Elijah had an appointment on Friday with a speech therapist, to do a brief assessment. There was also a student working with her, so both the therapist and the student went through a couple books with Elijah. They were looking at various pictures, pointing things out, asking him what he saw, etc. The books were perfect - they had MANY pictures, and many things he liked looking at and pointing things out.
As they went through, they took notes on what sounds that Elijah could make, and what sounds he couldn't make. For the sounds he couldn't make, they made notes about what sounds he substituted for them. They also were listening to how many words he would string together in a phrase. It was very interesting, and I think the results were a very accurate assessment of his speech skills.
Basically, there are several letters that he doesn't say at all. There are some that I thought he didn't say, but he would say them if he was looking right at the therapist when she said it and he looked right back at her and repeated it, showing that he can make the sounds. He is putting together 3-words sentences fairly well - although of course they are more mangled when they are strung together. (Actually sometimes at home we do hear 4-word sentences - now that I know to listen for that!) And she said he's about at the level of a child who is 2 yrs 10 mos to 3 years old.
The therapist gave me two options. The first was to refer him on to another therapist, who would work with him intensively for six weeks, and watch how well he improves, at which time they would decide whether he qualifies for special education services. The other option was for us to continue working with him, and bring him back in about 4 months and see if he's continuing to improve.
She asked me questions about where his speech was in January when we brought him home - and we don't think he was really talking at all - he didn't to us and we doubt he was in the orphanage either. In addition to learning to talk in the past 8 months, he's also learning a new language. Thinking about how far he's come in those 8 months, we think he's improving at an incredible rate just with what we're already working with him on. She thinks that will continue to improve with the care and instruction he's receiving - and being around his talking peers at daycare and elsewhere. I also mentioned that he's just begun really talking a LOT more in the past couple weeks - even since I'd set up the appointment! I think it has a lot to do with his confidence in his rapidly-expanding vocabulary, and she thought so too.
So we opted for the second option. She gave us some helpful hints on how we can continue working with him. She will hold on to his assessment - a great baseline to compare to in 4 months when I have her do a re-assessment. Then if he's not improved very much, then we'll definitely get her referral to ahead with the more intensive work.
So in the next few months, she wants us to not ask so many yes/no questions - where he can be lazy with one-word answers. Instead we can ask him open-ended questions. When he talks to us in a 3-word sentence, we can validate what he's saying. For example, if he says, "See my truck", we can respond with, "Yes, I see your yellow truck." That way he'll likely repeat back, and learn to add more words to his sentences.
Also, she said not to worry so much about the ending consonants that he rarely says. She says that as he gets more used to saying more words in a sentence, those will come, as will just the general letter sounds that he can't say - and not to worry about those either. Those sounds will come as he gets more practice talking.
Anyway, it was VERY interesting to me to meet with her and talk with her about how we can help him. And it's encouraging to me that she thinks he's learning so quickly, which we also have noticed. She said the key is that he continues to get better, and doesn't stop improving. We'll see in January how he's doing, but I'm so glad to have met with her. It gives me peace of mind that we're doing things right, and I'm certain that, at the pace he's going, soon he'll be caught up with his peers.