Tuesday, February 24, 2009

Why Not Sign?

I just had this conversation with VeeGee's ST (speech therapist) yesterday about whether or not we should be focusing more on signing with VeeGee to help her communicate. VeeGee has been taking fish oil for about three months and her language ability (caveat in a moment) has increased dramatically. What I mean by ability, though, is that she is stringing longer and longer sentences together and clearly producing much more abstract thoughts/statements. Problem is, her apraxia itself has not improved enough to make her speech any more intelligible. In fact, because her sentences have gotten so much longer and now include non-concrete things that aren't in the immediate vicinity, she is actually harder to understand. Pair this with her increased desire to communicate, and you can imagine the mounting frustration.

Anyway, I asked her ST about whether or not ASL would help VeeGee and she said that it wouldn't necessarily be the best use of time/resources for her because she would have such a learning curve to catch up with the words she's already "using" that it might actually slow her down. Also, she said that it's important for VeeGee to keep trying to verbally communicate, since not everyone is going to understand her with ASL anyway, and so her frustration at not being able to say/be understood wouldn't necessarily go away. Finally, she suggested (a while back, and we have ordered) a augmentative communication device which, she thinks, is going to do more to help her with the motor planning aspect of her apraxia (because of the time/planning it takes to find the correct button) PLUS it will give her a "voice," which she can then mimic.

Now, if VeeGee had had a better foundation pre-verbal with ASL the story may be different, but that's not the case. When she came to us she was using a very limited amount of sign but immediately abandoned it whenever a verbal approximation achieved the communication that she was attempting. I think it has to do with the impulse that children with apraxia have. It's my understanding that, generally, the desire is pretty high to be able to communicate verbally and the outlet that ASL provides is still just a band-aid - a good band-aid in many cases, yes, but not always, because it doesn't actually treat the problem but rather is simply a coping mechanism and/or stop-gap.

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