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One Mother’s Experience….. Judging Quality Speech Therapy for Toddlers and Preschool-Aged Children

SLP and Mom Laurie Felty is offering another article in her series about parenting a child with apraxia of speech. In this one she describes their successful and not-so-successful experiences with her son Jack’s speech therapy. Just so you know – whenever I have a guest blogger, I never direct them as to what to write. When they say nice things about me or this site, it has been unsolicited. While I am a little embarrassed by the compliments Laurie gives me in this article, I want to share it with you as is so that you’ll know when to recognize a good fit for therapy for your toddler. Laura

One Mother’s Experience….Quality Speech Therapy or Not?

By Laurie Felty, M.S., CCC-SLP

Since the time my son, Jack, began speech therapy almost 2 years ago for apraxia of speech, he has had four different therapists with four different styles of therapy. Some of those styles were successful and some were not.

As a speech therapist myself, with 15 years of experience, I feel that I have the qualifications to judge the level of skill and quality of services that a therapist delivers. Not only can I speak from my own experiences as a therapist, but also from my experiences of working alongside other speech therapists and having the opportunity to observe more than one successful style of therapy. Based on all of this, I have very specific ideas about what I expect from my son’s speech therapy sessions.

I feel that we were very fortunate to have had Laura Mize, the creator of this website, as Jack’s first speech therapist. Our service coordinator through our state’s early intervention program recommended her because she knew that Laura had experience with apraxia of speech. She treated Jack until he turned 3 and was no longer eligible for early intervention.

From the moment Laura walked through our front door, she exuded warmth, friendliness and enthusiasm that immediately captured Jack’s attention and gained my respect. She came in and briefly introduced herself, kicked her shoes off and in the sunniest, brightest voice, invited Jack to “play toys” with her. Jack was absolutely mesmerized by her bag of toys, and she never missed a beat transitioning from one activity to another as Jack’s interest would shift, as a toddler’s interest so frequently does. Just like that, therapy had begun and Jack had a new best friend!

Laura’s method of therapy was completely play based. If you’ve read any of Laura’s articles on this website, then you have a pretty good idea about her style of therapy. Laura honestly uses every strategy and technique that she has described in her articles in her therapy sessions every day. Jack was continually engaged in expressive speech tasks with multiple, multiple repetitions of sounds and words during the entire therapy session. Of course, Jack thought he was just playing because Laura made it so fun.

Another key factor that made Laura’s approach to therapy a success was that she worked directly with us, as parents, to deliver therapy services. There was a continuous exchange of information, and Laura welcomed us to not only observe, but to actually be a part of Jack’s therapy. I feel that this is especially important because parents are with their children 7 days a week to carryover strategies and techniques learned from the therapist, who is, at most, with the child only 1 to 2 ?hours a week. Doesn’t it make sense that parents need to be involved in their child’s therapy sessions in some way?

Now, I will not go so far as to say that the unsuccessful styles of the speech therapists that treated my son were “wrong,” but they were definitely not “right” for my son, and they did not meet my expectations as a mother or as a speech therapist.

For example, the second therapist that treated my son was at a pediatric rehabilitation center, through our private insurance, that only provided 20 therapy sessions per year. With only so many visits allowed, it was important that each one be the most productive possible.

This therapist took the first 30 minutes of a 1 hour session to “establish rapport” with Jack by allowing him to play on indoor playground equipment while she followed him around occasionally commenting on Jack’s movements. Jack did not say and wasn’t asked to say one single sound or word during this entire time.

Once in the therapy room, which was filled with toys, she chose to look at books with Jack. Again, not requiring or asking Jack to say anything. Jack, of course, wanted to play with all the toys. However, the therapist made him sit there and look at books until she decided it was enough because she said she was working on increasing his attention to task. It is important to know that Jack has an expressive speech disorder with age-appropriate receptive language and attention skills.

Only after I asked her if she had any therapy strategies for working with apraxia of speech did she ask Jack to imitate some vowel sounds. This was in the last 5 minutes of the 1 hour session. Needless to say, that was the one and only time Jack saw that therapist. I also called and complained to her supervisor.

Our next therapist was slightly better. She did engage Jack in play therapy but only while seated at a table. With apraxia of speech, it is important to elicit as many repetitions of sounds/words as possible to improve motor planning. Although this therapist encouraged Jack to talk, the speech tasks were very non-specific with no multiple repetitions.

Also, one of his “speech goals” was to attend therapy sessions with no parent present. What? He wasn’t even 3 years old yet. How could that be a “speech goal” and what did it have to do with apraxia of speech?  Where was the partnership between parent and therapist? Plus, after our last experience, that was never going to happen.

We stayed with this therapist only for a few sessions until Jack transitioned to the public school system for speech therapy. I was prepared for a disappointment, yet again. However, I was pleasantly surprised by our new therapist’s style of therapy. It was play based with lots of expressive speech tasks and repetitions of target sounds and words. Jack often brings his own toys to therapy, and his therapist uses them in his sessions. She also welcomes parents to observe therapy. Once again, Jack is making progress and enjoys speech therapy.

I hope, through these examples, that parents will be able to recognize if their child is receiving quality services. A few of the things that I’ve learned from this experience are: Not all speech therapists are qualified to treat all disorders of speech and language; there is a huge difference between play and play therapy; and it is absolutely the parent’s responsibility to monitor, be a part of, and demand the best possible services for their child.

 

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Laura

2 Comments

  1. Kathy on June 4, 2008 at 12:58 pm

    Another excellent and informative article. I wish more parents and therapists of all kinds would recognize that “play” is actually a child’s work. Through play they learn most of the developmental skills they need, as well as a whole host of emotional skills. We tend to see play as a “break” from the “real” tasks of life. This may be true for some adults (as I type this I’m actually wondering why) but not for children. The best teachers are the ones who recognize that play is different for children; it’s their “job”. It’s too bad that all teachers and therapists aren’t trained to use what we call play as lessons and therapy.

  2. Holly on June 17, 2008 at 12:06 pm

    We are changing therapists starting this summer for my son. His current therapist is moving so we were forced to find a new one. I can’t wait to see a ‘different’ approach to therapy to see if it jump starts my son more. He has made great progress over the past 1 with the current therapist. She mostly read with him and played some sit down games with him as part of his therapy. The new therapist we will be seeing is mostly centered around ‘play’ therapy for children my son’s age. I’m hoping perhaps this one will get up and move with my son during therapy to see if that helps him more. He’s a very active little guy and sitting still for 30-45 minutes is really tough on him. Wish us luck 🙂

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