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More than words, part 1















I love to talk.

It began with my family and childhood friends and blossomed at school and in my initial work as a journalist.

Talking was central to what I judged to be most meaningful in life.

I had the gift of the gab and found silence awkward and uncomfortable – a void I needed to fill. If I was nervous, I could talk your ear off. As a child, I grilled my babysitters on endless subjects when they turned off the light and tried to extract themselves from my bedroom:

"What is your favourite colour?"

"Who is your religious leader?"

"What if it was the third period of the 1972 Canada-Russia hockey game and Paul Henderson had to go to the bathroom?"

Once a psychologist told me that I used conversation to control situations and glide above my own insecurities, dictating the topics and drawing out more from a person than they probably wanted to tell.

But I was raised in a home where talking to people and showing an interest in their ideas and lives was highly valued.

Before Ben, I always thought of speech as being automatic and related only to thought: you think something and then it comes out in words.

I didn't realize that, in fact, talking is like walking – a motor activity involving a complex interplay of breathing skills and lip, jaw and tongue movements.

It was incomprehensible to me that someone couldn’t speak. I guess I had read about children who were non-verbal, but it was something completely outside my experience.

Ben babbled exuberantly at 3 weeks. I still have the photo D'Arcy took of him propped up on my knees facing me, interacting. At seven months, other mothers in a play group marvelled when I passed him to someone to hold and he cried clearly: "Mama, Mama!"

At 1 he referred to his favourite Sesame St. character – Elmo – as Elma. Bottle was "bo" and "Be go bo" meant Ben go bottle. Apple was "apu" and Daddy was "Uma." His pediatrician noted that he was talkative and sociable for his age.

Severe recurrent ear infections kicked in then and we didn't know Ben also had a permanent moderate hearing loss in both ears – made worse by constant fluid in his ears. We later learned he had a submucous cleft palate and related abnormality of his ear canals. This explained his constant ear infections that didn't respond to prophylactic antibiotics or eight sets of surgically-placed tubes to drain what one ENT described as "copious thick black fluid.”

It was at about this time that I learned that severe speech delay or absence of speech was a symptom in some descriptions of Ben’s syndrome, called Langer Giedion.

Given my love of talking, and the general value our culture places on speech and people who speak well, this frightened me.

The anxiety that had attended waiting for Ben to sit, stand up and do other typical motor activities – while taking him to therapy and carrying out a million exercises at home – was now overshadowed by the weight of: "How am I going to get Ben to talk?"

I asked about speech therapy, but learned that in Ontario it didn't traditionally start until age three.

At about age two, I managed to get a speech therapist through our home-care service to visit, and she assessed him as being at an 18-month level for speech (I often go back to her document, just to prove to myself that he really did have some speech early on).

She came for two sessions and was fabulous -- but she was retiring. The person who replaced her was a new speech pathology grad who specialized in working with seniors with swallowing disorders. She spent her visits chatting with me and didn’t come for long.

We began private sessions with a program called KidSpeech. “Ben says ‘owl’ very clearly,” wrote the therapist in April 1996.

One night as I went into his room for a second time to tuck him in his crib, he said, as clear as day: "Hi Mom."

Another time, he was pulling vegetables out of the crisper and said: "gwee peppa" for green pepper.

He said up and “oben” for open and “bubbu” for bubbles and “weh” for web (as in the spider's web in his Eric Carle book). He said "Gobuh" for "Goldbug" – a favourite character in his Richard Scarry series. “I wa” was I want.

Is the universe trying to tell me something?


Two weeks ago I wrote about how Ben had deleted the Proloquo communication app off his iPod. We didn't have a recent backup, so I spent hours recustomizing it – deleting unnecessary vocab, moving categories around to make it easier to navigate, creating new folders and words, syncing new photos so that Ben's favourite Star Wars area grew to epic proportions.

We had just started to use the characters in those photos as a basis for writing simple sentences. Ponda Babba's face looked like a spider and Greedo looked like a giraffe because he had the same little horns on his head.

So last night I was looking forward to Ben choosing another figure that we could write about. Instead, he brought me the iPod to show me that he had deleted the Proloquo – AGAIN!

I kept opening and closing my eyes, unable to fathom that the kid had done it again. I was furious – knowing I'd have to start back at square one reprogramming the device – and I also felt stupid. Why did I assume he wouldn't delete the software again? My kid is impulsive and the process is simple: You hold down the owl icon on the app page until it shakes, a box asks you if you want to delete, and you click it.

As I contemplated the task of ONCE AGAIN redoing the hours of work I'd spent over the last couple of weeks, I couldn't help thinking about the time I've spent trying to help Ben communicate over the years.

There were eight years of speech therapy, which sometimes saw him going four times a week. Multiple times we drove the 10 hour trip from Toronto to New York – Ben's toddler sister in tow – so he could be seen by specialists using approaches not available locally. Sometimes we'd drive the 10 hours one day, have the consult the next, then hop back in the car for 10 hours back. We were on a mission, and if it was going to help Ben speak, we would have driven to the moon.

I spent exorbitant amounts of money on speech kits. There was Easy Does it for Apraxia and the Kaufman Speech Praxis Treatment Kit, by Nancy Kaufman. We took Ben to see Nancy twice in Michigan. We also saw Sarah Johnson – who developed the oral-motor approach to therapy – and a few of her staff who lived in various parts of New York State. I bought enough oral-motor horns, straws, bubbles, tongue depressors and toothetes to equip a clinic and did the exercises religiously. We visited Dr. Shprintzen in Syracuse, an expert in surgery to close a floppy velopharyngeal flap, one of several structural problems Ben had, and a team of specialists at the NYU Medical Center.

Early on, we put picture symbols everywhere. When we began sign language, I remember cutting out hundreds of picture symbols with signs, taking them to Grand and Toy to get them laminated, then cutting the laminated ones out again. There was sign-language immersion camp and a dynamyte voice device – which I first acquired as a loan from the distributor because our therapist wasn't willing to authorize it. That changed when we videotaped Ben using it and were able to prove he was capable. However, the dynamyte was heavy and couldn't travel with Ben – who was mobile but tiny and weak. The technology was archaic and it took so long to move through the deeply embedded pages of vocabulary that it was easier not to use it. But still, I spent hours and hours programming it.

The AAC therapists didn't believe in sign language and advised strongly against it. A developmental pediatrician convinced us it would be useful for Ben, and it was. But he was still limited by his weak, uncoordinated hands and according to one psychologist wasn't smart enough to become more fluent.

When he was a baby, he babbled exuberantly and we always thought he would speak early. He had many word attempts in his first year. “Bo” was bottle and “'Ben go bo” meant “Ben go bottle.” His beloved red Sesame Street character was pronounced "Elma.” A speech therapist noted that he referred to his favourite furry creature – “owl” – “very clearly,” and an assessment at age two said he was at an 18-month speech level. But once the severe, recurrent ear-infections started – and with his hearing loss still misdiagnosed, despite frequent hearing tests – he lost it. I used to go back and look at the lists of words he'd said, unable to grasp why they had vanished.

When Ben was about four, it hit me hard that he might never speak. I went back to church and I asked the congregation to pray for Ben, who we were taking to Michigan to see Nancy Kaufman. An old man turned to me and said: "Maybe God doesn't want him to speak. Have you ever considered that?”

The message that Ben wasn’t destined to speak came again at age seven when we were doing a second week of intensive, twice-daily therapy with the Michigan therapist. “I don't think Ben is ever going to speak,” she said during a morning session. “I don't think he'll ever get past word attempts that you understand but that others don't. I think his brain is wired differently.”

I went back to the hotel room and I got under the covers and I wanted to die. But I couldn't, because we had another therapy session scheduled for that afternoon and I had to keep Ben motivated and up. I didn’t have time for grief, because every second of the day was a therapeutic opportunity we couldn’t afford to miss; the window for intervention was beginning to close.

I didn’t listen to the man who suggested God didn't want my son to speak, and I didn’t listen to this speech therapist.

Last night, when I realized Ben had deleted the Proloquo a second time, I wondered: Is the universe sending me the same message?

Maybe Ben deleted the software because he doesn’t want to use it, plain and simple. While it’s freeing for him, it’s also challenging.

"Ben, I've spent hours fixing this machine for you,” I said. “I did it because I thought you wanted to use the iPod to communicate!”

"Eh!" (Yes!) he said vigorously, nodding his head.

Sometimes I wonder if there is some larger message at play. Sometimes I can't help imagining a higher being watching my never-ending attempts to help Ben communicate, and shaking his/her head and laughing: "She just doesn't get it, does she?"

But I can't stop. I don’t have a choice. I have to get the software reloaded at Bloorview today, and I have to start recustomizing again. Because it's Ben's only opportunity to increase his communication – whether he's capable of using it as adeptly as I'd hope and whether he wants to use it – or not.

Later last night Ben tottered like an old man down the hall, almost upended by the giant Pixar movie encyclopedia he was carrying. A bony growth inside his hip is pushing it out of its socket and causing him to limp. He’ll be having major surgery in two weeks to remove it.

If only life was a Pixar movie, where friendship saves the day, being different is okay and the good guys eventually win out.

“I’m sorry,” Ben signed, and then he signed that he wants me to be happy again. He hugged me.

I don't have a choice on that either.