Janine J

Janine is seven years old and loves school. She attends a special ed class for part of the day, and joins her kindergarten class for lunch, recess, music, art, and PE. After school, Janine often has speech and occupational therapy through the local children_s hospitals. She enjoys horseback riding, swimming, and shopping! After a long day, she looks forward to coming home and just relaxing with her brothers.

Janine was born with a rare genetic condition called _Cri du chat" syndrome (French for _Cry of the Cat", one of the first signs associated with suspicion of this disorder). There are several features in common with ataxic cerebral palsy: low muscle tone, poor coordination, and an unsteady gait. Janine also has global developmental delays, the biggest in the area of oral motor development and speech production. Attending clinical speech, occupational, and physical therapy since infancy, Janine has always made steady progress.

Phenomenal gains have been made over the last year in Janine_s ability to communicate through the use of adaptive equipment and assistive communication technology, such as picture symbol boards, picture schedules, gesturing, and American Sign Language. Because of this progress, in February, Janine was introduced to the use of a computerized _talker"), which can generate audible words for her. After some initial training on the device in the speech clinic, we were given the opportunity by United Cerebral Palsy to _trial" a communication device in daily life at home and across all her usual settings (school, therapy, doctors_ appointments, and leisure) for several weeks.

Results have been amazing. Teachers and therapists were shocked at the higher level of cognitive understanding that Janine was demonstrating versus her very limited verbal skills. Some of the professionals working with Janine were previously unaware that Janine knew colors, numbers, letters, even sight words, appropriate to her age. Low expectations had often led to a _dumbing down" of her preschool curriculum, which in turn had led Janine to _tune out" or _shut down" when bored, thus perpetuating a false notion that she _obviously" was not capable of understanding more than they were giving her credit for. She has proven that she is quite capable of navigating the device, expressing her thoughts, needs, emotions, and opinions, often in complete sentences, which she can quickly assemble word by word from her picture keys.

Other adaptive equipment has been essential to this progress as well: supportive seating, a special needs stroller, and an adaptive tricycle have all enabled Janine to do the things a typical kindergartener would do. She has just had to work harder at the things that come naturally to her peers: eating, walking, talking, learning