Friday, June 27, 2008

What Was That?

My husband flies military planes. He is a great pilot and he loves what he does. In almost nineteen years of marriage we have lived in five different communities. Active duty military members and their families know the drill: show up, unpack, meet the neighbors, find the schools, find the stores, find the doctors. When we arrived back in southern California-- home for both of us--it was not as daunting as usual to get the drill done. McKenna was six years old and in first grade and the boys, now almost four, had enjoyed a two day a week Mom’s Day Out program in South Carolina so I enrolled them in a preschool associated with McKenna’s school in our little town. The initial doctor visits for immunizations and physicals for school were routine as well. Wrapping up the boys’ examinations, the new pediatrician said very little. What little he did say would ultimately change our lives.

“I can’t understand them” came the sentence out of the doctor’s mouth. “What was that?” I reply. “Their speech. I think they should both be evaluated for speech and hearing. At this age, I should be able to understand them”. And, with that our adventure began.
Both boys passed hearing exams easily. Enter the world of Speech and Language Pathologists. What a remarkable, intelligent, special group of professionals these folks are. I’ve not met one (and I’ve met a lot) who did not impress me. The pathologists were responsible for screening the boys to determine if they qualified for “services”. These screening appointments were conducted in an office space rented by the Student Services division of County Schools. These spaces are ordinary and look like any conference room until a speech pathologist comes in with their box of tricks; pictures, toys, noise-makers, charts, and a potpourri of nursery discards come out of the box and transform the office space into a child’s dream play date. Except the play has a purpose and the pathologist makes the rules. Campbell and Wylie were to be screened at separate appointments (of course to be fair).

Wylie was first.

It was on the floor in a leased office watching a speech pathologist trying to engage my son with her box of tricks that I first began to process: this isn’t normal. What my husband and I had done for four years to relate to Wylie was not normal. Seeing him through the pathologists’ eyes—or more accurately—“hearing” him through her ears was a moment I will never forget.
Finger-puffing, dropped-like-a- rock-Wylie resisting the well-trained and very patient therapist…it was almost too uncomfortable for me to watch without intervening. She would try to direct his attention to her chart. He would hum and play with his toy. She would try to hold Wylie’s gaze. He would speak without ever looking into her eyes. Occasionally she would hit upon an activity that he would participate in. Flash cards of known objects were relatively easy. “Duck”, “boat”, “train” came the responses. But, when the flash cards began to depict faces displaying human emotions…nothing. Wylie would go back to the last known thing he got “right” and repeat it. Additionally, Wylie would say pet phrases and lines from familiar cartoons or shows over and over again in between and sometimes during the examination. (This is called “perseverating” and “palilalia” I would learn later). When Wylie got overwhelmed, into rock position he would fold.

Even though she could not conduct a complete examination, she had enough to demonstrate that Wylie definitely qualified for speech services through their early intervention program. He had the requisite number of vocabulary words. However, it was his social use of language that was of greatest concern to her. Intuitively, I felt she had more to share concerning her time with my son. But, professionally she had to report only on her area of expertise. Still, I knew she must see children with varying “issues” during the course of her work and something told me she saw more than her report revealed. I bit my lip and my eyes stung with tears held back while we discussed her findings. Lots of kids receive speech therapy she assured me. Most of them grow out of their need for it. What I knew after that day, though, was that Wylie’s speech was just the tip of a Titanic-sinking iceberg.

Campbell was evaluated as well. Anyone who knows Campbell appreciates his ability to tell a good story. This has been going on as long as he could talk. While the pathologists found some minor articulation problems, they believed these would self-correct. By comparison (there’s that word!), Campbell had very good social use of language and an appropriate vocabulary. While I was relieved to learn Campbell’s speech was fine, it only served to underscore the emerging differences in the boys. The initial attempts at “not comparing” gave way to a constant categorization of the extreme ways Wylie was like no other child I had known. It was as if the speech screening experience gave me permission to acknowledge my private thoughts; once I acknowledged them, they were ever present…and loud.

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