A lot of my time with “Euterpe,” a young woman with developmental delays and a strong speech impediment, is spent on vocal play. That might be the formal term for it anyway: we’re just playing around, and it’s largely a matter of me trying to keep her entertained, which takes some doing.
[Note: my code name for her, Euterpe, is pronounced “you-TER-pee.” From Greek mythology: she was the Muse of music]
I’ve sung her every song we both know, in every conceivable voice and register that I can manage. We’ve played her favorite question games more times than I can count. She loves to have me coach her speech, because she desperately wants to be understood better by everyone. She’s made great strides in the 7 years that I’ve known her, but she can still only say a handful of things that can be understood by anyone outside her immediate circle.
One of her particular difficulties is that she tends to leave out most of a word or phrase, and only the first and last syllable, or perhaps just the last two syllables, bears much resemblance to what she’s trying to say. For instance, if she were to try and repeat the phrase “Hello, how are you doing today? ” She would likely come out with something that sounds approximately like “Heh-weh-woo-day?” Given the commonness of this phrase, it might be easy to guess what she means, but that’s rarely the case with other things she wants to say. One thing her therapists and I do to try and help her be understood is to think of the shortest possible way for her to say things. “How’s your day?” for example, is a lot more manageable than the sentence above, so we have her practice that version.
She relies heavily on the intonation and rhythms of speech to get her message across, and it’s amazing to realize how much one can understand from cadence alone with reasonable approximations of vowels and the occasional scattered consonant sound. It’s also amazing to realize how much we rely on these cues even when we can hear most of the speech sounds, because on the rare occasions when she gets the rhythm of the language wrong, getting the sounds right is little help. It took me ages, for example, to tell when she was saying “computer,” because, despite her actually pronouncing all three syllables almost correctly, she would put the emphasis on the first one. The result was “KAH-puh-ter,” and I didn’t even think to connect it to the word “computer” until she managed to put it into a sentence with the word “homework.” I’ve been working with her to correct this.
She gets regular speech therapy, and her other therapy programs also have a strong emphasis on language, including a picture-based communication app and typing. But speech practice is her favorite, and she asks for it all the time. These therapists have a lot of good tools, and they help her immensely. But sometimes she’s also helped by something less formally structured.
Two different instances of playing around with music gave me insight into some of her areas of struggle. The first was, that to amuse her, I tried speaking and singing in a low, slow, drawn-out, voice, as if I were an LP record or audiotape being played at the wrong speed. (Fortunately, with been renewed popularity of records, I can count on people outside the DJing business to have some idea what I’m talking about. The era of CDs and mp3s offers no equivalent.)
Euterpe loves the “slow” voice, and requests it frequently. She also tries to imitate it. And when she started doing so, I noticed something. When she slowed down (far more than people do even when they are trying to enunciate clearly), she left fewer things out. Her therapists will say words slowly for her to copy, but their pace is still in the range of normal speech. Only when I stretch things out several seconds per syllable is she able to recall more of the sounds when she repeats them back. As a science person, I’m intrigued by what this implies about her auditory processing and working memory. As her caregiver and companion, I am simply thrilled that it works.
The other voice she requests constantly is my “robot voice.” Out of boredom one day, I said a sentence and tried to make it sound like an old science fiction portrayal of a robot — choppy syllables, completely flat intonation. To my surprise, she loved it, and it quickly became her new favorite. On a personal level, I might wish that I hadn’t come up with this option. The robot voice is not easy on my voice and tends to leave my throat feeling strained, nor is it particularly enjoyable or interesting to do. But it’s worth it, because of what it offers her.
Chopping up the syllables into separate units has clarified many of them for her, again in a way that her therapy has struggled with. Usually, they use visuals to break down a word, asking her to touch the dot beneath each syllable as she reads. I do this with her too, and it’s a good method. But she hates visual tracking, tires of it quickly, and still tends to skip over things. Exaggerating the cutting off each syllable after I say it, I seem to have come up with an auditory version of the same thing.
Another advantage to the robot voice is that it takes away the cadence she usually relies on, forcing her to focus on the actual speech sounds. She’s incredibly good at copying the rhythm of someone’s sentence, and often focuses on reproducing that rather than on fixing her pronunciation. When I separate the rhythms from the speech, she starts to treat the sounds differently.
What I’ve come up with here isn’t anything amazing or miraculous. They are just some tools that developed naturally through playfulness on my part, and me paying close attention to how she responded. Open exploration offered options that a structured therapy program didn’t. And because we have no formal goals during our sessions, I’m free to let her essentially design her own lesson plan. She tells me what she wants to learn (often a theme like “kitchen words,” or the lyrics to a song or nursery rhyme) and asks me to say those things in certain voices over and over and over, sometimes just listening, and sometimes imitating me until she’s comfortable with the words. I certainly take the opportunity to add in and focus on words and phrases that I feel will be useful for her, but I don’t put pressure on her to stick to my ideas when she tires of them. As a result, she never tires of the lessons themselves. Sometimes, when my voice gets tired or I get sick of repeating something, I almost wish she would! But then I see the progress she’s making, and it fills me with joy.