Augmentative Alternative Communication
Today Agent Murphy went for an AAC evaluation because he’s been at something of an impasse in his speech therapy lately. He won’t consistently use the signs he knows, he won’t consistently even try to imitate sounds (let alone get the right ones), so his speech therapist wanted the AAC specialist to evaluate him to determine if there’s anything else that might help him communicate while we keep working on speech.
Today’s therapist agreed with us that he understands a lot. She said when she sees such a big gap between comprehension and expression, she expects there’s something oral-motor going on. She agrees with our speech therapist’s unofficial diagnosis of apraxia — an inability to make a particular sound on cue. Apparently it’s something you might see in adults who’ve had a stroke. They can make all sorts of sounds and say lots of words, but if you say something to them like, “Say ‘mother’” they struggle and think really hard and can’t say it. And then an hour later they’ll just blurt out “Mother.”
An occupational therapist observed his session today, too, and she said she thinks he might have slightly low tone in his facial muscles; but nothing that seems to require intervention now. We’re just supposed to keep working with him on imitating sounds and such.
And we’re going to work on putting together a communications book for him — pictures of various things in different categories that he can use to communicate. They also loaned us a basic communications device to see if he’ll get passed the stage of “let’s just push all the buttons” and actually consider using it more reliably to communicate. Her preference, like mine, is to stay pretty low-tech with assistive stuff at this point, given that he’s still pretty young and hopefully will start vocalizing more. (Of course, he vocalizes much more at home than he ever does in therapy; but it’s all still pretty random. Although he does seem to be learning to say “No” — like when we tell him he has time out — though it’s a bit more like “Nuh.”)
We’re supposed to see the AAC specialist again in about 6 months to see where we are and if we need to change course.