Guest Blogger: Erin Jankus, MS, CCC-SLP
( Erin has been a pediatric speech language pathologist working in a variety of settings for 18+ years)
"The most important thing in communication is hearing what isn't said."
-Peter F. Drucker
One of the hallmarks of Autism is difficulty with communication. There fore speech therapy plays a pivotal role in progress. However, I can say as a speech language pathologist that nothing we do is magical or beyond your capabilities as a parent. We may be the experts when it comes to language development, but you, mama, are the expert on your own child. Please never forget that. You play the most important role in your child's progress.
So what should you look for when selecting a speech language pathologist for your child? Here are my top 5 things a therapist should be doing with your child:
1. Your therapist should involve YOU in therapy.
This is key. You should understand why your therapist selected the activity she did. A good therapist will explain their rationale to you in terms that are easy to understand. As a parent, ask questions and don't be afraid to participate. This will help you know how to implement strategies after the therapist leaves. If your child only receives that intervention during their one hour therapy session each week, that is approximately 1% of their time! If you can build therapy techniques into everyday routines, you will see more growth more quickly.
2. Therapy tasks should be relevant.
I once watched a session where a therapist had a child beat on a drum and put puzzles together that targeted related concepts (For example, "A bird lives in a nest!" Inside I was screaming. "Who the heck cares if a bird lives in a nest!" It had no meaning for him. He looked utterly and completely bored and frankly, as an adult, I was bored, too. Don't be afraid to ask about the relevance of activities . An example of a functional therapy activity would be mealtime requesting. Your therapist could set up an activity that mimics your typical mealtime routine, and you can work together to think about what you want your child to be able to do, whether it is asking for more or telling you he is all done instead of throwing his plate on the floor.
3. Therapy should be fun.
If your child cries when you tell him his therapist is coming over, there is a problem. If your therapist straps your child into a chair and drills flashcards over and over and over again, there is a problem. According to Dr. Karvyn, it takes 400 repetitions to create a new synapse in the brain (to learn a new skill) when it is taught without playful engagement or just 12 repetitions when you play. JUST 12. Play and fun are essential for successful therapy. For example, if a therapist is working on using personal pronouns (I, me), a game of hide and go seek can be used. Instead of the child saying, "Bob is here!" He will be prompted to say, "I am here!" In addition, spatial concepts (over, under, in front, behind, etc.) and yes/no questions can be targeted. An adult can say aloud, "Where is Bob?" Is he under the blanket? "Yes!" This kind of game works in routine and repetition which is essential when learning language. Other opportunities for communication within this game are abundant.
4. Your therapist should be using plenty of visuals.
Often individuals with Autism are poor auditory learners. This means that the sounds of language, words, often don't make sense to them. Conversely, many people with Autism are very strong visual learners. When a picture is paired with a word, comprehension increases. People often refer to pictures that are used in therapy world as 'PECS'. This stands for 'Picture Exchange Communication System', and is actually a specific type of therapy. However, you can just start with your own pictures. You don't need anything fancy. Take a picture of your child's favorite food, toy or task that needs to be completed. Start by giving him 2 choices and use a short and clear label. If you know your child should hang his coat up when he walks through the door, show him that picture and say the task. As mothers we often know what our children want. If you know your child wants a particular food, show him that picture and say the name of it. Put it on the refrigerator and do it every time an opportunity arises. You can just keep it to a generic label to begin such as "eat". Toys are great motivators. You can show him a picture of his favorite toy and say the name of it or just say "play". Then sit down and play with him. This will reinforce that concept. When you show your child the power of having words, a new world opens for him.
5. Your therapist should check in with you.
Conversations about progress should be happening often and regularly. If your child has a goal, and you haven't seen him make progress, ask your therapist to explain why you haven't seen any changes. Perhaps, the changes have been subtle and in that case, you will have a better idea what it is you should be looking for. That being said, we can talk about more than just goals. We can help with things that come up in your day to day life. Each time you meet, your therapist should ask how things have been going since your last visit. Please be honest so that she can help you. Even if the only update you have is "Everything is the same, but now Bobby doesn't seem to want to take a bath anymore." 99% of behavior is communication. Think of your therapist as your trusted advisor. We are there to help you get to the bottom of things, and to offer suggestions. Our suggestions may or may not work. However, if we don't know what's happening, we can't help! There may be a simple solution we can discover by working together.
I'm hoping this list has helped you.