Doesn't she look GREAT? This was at the end of our session and she was TIRED but look at that smile...if you are an SLP, you will also notice that her left side weakness is improving nicely as we have an almost FULL smile here. Her dad was on the side making her LAUGH by saying "Blake Shelton." :)
Oh, hey...did you catch that?????? I said she LAUGHED.
Yes! Yes! Yes! Lauren is laughing. We don't always get voicing but mom reports that she is watching more T.V and that she is laughing appropriately.
I'll tell you, I don't think I'VE laughed as hard as I did, with Lauren, on Tuesday. Her entire body gets going with the laugh...NO SOUND...but the facial expression, timing and body shakes are there and well, it's FUNNY.
I am stockpiling jokes for our next visit which may a bit selfish because I want to laugh that hard again. In all seriousness though using jokes, riddles and puns in our treatment meets many of the goals we are working toward so it's a win/win. Jokes are great therapy for language comprehension, processing and of course all of those facial muscles used to do it. It also is a very natural, automatic vocalization which will hopefully encourage more vocalizing overall.
Oh, HEY. Did you catch that also? I said OUR NEXT VISIT. I'm so happy to tell you all that Lauren's family has asked me to stay on as one of her therapists because they like what I've done with her. I'm OVERJOYED and excited because I have SO many ideas and I think Lauren really responds to my crazy, outside of the box therapy ideas...
We WILL have to agree to disagree on one thing though...
She is a BEARS fan and I'm a PACKERS FAN.
How did we find this out? Well, you can see in the picture that she has a Chicago shirt on so I asked her "are you a Cubs fan?" She SAID "yes." Then she proceeded to spell out "I love the Bears too." I feigned disgust, as any self respecting Packer fan would do, and she proceeded to spell out "you like the Pack?" (complete with her own disgusted facial expression).
Ah, a match made in heaven. I can't wait to show up in my cheese head next week....
Keep an eye out because we are taking our therapy "to the streets." I have some community outings planned to assist Lauren with using her newly acquired skills in more functional settings. So, if you see us out and about be sure to stop and say "hi", tell a joke or tell her you've been reading about her. She would love that.
As always, thank you for reading and sharing my blog. I'd like to ask now that you go to www.missionsmallbusiness and vote for Therapy and Learning Services, Inc. I'm trying to win one of several $250,000 grants to start a program for families like the Pokutas who need a little help with therapy funding during periods of insurance lags. THANK YOU for helping!
Can you believe it? I'm actually writing on THE day I got to see Lauren. You'll see why and I have a little plan for a surprise for Miss. Lauren so I need to get the wheels in motion. For those of you that don't know, Lauren was VERY involved in music and was quite the singer/performer. She LOVES country music and Taylor Swift is a favorite. When I see Lauren at home, they often have music playing for her in the background.
At one of our first visits I asked Lauren if she would like to use music for some of our activities. The vigorous shake of her head and spelling of "yes" on her alphabet board let me know that this would indeed be a very therapeutic activity for her.
So, today was THE day for our "music therapy."
She actually met me at the library because she travels there to use the computer to work on some high school classwork she is doing. It was nice for her to be in a different setting and I know that our community enjoys getting to see her out and about. She was going for pizza after our visit and we had a long discussion about what she liked on her pizza...cheese...pepperoni but NOT onion (vigorous head shaking on that one).
Oh..I bet you want to know what happened don't you? I'm sure you are wishing I would have taken some video of what happened when I turned on the music....right?
WELL....FIRST we have to see/hear how well Lauren is doing with her /m/ words. Much.Much.Much improvement. So, I raised the bar a bit and we did final /m/ (a little more challenging) and we tried some two and THREE word repetitions (those were the pie in thy sky goal). Here's how she did.
Pretty awesome, right? So much stronger than last week and her breath support is improving nicely. Shortly after this "boring" work, I asked which musical artist she wanted to use for our next activities...without hesitation and quicker than I've EVER seen her spell out anything, she answered Taylor Swift...so I got YouTube up on my iPad and found a T.S song and here's what happened. Please, watch her face carefully...I think this is what JOY really looks like.
So...pretty amazing right? :) She remembered every word and was keeping time with T.S while mouthing. HUGE. Just wait though...there's MORE and I saved THE BEST for last.
and THEN...she even played some air guitar and did hand motions...(I wish the music would have been louder because you would have heard that she was once again right on cue.
To say that today was an amazing day is a huge understatement. Lauren LOVES Taylor Swift and so, I wanted to get this post written so I can Tweet her in the hopes that T.S will write to Lauren, send her a picture or make Lauren's dream come true by inviting her to a concert. :) I will probably even include Ellen Degeneres because she seems to have this way of making dreams come true.
"Pie in the sky?????" YES, but 4 weeks ago hearing Lauren vocalize ANYTHING was "pie in the sky" so I'm going for it. Feel free to Tweet them yourselves.
As always, thanks for reading and please visit either of these sites to keep up with Lauren's progress and/or donate to her family.
I got another surprise when I arrived, on June 5th, to find Lauren sitting up in a dining room chair instead of her wheelchair and a hearty "HI!" when I turned the corner into the room. :)
During this session, we worked on really getting Lauren's voice to be "on" more than "off." She demonstrates many symptoms of motor planning delay which, in a nutshell, means that even though her brain tells her vocal cords to "voice" the message doesn't always go through. Add the breath support issue and muscle atrophy onto that and it is quite a task to vocalize!
For our session, I had decided that we would try "humming" and working on initial /m/ words...with Lauren's singing background I felt that this would be a great way to get her to vocalize more while also encouraging longer stretches of vocalizing. Cueing her to "hum" is also a great way to get her voice going instead of saying "say __________." Not surprisingly, this worked like a charm and she had GREAT success with a list of 10 or so initial /m/ words. In particular she vocalized a really strong MOON! I gave her "homework" which I'm not sure she was thrilled about.
Since Lauren enjoys her iPad and UNO so much, I incorporated our "drill" work into a more functional activity (playing UNO) by having her say "my turn" during our game. She not only said this but also vocalized a weak but audible "your" (turn) as well.
Here is some video of us playing UNO...she was getting tired by now but you CAN hear her say "mine" and "yours" pretty clearly.
Isn't that AWESOME?!
and for the record....I WON this time! Not that Lauren and I are competitive or anything. :)
Stay tuned for more updates from our next visit and as always, please visit either of these links to keep up with Lauren's progress and to donate.
Thanks for reading!
Before anyone calls me a liar...you must know that I didn't see Lauren on a Tuesday this week as she had an eye doctor appointment. I didn't feel like changing the name of my post as I like the name of my series...stubborn, I know.
So, I wasn't expecting to walk in and be greeted by Lauren's dad today with a video of her laying in bed vocalizing about 10 different words he asked her to! Exciting, right? My goodness was he excited! Her face was priceless when he showed me the video...so very proud of herself. One of the reasons I mention that she was laying down is that oftentimes, individuals will vocalize much better in this position. Their body is getting much support, much information and THEY ARE RELAXED. I will lay on the floor with many of my clients (kids and adults alike) when working on voicing and breath support.
Today's visit was spent on trying out some new apps to work on comprehension and speech production. They were: Speech Lite, Can you find it? and What does not belong. Lauren enjoyed them all and will be challenged by them which is good. Part of rehab is to continue to raise the bar when new skills appear. This keeps the new neural pathways forming and you must "ride the wave" of progress when it happens so I am trying to give them as many things to work on at home as possible to optimize the time between visits with me and her other SLP's. There is that little matter of Lauren REALLY loving her iPad as well which helps the situation dramatically.
One of the things that happens when speech is lost, for quite some time, is that the brain "forgets" how to make the sounds-there are many reasons for this and I'm sure you don't want a neurology lesson right now, so we'll just leave it at that. One of our jobs as therapists is to help the client relearn how to make those sounds and a very helpful tip that I learned from my training in Apraxia treatment (Nancy Kaufman) is that you must TELL the client what to do to make the sound. Since L's comprehension is so good, we tried this out today. She vocalized on a word with initial F ( I almost said F- word there but didn't want to give the wrong idea) but the /f/ was weak and unintelligible. I told her "L you need to bite your lip and blow." Voila'. A beautiful /f/ was heard. If only it was that easy all of the time. Sidenote: the app I recommend today, Speechlite is a FREE app that has video of someone making and verbalizing HOW to make each sound of our language. I am confident L will use and do very well with this app now that she is vocalizing.
You want video....right? HA. Don't worry, I have it but I must warn you....get the tissues ready (that is her mom with her) AND remember that L had been sitting up in her chair and so she is very weak with her vocalizations (her /e/ was fabulous though!). The video her dad showed me was MUCH stronger and louder and I hope he posts it to her Caring Bridge site. Just last week, it was very rare that L could vocalize on demand so that fact that she can do it almost 50% of the time now is VERY encouraging and I can't wait to go back next Tuesday. She has a long way to go but I know she will progress through this.
As always, thank you for reading and please visit Lauren's links to read more about her journey as well as to donate if you can.
OK. OK. I know I neglected to post right after my last visit...Now that we have that out of the way, let me update you on our visit from 5/22/12.
Lauren is enjoying her Brain Lab app and requests to play it often. Yay! Her mom even said that sometimes, L reads the instructions so fast that she (mom) doesn't even get a chance to figure it out. HA. Go Lauren!
I had a surprise for L this day as I had spent a wonderful Saturday, with a "bestie" celebrating my birthday, getting our make up done, shopping, eating and giggling. As we were enjoying our day, I was reminded how therapeutic it is to enjoy new hair, makeup and nails (if you enjoy these things of course!)
Each week when I arrive at L's house her hair is done differently and her nails are painted a new color so I had decided, while planning therapy, that I would incorporate some of these "girl treats" into our session. Although I didn't know L prior to her accident, I can tell from her pictures that she very much enjoyed "pampering" items. I had so much fun shopping for head bands, nail polish, CHOCOLATE, lip gloss and gum.
I told L that I had some surprises with me but to get them, she had to guess what they were, in two guesses, based upon my clues. This was not only a lesson in comprehension but also practice using her alphabet board and Verbally app (on iPad) to communicate her thoughts. So, here is how it went with the alphabet board...
Don't you just love her Cookie Monster T-Shirt? You can see that, while L is comprehending much, there are still times that she might "get stuck" on previous thoughts. This is one of the reasons we do these types of exercises...to get her to really tune in to the minute details and stay focused into my voice and our activity.
One of the things I want you to really pay attention to is that L makes the motor (mouth) movements for words...this is VERY encouraging. We continue to work on voicing but this will take some time as she can not always get "voice" when she wants it.
Thanks for reading! Remember that you can visit on of the links below to donate or keep up with Lauren's story.
http://www.caringbridge.org/visit/laurenpokuta or http://staystrong4lauren.com/Until next time....Jen