Resist the Urge to Steal Small Children

Last month I made plans to tag along with a speech therapist for a day, to get a sense of what her daily work routine is like. Those plans fell through when she mistook my 315 phone number for a 312 number - an honest mistake, of course, and an understandable one - 312 is local to Chicago. She came to my apartment to pick me up, but dialed the wrong number and figured that something must have come up for me. Meanwhile, I was upstairs putting the finishing touches on all the questions I was going to ask her.

Well, we finally had a chance to reschedule, and I spent a full day with A on Wednesday. We drove from home to home (and to one day care), seeing eight clients in total. A's specialty is early intervention speech therapy, so her clients are between 1 and 3 years old. It was fun to see how much she clearly loves her job. "I get paid to play with kids all day!" she said. Which is true, sort of, but there is obviously much more to it than that...

So how does one administer speech therapy to children so young? Well, one aspect of it is exercising and toning the muscles necessary for speech. Many of the children we visited have already faced serious health challenges (like heart surgery or liver transplant, or in the case of one little boy, down syndrome) in their short lives, and as a result their physical development lags behind what is considered normal for their age. Part of A's job is to get them to strengthen their chest, core, neck and face muscles, as these are all necessary to support speech.

Another key is improving the kids' ability to focus. For example, when A reads a book with one of the children, she gets them involved with pointing to and trying to name things in the book and turning pages. If the child starts to get distracted, A brings their focus back and tells them, "We have to finish the book first." She is strict about keeping the child on track, and she doesn't back down. Some of the kids were pretty irritated with her at times, but they always came back around to smiling at her. Tickling was occasionally necessary.

There is something very appealing about working with young children. For one thing, their little brains and bodies have such an astounding ability to overcome early challenges. A's expectation is that all of her Wednesday clients - except the boy with down syndrome - will fully overcome their difficulties and catch up with 'normal' developmental milestones within several years.

The case that sticks with me the most is that of a 35-month-old girl, L, who has apraxia and extremely low energy. Speech apraxia is when a person has trouble saying what she wants to say correctly and consistently. It is due not to weakness of the speech muscles, but to the muscles not receiving the correct messages from the brain. So L has difficulty putting sounds and syllables together in the correct order to form words. When asked to say "pretty, pretty, pretty," she might say something like, "tehpee, petty, beepee." She seems to understand everything being said to her, but it is very difficult for her to communicate.

Imagine being one month shy of three years old and so totally stuck in your own head like that! I am sure it is immensely frustrating. As a result, L is a very quiet child. It took A a while to warm her up to even trying to talk. Finally, it was the talking toy refrigerator that did the trick. (A brings bags and bags of her own toys and books with her to every home.) L had to say the name of each piece of food in order to play with it. I think I heard a tiny improvement in L's articulation just in the hour that we spent with her. I bet that if her family tried to engage with her and get her to talk every day, her progress would be remarkable. Sadly, that does not seem likely to happen. L's long, dirty fingernails (clip them!), really dry skin (lotion, please!) and blank stare do not paint a very pretty picture.

When I got home on Wednesday, I told K all about my interesting day. I described L and her dirty house and how her parents were home but didn't show any interest in her speech therapy. Sigh. "Should we go steal her and bring her here to live with us?" asked K. Well... that sort of sounded good, but needless to say, "No dear, we really can't do that." Nice of him to ask, though.

Chasing Shadows

On Wednesday I was supposed to shadow A, a speech pathologist I met through a friend of a friend. I looked forward to it all day on Tuesday, even taking the time that evening to mentally prepare a list of questions to ask her between client appointments. I was excited to see first hand how speech therapy is administered to infants. Seriously, what does that even mean, really?

So, Wednesday rolls around... 6:30am: I'm up! It's a miracle! How was it this easy for me to get out of bed when I normally struggle to get up at 7:30? I must really be pumped!... 7:00am: I'm showered and dressed with packed lunch ready to go. Just listening to NPR, eating my breakfast of champions and drinking my coffee... 7:30am: She'll be here any minute and I'm literally on the edge of my seat - as soon as she gets here and calls up for me I'll hurry down. If we're late to her first appointment, it will not be on account of me... 7:40am: I'm getting a little antsy. I check the weather channel... 7:50am: I send her an email - "Hey A, just checking in. Schedule change this morning?" Why didn't I get her phone number? Oh well, she'll get my message on her crackberry... 8:45am: Still no word from A. I send another email - "Hey there, I think I'm going to head in to work so I can save the day for future vacation. I'm not sure what happened this morning - I hope that everything is ok!"

I figured I would hear from A within a couple of hours after getting to work. She probably just zombied out and forgot to pick me up. Maybe she's not a morning person - I can relate! But then 11 o'clock rolls around: Still not a peep. Strange how she sent me a message at 8:30pm on Tuesday re-confirming our plan and then less than 12 hours later I've fallen so totally off her radar... Noon: I'll head to our free Wednesday lunch and lecture series. Surely by the time I get back I'll have a message from her... 1:30pm: Nope, no message... 5:30pm: I leave a voicemail for one of our mutual friends since I don't have A's number - "Hello, just wondering if you have heard from A today. Give me a call." I'm getting concerned...

8:30pm: Just when I thought there must be more to the story - bazinga! - A emails me and says, "I actually was down there and called up. I hope I didn't leave a message on some random person's voicemail! I guess I didn't call the right number. Looking back now, I actually think I dialed the wrong area code. I am SO SORRY!" Then she reveals this clarifying gem to me in a follow-up email - "My beloved blackberry pearl committed suicide in the toilet. It was a very sad day."

It really couldn't be more anticlimactic.

Baby Talk

I am just over a month into my community college course in 'Human Growth and Development' (see here and here) and it has been a splendid experience so far. I lucked out with a very capable instructor who aptly breaks up our three hour and forty-five minute evening class periods into smaller, easier to swallow sections of lectures, small group discussions and videos. (Even so, I don't know what I would do without the Dunkin Donuts across the street.)

I have been finding the subject matter fascinating. Here's a tiny sampling:

- A newly fertilized egg survives without any nourishment from the mother for up to two weeks as it makes its way through the fallopian tube to the uterus and implants itself.
- Following childbirth, the uterus continues to contract for several weeks. (This is how it 'shrinks.') A few women report more pain from these contractions than from those accompanying childbirth. (!) Breastfeeding helps stimulate the secretion of oxytocin, which encourages the uterus to contract back to (approximately) its pre-pregnancy size.
- Infants literally grow overnight. Researchers have measured growth of up to a full inch in less than 24 hours in infants up to 21 months.
- Hopi infants spend the first year of their lives strapped to a board yet begin to walk at about the same time as children in other societies.
- Researchers who re-wired the brains of baby ferrets so that visual input was sent to the auditory cortex instead of the visual cortex found that the ferrets actually learned to see pretty well.

In last night's class, we started getting into the ways in which infants begin to develop language skills, and how their brains lay the groundwork for the tremendous burst of language development that will take place over the next several years. I perked right up, because one of my main reasons for taking the class is to explore my interest in speech therapy.

As part of my efforts to figure out whether I would enjoy studying speech therapy, this foundational course is all well and good. Actually doing speech therapy, however, is a pretty different animal. For that reason, I knew I would have to seek out opportunities to learn more about what it is really like to work in the field and whether the practicalities of being a speech therapist would be a fit for me.

With that in mind, I am going to spend all day tomorrow with a real live speech pathologist. Although A is not working in an area that I am particularly interested in - she works exclusively with 0 to 3 year-olds - I think it will be beneficial to pick her brain about the different types of work that are out there, her likes/dislikes, etc. Plus she is really cool.

So tomorrow I will shadow A as she visits her clients. I will have to get up a whole hour earlier than usual, but I'm thinking the adorability factor will make up for it. My co-workers are pretty cute, but who can compete with a bunch of toddlers? Speaking of adorable, here's a photo of the Amazing J, who I will have a chance to hang out with this weekend.

Look at that arm! It's like someone put a really tight rubber band around her wrist. So cute!

Last time I saw Amazing J, I wasn't sure what the correct term was for our relationship (she is my cousin's daughter). According to the Internet, she is my 'first cousin once removed,' but that sounds cumbersome and formal so I'm just going to stick to calling her Amazing J. 252 days old and counting... If any of the children tomorrow are as cute as she is, I may just have to steal one to bring home to live with me.

Developments

For several months now, I have been talking a little and thinking a lot about going back to school. From where I sit, almost five years removed from full-time studenthood, I can enthusiastically say that I love school. And I am absolutely not too cool. When it comes to deciding where and how to go back, the first major hurdle is figuring out what I want to study. I'm sure that I am not alone in feeling that having a shallow depth of knowledge across a wide range of interests makes it difficult to set a course. But at least I have an idea:

In the last year and a half or so (and not totally unrelated to this experience), I've started to read up on and become more interested in how people learn language, the ways in which those processes might be different for different people, and how we can teach the brain to recover lost language skills and knowledge after a traumatic injury. So it sounds like maybe I should learn about speech pathology. The only problem is that I don't have any training in teaching, therapy or speech. So how to know if they are really for me? I need an affordable introductory course to test the waters.

I've looked into a couple of options, and I think the best one for me is to sign up for a class at Truman College, one of the City Colleges of Chicago. They offer fall courses in 'Language Development ' and 'Human Growth and Development' at the very attractive price of $79 per credit hour for Chicago residents. Good sign: I emailed one of the instructors in their Social Sciences Department to ask for guidance, and she responded within an hour with useful advice.

I've done my info-gathering and paid a visit to Truman. Now it's time to take the plunge. My mission for this week is to sign up for a fall class. I get a few butterflies in my stomach when I think about the fact that the first day of term is in just two and a half weeks, but then I remember that this is school we're talking about. And I love school.