Speech Therapy Works

The good news is things no matter how dire the current moment, things almost always improve.  How do I know that?  It’s lesson the people I’ve helped over the years have taught me. It’s something a two year with a developmental language delay who at three could say at best five words and today speaks volumes.  The child classified within the autism spectrum, who six months later is off the spectrum. The little girl with Cerebral Palsy mastery over sign language. It’s the success stories of these individuals and the many many others who have collectively taught me the role of patience.

Not every case is cut and dry and as a therapist I offered a forecast for how things may turn out, but I didn’t always know exact moment when the tide would turn.

So does patience automatically appear when told your child has a language or speech delay? No… simply knowing its importance may not make the process any easier. It’s reasonable to want solutions to come about quicker. The attribute of patience is having the vision to understand and see the accomplishments your child makes over the course of their speech therapy program. It’s pushing aside the worry of the moment in favor of a developing confidence that things will be better than what’s happening in a particular moment. The ability to appreciate and see the little steps a child takes toward a therapy goal.

On Babbling…

Lately, I’ve witnessed that sometimes my 6 month year old grandson “Jack” is quiet and sometimes he talks a ton. I noticed also there are times when I want him to babble and he won’t make a peep. There appears a window of sorts that suddenly opens and sounds come forth.

The cool part of this window is that it can open at any time . Often it catches me by surprise. I’m working writing this blog, or in the kitchen cooking  and out of the quiet comes an array of sounds – “ah, ga. eeee. iiii ” with an occasional “h,m or even a “ba”.

These windows to vocal play can occur unannounced and quite randomly. Babbling just happens. As a therapist, I see such windows as having particular value to Jack’s overall speech and language development. It’s here Jack begins to explore and play with sounds. It’s in this place, using random sounds, Jack initiates some of the first conversations of his young life.

Yet given the suddenness and random nature of the window, it’s easy to miss or even misunderstand the teaching opportunity presented. So when for no apparent reason the window opens,  put down the computer, move away from the kitchen and join the fun! There’s some speech a brewing…

Person Centered Care (PCC)

Three words that make so much sense it’s a wonder they’ve take this much time to become part of the main street conversation in speech therapy. Having completed an online course by Sarah Baar at SpeechPathology.com it’s clear Person Centered Care will be a centerpiece of neurogenic disorders therapy moving forward. Sarah Baar is both an authority and advocate for PCC and her work presents  a passion and a sense of inevitability with respect to the direction neurogenic disorders therapy must now follow.

In her course Sarah defines the role of a therapist as one of a teammate where patient and therapist work in tandem on agreed upon goals. Within this model therapy activities and goals are defined by the life experience and personal interests of the patient. Sample goals might center around;

  • Operating a coffee maker
  • Responding to a phone call
  • Organizing a grocery list
  • Making a date to play golf
  • Alerting a friend you may have an issue with speech
  • Going through the steps of writing an email
  • Re-learning a work task

The current medical model of treatment bases it’s therapy in universal teaching contexts which may or not be relevant to a patient’s life. In this model therapy success is defined by results on a standardized test or a predetermined performance standard.  In contrast Person Centered Care breaks from this more traditional model the therapy to structure goals around the functional needs and interests of the patient. If you need groceries – how might you order groceries online or by phone. If using a phone is problematic practicing phone conversations in real life contexts may be in order with possibly the first goal alerting the listener you may have a problem with speech.

Therapy is suddenly personal, meaningful and pertinent. Therapy materials which filled closets for in some cases decades are out the window. ST’s longer work to improve numbers measured by a standardized test but performance on an everyday task.

Therapy materials are formed around the everyday interests and needs of the patient which in turn powers ST’s to be creative. This approach to therapy presents a unique therapy challenge. It’s not as much about thinking outside the box – but understanding the box sitting in front of you and that’s the real fun. In a very real sense we’re helping a person find and be themselves.

Sarah Baar cites studies by (Hinckley & Yones, 2014) (Rutherford & Childs, 2015) which finds PCC patients;

  • Are less likely to be readmitted
  • Show more trust and motivation
  • Are more likely to adhere to treatment regimens
  • Show better recovery, quicker rates of generalization, improved self-awareness
  • Demonstrate better emotional health at follow-up
  • Require fewer diagnostic tests and referrals

Sarah goes on to indicate insurance companies are very much on board with PCC and that Medicare actually now includes PCC as part of their annual goal and five year centered vision plan.

This approach to therapy makes so much sense it’s surprising it has taken this long to become a thing in speech therapy. If you are Speech-Language Pathologist, or person concerned with the topic of speech therapy for neurogenic disorders, we strongly suggest a visit to: HoneyCompSpeechTherapy.com  and the words and works of Sarah Baar to learn more.

Qualities of a good therapist

 Some important prerequisites

  • Proper credentials
    Master’s degree in speech and language, state license (in states that require), Certificate of Clinical Competence CCC from the American Speech and Hearing Association (ASHA). Therapist schooling takes two years beyond college and can include a 9 month clinical fellowship.
  • Experience
    Has experience working with your child’s particular problem.
  • Initial Assessment
    Everything starts with the initial assessment ; one written competently defines the problem and sets up everything that follows. It’s a critical document. It’s content provides useful information to other professionals working with your child.
  • Rapport
    Your child likes and feels comfortable  with your therapist. There is an obvious level of trust. Your child looks forward to the therapy session.
  • You feel good about them
    You believe your child is in competent hands.
  • Communication Skills
    Therapist communicates regularly with you. They make a point to talk with you after the session. Their documentation is timely, readable and helpful.
  • Inclusive
    Your are part of the therapy process. There is a home program. 
  • Team Player
    Therapy often occurs with other disciplines. Therapist reaches out and communicates consistently with other professionals e.g.  OT, PT, doctor, nurse, teacher, social worker.
  • Blends with your child’s world
    Therapist integrates interests and things of importance to your child in therapy.
  • Achieves goals
    Is therapy on target with initial goals?  Are goals achieved? Were achievable goals set in the first place?
  • Documentation
    Proper and timely documentation is paramount. Poor or missing documentation stops funding.

These are nice things to have too

  • Current
    Therapist is up to date with new things happening in the field.  Familiar with trends going on in the field.
  • Creative/Thoughtful
    Thinks outside the box. Sometimes obstacles to progress require creative solutions.
  • Generous
    Goes beyond the minimum expected. Spends extra time with you or e.g. makes therapy materials, coordinates with a teacher. Does things you might not expect.