Tuesday, March 4, 2014

Non-verbal communication

We're waiting on another loaner unit speech device for speech therapy at school, hoping it's in by next week.  Having worked with one for 6 sessions, he expects it to be there, and was really disappointed when it wasn't at the last session - already packed back up and shipped back for the next person.  I can't wait for when Kaiden can express himself fully!! He gets so frustrated not being able to do that and turns to banging his head on hard objects to vent his frustration, which of course, causes some lovely bruising.  Kaiden's online fundraiser is off to a great start!  We're currently at about 30% of our goal thanks to a lot of very generous people!!  Someone has even offered to organize and run a benefit for him should we need it!

I've been doing a lot of "Show Mama" with him, and now have to remember to say "Tell Mama" instead of "Show Mama" as another way to encourage speech (with or without the speech device).  I've mentioned before, maybe not here, but other places - Kaiden invented his own non-verbal language:

The how:
  • comes to someone, raises arms = pick me up; once picked up, will use carrier's arm as a joystick to indicate where he wants to go
  • pushes down on a seated person's knees to tell them to get up
  • gets behind standing person to push them in the direction he wants them to go/at certain objects
  • takes person by the hand and pulls them in the direction he wants them to go/at certain objects
  • takes person by the hand and pulls down to indicate either sit on the floor, or help with an object near the floor
  • brings objects to person he needs help with
  • brings books/flashcards to person he wants to read to him
  • brings toys to person he wants to play with (including the dog)
  • brings bib to indicate hunger/thirst
  • runs into the bathroom and closes the door to indicate the need for a diaper change (this one is about 75% consistent)
More specific:
  • snacks - brings bib to indicate hunger.  Pulls or pushes me into the kitchen.  Asks to be lifted up.  He can open the cupboard, take a plate out, close cupboard door, place plate on cutting board, open freezer (with a little help, it has a great seal!), take out his favorite bag of frozen fruit, place next to plate on cutting board, wait for me to prepare, helps carry full plate to table, brings me bib (if dropped on floor), tries (unsuccessfully) to climb into his chair, and can self feed his snack of frozen fruit.  Pushes me away to indicate he'd rather eat his snack alone!
  • brings bib to indicate thirst.  Depending on the time of day I may offer him water instead of a meal or snack.  He can take the sippy cup out of the (opened) fridge, drink, place cup back in fridge, and close fridge door.
  • meals - brings bib to indicate hunger.  He knows that a bowl = meal and plate = snack.  Depending on the time of day I may offer him a choice of meal or snack.  If I have a pre-made meal waiting in the fridge, I offer that to him.  He will push it away if it's not what he wants (doesn't mean that isn't what he gets!!).
  • mealtime - taps empty spoon on table or person, or looks at person to ask for help loading spoon, will feed himself as long as he has help loading each spoonful
  • pushes bowl away at mealtime to indicate dislike of a meal
  • pushes bowl away at mealtime to indicate he's done eating
  • indicates he wants a bath by pulling/pushing me to the stairs, I lift him over the gate, he goes up the stairs and into the bathroom to the tub.  Will throw his bath toys in the tub to indicate he wants to play in the bath for awhile.
  • indicates he wants to play in his room by pulling/pushing me to the stairs, I lift him over the gate, he goes up the stairs and to his bedroom, I lift him over the gate and he happily plays.
  • indicates he needs a diaper change while in his room by coming to the gate and throwing toys over the gate into the hallway
  • indicates  he wishes me to play or read to him by pulling/pushing me into the living room, pulling me down to sit on the floor, then brings me toys or books
  • indicates he wants to watch a video by pulling/pushing me to where the video he wants to watch is stored (videos stored on top of the piano or inside the TV cabinet).  If videos on top of piano, raises arms to say pick me up, then picks out which video he wants to watch.  If video in TV cabinet, pulls/pushes me to TV, pulls my hand down, and pulls my hand to the knobs on the TV cabinet, then picks out which DVD he wants to watch.  Once one is chosen, he can put the DVD into the DVD player (must be lifted, it's on top of the TV).
  • indicates he wishes me to vacuum the floor by pulling/pushing me to the vacuum and touching the on/off switch
  • indicates he wants to go somewhere (although I have no idea where!!) by pulling/pushing me over to his coat and shoes
  • indicates he wants to go to bed by either raising his arms to be assisted climbing in my lap, or pulls/pushes one of us to the stairs, goes upstairs and into our bedroom, where he likes to be cuddled to sleep.
  • gets out of bed at night to indicate thirst or a diaper change.
  • shows affection by touching his forehead gently to a person's cheek.  He had been doing this for quite a while before I thought to ask how he says "I love you".  This is the motion he consistently made upon being asked.
Kaiden has an excellent spatial memory.  No matter where or when he left something in the house, he can find it, even if I can't.  Also for where activities have previously occurred outside the home.

Most things, as long as it's his idea, he can do it, same with the aim of touch.  But to tell him to do the same thing, he can't.  Part of the motor planning process that doesn't work right with motor apraxia.  It's not that he doesn't want to, he just can't get his body to do it unless it's his idea.  I like to say it's like me and choreographed dance - cheerleading, line dancing, the YMCA, etc.  I can watch it all day long, but I can't get my body to repeat the moves, especially not in the correct sequential order; it just ain't gonna happen.  Now if I wanted to dance on my own, sure, I can do that.  But to watch someone else and try to follow?  Nope.

Now, there are things he can do upon being told.  Things like: come here, sit down, stand up, give it to me, go get your bib, put your bib/napkins on the table, go get the toy for Lola, pick up the toy(s) you threw, put it back, put it in, take it out, help me dress you, hand me the diaper pins, hand me your pants, socks, shirt, shoes, coat, mittens - same goes for removing coat, mittens, shoes.  He can help me remove his shirt, but not pants or socks.  If he's standing for dressing/undressing, he knows to use my shoulder for balance and lift each leg when prompted by a touch to the calf or back of knee. Sometimes he'll throw a 10 minute tantrum first, but he'll do these things.  My favorite new thing he'll do upon being told: give me a hug!  This one is huge for him; previous to this he would ask for affection by asking to be picked up, then cuddling, but would not return a hug nor spontaneously give one.  There's more, I'm sure I'm forgetting some of his non-verbal communication.

I have no worries about his receptive communication; he's a smart kid.  But it's frustrating for all of us, especially him, that he can only indicate his wants/needs.  He can't tell me if he doesn't feel well, or if something hurts, he's too hot/cold, or if he's sad/scared/confused/angry/happy/etc. (although some of that I can read his body language).  He can't point, wave, or sign, but he can touch.  His expressive communication is what we're trying to coax out.  And for that, until he's verbal (if he ever is), he needs the speech device. 

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