Thursday, 11 April 2013

Will our daughter ever learn to speak?

The big question we all asked when Maria was being assessed for her Statement of Educational Needs (SEN) was: would she ever learn to speak? She was four years old and mainly using a mixture of body language, Makaton and babbling to communicate. Her total expressive vocabulary was less than ten words, even though her receptive vocabulary appeared normal at around 2000 words. Being able to speak less than 1% of the words she knew meant that Maria was caught in a communication trap. I can only imagine the sense of frustration she must have felt. From Cathy A Stevens (2011) paper I knew that 56% of RTS adults weren't conversational; of these 17% used signing, so there was a significant chance that Maria might end up using sign language in adult life. 

I raised this issue with Maria's Educational Psychologist (EP) who, despite having no professional experience of RTS, felt that Maria would eventually speak given her current drive to communicate and recommended Makaton in the meantime. I said okay but - recalling the statistics in Stevens paper - wasn't so sure that she would speak. I said that Makaton is fine up to the age of six but that Makaton wasn't actually a language and if Maria still wasn't speaking by that age then she should be taught a language other than English to express herself with; clearly this should be a sign language and since we live in the UK then it must be British Sign Language (BSL). 

Our Local Education Authority (LEA) wasn't prepared to offer Maria BSL as part of her school curriculum and the 'local' BSL school in London only accepted deaf children. And so I reached my first impasse with the LEA; it was to be Makaton or nothing at school. The opinion of the EP was final and parents had no influence on their judgement when drawing-up a final SEN. I couldn't argue because Maria was still only four years old and two years from my rather arbitrary six year mark. I'd chosen 'six' because I couldn't imagine going through life much later than that without being able to fully express myself.  

Coming back to Maria, I found that regardless of the communication medium, she seemed unable or unwilling to express herself. We tried a 'speech' system approach and a 'non-speech' system approach, namely Makaton signing and the Augmentative and Alternative Communication (AAC) iPad application Proloquo2go. Maria learnt to sign Makaton very well but failed to use it to express herself. Regarding Proloquo2go, she only ever used it once to express a need; the rest of the time she played with it, listening to the word associated with each symbol. I wondered if she was ever going to stop throwing temper tantrums and learn to use these tools for self expression. 

Maria is now five and since starting reception class in her new 'special' school she has acquired a larger spoken vocabulary. She regularly surprises us with new words we hadn't heard before. It can be very difficult to understand many of these words because of her articulation (aggravated by glue ear which affects the hearing of sibilant sounds; sure enough, Maria has trouble articulating 's' sounds) so it remains to be seen if her speech develops to become fully intelligible. 

Since the age of two Maria has communicated by getting excited and babbling. Since the age of three she's included some Makaton signs. Since the age of five she's included some English words. Currently we're trying to encourage Maria to verbalise (speak) her vocalisations (babbling) by interrupting the babbling and asking her to 'say' something. We tell her that we don't understand and remind her to use words instead of babbling. It's a slow process but it seems effective. 

More recently she's started to create some spontaneous sentences. The longest we've heard so far is a five-words, although she typically uses only two or three words. For example: 'Good morning', 'Maria beautiful', 'Maria naughty girl', 'Hi how are you' and 'Mummy tidy up bed room'. I'd estimate that Maria uses no more than 30 words spontaneously (without prompting). As a five year old she probably knows around 2500 words, meaning she's using 1.2% of her vocabulary to express herself with, so I believe she's still caught in a communication trap, especially when I compare her language abilities with three year old Isabella.

Looking back when Maria was three, I tried teaching her some Makaton signs. She picked up the first ten signs I taught her in less than 30 minutes. I was both surprised and delighted. I realised how desperate Maria was to express herself and how much her articulation and speech processing was holding her back.

When she was three years and five months old I bought her the first of the Sing & Sign DVDs (compatible with Makaton and Signalong). She loved it and almost wore it out through watching it hundreds of times. After a while she knew the DVD so well that she could turn her back to the TV and perform all the signs and gestures in sync with the picture. 

Maria progressed to Makaton by watching the children's TV show Something Special on the BBC CBeebies channel. The lack of Makaton books got me looking at BSL books instead. Before long Maria and Isabella were both singing and signing songs in BSL as well as praying in BSL before they went to bed. 

More recently I decided to learn BSL properly and bought some BSL videos which I placed on our two iPads. I soon found both girls watching these, which surprised me because I expected they'd want to watch the more entertaining Sing & Sign videos instead. It's difficult to say if their motivation is to watch something new or to learn something new (probably both). 

Isabella watches these videos but doesn't sign now that she can talk. Most of the time Maria doesn't sign either when watching the videos but this doesn't mean she's not learning the signs. Ask her any of the signs afterwards and she'll demonstrate them to you; so her short-term memory seems to be pretty intact for this type of task. 

The result of all this apparently passive watching is that Maria knows more Makaton and BSL than Joan and me. At her most stunning, Maria has twice performed a simultaneous translation into Makaton as we read her bedtime story book; she found it amusing but we found it amazing!
As an aside, a few weeks ago it was Easter and we were about to give Maria and Isabella a chocolate Easter egg. Seizing the opportunity to sign with Maria (an opportunity I often forget), I recalled the Makaton for 'chocolate' but realised I didn't know the sign for 'egg'. I asked Maria to show me and she signed something that neither Joan nor I recognised. We looked at one another and wondered if she was bluffing. I checked in our Makaton and BSL dictionaries and sure enough she was absolutely right; hers was the Makaton sign. Curiously the BSL sign for 'egg' is similar but not identical, which is strange because Makaton claims to be based on BSL but more on that topic in a coming post. 

One day I wondered to myself: what if IQ tests were issued in sign language. What IQ would I have in a world that judged me on my ability to communicate through manual signing?

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