Category Archives: Special Needs Kids

Get Up and Go (With Video! Woohoo!)

Wonderboy is a bit of an enigma. So far I have counted six specialists who’ve used some version of the phrase, "We’ve never seen another kid quite like him." Neurosurgeon, surgeon, neurologist, physical therapist, developmental pediatrician, and general practitioner. Possibly two general practitioners. We have come to accept that there is no name or label for what sets our boy apart, no previously mapped-out territory. He is truly, completely, uniquely one of a kind.

Pants
His physical abnormalities—and that is not a word that bothers me; "normal" refers simply to qualities shared by the majority of people, and there can be no denying that there are many things about Wonderboy that are NOT like most people—his abnormalities are not genetic. His chromosomes, the geneticists tell us, are normal. No extras, none missing, not even any little pieces of a chromosome missing: the big fancy tests they ran confirmed this.

No, in his case, it seems something went slightly awry during the first few weeks he was developing in utero. All of his physical abnormalities are what’s called "midline issues." Run a line down the middle of his body and you’re pointing at the places where he isn’t put together like your average Joe. Skull, brain, inner ear, heart, abdomen, tail. Um, yes, tail. He was born with an unusually long and protruding tailbone. It stuck out beyond the end of his bottom a little, a hard little bump that made it painful for him to sit on hard surfaces. Last summer it had to be surgically removed to prevent the skin over the coccyx from breaking down and getting infected. It took us months to get used to not seeing it when we changed his diaper. But he can sit comfortably now, and that’s a great thing.

He has very high muscle tone, a neurological issue that made it hard for him to stretch out his arms and legs to their full range when he was a baby. He started physical therapy at five months of age, and after hours and hours of stretching and exercising and basically sort of kneading him like Silly Putty (um, really stiff inelastic Silly Putty that doesn’t have any of the pliable properties that pretty much defines Silly Putty, so that’s a stupid simile to have chosen, but there you go), he has gradually gained the flexibility necessary for things like walking. He walks! Really really well! Time was, we weren’t sure that was a given. Now here he is two and a half, trying to run.

But. One of the most "we’ve never seen anything like this" things about Wonderboy is that he has these  bizarre gaps in his development. I guess he didn’t get his copy of "What to Expect the First Two Years" in the womb so he doesn’t know in what order things are supposed to happen. Case in point: he’s been walking for over a year, but he couldn’t stand up until last month. If he was lying down, he couldn’t get up into a sit, a crawl, or a stand. Sitting? Couldn’t get onto his feet. Or hands and knees. Could only just sit there.

Stands_1
You could pick him up and set him on his feet and he’d take off like a little wind-up toy. But if he was just lying on the bed or the floor, he was stuck there. And for a kid who can’t hear well, who relies on visual contact for communication and happiness, being stuck was scary. So he never sat down. All day long. Except when one of us would get on the floor with him to play or do PT, he just trucked around on those knobby little legs of his.

And then, last month, the miracle happened. He—just—did—it. All the months of physical therapy paid off, all the hours we’ve spent, the big sprawling bunch of us, taking turns having floor time with him, making up games that stretched his tight muscles and worked some strength into those bony little arms.

This unbelievable victory occurred about three days after a PT session. We couldn’t wait to show his physical therapist, the wonderful Molly. But it happened that for one reason and another, it was over a month before we had another session with Molly. By then Wonderboy had spent hours practicing his new skill with immense delight and to much applause from admiring sisters. He spent a couple of weeks with his forehead carpet-burned from using it to balance as he maneuvered himself to his feet. Let me tell you, this getting-up business is HARD WORK. I bet you take it for granted. I know I did. Watching Wonderboy struggle, I have realized it requires an astonishing amount of muscular finesse and strength. Now I feel like a powerhouse every time I stand up from my chair. Did you see that! Dozens of muscles working in sophisticated interplay, and I didn’t even break a sweat!

So by the time Molly got here last week, Wonderboy was primed. Scott put him on his belly on the floor, and the boy GOT RIGHT UP. Okay, it still takes him about thirty seconds and some forehead-scraping. But he can do it. Every time. Molly was blown away.

And then she blew us away, because after watching the boy demonstrate his fabulous new skill some fifteen or twenty times, she announced that Her Work Here Was Finished. For now, at least. To our surprise and joy, Wonderboy has graduated from physical therapy. You may commence the trumpet fanfare because this is HUGE news.

He may need PT again someday to help develop other motor skills. But for now—and with this boy, NOW is where we are, day by day, moment by gorgeous, miraculous moment—for now he doesn’t need the extra help.

And that is a really big deal.

Jane caught him on tape this morning, getting up onto his feet. It’s our little thirty second tribute to the marvels of Early Intervention, and our big giant thank you to Molly.

Click to watch the video. (Sorry, folks, I didn’t realize it was auto-loading for some of you! Thanks for the heads-up, Daryl.)

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Learning American Sign Language

Amy asks,

Are you learning alongside your children and just signing as you can, or are you the “expert” in the family? How are you teaching yourself?

Actually, Jane is the family expert. We are all learning together, but she’s ahead of me. My downfall is fingerspelling—I can spell words quickly, but I can’t read fingerspelling to save my life!

We have used (are using) a number of different resources. The Signing Time DVDs are definitely our family favorites, and all of us—including Wonderboy—have learned dozens of practical, useful, everyday signs from those. A dear friend of mine gave us the four new volumes as a baby gift for Rilla. Such a great present!

I’ve heard there’s now a Signing Time show on PBS—anybody know if that’s correct?

Another video series we have learned from—and I get goosebumps over the fact that we actually went through this program long before Wonderboy was born, just because Jane and I both had an interest in learning ASL—is the Sign with Me program published by Boys’ Town. This video series (not available on DVD, unfortunately) is aimed at parents of deaf children, with the vocabulary consisting of words frequently used when talking to babies and toddlers. This made it a delight for then-seven-year-old Jane and four-year-old Rose, who enjoyed being able to sign important things like “yucky,” “sticky,” and “Cookie Monster” to their baby sister. After Wonderboy—and his diagnosis—came along, we watched the 3-volume series all over again. And somehow I think having gone through it once already, having watched deaf toddlers signing on the video, helped me take Wonderboy’s hard-of-hearing diagnosis in stride.

Last year Jane and I took a course online. Signing Online is geared for college students or older, but it worked out beautifully for us. Each lesson teaches conversational vocabulary through video clips. Again, we found the vocab extremely pertinent and functional: phrases like “What are you doing?” and “Of course!” really help you to converse in a natural manner. (There are a good many nouns, verbs, etc also.) It was a little pricey but we felt it was worth the expense. I think the full course is the equivalent of a semester at the university level.

However, there are some excellent free resources as well:

ASL Pro and ASL Browser are free online American Sign Language dictionaries with video demonstrations of each sign.

ASL University offers a free online tutorial with a combination of video clips and stills.

• I really have no excuse for my lousy fingerspelling skills—I could be honing them with this Fingerspelling Quiz.

• Finally, if your family has a deaf or hard of hearing member, you automatically qualify to use the Captioned Media Program’s free lending library of videos and DVDs—including a wide selection of ASL instructional materials. You can even view them via streaming video! Jane, Rose, Beanie, and I plan to begin a new series in the fall. (I just have to figure out which one.) CMP is funded by the Department of Education and has a library containing thousands of captioned movies, documentaries, and other resources. It’s an amazing program. Your tax dollars at work!

The Speech Banana

Wonderboy’s hearing loss came as a shock to us. Sure, we knew he’d failed the newborn hearing test. Three times. But those rounds of testing were administered in the NICU where there is always a humming and beeping of background noise, and the tech had told us that ambient noise could skew the test results. We had more pressing things to worry about: his (minor) heart defect; his recovery from omphalocele repair surgery; the genetic testing necessary to determine whether he had a potentially serious chromosomal syndrome; the fact that he was going home on oxygen. At least he was going home, and we tucked the hearing-test business to the back of our minds and focused on the immediate business of keeping him alive.

Every month the health department sent us a letter reminding us to have the hearing screen repeated. Sure thing, we said, just as soon as things slow down a bit. We were constantly having to take him to some specialist or another. The chromosome study came back negative: his medical issues were not due to a genetic syndrome. He was just one of those babies for whom something goes slightly awry early on in utero, resulting in a number of physical abnormalities down the line. An MRI had shown brain abnormality, but what its effects would be, no one could say: time will tell, they said. (They are still saying that.) He had extremely high muscle tone (hypertonia) and could not stretch out his arms and legs very far. His fists were tightly clenched. He started physical therapy at four months of age. He required emergency surgery to repair a double hernia with incarcerated bowel. The cardiologist was still keeping a close eye on his heart. The hearing test would just have to wait.

Besides, we told ourselves, we know he isn’t deaf. He startled to loud noises. Of all the things there were to worry about, we really didn’t think hearing loss was one of them.

But by six months, we had suspicions. He wasn’t babbling. He didn’t turn his head at the sound of my voice, lighting up with recognition before even seeing me, as our other children had. We took him back for another hearing screen.

He failed.

The audiologist said something about a "mild" hearing loss, and I thought that didn’t sound too bad. "Oh, no," she told me, hastening to set me straight. "It isn’t like a ‘mild’ fever. ANY hearing loss is serious. Most speech sounds fall at the bottom of the scale, so if you have any hearing loss at all, you’re going to have trouble with speech."

Speech
As it turned out, Wonderboy’s loss was a bit more serious than the audiologist first thought. Further testing placed him at the "moderate" level on the scale of mild—moderate—severe—profound. Unaided, Wonderboy’s ears can’t detect sounds softer than 50 decibels. Most speech sounds fall in the 20-decibel-or-lower range. Our little guy can hear vowel sounds, the louder middles of words, but few of the consonants that shape sound into speech. For Wonderboy, people probably sound a lot like Charlie Brown’s teacher. Wah-WAH-wah-wah-waahh-wah. We learned about the speech banana: the area on a graph that shows where speech sounds fall in the decibel and frequency ranges. Wonderboy can’t hear sounds above the horizontal 50 line on that chart.

(More or less. He has a sloping loss which is slightly better at the lower frequencies.)

By his first birthday he was wearing hearing aids, and what a huge difference we could see! Aided, he tests around the 20-decibel range. He hears and understands a great deal of what we say. He is two and a half years old now, and he is finally beginning to add some consonant sounds to his verbal speech. Daddy used to be "Ah-ee" and now he is "Gaggy." (This cracks me up. You can get a lot of mileage out of calling your husband Gag.) Grandpa is Amp-Ha. Wonderboy’s baby sister is "Gay-gee." As you can see, he doesn’t have a B sound yet. His M is perfect, though; I have been Mommy, clear as a bell, for over a year.

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But Wonderboy’s verbal speech is only part of the picture. His actual vocabulary is enormous, thanks to sign language. He uses a combination of sign and speech; we all do. Although it appears he will be primarily a verbal person as he gets older, sign language will always be an important second language for him. Hearing aids, incredible as the technology is nowadays, don’t do you any good at the swimming pool. Just for instance.

Hard of hearing. It used to be a phrase that conjured up in my mind the image of a grizzled old man with an ear trumpet. What? What’d ye say? Speak up, lad! (Apparently he is a grizzled old Scotsman.) Now it applies to my son. Words pop up on a TV screen, "closed captioned for the deaf and hard of hearing," and I’ll give a little mental jump: Oh! That means Wonderboy!

Watching our children learn to speak is one of the great delights of parenthood. We mothers tend to collect their funny pronunciations, their experimentation with the meanings of words. This time around, my joy has been doubled, for I get to see communication unfold in two languages. His funny little toddler signs are just as endearing as any "helidopter" or "oapymeal" ever uttered by a two-year-old. ("Oapymeal" was one of Jane’s. It meant oatmeal. I served it often just to hear her say it.)

I put some links in my sidebar for American Sign Language resources. I can’t say enough about the wonders and benefits of ASL, not just for deaf and hard of hearing children, but for all babies and toddlers, especially those with any type of speech delay. ASL is a beautiful, nuanced language, a visual poetry. I count myself privileged to have been put in the way of learning it. Jane is determined to certify as an interpreter someday, and I have to admit I’m a little jealous. I wish I’d learned at her age.

Wonderboy makes a fist and touches a knuckle to his cheek, wiggling the hand. "Ah-hul!" he shouts. Apple, in two languages. The speech banana? We’ll get there, one way or another.


*Audiogram image courtesy of GoHear.org.

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