This is part 1of 2 -
At 18 months old we felt R had either plateaued or regressed in her speech. She stopped saying things she previously had been saying like " help" and "baby". It didn't appear she was picking up any new words either or if she was, it was at an incredibly slow pace. I messaged our pediatrician who referred us to a speech and language pathologist for an evaluation. There was a bit of a waitlist but we were finally seen and started therapy- She qualified for speech therapy once a month. In addition, we also initiated a referral to early intervention to try to work around the waitlists and see if she might qualify for a greater frequency of sessions. I felt like we were doing everything the handouts recommended, all the modeling, reading, singing, and talking, and by two she still had less than 50 words and she wasn't combining two words. I also noticed the two-word combos she had were memorized and or generalized "open door" was used for anything she wanted open whether it was a toy, a door, or a container of strawberries. Interestingly, I also noticed some of the words she said had the same pitch and sound to them every single time she said them or were not used in the correct context. I specifically remember the way she would say" hot!" or "Hi!" and how they always sounded the same- that struck me as odd. The list of words she did have was mostly labels like animals, colors, and shapes- things from picture books or nursery rhymes. She also had a lot of what we were told was jargon.
At two she was having frequent meltdowns and was frequently in distress over not being able to communicate her wants and needs. She knew what she wanted to say, but wasn't able to communicate it to me or anyone else. I felt her current speech therapy wasn't working. She had independently taught herself to identify all the letters of the alphabet and could count forwards and backward to 10 but couldn't say "mama" or communicate basic needs like hunger or thirst or even make requests. I scoured the internet which led me to learning about hyperlexia and gestalt language processing. I came across https://www.meaningfulspeech.com and https://www.andnextcomesl.com and absolutely devoured the information from both their social media pages, websites, and any podcast I could find about gestalt language processing. It was like a lightbulb went off. We immediately started acknowledging the somewhat funny things R would say ( which we now know was delayed echolalia) like " ba ba sheep" or " hap no" and her eyes would beam with excitement. Her interest in attempting to communicate with us started to increase dramatically. We searched the meaningful speech NLA-trained registry https://www.meaningfulspeechregistry.com and found an SLP familiar with gestalt language processing in our area. We started sessions and after about three sessions our SLP asked us if we'd be interested in AAC. We had no idea what that was. We learned AAC stands for Augmentative and Alternative Communication- It's all the ways we can communicate other than speaking- this can include things like facial expressions, gestures, pointing, spelling, typing, or in our case- an iPad with an AAC application. Our only initial hesitation was- would it prevent speech? No! our SLP educated us that research showed it actually supported verbal communication development. We were on board!
We knew R was using delayed echolalia or gestalts she had picked up from media or things people had said in order to try to communicate- and although they had meaning to her, we still didn't yet understand their meaning. Additionally, a lot of her speech was unintelligible, or when she was overwhelmed with emotion or sensory stimuli, she had trouble communicating verbally. We had waited so long to find a way to help our daughter communicate we wanted to dive right in. We purchased the iPad and the AAC app and started working with it at home and with her speech therapist right away. The first step was to customize the device and see how R responded to it!