Friday, February 25, 2011

Speech Therapy: What We Have Learned

I want to take a little time to write about our family's experience with speech therapy for Cricket as he approaches his 3rd birthday and ages out of our state's Early Intervention program. At Cricket's 2-year pediatric exam, we were referred for speech therapy. Shortly thereafter, his expressive speech was assessed at about a 15-month ability. (And that took into account about 50 ASL signs that we had taught him.) We were fortunate to end up with a fabulous speech therapist, but I am sad to say that the philosophy that she uses and teaches is rarely used in the Midwest, where we live. I write this with the hope of educating other parents seeking help with their speech-delayed children.

Our initial experience with speech therapy was not a good one. By the third session, the speech therapist was asking my 2yo to make his own schedule and mark off each item as they completed them. When she asked him what he wanted to do, he would tell her; but then she would tell him he couldn't do that activity. In other words, she already had her own plan, so I could not understand why she even bothered to ask him what he wanted to do.

My other concern was that she refused to use activities that were of high interest to Cricket. As a typical boy, he absolutely loved sports and vehicles. However, she never brought those sorts of activities. I also advised her that he really loved the alphabet and phonics. Although this may be an unusual interest for a 2yo, I thought it would be very easy to integrate this interest into a speech therapy program. But she made no effort to satisfy his needs, but rather, she kept to her own agenda. I also discovered later, that the sounds she was working on with him were not appropriate for his age.

We very quickly requested a new therapist, and we had the very good fortune of getting one that was Hanen-certified. We did not know then that is was good, but our experience has told us that it is. With this approach, speech is integrated into all of life--not just one or two sessions per week. This means that the speech pathologist becomes a trainer and teacher to the parents, which substantially speeds up the child's progress.

The first thing we were told was to stop asking the Cricket questions and telling him what to say. You see, when our children are learning how to speak, we parents get very excited and ask all sorts of questions to spur conversations with them, and we give endless commands to, "Say XYZ." But for a child that struggles with speech, this is a very heavy burden for them and usually results in the child "shutting down" and ignoring the parents or refusing to speak. Instead, dh and I were taught to model the words that Cricket might want to say.

So, for example, if Cricket were point to the milk to indicate that he wanted some, we were not to tell him to say, "Milk, please." Rather, we are supposed to say, "Milk, please," and leave it at that. If Cricket wanted to imitate, he could, but he had the option not to. The speech therapist promised us that within a week or two, he would begin to imitate words on his own. And she was absolutely right. Once we gave Cricket control over his own speech, we saw a huge leap in the frequency with which he spoke.

From this point, the speech therapist helped us to walk Cricket through each developmental speech step that he had missed, in the order and at the time that it ordinarily occurs in typical children. Some of the steps included putting the -ing on the end of verbs (I'm eating, I'm jumping, etc.), negation (I don't like, I am not, etc.), using articles (a/an/the) and practicing nasal sounds (/m/ and /n/). As the parents, we are never to require correct speech, even if we know he is capable of it. Instead, we train his ears to recognize how things are supposed to sound. We constantly model what he wants to say. When he says something wrong, we are supposed to model the correct way without requiring him to say it. But most of the time, Cricket will correct himself when he hears us model the correct way. He also often self-corrects before anyone identifies the mistake for him, so I know that this approach is working.

The speech therapist's help was absolutely critical. It was vital that I know at what point to teach each step. If you try to teach it before a child is developmentally ready, everyone will get frustrated. If you wait too long, then the child develops incorrect habits that are difficult to overcome. Cricket is now doing very well. He is still only at about a 24-month level in terms of intelligibility, but he has made about a year's worth of progress in about 8 months.

Before this experience, I was very cynical of speech therapy in general, because there is no way to know whether it is working, or whether the same progress would be made without it. I also had speech therapy in kindergarten, which I absolutely hated. It made me feel completely incompetent, and I wanted to crawl under a rock. After my experiences with Cricket, I am still cynical of traditional speech therapy, but I know that this particular approach works wonders. I would encourage anyone needing a speech therapist to seek out one that is Hanen-certified.

1 comment:

  1. I'm glad you found a good therapist! It took us a while too. The middle 2 of our 4 so far have needed speech- our dd just graduated woo hoo and we are watching #4 closely as he speaks very little. We found the same benefits when switching to modeling for ours rather than asking/correcting and I agree that finding a good therapist makes all the difference. Ours once even recommended a 4 month break from services to give ds a break when he was really frustrated and just needed time to mature- proving she cared about the kids more than the paychecks!
    Good luck to your son!


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