I could see the voicemail icon blinking on my cell phone, but it was going to have to wait.
“Look over here, Michael, look at the balls, which one is this, let’s see it go down the tunnel, can you try, can you try?”
I looked at the speech therapist working with Michael. She was young, and enthusiastic. I wryly thought that I had gone into the wrong side of the teaching profession; this woman got to work one on one with kids and the office was charging us $125 for an hour long session.
But she was clearly having trouble with Michael. I hadn’t quite known what to expect with speech therapy for a child so young, but I quickly learned that it involved playing with and talking to a child, repetitively and engagingly, over toys that the child truly loved to play with.
So far, she was having trouble finding toys that my son liked enough to want to bother with. During the first visit, I’d had to get down on the floor with him and she conducted the whole session with him in my lap while she begged him to take the blue ball from his hand or tickled his face with the “koosh” ball. But mostly he wanted the Cheerios in my bag and kept trying to turn away from the singsong voice.
Finally, after a few visits she found that Michael liked the puzzles (but was only interested in pulling out the pieces; she tried modeling the putting the pieces back with little success), the tugboat (but only because he could line the multi colored balls up on the top of the tunnels) and the colorful stackable pegs. While she never showed her frustration, mine certainly built as I wondered why my son was not engaging with her. My daughter would have loved to be back here playing and talking for an hour; why wasn’t Michael interested?
“I think your son has a little more going on than a simple speech delay,” the therapist told me at the end of the fourth visit to her. “By now he should be picking up words and introducing them outside of the therapy room, but all he seems to be doing is repeating after us, without getting the context of what the words are used for.”
I listened carefully, my heart picking up a few beats. I knew R was outside, minding Melinda, watching this all on the closed circuit TV. “What do you think is going on then?” I asked slowly.
“I think Michael has something called apraxia. It is a neurological condition where the neurons in the brain have trouble communicating with the muscles to tell them what to do; in this case, Michael’s facial muscles. It makes it much, much more difficult for him to form words. He also seems to have low muscle tone in his face, which makes it doubly harder for those muscles to do their job.”
Apraxia? I had never heard of such a thing. “What can be done for it?” I asked.
“Exactly what we are doing: speech therapy. In Michael’s case, though, I am concerned it is not enough.”
Not enough? We were already paying $120 a month in copays for these therapy visits. We couldn’t swing two per week. “What do you suggest?” I asked.
“I would call Help Me Grow. Do you know what that is?”
I did not. “No, I don’t.”
“Help Me Grow is Ohio’s Birth to Three program. Each state has one. The federal government has a law which states that if a child is delayed in any way, either physically, mentally or emotionally, the child can be evaluated free of charge by Help Me Grow. If they determine your child requires services, they will provide them at no cost until the third birthday.”
I was stunned. I’d never heard of this program. How could something required by every state for children age three and under go under my radar? But I knew the answer; I’d never had a child who’d needed any special services before. “That sounds great. How do I get in touch with them?”
“Each county has an office; I’ll get you the information before you leave today. Michael will definitely qualify for more speech, and possibly some occupational therapy because of his low muscle tone.”
I had no idea what occupational therapy was. My two year old didn’t have any occupation to train for yet. “Thank you,” I responded, knowing my voice sounded bewildered and far away, like I’d just entered a foreign country where there was much to learn and everything was different.
Which of course, I had. That voicemail would have to wait even longer today.