Finding Noah’s Voice: “This my kindy friend.”

Dear Noah,

Little guy, you’ve almost completed your first year of kindergarten.  You began the year with maybe 200 words and approximations of words and were just beginning to put two words together.  We sent you off into that little adventure land of bricks and play dough, painting and stories, animals and climbing frames, dirt pits and sand pits a little uncertain as to how you would cope.  At the end of each day I would ask,”What did you do today?”  And you would say,”Play.”  That was it.  One little word to sum up an entire day, unlike the avalanche of words I would get from your big brother!

I relied on your teacher and teacher aide to give me a little insight into what you were doing and learning.  You were quite happy to explore the kindy environment, always busy, always keen to learn things.  But I would watch you playing by yourself.  You would play beside other kids, but not with them.  I wondered if the breakthrough would ever happen – seeing you join in.  When I picked you up, the other kids would usually be in a group interacting with the teacher and you would be doing something quietly by yourself, quite content in your own little world.  You’ve always been happy to explore things on your own, focussed enough to find enjoyment in it, curious enough that your little mind is occupied without the need for constant companionship.

First day of kindy, Noah all ready to go.

First day of kindy, Noah all ready to go.

Yet I hoped you would find a friend.

On one of my roster days, I met Will, a tiny friendly boy who took an interest in you and would play where ever you went.  Your favourite part of the playground is the dirt pit.  It’s got a shed with toy tools and builder’s helmets.  You love tools and you dominated the tools, even before you had the words to do it.  I heard that when the tools came out and other kids wanted some, you would sort them out – these are MINE and these are YOURS.  Apparently another mum took the tools one day, before being informed,”Don’t touch the tools!”  by an anxious teacher aide.  You’ve trained ‘em well.

The tool hat

The tool hat. Crazy hair day.

Anyway, Will joined us this day.  You were busily building a road.  Will played nearby and kept calling out,”Noah, come help do this!” and trying to get your attention and involvement.  He asked me why you didn’t talk and I explained that you were still learning but were getting better.  I’ve noticed Will greeting you and saying goodbye at the start and end of the day.  I even told his mum how special this was.

As the year has progressed, you’ve gained so many words and have been learning the art of putting sentences together.  They’re not perfect, but we are getting so much more insight into what you think and do.  I’ve seen you making eye contact with other children, speaking to them and even joining in with them – tea parties with the girls, building blocks with the boys.  Your language is still limited and makes social interaction difficult, but you are trying hard to engage with your kindy buddies.  When you couldn’t explain what you wanted to build to the boys, you ran to the craft table and drew a picture to show them.  What a creative and smart way to communicate!

The cutest little jailbird.  Dress ups!

The cutest little jailbird. Dress ups!

Today Will joined you at the activity table where you were hammering wooden pieces into a cork board and you told me,”This my kindy friend.”  It is wonderful that you have a friend.  Will has persevered in being a friend, even when you didn’t quite understand what it was to be a friend.  You are reaching out to other kids confidently, even when they knock you back a bit because of your speech.  You have an enjoyment of all that you do and see the humour in so many things – stories and jokes and games.  You have an infectious giggle that gets the other kids laughing too and joining in with your imaginative games.  And you have a friend who is not one of the teachers!

And we get to do it all again next year.  Kindy has been so much fun, you’re coming back for more.  This time you’ll be able to tell me about your day and you’ll be interacting with the other kids from the very beginning in preparation for that next big first day – SCHOOL!

So this year, you’ve found two very important things – your voice and a friend.

Love you lots,

Mummy

Finding Noah’s Voice – The Carburettor

A carburettor is a device used to combine air and fuel in an internal combustion engine.  They are also an excellent device for helping mechanically inclined four year old boys to develop their speech.  I discovered this fact during Noah’s speech therapy session today.

You may be wondering how attaching such a device to a four year old boy could possibly generate more articulate and fluent speech.  I don’t know either!  Maybe it could work, but we haven’t tried that yet.  But, when Noah is allowed to take it apart, it is an excellent motivational tool.

So much fun.  Let's take apart that carburettor.

So much fun. Let’s take apart that carburettor.

This year I took Noah along to a new speech therapist who specialises in apraxia of speech.  I was impressed with this young man from the beginning as he is highly knowledgeable in the area of apraxia and has the ability to engage, motivate and keep kids interested in their therapy while thinking it’s a huge game.

When we make the trip to Brisbane every week, Noah must pack some essential items for the road.  Number one is his tool box.  Now, this isn’t the ordinary assortment of plastic toy tools that the average young boy plays with.  Noah loves real tools.  He has claimed most of my husband’s screw drivers, spanners and wrenches, has a real tape measure and an assortment of nuts, bolts and screws he has collected.  Some people may think this is a safety issue.  We let him because the little guy actually has an aptitude for working with tools and intuitively knows how to use them and is generally safe with them.  Note, he does not have access to a real saw, pliers or cutting implements.  The toy tools also come along.

Noah’s speech therapist, being a guy, also does a bit of work on cars with his dad and now keeps his socket set in his rooms so Noah can play with them during a speech session.  Back to the carburettor.  How do you incorporate this into a speech lesson?  Well, it looks cool and immediately interests a little grease monkey in the making.  You then tell the little grease monkey that he gets to take it apart.  There’s a catch.  He must complete each word set before he gets the Holy Grail – the appropriate tool to remove each nut, bolt or screw.  And so we work our way through “wash car”, emphasis on the /sh/ sound and “bus go”, emphasis on /s/.  We also practice saying ‘open’ and ‘I want screw driver please’ and ‘turn bolt’.  By the end of the session, both Noah and the speech therapist have hands covered in grease.  Both are happy and Noah doesn’t even realise he’s been getting ‘therapy’.

Noah: "I've said the word, now hand me the screwdriver!"

Noah: “I’ve said the word, now hand me the screwdriver!”

So one day Noah will be able to speak…and take apart any car component.  He has also gotten to disassemble a headlight and an old battery operated game.  At home, he has taken apart his toy tool bench, removed the planks from our fort and taken apart a saucepan lid with no fewer than 5 components needed to get it back together!  Oh yes – the ultimate feat:  We got Noah to say car-bu-et-a.  Four syllable word.  High Five!

My First Cruise – Sailing, Sea sickness and Medical Mission

A few years ago, I took my first cruise.  Not P&O.  It was aboard a 30 year old ship that had once been a training vessel for Japanese fishermen.  My destination was not the Pacific or Mediterranean Islands, Alaskan coast or European rivers.  This ship did not have multiple dining rooms, theaters, gyms, running tracks or hot tubs.  It did have a dental clinic and storage for medications, wound dressings and medical equipment.  This was not a typical holiday, but an adventure in providing basic medical care to people in remote areas, far from hospitals or medical clinics.  This was the YWAM Medical Ship, Pacific Link.  Our starting point was Port Moresby, our destination Daru, Western Province, Papua New Guinea.

YWAM Medical Ship

YWAM Medical Ship

I had heard about the ship through an email from a medical organisation.  I was excited to see that they wanted doctors with general practice experience.  I had long had an interest in medical mission.  This was the perfect opportunity for me to join a team of health professionals for a short term medical mission, not far from my home country of Australia.  The team consisted of 50 people from 10 nations.  There were doctors, nurses, a physiotherapist, optometrist, dentists, general volunteers and the ship crew.  Over two weeks (one week in Port Moresby, one week in Daru), we would do clinics in villages, providing health checks, consultations, immunisations, wound care and health education, eye checks, glasses and dental care.

Life aboard a relatively small ship was a novel experience.  There were so many people that we couldn’t all fit into the dining room at the same time and ate dinner in two shifts.  There were still port holes in the dining cabin and lounge area.  Everything was very compact, from stairs to tables and benches to the bunks.  Workmates, curious about my time on the ship had asked if I got my own cabin!  Down below are men’s and women’s dorms.  The bunks were certainly designed for Japanese fishermen and not long-legged Westerners.  Each room contained four bunks (two top and two bottom bunks), separated by a narrow central aisle, big enough for one person to stand in.  Each morning, I would lean over to put my hand on the top bunk across the aisle before letting myself down off the bunk.  Each bunk was cosy, with a navy blue curtain you could pull across for privacy, a reading light and small bookcase, useful for stashing all my personal items that didn’t fit in my locker.  I tried to make mine more homey by sticking up pictures of the kids and a painting done by my 3 year old.

I love the port holes!

I love the port holes!

Compact locker space

Compact locker space

The bunks

The bunks

I was glad I had followed instructions to pack light, as each person has a locker, or really half locker with 3 shelves and 10cm wide hanging space.  The girls shared a small table and mirror in the main corridor which had power points all around it.  There was always a tangle of cords from phones, ipods and cameras plugged in for recharging.  This was not a trip for anyone who does not like to get close to their fellow homo sapiens.  I loved it.  It was like school camp in the old days.  It was social and multicultural and a great way to meet people.  Some people got a double cabin – a little luxury, but certainly not like the state room on the Queen Mary!

The lounge area was large and spacious, with a good sized screen for watching movies and presentations about our trip.  This was also a great place to hold meetings.  On the aft deck was a large storage cupboard with a cumbersome wooden door, nicknamed ‘Narnia’ by David, our team nurse.  There was an air of mystery surrounding this cupboard as a person who entered may not re-emerge for sometime as they searched for particular items among the medical paraphernalia.  On my second trip, ‘Narnia’ had disappeared, to be replaced by a variety of well ordered and compact storage areas.  The aft deck was opened up to be used for meals and barbecues.  This was a marvelous innovation, but I felt nostalgic for ‘Narnia’.

Compact medical storage, a replacement for 'Narnia'.

Compact medical storage, a replacement for ‘Narnia’.

Showers were limited to 3 minutes per person a day as the water supply was obtained by desalinating sea water.  The girls had 3 showers between them, no doors, just a shower curtain and a bath mat.  This brought on the challenge of dressing quickly and maintaining modesty without getting clothing soggy wet.  The toilets would regularly get a blockage due to the curious bends in the old pipes.  It was the lucky job of the earliest risen member of the ship’s crew to grab a plunger and remove the offending blockage and smell on the mornings this happened.  These little things are bound to happen anywhere a large group of people use a small range of facilities.  The crew were very handy and always quick to fix any problems.  A blockage did occur at the start of one of our sails.  Going up onto the deck for fresh air, the wondrous aroma of fresh sewage would waft towards our nostrils as we lay prostrate, fighting off the waves of sea sickness.  God bless the man who fixed this problem early in the voyage!

Sea sickness is funny in retrospect.  At the time, it felt like an ordeal that would never end.  It did not take me long to turn green.  Ironically, I threw up just after taking my second sea sickness tablet.  I think it was the claustrophobia of navigating narrow ladders down to the bunks while the ship rocked beneath me.  I grabbed a bucket from the laundry, kept there for the express purpose of gathering the stomach contents of the truly sea sick.  That bucket became my comfort item for the rest of the voyage and I held onto it for almost 24 hours.  I didn’t need to use it, but felt safer with it nearby!  I lay on the aft deck with a group of other similarly affected people.  We lay on woven mats, side by side, as the ship moved relentlessly up and down, sea air blowing across our faces.  Every now and again, a large wave would cause the ship to tilt to the port or starboard side and we would slide in unison across the deck, just like a can of sardines.  I counted hours until our projected arrival.

Towards the end of the voyage, the waves levelled out.  We were approaching land.  I grinned with relief.  We were almost there.  I would soon feel my equilibrium return to normal and be able to face the thought of food without flinching.  It would be a week until our return voyage.

At the bow

At the bow

I had an incredible time, serving with a health care team in the Western Province.  I loved meeting the people of Papua New Guinea and have returned since.  Next week I venture to Port Moresby again – this time with my husband.  I am happy to say, I don’t have to sail this year as we will be based in Port Moresby.  Soon YWAM will add a new ship to the mission, one that is larger and more stable in the water.  I am banking on this one being less likely to induce sea sickness and look forward to visiting it soon…and sailing without a green-tinged complexion!

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Finding Noah’s Voice: The Age of Why

What is one thing guaranteed to drive parents to the brink of a cliff, to cover their ears and chant,”La, la, la!” or to wonder whether their college education was really good preparation for life?  The age of,”Why?”  This simple, innocent question is so beautiful the first time you hear it.  Your three year old is embarking on a journey of wonderment, seeking to fill their little mind with knowledge.  Then you discover that “Why?” has no boundaries.  “Why?” is exhausting and has no end.  “Why?” proves how much you don’t know.

But then, I thank God for “Why?”

“Why?” you might ask.

We have a four year old son.  Noah struggles with speech and has had to work hard to get to a point of being able to make simple requests.  Everything he has learnt so far has been through his exploration of the world around him or that which we have told him or thought he would like to know.  He hasn’t been able to ask questions.  Until one day he did.

Noah was playing out in the garden.  Daddy was running him a bath and called through the bathroom window.  “Noah, it’s time for your bath.”  Noah kept playing with his dump truck and asked,”Why?”  Daddy replied,”Because you are dirty and it’s almost time for dinner.”  Hang on.  He just asked,”Why?”  Why!

Noah - the age of Why? has arrived

Noah – the age of Why? has arrived

I had lamented that Noah would pass through the age of insatiable preschool curiosity and never be able to ask,”Why?”  I laugh, because why has appeared before what or where, which developmentally should happen first.  Noah has an active little mind and is losing no time in catching up on the why’s of life.

And now I am subject to his continuous,”Why, mum?”  Thankfully, big brother Sam has already put me through a gruelling two year program of WHY preparation.  I have learnt to think on my feet, recall information that I was taught to me in school, divert the attention…and the ultimate strategy.  Turn the tables back on the kid.  “What do you think, Sam?”  At the end of a seemingly endless quiz where each answer given, simply led to another why and the tidal wave of why seemed ready to overwhelm me, this would be my lifeline.  Strangely enough, it worked.  Sam would stop.  Think.  And come up with an answer of his own.  And now he demonstrates an in depth understanding of many natural and scientific processes that I did not at that age.  Accidentally, I became Socratic.  And that has led my boy to think for himself and to start answering some of his own questions.

Why is a celebration.  It’s the start of Noah being able to let us know what he wants to know.  It’s the beginning of a new era of learning as he becomes curious about the world and seeks out knowledge for himself.  So I am happy to answer the endless,”Why mum?”  And already I have had to turn the tables on Noah and ask him,“What do you think, Noah?”

In this new phase, I have answered such ground breaking questions as:

Why does the foreman on a building site have to direct the operator of the crawler crane?

Why do bees collect nectar from flowers?

Why can’t I eat the raw egg straight out of the mixing bowl?

Why do I have to wear pants?

Why did Jesus die on the cross?

Why can’t we see dinosaurs now?

Of course, Noah does not use all these words in the question.  But, “Why, mum?” can be interpreted in the context of what we are reading or doing or looking at.  Why infiltrates every aspect of life and makes its way into so many interactions with my son.  It may drive me crazy sometimes, but I won’t complain about why anymore.  It’s been a long time coming.  My little boy has asked his first question.  Now he is embarking on a marvellous learning journey with plentiful questions that MUST be asked.  And I have the privilege of answering them.

Jedus Die Cross – Sam, Noah and Jesus

One of our biggest desires as parents is to see our children realise that God loves them and to know Jesus as their Saviour.  Sharing our faith with our children is a big responsibility and a privilege.  It’s also an adventure as we laugh at their theological insights and delight in seeing them discover God is real.  But how do you know when they have chosen Jesus for themselves?

Sam’s Story

Little Sam is six now and we know he loves God with all his heart.  Sam wears his heart beating outside his body and ready to envelop anyone who crosses his path in a big hug.  Even when he was two years old, Sam was asking questions about God.  I think he accepted Jesus as his friend when he was three years old.  There was no defining moment that I can remember him coming to that point.  It just kind of happened.  He knew the gospel and understood it.  We’d had talks about how our hearts got dirty from sin and how only Jesus could wash us clean.  We talked about how God made everything and Sam would go through everything in the garden saying,”God made that.”  Sam simply accepted Jesus as his friend.  He went through a phase of always choosing Jesus dying on the cross as his Bible story every night.

This little boy managed to teach me a few lessons about faith and forgiveness in his own innocent way.  He was about two years old.  I remember being mad about something he had done, scowling at my little Sam and telling him,”Mummy is cross.  Do you know why Mummy is cross?”  I can’t even remember why Mummy was cross!  He looked cute.  He looked perplexed.  Then he said earnestly,”Jesus died on the cross.”  That shot an arrow straight through my heart and reminded me that I just needed to let go and forgive.  And he continues to teach those lessons.  That’s a whole post in itself!

Sam befriending a baby during a trip to China (2012).

Sam befriending a baby during a trip to China (2012).

Noah’s Story

Noah is four and as many of you know has severe apraxia of speech.  He has understanding of what we say, but has much difficulty producing speech.  For a long time I struggled with not knowing whether he had any understanding of who God is or who Jesus is.  This was because Noah simply couldn’t tell me verbally what his thoughts were.  He couldn’t ask questions.  He still can’t ask questions.  Each night we read him a Bible story and pray for him.  The first time I actually felt like Noah was able to participate in prayer was when he started to get more words, around age 3.  We would begin our prayer time by thanking God for blessings in our lives.  I asked Noah,”What would you like to thank God for?”  He smiled and said,”Trucks.”  I laughed.  It was so cool to have him participate in prayer in a small way.  He has since thanked God for everything from tools to kindy, Mummy, Daddy, Sam, Nanna, Grandad, Earle, Bec and Jedus.  Of course, we know that you don’t have to be able to talk out loud to pray – God hears the unspoken.

When ‘Jedus’ started to show up in Noah’s thanks night after night I knew he was beginning to have some understanding of Jesus beyond a storybook character.  Jesus was becoming real to him.  I was trying to find ways to talk to Noah about faith in God and in Jesus that he could understand.  It was hard to gauge his understanding as he can’t speak in full sentences yet.  But Noah was picking things up through Bible stories – he knew Jesus was kind and loving and that he could heal people.  His favourite story was the parable of the Good Samaritan and we read it over and over again.

Noah and me

Noah and me

My first attempts at explaining the gospel to Noah fell flat.  I didn’t really think about how my explanation would sound to a little three year old.  I tried to explain how sin makes our hearts dirty and that sin was all the bad stuff we do.  I asked Noah if he would like Jesus to wash his heart clean.  This was met with a loud resounding,”NO!”  I imagine he had visions of his heart being pulled out of his body and put through a washing machine.

As Easter approached this year, I had a great desire to help Noah more fully understand the gospel.  We read the Easter story quite a few times.  One night I again explained that the bad stuff we do makes our hearts dirty.  Jesus died on the cross for us so that we could be forgiven for all the bad stuff we’ve ever done or ever will do.  Jesus will always love us, no matter what we do.  And we will get to be his friend while we live on earth and forever in heaven one day when we die.  This time I asked Noah if he wanted Jesus to always be his friend.  He smiled sweetly and said,”Yes.”  So I prayed for him and watched my little boy fall asleep with the most beautiful smile on his face.

How do I know for sure that Noah accepted Jesus that night?  I can’t know for sure, but I’m pretty certain.  Since then he has asked again and again for the story,”Jedus died cross.”  Just like his brother Sam did when he first trusted Jesus.  Ever since Good Friday service at church, Noah regularly crosses his arms and simply tells me,”Jedus died cross.”  And I ask,”Did Jesus stay in the tomb?”  And Noah says,”No! Alive!”  Everywhere we see a cross, Noah pipes up with,”Jedus die cross!”  Jesus has become real for him and is a true friend to him.

Perhaps it seems morbid that little children would have a fascination with a story about a man nailed to a cross, especially as a bedtime story.  But they know that’s not the end of the story.  That man was the Son of God.  By the power of God he was raised to life again and calls each of us into relationship with him – life changing friendship that will last our whole lifetime and beyond.  They see in Jesus total acceptance, no matter what.  They see a friend who put his life on the line for them.  They see that this friend will always be with them, whatever happens.  They remind me of the wonder of salvation and that sense of coming home that I had when I first believed in Jesus.  And I remember that He is preparing a place in heaven for each of us even now.

Finding Noah’s Voice – Rainbow Lorikeets

Dear Noah,

In later years, I hope you will have memories of warm autumn afternoons under halcyon blue skies, spent in our garden, simply enjoying all that God has created.  Halcyon.  What does that even mean?  Peaceful, gentle, calm.  Happy and carefree.  All that I hope your childhood will be.  The English language has so many words of subtle difference in meaning that allow us to express so many shades of an experience.  And I wonder what you would express…if you could.

I sat with you in the sandpit, fingering the sand while you moved diggers and dump trucks and used a bucket and spade to create a quarry, accompanied by the sound effects that only four year old boys can make.  I looked up at our Bottlebrush tree, the bright red flowers and deep green foliage standing out against the blue of the sky.  Soon a flock of rainbow lorikeets arrived, chattering excitedly as they fed on the nectar of the bright blooms.  I pointed out the ‘rainbow birds’ to you, their colours and how they got their food from the flowers.  You can’t ask ‘Why?’ yet, so I try to guess what you would ask if you could.

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Rainbow Lorikeets

 

You were entranced by the beautiful birds with their feathers of green, red, blue and yellow.  Jumping up and down, you waved your arms in wide circles to tell me that you wanted to be picked up and put in the tree to be closer to them.  I explained that this would scare them and they would fly away.  The best way to see them would be to crouch quietly by the tree and just watch.  I went inside, leaving you to play.  Cheeky boy!  You didn’t follow my instructions.

Soon you came in side, visibly upset.  Usually a game of ’20 Questions’ follows as I try to work out what has happened.   Yet this day, you said,

”Bird….wings (making flying movements with your hands).  Fly…away.”

A simple, yet breath-taking moment.  You communicated, for the first time, an experience that I had not been on hand to witness.  I understood without needing to ask further questions to clarify.  The rainbow lorikeets had flown away and you were upset about this.

I don’t believe anybody outside our family would have caught the words.  But I did.  Spending more time with you than anybody else, has made me attuned to your way of communicating.  I intimately know your speech patterns at any point in time.  Without words, I’ve had to tune into your moods, tone and expression, gestures and demeanour.  In many ways, I realise I am still your interpreter, deciphering those imperfect, yet precious words of yours for other people.  You understand so much, but are still unable to put most of your thoughts into words.  Little by little, your brain is learning how to send signals to your mouth muscles to form speech.  The thoughts held prisoner in your head for so long are starting to be set free and take flight, much like the rainbow lorikeets.  I’m looking forward to discovering more of the beauty that is you, Noah.  In the meantime, I’ll hang onto this precious bond we share – learning a language that doesn’t need words.

I love you, buddy!  Here’s to many more afternoons spent under those halcyon skies…blue skies…or as you would say,”Boo ky”.

Love Mummy

Dr Noah and the Ste-a-cope

Parents dream big things for their children.  And sometimes we even flatter ourselves that they want to follow in our footsteps.  Hopefully we are giving them good footsteps to follow!

When Noah was 18 months old, he had some words and even fit within the normal range for speech if you put him at the lower end of normal.  We waited.  He turned 2.  There were some more words, but he never hit that elusive ‘word explosion’.  I waited to hear him start combining words.  He turned 2 ½ and it hadn’t happened.  My dream for Noah was simply that he would be able to talk.  My fear was that he wouldn’t.  I was reluctant to go to playgroup as my heart would catch when I heard other children of Noah’s age speaking in sentences.  Noah couldn’t even tell me what he wanted most of the time and would cry and cry and cry because he could not make himself understood.

Yet thankfully, I am not still in that same place.  Noah is no longer in that place.  I am starting to dream things for Noah beyond the acquisition of speech.  18 months has made a big difference and he is now four years old.  I have learnt a lot more about speech disorders.  We have been regularly attending speech therapy sessions locally and now with a specialist in Childhood Apraxia of Speech.  Daily drills and practice are starting to pay off and Noah’s speech is becoming clearer.  In the last 6 months several significant milestones have been reached – two syllable words, growing vocabulary, the first sentence and being able to request things….and wait for it…..THREE SYLLABLE WORDS!

This started with Noah becoming increasingly interested in all things doctor.  He proudly points to me and says,”Mum.  Do-tor!”  He has a toy doctor’s set and has learned how to use all the instruments.  Techniques needs to be refined a little, especially examining throats.  He says,”Aaaahhhhh” and shows you how to open your mouth…and then shoves the whole torch into your mouth.  We all get bandaged if we have the slightest boo boo.  Noah even bandages himself.  The kid can do a pretty mean ankle strap, if I do say so myself.  (He must’ve had a good teacher!)  If bandages are not in sight, then a roll of toilet paper will do.

Dr Noah - Croc gets a needle

Dr Noah – Croc gets a needle

We wonder if we have a little hypochondriac on our hands as he runs for band-aids or medicine for the most minor ailments.  Noah had an infection recently that needed antibiotics.  When I told him he would have to take some medicine to make it better he jumped up and down and yelled out,”Yay!”  At least I didn’t have to force it down his throat!

A favourite bedtime story is about the Flying Doctors and three times a week he wants us to read the Good Samaritan from his children’s Bible because it’s got cool pictures of a beat up guy getting medicine and bandages.  And those stories of how ‘Jedus’ makes people better are pretty cool too.

A true love of bandages!

A true love of bandages!

Apraxic kids are great at charades.  You see, while their tongues trip them up and they can’t get their words out clearly, there is nothing wrong with their understanding.  They get quite inventive with acting out words and communicating their message.  Noah naturally prefers my real stethoscope to the toy one and when he wants it, he pretends to put ear pieces in his ears, put an imaginary stethoscope on his chest and mimic the sound of a heartbeat – “m mm, m mm”.  Now, stethoscope is a pretty tricky word for most kids to say.  Imagine my surprise when one day I held up my stethoscope to Noah and asked,”What’s this?” and he answered,”Ste-a-cope!”  It was a proud mum moment.  Not only is Noah showing interest in my career, but he managed a three syllable word.

So, my friends, words are coming.  They are being joined together to make small phrases (with pauses between each word as Noah still has to think hard to get the sequencing right).  Vocab is expanding all the time.  Words and sounds are getting clearer.  We still have a long way to go and my heart still catches when I hear other kids of the same age chattering away.  And even hearing younger children reaching the milestones we have worked so hard to get to.  Don’t get me wrong – I love hearing little kids chatter.  I just can’t wait to hear my own little munchkin chatter.  But instead of fear about Noah’s future, I now have hope because we have reached milestones I was fearful would not be reached a little while ago.  He is going to make great progress in the next two years.  His voice is being found and released bit by bit.  We are finally getting a little window into his thoughts and feelings.

So, is my dream that Noah will become the next Dr Swan?  No way!  But I am dreaming that he will be able to speak clearly and confidently and find his place in the world doing something he loves.  As tools are his biggest obsession, I’m guessing mechanics, building or engineering!  Meanwhile, we’ll try and add to those 3 syllable words with some medical vocabulary – ot-o-ope, med-i-in, mom-e-ter…

PS. We are still waiting for ‘c’ and ‘s’ sounds to appear consistently in words, thus the missing consonants in some of Noah’s pronunciation.

Beth and Enwah – PNG and the fight for life

Papua New Guinea lies on Australia’s doorstep.  I have visited twice now and will be returning later this year.  Increasingly I find myself thinking about PNG and her people, especially those that I have met and talked with and briefly shared life with.  Beth, a young mother, and her newborn son, Enwah are two of these people.  Enwah, like many babies in PNG began his fight for life very early.

My time in PNG was spent with a medical ship that takes health professionals to remote areas along the southern and eastern coast where basic medical care is not easily accessible to most people.  PNG is mountainous and covered by thick jungle.  In the Gulf Province and Fly River system in the west, most people travel by dugout canoe along the intertwining river systems.  Roads are few and far between and often in poor condition.  With 88% of people living in rural areas and health facilities sparsely distributed throughout the country, most people with a serious health problem will not have the chance to be treated in a hospital.

Jungle along the Oriomo River

Jungle along the Oriomo River

In 2011, I was part of the primary health care team on the ship.  This was my first journey to PNG.  The ship sailed 27 hours from Port Moresby to the Western Province where we anchored off Daru, the capital.  Each day we would travel by zodiac (inflatable motor boat) from the ship to a village or settlement where we would set up our clinic for the day.  Our role included seeing and treating people for a variety of medical conditions, vaccinations and health education.

The last two days of clinics were to be spent at a village named Abam, well up the Oriomo River.  The only way to reach this village was via the river.  Floating debris had to be skirted carefully to avoid catching the propeller and resulted in many a disappointed attempt to spot a crocodile!  Along the way we passed dense jungle, traditional villages and smiling families in dugout canoes.  The people of this area hunt, fish, harvest sago and grow vegetables, much as their ancestors have done for centuries past.

We received a warm welcome from the villagers who helped us unload our gear and mount the steep banks.  They gave us the use of their school house for the clinics, a two storey building made from traditional materials and surrounded by lush green lawns.  There were dirt floors, blackboards and desks with benches made from planks of rough wood.  Most of our patients presented with conditions seen frequently in Australian general practice – respiratory infections, diarrhoea and musculoskeletal problems.  However in PNG, a flu-like illness could easily be malaria or a chronic cough, tuberculosis.

On our final afternoon, riotous laughter drifted through the school house windows as some of our team played with the children on the lawn, turning skipping ropes and blowing bubbles.  Not long after, I was called to see Beth and her newborn baby, Enwah, only 10 days old.  Enwah nestled in a colourful blanket, crying weakly, skin taut across his tiny skull, with the wizened appearance of marasmus.  Beth and her parents had left their village, further up the river at 5am that morning, having heard about the visiting medical team.  We settled Beth into the storeroom with our team leader, Jennifer.  I advised them on how to express some breast milk and syringe feed the baby.  While Jennifer helped Beth to feed Enwah, she told us her story.

Jennifer feeding Enwah

Jennifer feeding Enwah

Beth had been attending high school in Daru, capital of the Western Province, but became pregnant at age 19 and returned home to live with her parents.  She worked hard and ate little on the advice of her mother in the hope she would have a small baby and easier delivery.  Beth received no antenatal care.  Eight months into her pregnancy, Beth became ill with a fever and went into premature labour.  She delivered a baby boy, Enwah.  After a few days, he became ill and stopped feeding at the breast.  Beth tried to spoon feed him for the next six days; however Enwah took very little orally and continued to grow weaker.  Enwah had now been ill for six days and had not fed for 24 hours.  He was severely dehydrated and malnourished.  Beth and her parents were distressed about Enwah’s condition.  The nearest healthcare facility was in Daru.  Their only mode of transport was dugout canoe.  It would take nearly two days to make the journey to Daru, paddling day and night.

After discussion with Beth and her family, it was decided that mother and baby would return with us to Daru for transfer to the hospital.  Beth’s parents would follow in their canoe.  This journey would take 1 ½ days in dugout canoe from Abam.  The same trip would only take one hour in the zodiac.  We prayed for Enwah as we set out for Daru.

Dugout canoes, Oriomo River

Dugout canoes, Oriomo River

Jennifer accompanied Beth and Enwah to the hospital and visited them the next morning to check on their progress before our departure for Port Moresby.  The doctor’s initial attempts to insert a drip into Enwah’s collapsed veins were unsuccessful.  Overnight, he developed vomiting and diarrhoea and continued to be syringe fed with breast milk.  Eventually an intravenous line was inserted.  By morning, he was crying more strongly.  It seemed as if Enwah had turned a corner and the doctor was more hopeful of a positive outcome.  I believe Enwah would have died if unable to get to the hospital.   Another day, he would not have had this chance.

Maternal mortality rates in PNG are among the highest in the Pacific at 250/100 000 live births1, compared with 8/100 000 live births in Australia2 (2009).  Child mortality is also high in the under 5 age group at 68/1000 live births1 compared with 5/1000 live births in Australia2 (2009).  It is not my aim here to address solutions to this problem, simply to share the story of Beth and Enwah, who for me have personalised the challenge of delivering health care to remote communities.  After our return, Jennifer tried to find out what had happened to Enwah.  The only information we were able to find out was that they weren’t at the hospital anymore.  We don’t know what the final outcome for Enwah was, only that he was given a chance that day that normally would not have been available to him or his family.

  1. Global Health Observatory, World Health Organisation.  Papua New Guinea – health profile (2009).
  2. Global Health Observatory, World Health Organisation.  Australia – health profile (2009).

“IWANCHEE!” – The First Sentence

Dear Noah,

We’ve been waiting for this moment for so long, little buddy – your first sentence.  You’ve kept us in suspense.  I anticipated that I would clap and shout and jump for joy when you reached this milestone.  I remember a time when I would dream that you had said your first sentence to me.  I would wake up so disappointed when I realised it was not true.  I have so wanted to hear your voice speaking freely for so long.  You know what?  Your mummy and daddy almost missed it!  But I’m glad we didn’t.

Noah - relaxed and happy!

Noah – relaxed and happy!

This is how it happened.  It was Wednesday, 14th February 2014.  You were 3 years and 10 months old.  We were sitting outside to enjoy the last of the summer evenings while we had dinner.  Grated cheese was on the table to eat with our salad wraps.  You and Sam generally get it all over the floor, so that’s probably why we were outside!

Mummy and Daddy were a bit preoccupied.  See, you’d just been through two separate speech evaluations with two speech therapists.  Both said you had severe Childhood Apraxia of Speech.  Your Mummy was feeling just a bit down.  I mean, you’re awesome.  In four months you’ve come so far – so many new words, two syllable words, two word phrases.  In one year you’ve gone from 30 spontaneous words to over 200.  Finally your communication is coming along.  But, according to some multitude of tests, you still have a severe expressive communication delay.  So what, buddy?  You’re catching up, right?

Just when I was wondering whether all our hard work was getting us anywhere, you sprang another surprise on us.

For months you and me have been practicing one little sentence.  Over and over.  Here’s how it goes.

Mum: I

Noah: I

Mum: want (signing want)

Noah: Drink! (after signing but not saying want!)

Mum: No, say want

Noah: want (garbled version of want with the sign)

Mum: drink

Noah: drink….pleee (please)

Anyway, Mummy and Daddy were busy discussing these latest speech reports.  You were reaching for the cheese.  I absent-mindedly reached out to take it away from you.  I didn’t want to clean up grated cheese mess.  But you, you would not suffer the deprivation.  Something welled up inside of you and out leapt a fearsome yell,”IWANCHEE!!!”

What?  I looked at your daddy.  Did he just say,”I want cheese?”  Yes.  I mean, Yes!  Three simple words.  I want cheese.  Your first complete sentence – a group of words conveying a complete idea and containing a subject, verb and object.  And guess what?  You got the cheese.

So there you have it.  Another major milestone and a reminder that you are progressing every day.  You are finding your voice bit by bit.  Since then you are saying ‘want’ so much clearer with the help of hand signals I learnt from your new speech therapist.  And you can now make the sentence on your own.  Now the exchange goes something like this.

Noah: Drink!

Mum: OK, you want a drink.  What do you say?

Noah: I….want….drink!

Mum: Manners

Noah: Pleeeee

So go ahead, Noah monster.  Ask for whatever you want.  Enjoy it while mum is caught up in the novelty of you being able to ask for what you want, ‘cause she’s more likely to give in to your requests for a little while yet!  IWANCHEE.  Awesome.  IWANBEER.  No.

I’m going to finish with this verse.  I read this the night I got the first speech report.  Discouraged, I opened my Bible and there was a book mark with these words on it.

1 Chronicles 28:20

Be strong and courageous and DO THE WORK.  Do not be afraid or discouraged, for the LORD God, my God is with you.  He will not fail you or forsake you.

It was a timely reminder that we are not in this alone.  You know more than any of us how difficult it is for you to turn sounds into words and words into phrases, little Noah.  I see how tired you are after a speech therapy session.  I see how much effort it costs you just to sequence a couple of words – your brain working overtime to try and program the motor movements for speech.  I’m praying this verse for both of us.  I know that the only way to overcome apraxia of speech is to practice sound sequences over and over.  So that’s what we’re going to do.  We’re going to DO THE WORK.  We’re going to celebrate every milestone, no matter how small.  And we’re going to be encouraged by your progress, no matter what the reports say.  What more can I say?  IWANCHEE!

Love Mum xoxo

Little Boys in Dreamland

Childhood dreams and imagination cast wonder on a world grown ordinary to the adult mind.  To spend a golden afternoon in dreamland is a rare privilege, led by small children into the realms of imagination and adventure.  I spent such an afternoon with my children, Sam (6) and Noah (3) last weekend – an afternoon I will long treasure.

Sunday afternoon is a wonderful time to spend together as a family.  To help the boys use up some of the energy they possess in such abundance, I took them for a walk to a park not far from our house.  This is a favourite place of ours – a wide green field, hills for rolling down, Australian gum trees and hills for BMX riders to ride (or little boys to run up and down!), playgrounds and bike paths, areas sheltered by shrubs and trees.  We have visited this park often since Sam was born and had many adventures.

Dirt Angel - Sam, age 3 on a trip to our park

Dirt Angel – Sam, age 3 on a trip to our park

Sam (3) and Noah (1) at our park

Sam (3) and Noah (1) at our park

On this particular afternoon, we were the only ones in the park for over an hour, and perhaps that is why imagination was able to ebb and flow, unstilted by the ears and eyes of curious onlookers.  It started with a camp fire.  The boys were collecting sticks and I was showing Noah how to place kindling, small and large sticks to build a camp fire.  Soon there was a small warm glow as we rubbed sticks together.  Sam announced that we were lost in the woods.  At least our camp fire would provide warmth and a means to heat water and cook our dinner.  

Some brown hens were scratching in the dirt nearby and we thought roast chicken would make a tasty dinner.  The boys had brought their shot guns and were ready to provide a bird for the cooking pot.  Meanwhile, I was hankering after some billy tea and set the water boiling, held up over the fire on a skipping rope, strung between Sam’s scooter and a branch.  My little boys had a craving for more fulfilling meat and soon were off hunting for rabbits, wolves, foxes, bears and ‘something with steak’.  We foraged for wild potatoes and yams and collected seed pods to be cooked in the embers of the fire.  This was going to be a feast we would not soon forget.

As night approached, we became aware of our need for shelter.  An old building nearby, a shack of two stories with a dirt floor and benches would be our sleeping quarters.  I became concerned about a bear that was approaching our camp site.  Sam soon allayed my fears, explaining this was ‘the friendly bear’.  He would sleep with us tonight, keep us warm and protect us from wild animals and collect wild honey for us to enjoy for dessert.  We were soon snuggled down for the night.  It was during the wee hours that howling awoke us.  Fear gripped us as we felt the unseen, but stealthy approach of wolves.  The boys got to the upper storey of the shack and levelled shots at the approaching wolves, while the friendly bear raised himself on his hind legs and growled menacingly into the night.  The wolves were set to flight and we went back to sleep.

As dawn approached, we awoke, limbs stiff from the activity of the previous day and the coolness of dawn.  Perhaps it was the open air, but our stomachs were growling and I wondered what we would have for breakfast.  The boys wanted wolves, so we prepared to hunt.  Sam had wandered off, but came dancing back towards us, a pack of cuddly wolf pups playfully snapping at his heels.  They captivated us with their frolicking ways and certainly would not be our breakfast that day!  They became playmates instead.

The sun rose and as we looked about us, the landscape took on a more familiar form.  We surmised that our direction home was approximately north and so we set off.  Other people were arriving at the park as the afternoon was cooling.  I wonder if their adventures were as exciting as ours!  We went home happy and smiling, sharing the secret knowledge that we had found dreamland and entered it with abandon.