Fistula Repair and P-Flap 6-Month Post-Op

Matteo had his six-month post-op visit to check up his recovery from his fistula repair and p-flap surgery back in February. Despite how well his mouth has recovered, he did develop a fistula, or in layman's terms, he developed a hole. The hole appears small, but the surgeon can't tell how deep it goes. The good news is that the surgery appears to have been a success given that the fistula is not impacting Matteo's speech and his p-flap closes off properly to prevent air from going through his nose, which gives him the ability to pronounce a broader range of sounds. At this time, we don't think he'll need another surgery to do a revision to the p-flap, which means his next surgery won't be until he's somewhere between seven and 11 years old when he'll have a bone graft.

The bad news is that despite Matteo's incredible work ethic during speech therapy, his repaired and lengthened palate, his age (he's turning four soon) and being home for a year and a half now, his speech is still nearly impossible to understand. And when I say impossible, I mean that I as his mom have extreme difficulty in figuring out what he's saying. It's heart-breaking to hear him repeat a word over and over again with such persistence and helplessly can't understand him.  

The doctors told me what I already know, that he has a severe articulation disorder. Of the 44 phonemes (the smallest units of sound that distinguish one word from another) in American English, Matteo can only pronounce nine according to his speech therapist's evaluation. His speech includes multiple phonological errors, such as phoneme omissions ("poon" for "spoon"), syllable reduction ("jamas" instead of "pajamas") and difficulty sequencing phonemes in single words. Just like Kiera, Matteo doesn't readily initiate verbally and communicates in one- to three-word phrases at most. 

Aside from identifying that Matteo has a "severe articulation disorder", they can't do further testing on his expressive language skills due to how unintelligible his speech is. So we must plug away at speech therapy and wait until he develops more intelligible speech to be able to identify a more exact speech disorder. 

Matteo is so smart and inquisitive and like his sister, I'm curious what he's thinking and wish he were able to tell me.