Birthday Boy

James celebrated his birthday today. For the first time ever, he became excited in advance (as in a month before the event) and kept asking us "Is James' birthday?" We counted down and talked a little about birthdays and what people do on their birthdays.

We practiced social verbal birthday exchanges and responses such as
 -- "How old are you?"
 -- "I'm six!"
and
 -- "Happy Birthday!"
 -- "Thank you!"

James asked if he could have a cake and picked out the flavours for both cake and frosting for this and the cupcakes to share in his class. He helped me make them as well.

He opened his cards first and looked at them before moving on to presents. "I ripping?" he'd ask us. "Yes, it's okay to rip wrapping paper," we'd assure him. I am glad he checks, because occasionally some items are Destroyed By Ripping.

In some past years, we'd be baffled what to get him. This year, we knew we had some winners:

Happy Birthday, James! And many, many more!

Hearing Test

I recently took James to his HMO, to get his hearing and ears checked out. He's already had several hearing tests and passed them, but he's also not sat through them completely and kept the earphones on his head. Plus, the audiologist and I had some doubts that he was understanding the directions.

Here he is in the waiting room, pretending to read a book from a nearby table:

I wanted to recheck his hearing because I have concerns about how his speech is evolving -- it does not sound normal to me. Rather, it reminds me of listening to people I know who learned to speak without being able to hear very much. I tried talking with his speech therapist from school, but she said she did not notice anything different. I know deafness runs in part of my family, so while James can hear, I really, really wanted any abnormalities in his hearing architecture ruled out.

(image taken from a chart in the Audiology Department)

James did so much better with the test this time! He left the headphones on all the time. He finished all the tests. He could sometimes say when he heard a noise. Mostly, they used pointing to a picture of the word spoken, or dropping a shape into a sorting can.

He loved the shape sorter. He's hold the piece up to the ear receiving the signals, then dropped it in after he heard the signal. Early on, he saw that the test person would look out into the control room to confirm the noise had sounded. So James started checking with the person on the other side of the glass too, between taking the shape off his ear and dropping it in the corresponding shape hole.

He actually spoke about a quarter of the words for the pictures he pointed to. I am guessing this is the same audiologist he had before, because by the test's end she was exclaiming over how big he'd grown and how many more things he could do and respond to.

His ears got a clean bill of health, including the ear drums and cochlear hairs. I am so glad I got this test done. While I was looking up the counterparts to the office chart on the internet, I kept finding correlation between the hearing organ and sensory & speech development, as well as vestibular activities. This reminded me that James for a long time hated swings and walked like he was drunk; therapists told be that his vestibular system was extremely sensitive.

Now I am mad at myself that I did not connect the dots between language difficulty and vestibular sensitivity better and sooner. I am wondering what I can do now to help James with speech issues. I am wondering why the O/T and speech therapist didn't talk together more at the school. Frustration! However, at least I can be pretty secure in the knowledge that James' hearing is fine.

Why Can't He Talk?

James' older sister asked a killer question this morning: "Why can't James talk? Why can't he say things the way I can?"

We've had variations on this subject before, where I've explained that he can talk, and that he's much better than he used to be ... that most people do things in their own time and way.

This morning, we talked about how sometimes the parts of the brain that control what we want to say and the parts that control the muscles we use to talk sometimes don't work right or can't talk with each other very well. It got me thinking about aphasia and some people having to be trained to relearn to speak. The people who want to use one word, but have another come out instead.

I've seen James want to tell me something -- I can read it on his face and in his eyes. I'll watch his mouth open and shut and hear strange sounds come out of his throat. Often, I never get to hear that thought. I've seen him blissfully happy, doing his verbal stimming of "Eeeeee-eeeeee-eeeeeeee-eeeeeeeee!" I've heard him do some beautiful mimicking, and scripting things he's heard from tv shows and using them as conversation soundbites -- appropriately too.

I wish I could watch what happens to my son's brain as he struggles to master speech, and understand what is said to him. I wish I has successful progressions to compare it with, so I could maybe figure out a better way to help him not struggle so much to communicate. I wish we could have some of those "why is the sky blue?" conversations.

I am very happy he's come as far as he has. Three years ago, he was nonverbal. Tonight I asked him to find his dad to tell him dinner is ready and he did just that. I still have questions, though. What can I do to help? Why is it so tough for him? What do I tell my daughter when the next question comes up about why her brother is so different?