The Study Ends; A Grateful Goodbye

[continued from part 3]

The intervention portion of the KidTalk study wrapped up at the end of August, and it was with great sadness that we said goodbye to Megan. What a blessing she has been to our family!


We had a little “graduation” a couple of weeks ago, and the before and after video clips Megan showed us were amazing. What progress Elijah has made in just a few months! I can hardly believe it when I think back to what he was like in April/May. I am to continue using the strategies I learned, and Elijah (and I) will be evaluated again in six months and then six months after that.

What's also exciting is the possible implications of this study and our participation for kids all over the country. Megan and her colleagues have already been invited to train Early Intervention personnel in other states. Apparently this study is a Really Big Deal in large part because of who's running it. Vanderbilt is the best in the nation for special education, and the principal investigator (Megan's boss) is Dr. Ann Kaiser, who's at the top of her field. So her findings through KidTalk could affect EI and special education nationwide.

And the timing of all this could not have been better. Steve and I didn't originally plan to have a three-year gap between our kids; we imagined them closer together. But how glad I am now that God orchestrated it this way! I never could have done this intensive intervention with a new baby. Instead, we were able to really focus on Elijah and get him the help he needed before his little sibling arrives—and the intervention ended just in time for us to prepare for the new baby's arrival.

So that's the story of our summer: a new friend for our family, new words for Elijah, new skills for me, and fresh evidence of God's sovereign, gracious care.

[previously in this series:]
part 1: Elijah's Growth and God's Gracious Care
part 2: Growth for Elijah *and* for Mama
part 3: Elijah's Skills Take Off

Elijah's Skills Take Off

[continued from part 2]

The first strategies we focused on in the KidTalk study were basic things like conversational turns (working not to say three times as much as Elijah says, but to wait and give him more opportunities to communicate) and "mirroring and mapping" (imitating what he is doing and then "mapping" language onto those actions). Then we got serious. Megan and her staff analyzed transcripts of Elijah's sessions and determined targets--what level was he currently speaking at, and what level did we need to use to best help him?

Megan's instinct was that although Elijah was using many longer phrases, he was not actually communicating functionally at a three/four-word sentence level. He had learned the phrases in one chunk, and didn't necessarily understand that the individual words were building blocks which could be combined in different ways. As I explained in my last post, he was talking a lot, but doing very little spontaneous communication.

So the first huge challenge for me was to back up and speak much more simply. My goal was that 50% of the time, I was to respond to Elijah using only two-word phrases. Then if he repeated it, I could add another word, and build longer phrases one word at a time, so we could make sure he understood each individual word. That sounded impossible at first! But it soon became more natural--and Megan's instincts were dead on. The progress we saw when we implemented this strategy was incredible. Elijah just learns language differently than a lot of kids--and once we figured that out, he really took off.

It wasn't long before Elijah was speaking at the two-word target level and we had to bump it up to three-word targets. I learned a few prompting strategies, and it was like something clicked in his little brain. It was clear that he suddenly understood that he could switch words in sentences and construct his own sentences, that he was grasping how to communicate his thoughts and desires!

After one particularly encouraging session, Megan analyzed the video and compared it to our very first session. The hard data confirmed what she and I had been seeing. One basic measure of language is “mean length of utterance” (MLU)--in other words, average sentence length. At the first session, Elijah's MLU was around 2. Two months later, it was 3.1—and to give you a frame of reference, Megan explained that typically they expect that to increase by one word per *year*!

It isn't the slightest exaggeration to say that the first six weeks of this study were more beneficial than an entire year of Early Intervention. I don't mean to disparage the people who served our family through EI; they did their best and were a blessing to us in many ways. But they really need to adopt these methods and strategies!

[part 4: The Study Ends; A Grateful Goodbye]

Growth for Elijah *and* for Mama

[continued from part 1]

Our participation in the KidTalk study began with a round of evaluations and standardized testing (including two days of wearing a recorder all day at home!). In May, we started the intervention. We were assigned to Megan, a licensed speech-language pathologist and the director of this particular branch of KidTalk (this is her doctoral work). We loved her right away--and she loved Elijah immediately, which totally warmed my mama-heart :)

All summer, we went to Vanderbilt every Tuesday morning. Megan would play with Elijah for 15 minutes, occasionally commenting to me about what she was doing and why. Then I'd play with Elijah for 15 minutes, and she would coach me. Everything was videotaped.

Unlike Early Intervention (which said its goal was to be this way...but it really wasn't), this study really focused on training *me*. Every few weeks, someone else would entertain Elijah while we'd have a workshop for Megan to teach me the next set of skills and strategies. She'd explain what I needed to do and why, and she'd show video clips of me playing with Elijah or her playing with Elijah as examples. It was fascinating, and so helpful!

I also had to keep a detailed log about our time at home during the week and how often I was using the strategies in daily life. This study focuses on "enhanced milieu training," meaning that rather than sending a child to speech therapy for an hour a week, you train the parent to create an environment for language development at home. Much more progress can be made, because therapy is happening 24/7--during meals, errands, diaper-changes, getting dressed, bathtime, in the car, you name it.

I had no idea what I was getting myself into, but I realized very quickly that this was going to be good for *me*, not just for Elijah. I'm ashamed to admit it, but if I'm honest, I have to say that I have struggled to engage with Elijah. I'm not sure why, exactly; maybe a combination of factors—the rough start we had; his laidback personality and willingness to play independently; sin issues in my own heart... But he wasn't the only one who had growing to do. I needed to step it up as a mom in terms of working diligently to help my child overcome language struggles.

It is humbling--humiliating, even--to think that you need to be taught how to engage your child, how to be a good parent. There's this sense of, what is my problem? All these other moms I know don't need to be taught these things, and here I am needing to participate in an intervention program to learn how to parent my son. Not to mention how it was painful to think about how my lack of engagement has perhaps contributed to his struggles.

But God had some important truths to teach me. I always need lessons in humility, and as this study began, I was forced to go back to the gospel. Christ knows the truth about me--my failures as a mother, plus a whole lot worse. The cross broadcasts for everyone to see how bad I really am, what I really deserve. So it is really that shocking to think I am an inadequate mother? Who am I trying to put on a show for or impress, anyway?

And lest you think this was merely a painful, discouraging revelation...there is *hope* when you begin to see ways that your problems are related to your sins. There's a Savior for sinners! Christ died to give grace not only to cover sin, but to enable me to change.

Similarly, if Elijah had some sort of developmental or physical disability like autism or cerebral palsy, I would be completely powerless to do anything about it. It wouldn't be my fault, but I wouldn't be able to fix it, either. Whereas if he has minor delays that have been caused (or exacerbated, at least) by my failures as a mother--well, I can do something about that! There is grace to grow. I can get help; I can compensate for where I have fallen short.

It became clear very early on that our participation in this study was way more significant than I initially expected. God was up to much more than simply "help Elijah talk better"! How thankful I was and am for His sovereign, wise, guiding hand bringing this opportunity to us. How thankful I am that He loves me enough to prune me, to teach me humility in hard ways, to entrust a precious child to my care even knowing I will screw up and hurt Him. He is good and loving, and our participation in KidTalk was yet another way to experience that.

[part 3: Elijah's Skills Take Off]

Elijah's Growth and God's Gracious Care

About six months ago, Elijah graduated from Early Intervention. We had been receiving services from the state for a year due to his delays, primarily in language--and a February evaluation revealed that although he still had a language delay, it was not significant enough to qualify for EI services any longer.

The developmental specialist who tested him gave us a flyer. And that little flyer was the beginning of a tremendous display of God's sovereignty and goodness in our lives.

It advertised a study at Vanderbilt University called KidTalk, which the specialist thought might be a good match for Elijah. At first we wondered whether it would be worth it (the small compensation wouldn't begin to cover our gas expenses driving downtown so many times), or what would be the purpose of participating. I have to shake my head in amazement when I think back to those questions. We decided to go ahead and check it out...little did we know!

A preliminary screening revealed that Elijah didn't have any other delays (they wanted kids with *only* language delays, not autism spectrum concerns, etc.) and that he qualified for the study--though barely, because his language delay was different than that of many other kids. He was (and still is) highly imitative. So although he was saying a lot of words, it was primarily phrases he had heard us use and was parroting, rather than phrases and sentences he was constructing on his own.

Kids like Elijah can easily slip through the cracks. And a gap that isn't super noticeable or severe now can get bigger and bigger if unaddressed. But--in God's kindness--Elijah was "randomly" chosen to be in the intervention group. Thus began four months of really intensive work...and four months of incredible growth in our little man.

[I'll break this up into a couple of posts since it's already gotten so long. That's what happens, I guess, when I put off writing about something until five months' worth of experiences and thoughts have piled up :) To be continued...]

part 2: Growth for Elijah *and* for Mama
part 3: Elijah's Skills Take Off
part 4: The Study Ends; A Grateful Goodbye