¦^ÂСG Updates from Lily from Hong Kong about Jacky who is now 18

[Guest guest]

Hi everyone!

Below are some update messages about Jacky from his mom Lily -

translated by (thanks !) Jacky is one of the older

members of our group who grew up with apraxia -he's 18 years old now

and from Hong Kong. There is a slight language barrier -however with

help from and Babel Fish we as a group can continue to reach

out and help Jacky and others. Below you will find information about

what Lily has dealt with in regards to therapy and costs in Taiwan.

Lily is wonderful and I want to encourage others to email with her as

well. I don't know the amount of local support that is there -but

certainly we can all provide them with online support! I've already

emailed Lily about some of the updates below but noticed the schedule

for EFAs and at Jacky's age the dosage appears to be a bit low. It's

best if you do the 2 to 1 ratio on the same day. In other words use

the 2 ProEFA and 1 ProEPA on the same day. On the other hand you say

you are seeing results with the dosage you are using so far-that's

great!

Lily we are all here for you and Jacky!

Lily do you think Jacky would be up for submission to the talking page?

http://www.debtsmart.com/talk

~~~~~~~~~~~~~start of messages about Jacky from Lily translated by

,You may post (if needs). Lily

,

EFA+EPA,Let Jacky have happy mood and to speak clearly (Now, I

observe)

Dear ,

you may post this - to the CHERAB group.

The appendix is the translation.

Jacky now first day efa 2,

second days, epa 1,

third day efa 2,

4th day epa 1,

5th day efa 2,

6th day epa 1......

Jacky loves the bowling, badminton - he starts to practice .

The blood test, what is? ( Sorry , My English is very poor,)

Lily

Dear ,

help translation this ! (The CHERAB Taiwan contacts the person)

Thanks !!

~~~~~~~~~~~~~~~~~~~~~~

Jacky was in hospital because of a high fever when he was 2.3 years

old. He didnft speak and always had bad temper. Therefore he had

evaluated as autism at the age 2.5. Because he was normal before

1.5, I even thought it was the injection that made him autistic at

that time.

Jacky had SI therapy from December 2006. Now, he has group class and

individual class on FumHong Society-Development & Support centre for

Persons with Autism every Monday, Wednesday and Friday from 1:00pm to

4:00pm. This center was established on Aug. 2006. It opens from

10:00am to 4:00pm. We pay by ourselves. It is comfortable there, but

the occupational therapists are too young to have much experience.

There is no SLP in the center.

Jacky has some problems with the sensory issue. He has dyslexia

also. Sensory Integration Therapy Center is down the Autism Center.

Jacky has SI and TL there every Tuesday from 3:00~3:45pm. He loves

there very much and his articulation is improving.

, through your help, I know the apraxia children need PROMPT SLP

very much. Therefore I asked Ms Lau to teach Jacky. Jacky has ST

every Saturday or Sunday afternoon at home. At first, Jacky could

only pronounced /a/ /e/ /u/ and /ma/. Now his vocabulary is booming

even though some of them are unclear. Miss Ho is Jackyfs teach from

July 2007 because of Ms. Laufs pregnancy.

Jacky was evaluated as oral apraxia by Hong Kong University on May

2007. They told me Jacky was not suitable for the case study and no

cheap therapy could be provided. I was so mad about this, therefore

I have to hire a SLP by my own.

Jacky had ABA therapy but failed. He always got angry on this.

His cousin is his friend. She is a nurse. Jacky likes sport programs

even though he canft play very well. He canft tell me what his dream

is. But I believe he can one day.

Hong Kong is a seven-millions-people-lived beautiful island. Even

though it is commercial, economic, still three hundred and two

thousand different kind of handicapped people are under an unsound

therapy service system. Neither the companiesf acceptance nor the

governmentfs regulation to the insurance application of the

handicapped children. Thatfs what we struggle for. HK$1,200 is given

to every handicapped people by the government. Besides the early

intervention, children under 18 take therapeutic classes at school

for handicapped. For those who are above 18, they stay in the shelter

center or factor till the end of their lives.

I love history and literature. I donftf have time to do what I want

after I knew Jacky was autistic. I just study hard and try to help my

poor son. Many experts told me that Jacky might not speak for all his

life. Itfs very difficult for me to understand that why many

autistic children can speak, while others canft. No one tells me that

apraxia would happen to children until I read f book - my poor

son has apraxia.

My English is very poor, therefore I canft discuss with you very

often. But I do want to know the effect of vitamin E, is there any

side effect also?

(Because Jacky has " to capture " , I must carefully process him to use

the drugs)

( Book -the secret, I thought it will be - the future science ! )

thanks for all your wisdom !!!

Thanks your help Jacky finds his sound !!!!

Lily in HK 2:50am Mar 20,2008

Jacky's assessment result on 8 July 2006

>

>

> > Dear and Ms Chow,

> >

> > I saw Jacky last Saturday. Ms Chow told me a lot

> > about Jacky. From the assessment, I had the following

> > findings.

> >

> > Positive indicators:

> > 1. Jacky can produce some vowels including a, i, u,

> > ma. It's a good starting of speaking. He also can

> > produce a+i, i+u, a+u which implied his oral

> > coordination is also good.

> >

> > 2. On Assessment about oral apraxia, his tongue and

> > lip movement are within normal limit. However, his

> > tongue tip cannot raise to the alveolar ridge which

> > may hinge his production of /d/ and /l/ sound.

> >

> > 3. Ms Chow is very willing to spend time on teaching

> > Jacky in every aspect. However, the schedule is

> > rather random and the objectives are not clear. It

> > can be modified in the near future.

> >

> > 4. When Jacky was reading a magazine and Ms Chow read

> > the words for Jacky, Jacky could point to the word.

> > It means Jacky can follow some written words and wants

> > to speak with Mum. However, he used to point the

> > words rather than producing sounds for the words. It

> > will be another objective.

> >

> > Recommendation:

> > 1. In order to reinforce Jacky's vocalization, Ms Chow

> > was told to encourage Jacky to vocalize whenever Jacky

> > wants to express including pointing the written words

> > and answering Ms Chow's answer.

> >

> > 2. In terms of communication, Ms Chow always uses

> > yes/no questions for Jacky and sometimes forced-choice

> > questions. She is recommended to use more

> > forced-choice questions and if necessary using more

> > pictures to enhance Jackyfs association of real

> > objects to picture cards.

> >

> > 3. In terms of play time, Ms Chow was recommended to

> > develop some clear objectives for every toys so that

> > she may increase the quality of play time. It may

> > some time to build up and modify the objective. It

> > acts as a start for Ms Chow.

> >

> > 4. In terms of oro-motor training, Ms Chow was

> > recommended to put some jams on every corner of the

> > lips so as to train Jackyfs tongue control. The most

> > significant part is the alveolar ridge which needs

> > ever more exercise. However, in order to prevent

> > perseveration and negative reaction of Jacky, Ms Chow

> > was told not to do too much.

> >

> > Here is the summary of the first session. Please feel

> > free to tell me if you have any suggestions. I really

> > hope Jacky can talk in the near future.

> >

> > Thanks for your attention.

> >

> > Yours sincerely,

> > Ms Lau

=====================================================

Dear Mrs. Chow,

I have carried out twenty speech and language therapy sessions for

Jacky, hereby I noted the progress summary for your reference.

Jacky has progress in different areas. First of all, his ability of

imitating sound improved a lot which enriched his phonetic

inventory. He could now produce the

followings: /ma/, /mau/, /mam/, /mai/, /ja/, /ji/, /jai/, /fa/, /wa/,

/wai/, /ai/, /ou/, /am/, /la/. In the first assessment, he only

got /a/, /i/, /u/. He had great improvement in his oro-motor

coordination and breathing support.

However, he needs more practice on using the vocabulary in his daily

life for making request. Now he only tried to produce different

sounds before someone gave models for him to imitate. I recommend

that he should consolidate more vocabulary by using them repeatedly

and only three vocabularies at a time.

Secondly, he was good at pointing at photos to answer questions

instead of just nodding or shaking his head. Moreover, he got used

to use his voice to answer questions while pointing and he was more

willing to imitate the target words with better speech

intelligibility.

However, he lacked initiation to use those beautiful photos in daily

life. Therefore, I recommend we can make up more scenarios in daily

life for him to make request and initiation. In most of the time, we

provide all the needs to Jacky before he really felt the needs.

Practice makes perfect. He should have more opportunity to make use

the photos to express his needs and feelings by his own initiation.

For the long term, he is expected to decrease the undesirable

behavior for reject and protest.

I deeply believe Jackyfs improvement was due to your hard work. In

the past few months, Jacky has improvement. In future, he has a lot

to improve. Therefore, we need to design more tasks on training his

oro-motor ability, breathing support, comprehension of commands and

questions, etc.

In the process of training, I noted some of Jackyfs characteristics

which might help his learning. He likes cutting and pasting tasks,

clear token system (such as giving him star, tick, toys, etc),

systematic tasks (feeling of accomplishment). His attention can hold

for about fifteen minutes for each task for best learning. He

doesnft like random order with repetition, too much difficulty. In

most of the time, I will choose the interesting task with a little

bit difficulty. For imitation of sound, I will provide slow models

with emphasis on the mouth shape. If he produces the wrong sound, I

will ask him to imitate once again. Only I need to make sure he

tries his best to imitate, I will provide reinforcement and verbal

praise to him so as to decrease his frustration.

Last but the least, since he used to produce some undesirable for

protest and reject, I recommend we ask him to imitate more sentences

to express his feeling and needs. For example, I am very happy, I

donft like it, etc.

I hope my treatment and recommendation can really help Jackyfs

learning. Thanks for letting me to join hands with you in teaching

Jacky and share your happiness and difficulties.

Best regards,

Ms Lau

Speech therapist

26/1/2007

Jackyfs assessment result on 30 August 2007

Informal assessment was conducted on last month. Here are the

findings from the assessment:

1. Jacky can produce some vowels /a, i, o, u/ and syllables /ma,

la/. He can also produce a combination of a+i, a+u, u+m, la+i in a

slow rate, which indicated a good start of production of speech.

2. On the aspect of his oro-motor function, his lips and tongue

movements are within normal limit. Jacky can elevate his tongue tip

to reach the alveolar ridge, which facilitate his production of /l/

sound. However, the strength of the lips and the movement of the

tongue base were weak, which may hinge his production of /p, b/

and /g, k/ sounds respectively.

3. On the aspect of his auditory comprehension, Jacky can simple

1-step command and pick out a specified object from a group of 4

items. Moreover, his vocabularies are limited and category specific.

4. Jacky is willing to imitate speech, which shows a positive

learning indicator. However, he seldom verbally requests for what he

wants, which hinders his generalization of what he learnt to daily

life.

5. Jacky enjoys reading magazine and drawing lines. He can write

simple character by following strokes. Therefore, pictures with

written words may be considered as an aid of communication in the

future.

Recommendation:

1. In terms of oro-motor training, providing multi-sensory

stimulation in oro-facial muscles are suggested. Providing stimulus

with different pressure, texture, taste and temperate on the lips,

alveolar ridge and tongue base, which are the significant

articulators in speech production, in order to facilitate Jackyfs

control of the articulators and produce clear speech.

2. Also, coordination of articulators in speech production is

essential. Therefore, oro-motor training on enhancing Jackyfs

coordination of lips and tongue by producing a combination of

different sounds will be focused.

3. In terms of communication, Jacky should be encouraged to

vocalize whenever he wants to express including requesting help,

pointing written words and answering questions.

4. Comprehension of daily commands can facilitate his

understanding and cooperation with others. Therefore, training follow

2-step commands or relate 2-concept should be targeted.

5. Furthermore, Jacky is good at imitation of speech, especially

the bilabial sounds and vowel /a, i, u/. Providing model with mouth

shape in slow motion can facilitate Jackyfs clear speech.

6. Expanding Jackyfs vocabulary size is also important in

facilitating communication. Vocabulary such as body parts, foods,

electric devices, furniture, actions, transportation, places etc.

should be focused.

=======

Miss Ho

~~~~~~~~~~~~~end of archives about Jacky from Lily translated by

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