At 18 months old, Danny Garvin only said one word: “dada.” While a typical 2-year-old can say between 50 and 300 words, at 26 months Danny could only say three. Friends and family said Danny would be fine, but his mother, Laura Garvin, found it difficult not to worry.
“Danny didn’t babble like his older brother had at that age, and I knew from my background in child development that if there was a problem, the earlier we started services the better,” confides Garvin.
The Garvins had Danny evaluated by Child Watch, a state-run program that identifies children experiencing a wide range of developmental delays. They learned that while Danny’s understanding of language was age-appropriate, he had an expressive language delay. A neurologist diagnosed the delay as apraxia of speech, which is characterized by a difficulty sequencing sounds, a limited vowel repertoire and a huge gap between understanding and use of speech.
Danny began speech therapy through another agency, but unlike his 2-year-old peers who were gaining about one word a day, Danny gained no words in the four-month period from June to October 2009. Concerned about his lack of progress, the Garvins switched to Christiana Care services.
“I felt more comfortable knowing that our therapist, Maria, was backed by Christiana Care,” explains Garvin. Maria Streletz, MS, CCC/SLP is a speech language pathologist with Christiana Care’s Rehabilitation Services Department who provides therapy services through the Child Watch birth-to-3 program.
Streletz used songs and games to engage Danny in learning to use words. Singing helps with imitation skills, picture identification, making choices and language fluency, she says. It also helps kids to relax and sparks automatic speech used to sequence sounds like ‘Ready, set, go!” or “One, two, three!”
Danny started therapy nearly one year delayed. Streletz began with simple sounds, such as saying “mmmmm” when eating a cookie. She used oral motor tasks to stimulate Danny’s mouth until he understood how his mouth, tongue and lips move to make sounds. As Danny progressed, Streletz taught him more complex sounds, words and word strings.
“It was like a light switch went on,” Garvin says. As his confidence grew, Danny started interacting with other kids in school and became less dependent on mom and others to interpret his needs.
Today Danny’s expressive language is almost age-appropriate. He has a vocabulary of more than 200 words, and he talks in two- to four-word sentences. His word recall has improved, and though he still has poor syntax, Danny is using novel combinations of words and is learning how to put them together properly. He graduated from the Child Watch program in April 2010 and will continue speech therapy at school.
“Danny is a bright, energetic 3-year-old who made quick gains with the right intervention. He had a tremendous desire to talk, I just showed him how,” Streletz says.
For Laura Garvin, Streletz’ impact runs deeper. “The first time Danny spontaneously said “I love you” to my husband and me was a really proud moment,” she says. “Now he says it all the time. It’s like he’s making up for all those times he wanted to say it, but couldn’t.”