The day we didn't see coming.

So yesterday was not exactly one of those days I would look forward to repeating. Overall, it was just another day in the life of sweet Ruthie, but it's amazing how one piece of bad news can take over if you let it.

Wednesday has become double-therapy day. Ruthie has OT followed by speech therapy, and yesterday was our first trial day to see how she would do with piggy-backing therapies. She is doing great in OT lately - accepting bites of finger-foods and chewing them up and, for the most part, swallowing them. She likes organic bbq chicken and Mum-Mums dipped in ketchup & mustard. Yes, she is a little quirky. :) She still refuses to be spoon-fed anything, unless she can do it herself, and most of the time she's happy to take the spoon away from you, only to throw it on the floor. We're very excited with the progress she's making!

Speech therapy.....was a totally different story. She had her evaluation two weeks ago, which consisted primarily of clinical observation and my answering questions about things she does and doesn't do. We got the results yesterday and they weren't good. We knew she was delayed in speech, even for her adjusted age (9 months.) Ruthie does not babble really, no consonant sounds and hardly vowel sounds. While she's very vocal (growling, making noises, etc) when she feels like it, she's not at all verbal. Babies her adjusted age are already making sounds like "ma, da, ba, pa" and others. She doesn't do that and she doesn't try to imitate when you do it in front of her. She also does not clap, point, or wave and seems very confused when you prompt her to do those things. So we knew she would need some speech therapy at some point, and I'm glad it's now.

Our speech therapist is wonderful - she meshes very well with Ruthie and I like her a lot. I was not nervous going into the session because in all honesty, I was not expecting what she was going to say. We knew there were delays but I was not at all prepared to hear the words "speech apraxia." While she said Ruthie was too young to know for sure at this point, she has a lot of red flags for apraxia. In layman's terms, this means there's a good chance Ruthie may never talk, and if she does, it may never be intelligible to anyone but herself. Children with apraxia often say words that, to them, sound totally normal, but to others just sounds like a....well, sound. For example, a child may be trying to say "dog," and is hearing themselves say "dog," but what really comes out is "uh." Apraxia is more neurological/psychological than physical. It's not that these children *won't* do it, it's that they CAN'T.

Ruthie scored very well on her receptive language - meaning she understands what is said to her. She knows what you're talking about and can follow simple commands. Apraxia affects the expressive language - as the term suggests, the ability to express your thoughts, feelings, wants, etc. She knows WHAT she wants, she just can't verbally tell you.

I've worked with children with apraxia and the thought of Ruthie dealing with this scares the bejeebers out of me. I know what those kids have gone through, only to still be verbally unsuccessful and made fun of, left out, and left behind by their peers. I don't want that for Ruthie, ever. When she was born, we were told she would have trouble doing a lot of things, simply because of her prematurity. For the most part, we've totally sailed along and I don't ever want to take for granted. We KNOW how fortunate we've been and how blessed we are for the road she's had versus what could have been. Ruthie has always had a stubborn streak and a fighting spirit - that's what kept her alive when she was a mere 1 lb and what will fuel her now to move forward.

There are other possibilities as to why she doesn't yet verbalize. The one we are most on board with is the fact that when babies are working on one area of development, others are pushed to the side; they can possibly even regress. Ruthie has been working so hard lately on crawling/pulling up/cruising, and before that, was working hard to learn how to sit herself up from the floor and back down again. It could be that she has just pushed aside the speech part of her development to work on gross motor, and speech may be the next area she decides to excel in. We'll just have to see.

We refuse to believe she will never talk. Ruthie has already proven to do so many things the professionals said she would never do. She rolls, sits, crawls, pulls up on things, and cruises. She's finally beginning to eat, albeit a little, but she's still willing to try. She's always been open to trying new things. If you show her how to do something, she usually has it mastered by the end of the day. She's such a quick learner, and very smart. We are not giving up or giving in. Ruthie will continue speech therapy once a week, and more if needed. She is so young still and if this is destined to be her road, there is a lot that can be done. There are other kinds of therapy we can pursue if we need to, and we'll find a way to make it work financially. If she does have apraxia and speech is not going to be her "thing," we'll all become fluent in sign language and our own weird gestures that won't mean anything to anyone but us. We'll do whatever it takes to keep her happy and healthy, because she is what's important.

Please be in prayer with us about this. We were devastated to hear this and our emotions are very raw. We're still processing. Ruthie is the love of our lives and we will never view her differently, whether she ever talks or not. I personally believe in a few years we'll be begging her for a few minutes of peace and quiet, and I will be excited to get that first note from her teacher saying Ruthie is on a red card because she talks too much. :)