More Words, Terrible Twos

January 22, 2006 By 3 Comments


Emily and Ana enjoy a sisterly moment.

There have been lots of new words in Emily’s vocabulary over the past few weeks. Her favorite two words are commands – No! and Up! Both words are heralding in a new age of Emily – the terrible twos. Does she want to have her diaper changed? No! Does she want to put on a shirt? NO!! Does she want to give mommy the pen back before she decorates her own arm? Hell NOO! Good thing it’s a mild winter because I’ll be damned if I can get a pair of pants on the child before 11 am. Still, I’m so enchanted with the fact that she’s actually expressing herself with language that I almost don’t mind the constant rejection. Her new repetoire also includes words like “Steve” (a character on Blue’s Clues), Yellow, Blue, Green (all colors she now recognizes), Home (as in, we’ve arrived HOME!), elephant (although it sounds nothing like that) and, well, the list is just too long. I think we’re really making progress.


Here’s a rare shot of me with the girls. We’re all coloring (well, Emily is coloring and Ana is sitting on my knee). I don’t know what sort of mullet-esque bilevel thing is happening with my hair, but it must be cut and SOON.


Ana’s very sick this weekend with a monstrous cold, but I still managed this pouty shot of her which shows off those amazing eyes. Hey, I’m a mom, I can’t help but exercise my bragging rights once in a while.

Filed Under: Cleft Lip
January 22, 2006 By Leave a Comment
Filed Under: Cleft Lip

Emily Says “N”

January 13, 2006 By Leave a Comment


She did it! Last week Emily started saying “N” for the very first time and she was so proud of herself. She’s had plenty of opportunity to practice because she and Ana have been playing together a lot (the above picture shows the two of them having just completed their tenth lap around the house). I didn’t realize how much Emily was really trying to say the sound until I heard her say “Gggnnnnnnana!” which was a cross between “Gaga” and “Ana.” I nearly fell over! Then she deliberately switched back and forth between the two words – Gaga and then Nana..AND THEN she started saying “night night” with an N instead of a G. We can definitely hear a lot of nasalness when she says N, but it seems to be getting better as she moves away from the G sound and into the N sound. I was so excited that I emailed Em’s speech therapist to break the news. Way to go Emily!

Sadly, this is Emily’s best friend and constant companion. We call her Cabbage, since we lost the paperwork she came with. Emily likes to walk around holding her by the pigtails. I think they sort of look alike.

Filed Under: Cleft Lip

Early Intervention – Six Month Evaluation

January 8, 2006 By Leave a Comment

Emily had her six month Early Intervention evaluation on Friday which involved her regular speech therapist and the EI team coordinator (not sure if that’s her actual title) coming in and setting new goals. The bottom line is that she’s doing very well in terms of making lots of different sounds and adding new words to her vocabulary. The biggest hurdle we have to face over the next six months is intelligibility of speech. The consonant substitutions and mid-palate noises she makes (sort of phlegmy sounds that remind me of Yiddish) make it very difficult for us to understand her. In layman’s terms, the best way to help her is to just get her to talk and request things. But there are certain things we can do to get her to use her soft palate more when she talks. I’m looking forward to the next six months to see how her speech emerges – she really seems to be embracing language but her mouth just isn’t cooperating when she tries to talk.


Emily takes a breather under the coffee table.


Ana’s eating a pretzel and wearing her best wings for the occasion.

Filed Under: Cleft Lip

Speech Therapy Guidelines for Emily

January 3, 2006 By Leave a Comment

Emily’s speech therapist gave us a list of goals for Emily that I thought may be useful to parents who are dealing with similar speech issues in babies and toddlers who have a repaired cleft palate.

Goals for Post-op Cleft-Repaired Children

  1. Increase frequency and diversity of sound production
  2. Increase use of consonant-vowel production (“Dada”, Mama” etc.)
  3. Increase communicative opportunities

    4. – Arrange the environment so that the child needs to ask for what s/he wants
    – Create consistency in the household schedule so the child can predict what’s happening next and comment on it.
    – Take advantage of every opportunity to lavel, describe, etc. (bath time, cleaning up toys, etc.)

  4. Create play “temptations” (put toys in containers, offer novel toys)
  5. Imitate the child’s productions to encourage turn-taking
  6. “Balance” the communicative terms. Don’t talk or vocalize too much more than your child.
  7. Engage in face-to-face vocalizations/verbalizations as much as possible
  8. Encourage imitations of large and small motor movements. Use songs with gestures and large motor movements to accompany actions in play.
  9. Keep a running list of consonant sounds produced spontaneously.
  10. Model words with initial pressure consontants (/p/b/)
  11. Expand on your child’s productions. For instance, the child says, “Cat”. You say, “Cat. Yes, the cat jumped”. Use gestures to accompany your explanations and expansions.
  12. Increase your child’s awareness of airflow with vocalizations. Start with a whispered “Paaa” with lots of airflow (in a play context. Try having a puppet make this sound to call another puppet, etc.) You can blow bubbles using this sound or gently blow pieces of cotton balls across a table using the sound. Gradually introduce some voicing. Whisper the “Paaa” then add a voiced “aaa” (Paaa-aaa). This technique can be expanded on by your speech pathologist to eliminate glottal substitutions which reduce intelligibility of speech.

Emily is now 20 months old and her speech is improving every day. She still has glottal substitutions for certain consontant sounds (e.g., she substitutes the “g” for the “d” and also the “g” for the “n”), but she’s getting much better with her “d” sounds. She still says “Gaga” instead of “Ana.” I think I’m going to cry the day I hear her clearly say sister’s name!

Filed Under: Speech