The milestone we all know you’re waiting for (we are, too!) is speech. The reality is that Nate may ever talk — and we’re okay with that. We just want to make sure that Nate has a viable way to communicate his needs and wants that can be understood by everyone (not just by his parents and therapists) so that he may have a productive life. That isn’t to say we’ve given up in any way; in fact, we’ve heavily invested in the idea. Nate has 30 minutes of speech therapy a day with his most awesome speech pathologist Ms. Mollie and has made great strides in the vowels and consonants that he can say in isolation. (And, by great strides, I mean we’ve got a handful and we’re over the moon about it!)
Nate can say some words though very few are spontaneously said; he mostly repeats back the part of the phrase you said that means the most to him. Nate says “up up” and signs “up” when he wants to be picked up or be taken upstairs. With a lot of prodding, he can say “hi” or “hello” and “bye” or “bye-bye,” sometimes with a wave and he often gets the two mixed up. Nate says “shoe” and “sock” when we’re getting ready for school; “cookie,” also with the sign (it sounds like “ook-ee”); and “thank you,” which is signed and verbally comes out as “ah-boom!” (no clue how he formulated that one!). As for names, Nate can say his own name in its entirety but he’ll only say it sequentially; it always comes out as “natenatenatenatenatenatenate” and last weekend he very quietly said “nathan” to Chad three times in response to the question of “What is your name?” (He has not done that for anyone else though.) He also says “Mom” and “Dad,” though Mom is also sequential and usually means, “I don’t want to do this anymore.” Dad is said correctly, sometimes spontaneously, and infrequently.
The one word Nate can say clear as a bell is “apple.” There is very little that Nate loves more than an apple. The color does not matter but the crisp crunch does. He’ll eat them whole, he’ll eat them sliced–does not matter, he just wants them. He eats about two a day, which is an expensive habit when buying organic produce! But it’s worth it to keep this little guy happy.
With his therapists’ help, Nate is progressing nicely in the use of Proloquo2Go, the augmentative/alternative communication software on his iPad. It’s the whole reason we bought Nate the device. He started out on a version we designed to look like his PECS board with all the words for any given activity on the same screen, like this:
In May, Nate transitioned to the adult usage of the software. The layout is completely different and requires Nate to toggle between multiple folders and screens to complete a sentence, which he took to right away. Nate still uses “I want” as his go-to phrase but now they’re separated into two “words.” To begin a sentence, he goes to the home screen and touches “I” and “want,” which go up into the sentence strip at the top of the screen. Then Nate clicks on the category folder (down at the bottom of the screen) to specify what he wants. In this case, Nate wants bubbles.
When he touches the “Things” folder, it launches subfolders, which are categorized by types of stuff Nate usually wants. To find bubbles, he touches the “Toys” folder.
Once the “Toys” folder launches, there are many options to choose from. There are also multiple screens of options available, which Nate can access by clicking on that bright blue “More” arrow at the bottom of the screen. When Nate touches “bubbles,” it goes up into the sentence strip. Then he has to touch the sentence strip to make it fully request his preferred item.
Also, each time Nate touches any given button or folder, the software audibly repeats the word. Many times, this helps Nate realize he’s made a mistake and he goes deletes something and makes the right choice.
Sound complicated? It’s not. See for yourself!
Every time Nate wants bubbles, he has to go through the entire process. There is no cheat; he can’t just touch the sentence strip that he’s already made; if he tries to cheat, he doesn’t get what he’s asking for. Nate’s totally down with that. He deletes the sentence, goes to the home screen, and blazes through his request. In fact, I’m not sure he’s really caught on that he could “cheat.”
The biggest difference between our modified usage and the adult usage of Proloquo 2 Go is that protocol dictates that we cannot hide words. When we used P2G like PECS, we hid or removed words that weren’t applicable to the activity. Now, the whole English language is available to Nate and, as such, we can’t take away words from him in the same way that you can’t take away a learned word from a verbal child. Nate memorizes the words’ locations (and trust me, he has) and has full access to them at a moment’s notice. That means I get a lot of Proloquo 2 Go requests over and over and over again like, “I want ice cream!” But it also means that Nate can ask me to put on a specific episode of Curious George; his eyes light up every time his request matches what comes on the screen!
As Nate gets more well versed with the software, we’ll reveal more and more folders of words to him. Some are irrelevant at this age (e.g. he’s not studying physics). As he demonstrates more interest in specific activities, we add those pictures to the applicable folders to give him a broader vocabulary. He can also say things like, “Your turn!” when playing ball or cars through the software, which lets him initiate conversation with others.
When and if Nate begins to talk, we are certain it will be all at once. Nate never practiced walking unassisted; his first solo walk traversed three rooms. Same thing with crawling; for months he crawled backwards and then one day he went forward and never, well, looked back. In the meantime, though, we are really grateful to have a robust system like this to bridge the gap and give our little guy a voice to, if anything, let us know exactly what he wants!