A few weeks ago, my nieces visited our home for their annual week of "Camp Rankin." We meet their family at the same park, halfway between our homes, each year to pick up and drop off the girls. Visiting a playground only once a year provides amazing insight into the changes in Nathaniel's physical abilities. In 2015, he kept his feet on solid ground. Walking on the uneven park surface carrying his tube feed in a backpack was challenging enough. In 2016, he was comfortable walking up a ramp to the lowest play area. His aunt and cousin were watchful spotters to his emerging climbing skills in 2017. This year it was hard for any of us to keep up.

We meet with our AAC team Wednesday afternoon for one of our quarterly consultations. It will be a transitional meeting for Nathaniel as his weekly speech therapist is anticipating a new baby soon. Nathaniel and Miss Rebecca had their last "before baby comes" session yesterday. (Many blessings to you and your little one, Rebecca!) Our therapy plans for the fall include continuing in Development Language Group two mornings a week and private therapy (Occupational and Speech) one morning a week.

As I prepare for our AAC meeting, I am again shuffling papers, making lists, and thinking about goals I have for Nathaniel's language growth. I reflect on times Nathaniel experiences communication frustrated as that often indicates areas that need solutions and work. This document, Language Functions & Early Generative Language Production by Gail M. Van Tatenhove, PA, MS, CCC-SLP, was given to me very early on in Nathaniel's AAC journey. It continues to be a help when I prepare for our AAC meetings. I revisited Tatenhove's word lists and compared the list to open words on Nathaniel's device. I have created a list of words that I feel we need to work on learning.

I have had two busy weeks since I returned from Wyoming. Three priorities have been filling my days: Josiah's homeschool work, Nathaniel's speech program, and getting ready to leave again. I will dedicate an entire blog post to our homeschool year someday, and I will write a bit below about new developments in augmented communication. But first some details about my next trip.

Nathaniel and I are leaving Sunday for Cincinnati again. We will be there two weeks this time. On Monday he will have a FEES study to evaluate his aspiration. On Tuesday he will have a tonsillectomy and adenoidectomy. Hopefully he will spend just one night in the hospital for observation, but we will need to stay in a hotel the Cincinnati area until October 3rd to be near the surgical team through a post-surgery risk period. 

It has been awhile since I have compiled thoughts on Nathaniel's communication skills and use of augmented communication. We are headed to St. Louis Children's Hospital today to check in with the Aug-Comm team; I am excited to share Nathaniel's progress with them and thought I would use my preparation for the meeting to pull together a blog post on communication.