Sign Language & Communication

I hope everyone had a nice Memorial Day weekend. We spent Sunday with Steve's family. I was surprised to realize that some of the family didn't realize Ainsley can communicate with us. So let me explain.

The way we vocalize is our bodies force the air we breath up through our vocal cords and that produces sound. People with a trach exhale through the trach tube so the air doesn't get to the vocal cords, or at least not well enough. So a person with a trach may wear a speaking valve. This forces the exhaled air up through the vocal cords. Breathing in the trach and out the mouth/nose takes extra effort and Ainsley doesn't like it much. Plus she wasn't able to wear a valve until after she was 2. So essentially being left without a voice during the early stages of language development has not been good for her learning to speak.

In addition Ainsley's cerebellum, the portion of the brain that controls movement, is undersized making everything that involves movement more difficult for her. Speech requires a lot of movement of the lips, tongue and face. In addition it requires motor planning which is also controlled by the cerebellum.

This is why while other kids are hitting milestones we celebrate "inchstones".

Over the past year we realized that Ainsley's receptive language was pretty good. She knew a lot of words. How do we know this? Check out this post. 

We've been working on sign language and PECS cards since she was practically a baby, knowing she was at severe risk for language delays due to the tracheostomy.  But because of the cerebellum malformation she had a hard time performing signs. She actually was doing a few signs at a very young age, we just couldn't tell what they were. At one time I'm embarassed to say I thought maybe she was autistic because she kept doing this thing with her hand that looked like "stimming". She was actually signing "all done" with one hand because her night nurse Theresa taught it to her that way.  Then there is milk, which looks just like "all done" when you do that sign with one hand. And both of those look like "hi". So we were very confused because of course for a young baby those are the first signs you learn and they all looked almost the same.  Nowdays I have the same problem with "mommy" and "water" which have only a subtle differentiation. I keep saying "Ahhhh, you said mommy. Did you say mommy?" and she shakes her head "NO!" "Water."  Shucks! Although she does know the sign for "mommy" she doesn't use it often.

So it has been difficult to tell exactly when a sign was mastered but here is a list of the signs she knows in the approximate order she learned them.

all done
milk
hi
book
more
eat
drink
ball
help
up
off
baby/doll
thank you
hat
bed/sleep
water
shoes
daddy
mommy
please
girl
boy
dog
DVD

Woohoo! We are up to over 20 signs!