Monday, August 11, 2014

Losing Language and Finding It

Tate developed language at a young age and spoke in complete sentences, and later lost it. I’ve told that story in other blog posts but I’ll give a quick review. When we began ABA therapy and discrete trial training, Tate was a little older than two and a half. At that time, Tate could still label almost anything but he could no longer speak in sentences. It seemed that when autism stole his ability to communicate, it was selective and it left him with a lot of nouns and a few verbs but no adjectives. He spoke with one word at a time. When he wanted a drink, he no longer said, “Can I have more milk?” but instead he just said, “milk.”

Tate, age 3
Now, this is the really interesting part: Some of his nouns were replaced by other words. The word umbrella was no longer “umbrella” like it used to be when he wanted to play with one, but it was changed to “rain.” The word “broom” was now “sweeping.” Sometimes he could use a phrase, and seemed to be using adjectives, but he really used the phrase as one word. For example, “wolf” was never just “wolf” but was now always, “big-bad-wolf.” The big and bad were not really used to describe the wolf but all three words used together were his label or his noun. It seemed like the autism scrambled his way of thinking. Tate could only think in very concrete thoughts. He was left with absolutely no ability to converse.

Because Tate was our sixth child I knew that most young children do not use pronouns correctly. Tate had amazed us at a very young age by using pronouns exactly as he should. He was able to say, “I want” instead of the “me want” that many small children use. I used to point that out to people so proudly and wonder why he was different than the other kids had been. I am absolutely sure that he could speak in four and five word sentences before he lost language. He could say, “Come, change my diaper” and “I stink” around age two, using the pronouns correctly. And then. It was gone.

As a baby, Tate had picked up pronouns from his environment. I did not spend huge amounts of time teaching him the correct way to speak. An eighteen-month old Tate could say, “I want” but a nearly three-year-old Tate usually said, “Tate wants.” Why was he in tune enough as a baby and toddler to pick up language but unable to learn from his surroundings as a preschooler without intense effort on his part and mine? Where did the pronouns, verbs and adjectives that he had learned previously go? He had to be taught again using systematic lessons. We had to go back to the beginning and start over. 

During the first ABA sessions, the teacher used very simple commands. She did not usually use more than four or five word sentences when she spoke to Tate. She did not use adjectives when giving him instruction. Because Tate’s receptive language was in the twelve-to-fifteen month range by this time, we had to communicate with few words. The more words used in a sentence, the less Tate got out of the sentence. During the discrete trials the commands were, “Do this” or “Build like this” or “give me” or “show me.” This seemed strange to me in a way. We were trying to build his vocabulary, not limit it. I remember telling the therapist, “But he could say, ‘this is delicious’ when he was just a baby and now he can barely talk!” I wondered why we weren’t trying harder to add words instead of limit them.

This was the answer I was given: We were going to build Tate’s expressive language by having him repeat sentences adding one new word each time. For example, when Tate said, “want milk,” I would say “want milk please.” Tate had to repeat my words before he got the milk. After he repeated my words, and as I was handing him his cup, I would say, “I want milk please.” This time he was not required to repeat my sentence but he usually did. We used this technique constantly. He started using real sentences and they began to lengthen. When Tate labeled something, then I repeated the word with an adjective or a verb attached. If he said, “truck” then I said, “big truck.” If he said, “frog” then I said, “green frog.”  This went on all day long every day of the week. Tate regained adjectives, verbs and adverbs. The progress was amazing. Sometimes we stalled for days but other times he added words by the dozens.

Some days were huge for us. Right after Tate’s third birthday in October, I took Levi and Tate out to lunch. Tate marched right up to the counter, looked at the woman taking orders and announced, “I want a cheeseburger please.” I nearly cried for joy. There was a day soon after when we were riding in the car and Tate called my attention to a school bus in the lane next to our car. Tate rarely called my attention to anything so I was shocked. He had never mastered joint attention, even before his regression. The bus was a yellow van. Tate was used to seeing the long buses that his siblings rode so he was confused by the size of the bus. He said, “Look Mom, a little bus.” We had been working that week on big and little and it was clearly getting through. He was generalizing what he had learned at the table. At that time we had only been doing our forty hours of discrete trial a week for about four months. And this is why I so strongly believe in ABA therapy and discrete trial training. Tate was regaining language almost as fast as he had lost it.

I should probably be clear about something because this comes up a lot. Some of you always want to know: Did Tate develop autism at age two? Is that why he lost his language? Tate already had autism. He was born with it. I know this. He had a lot of quirky behavior before he lost his language. He may have had such a huge vocabulary BECAUSE he had autism. I don’t know how autism works. Some kids never gain language. Some kids get it and lose it. Tate’s regression is common in children with autism. I don’t believe his shots at eighteen months caused autism. I didn’t drop him on his head at age two and cause the autism. There was no tragic event in his life. Tate was “different” from day one. I didn’t know what it was called or why he was different but he was different long before he spoke his first word and long before he lost the words.

Other posts about language: What brought you here? and Speaking Tate's Language

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