June 12, 2013

An Effective Speech Language Pathologist

My oldest child never babbled as a baby.  She never babbled at all, actually.  She had to learn how to say each sound, and every sound was work.  Then she began to say word approximations and words, but each was an effort.  Eventually she would string words and approximations together to make a sentence.  She was two months from her 3rd birthday when she said her first BIG five word sentence, "No. Brother'sNickname. Eat.  Mamma.  Shoes."  Each word was said slowly and with a pause in between each word, but we were beyond thrilled.

When she was nearly 3, we could not understand her attempts at communication on a daily basis.  Even with context clues, we still often puzzled over what she was attempting to say.  When she was 2 1/2 and a young 3 she was knew all sorts of songs and rhymes, yet she could not say a single one.  Instead, she would fill in the blanks when we would pause during the rhyme.   She has overcome her verbal apraxia with a lot of hard work and years of therapy. (Apraxia is a neurological speech disorder, not muscular.  It is not outgrown with time.)  Her story is not typical of apraxia, and we are grateful.  Much of her success is thanks to an effective therapist who taught my husband and me to think like an SLP and who worked diligently with our girl.
From the time Big Sister was about 17 months until nearly five, she worked with several speech language pathologists (SLP).  One of those therapists stands out among the others.  

Big Sister was 21 months when Ashley began working with her and worked with her until her third birthday when she transitioned out of the Early Intervention program.  

This effective SLP was...

In Control
During each session, she was in control and in charge, leading purposeful play while highly sensitive to Big Sister's reactions and desires.  
Firm
Ashley was firm.  Just because Big Sister didn't want to do a certain activity didn't mean this very persistent child didn't need to do it.  I learned that even a nonverbal child can be expected to make sounds (though she had very few).  
Motivating
This effective therapist motivated her to complete each activity.  She used familiar and new (or not often used) activities during each session.  This helped Big Sister be comfortable, yet excited and eager for what was to come.  
Questioning with Follow-Through
Ashley asked questions about her speech even though there was no or minimal progress for months.  She remembered what I said and later documented it in her daily notes.  Based on the session and Big Sister's development and goals, she would assign homework for my husband and me to complete.  Much of the homework was something we could implement easily into daily routines, too.  (We had a fussy newborn at the time.) Despite the lack of speech for months, she still created purposeful and meaningful homework for us.  
High Energy
Ashley’s high energy was important to keep my daughter interested.  (She kept me interested, too!)  Her energy, interest in Big Sister, and the homework she assigned helped me to better understand the speech problems and keep Big Sister working hard.   Her energy probably made the biggest impact on Big Sister, as a child, and on me, the mom who was trying to learn from her.
Learning
When Ashley was stumped over Big Sister's lack of progress after months of therapy, she sought out more information.  She didn't wait for the verbal apraxia diagnosis to change how she worked with my daughter while still working within the speech goals.  

It was even during therapy that Big Sister first said mama (/muh-muh/) for the first time at the age of 27 months.  It was hard to say goodbye to Ashley when Big Sister aged out of the program and began attending a speech and language preschool.  But really, our daughter's progress is simply amazing.  The child who could barely string words together at age three had the lead in a play at age 5 (and she totally cracked up the audience with her acting and inflection).  At age 6 1/2 she was privileged to have a line at the kindergarten graduation.  She spoke clearly!

Certainly, we are thankful for the people who have influenced our daughter's progress, and most of all to the Creator who formed each of our children perfectly with verbal apraxia, epilepsy, and SVT.  As a parent with special needs children, I know that my identity cannot be on the circumstances!

~ Annette {This Simple Mom}

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