Q: How long will my child need therapy?
A: A child’s overall “prognosis” depends on many variables. Positive prognostic indicators depend on the following: the child’s cognition, attention, stimulability, continuity and consistency in attendance, and internal self-motivation. Additionally, having a strong family support system with proactive, trusting, open minded, and involved parents will also improve a child’s overall prognosis. Parents naturally want to know how long their child will need therapy. Unfortunately, there is no valid way to determine a child’s overall duration of therapy warranted. However, as diagnosticians, we constantly assess the child’s progress on measurable goals and are able to predict the same amount of progress going forward. Our progress reports are written every 6 months to ensure that goals are “emerging” or “met.” This allows us time to talk with the family openly, about our professional recommendations for the type, duration, and frequency of therapy going forward. The treatment plan must be a collaborative and continual effort between the clinician and family. A child “graduates” from speech, once his/her goals are all “met” with 80% accuracy without prompting, over three consecutive sessions.
Q. Should I give my child the “gift of time,” or start therapy when they are younger?
A: Several studies have demonstrated clear benefits of early intervention for speech and language, pragmatics, and literacy. These studies clearly and consistently report that beginning therapy at a young age provides the child with long-term advantages in literacy, cognition, self-esteem, self confidence, academics, socialization, and language processing compared to untreated children with the same diagnosis. Children who are not treated, continue to have difficulties throughout their academic learning and socialization, compared to children who receive early intervention services.
Q: What kinds of speech and language disorders affect children?
A: Speech and language disorders can affect the way children talk, understand and analyze or process information. Speech disorders include the clarity, voice, quality and fluency of a child’s spoken words. Language disorders include a child’s ability to hold meaningful conversations, understand others, problem solve, read and comprehend, and express thoughts through spoken or written words.
Q: Why are speech and language skills so critical for literacy?
A: Spoken language provides the foundation for the development of reading and writing. Spoken and written language have a reciprocal relationship; each builds on the other to results in general language and literacy competence, starting early and continuing through childhood into adulthood.
Q: What are signs that a communication disorder is affecting school performance?
A: Children with communication disorders frequently perform at an insufficient academic level, struggle with reading, have difficulty understanding and expressing language, misunderstand social cues, avoid attending school, and show poor judgment.
Q: How can speech-language pathology services help children with speech and language disorders?
A: Speech-language pathology services can help children become effective communicators, problem-solvers and decision-makers. As a result of services such as memory retraining, cognitive reorganization, language enhancement and efforts to improve abstract thinking, children can benefit from a more successful and satisfying educational experience as well as improved peer relationships. The services that speech-language pathologists provide can help children overcome their disabilities, achieve pride and self-esteem, and find meaningful roles in their lives.
Q: How do I generalize social skills from therapy to home?
A: Instead of asking “What did you do at school today” re-frame your questions with more specific questions such as “Who did you play with today?” “What did you play at recess”? “What was the most interesting thing that happened today?”
Model idioms and figures of speech during everyday situations. Modeling non-literal expressions such as “We don’t see eye to eye” or “You’re pulling my leg” will allow your child to think critically and understand that what we say is not necessarily what we mean.
At dinner time, play “pass the ball.” Whomever is holding the ball is able to talk while others are listening. You can also write down “ice breaker questions” such as “What’s your favorite___.” Whomever has the ball, asks someone a question. The ball is passed to others at the table until everyone has had a turn. This activity will reduce interrupting, improve impulse control, and encourage your child to sit down during meal time and participate in a conversation.
Play games such as “20 questions” and “I spy” in the car so that the child can foster their memory, deductive reasoning, and descriptive vocabulary. Ask questions such as “what category is it, what does it look like, what parts does it have, what does it do, and where do you find it when you’re playing these games.
Model “bridging phrases” to appropriately change topics while maintaining the conversation. Phrases such as “Bye the way..” “That reminds me of…” “On a different subject….” “Speaking of….” will teach your child how to change subjects more appropriately while maintaining the conversation.
When your child is talking, model ways to politely interrupt by saying “excuse me” or “May I please interrupt?”
Encourage your child to understand that every problem is fixable. During natural problems that occur throughout the day, ask your child how they feel and two ways they could solve the problem. For example, if your child is having a hard time getting ready in the morning, ask him or her two things they can do differently to prevent the same problem from happening tomorrow morning.
Pay attention to greetings and farewells with peers and adults. Encourage your child to approach the host of a party to say “hello and good bye.” Discuss when you would give a “hi five” “knuckles” handshake, pat on the back, and a hug. Your child will learn the difference between formal and informal salutations (greetings) when saying hello to familiar and unfamiliar peers and adults.
Model flexible language such as “no big deal, maybe next time, first/then, let’s compromise” so that your child can learn to be flexible in thought, action, and language.
To encourage emotional regulation and frustration tolerance, ask your child to rate a personal problem on a scale of 1-5. Ask your child if this is a big problem or a small problem. Whenever you are stressed, model coping strategies to de-escalate the frustration such as deep breathing, walking away, counting backward from 10-1, or humming your favorite song.
Give your child a 10 minute and 5 minute warning before leaving a preferred activity.
Provide reinforcement instead of bribery. For example, “when you calm down, we can..”
Positive reinforcement is always better than punishment. Giving your child social praise, marbles, quarters, or stickers for good choices will help maintain the positive behavior.