Jennifer has had more medical procedures and hospitalizations in her three years than most people have in a lifetime. She was born prematurely at 24-weeks gestation and spent the first six months of her life in the Neonatal Intensive Care Unit. When I saw her for her initial speech-language evaluation, around the age of 11-months, she had a gastrostomy tube, a tracheostomy tube, required oxygen for most of the day, was unable to vocalize secondary to her trach, and was orally defensive.
Initially, therapy focused on tolerating touch to the face and mouth and increasing basic interaction skills. She received a Passy-Muir valve about six months after I began seeing her, but was unable to use it regularly due to intolerance and various hospitalizations. She also never vocalized with the Passy-Muir valve when wearing it. She was approved, through a video flouroscopic swallow study, to begin oral feeding about a year after she began therapy.
Slowly, goals began to focus more on vocalizing with the Passy-Muir valve, tolerating oral feeding, and increasing interaction skills. Around the fall of 2008, Jennifer began vocalizing with both a Passy-Muir valve and humidifier that was placed on her tracheostomy tube. She was finally able to have her tracheostomy tube removed in April of 2009.
Today, besides her feeding tube and healing hole where her trach was, you would never guess that Jennifer was born so early and has come so far. She receives nutrition by mouth and through her gastrostomy tube. She is tolerating all textures, although she is still developing a good chewing pattern. She is using a large vocabulary of words and beginning to use 2-3 word utterances. Now, every time I see her for therapy, she has learned several new words and talks constantly.
Jennifer is excited when I come for therapy and often runs to the door yelling, in a still weak voice, “Shannon! Shannon!” I know her supportive family and occupational, physical, and speech therapies have helped her tremendously. She still has improvements to make, but has come leaps and bounds in her short three years!