adjusted boy. However, he has experienced extreme difficulty with language, with a severe delay in expressive communication and a moderate delay in reception communication.
Sammie seems to understand both French and English (the two languages spoken at home) very clearly, but sometimes seems to experience difficulty in following instructions or in translating what he understands into actions. This, coupled with his being almost completely non-verbal, creates challenging in creating connections with others who are speaking to him.
Sammie has also shown a different approach to socialization than most children his age, however these delays tend to be moderate or mild. While he is very friendly, loving and outwardly affectionate, he does not tend to imitate or mimic actions. This hinders him from being able to participate fully with his peers and engage in "turn taking" behaviour. I suspect that this is also closely connected to his challenges with expression. He is extremely responsive to the gestures made by others (ie: "hands", or "water", or "food") but does not use gestures as a primary way of communicating. He prefers to show what he wants, either by bringing you to the object or bringing the object to you. However, he seldom uses others as 'tools'- instead preferring to observe what is being done and then attempt to repeat the mechanics over time (ie: fixing the train's batteries).
Sammie does make eye contact, and engages actively, but only with certain people and under circumstances that he chooses. He shows his interests in others through touch, and communicates happiness through laughing or smiling at the object. He seldom invites others to share in his joy, but often checks to assess your overall reaction to stimulus (ie: he will "observe" whether or not you are observing him).
Sammie is an active builder. He enjoys trains, blocks, puzzles and cars. He tends to use things only as they are designed to be used, and does not seem to engage in much creative play. However, he has done so in the past, on occasion. (Ie: Placed a doll on a swing or made it go down a slide, tried to feed his stuffed dog Spike, engaged in active create behaviour with trains, etc.) Sammie does not tend to take apart whatever he builds, but does not react poorly when it is done by someone else. Once a puzzle is complete, he shows great pride in it and he tends to master them very quickly. (Ie: Melissa and Doug train puzzle, mastered in less than 2 days). Sammie also shows an interest in music (especially the piano), in videos of children and other interests (trains, etc.), and in puppies (real or stuffed).
Sammie has not been noted to display any significant RSB behaviours or stims; however, he does display sensory-seeking activities, particularly in terms of gross motor skills (running, climbing, jumping, spinning) and oral sensation (tonguing, chewing, finger sucking). These are sporadic, non-patterned and tend to occur in "downtimes" or when Sammie is very tired. The oral seeking behaviours also seem to be an indication that Sammie is hungry, or ready for a drink of water.
Sammie has a wide range of vocal intonation which allows us to gain insight into his mood and wants. He does engage in babbling behaviour, however this is seldom done "conversationally". However, he will actively engage in "sound mimicking", taking back and forth turns making certain noises or sounds (ie: 'evil' laugh, sighing, humming, "duh duh duh").
Sammie has also displayed an stronger understanding of language than he often lets on by responding immediately to some commands (ie: down), or occasionally performing unexpected tasks (ie: "go get your shoes and bring them here", "push the red button", or "where's mommy's/Sammie's belly button/nose?") This indicates that it is possible his receptive skills are stronger than he is willing to let on at this point.
After our initial meeting with Bev, our EIP counsellor, we've been assigned certain activities to work on in-between visits. These activities are:
- Simplifying our language to "2 Word" phrases and short, simple words. (Ie: Instead of "I can see that you are frustrated" saying "Sam's MAD!") These are easier for him to hear, mimic sounds and ultimately repeat. Emphasis should be on the second word as this is usually the one children are most likely to pick up on.
- Actively engaging in copying Sammie's actions and gestures. This can lead to a better overall understand of mimicking and turn-taking behavior. This should be done in small doses, but frequently throughout the day. (Ie: 4 minutes, 4 times per day). Sammie's reaction should be noted: does he find it funny? Frustrating? Hurtful? Does he engage in more dynamic play in the hopes that we will continue? Does he wait in between movements to observe our response?)
- Keeping language very specific to the activity at hand: (ie: Always playing trains with mom in french. Always brushing teeth with Dad in English).
- Completing the ASQ-SE for 30 months with Dad and with Mamelie (French Grandma).
Our next appointment with Bev is on November 27th, at 11am. This blog will be updated daily with observations to further contribute to this dialogue.
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