Resolutions for Therapists who Work with Young Children

Happy New Year!

Did you make any New Year’s Resolutions? Are any of them related to your work as a therapist in early intervention or a preschool program?

When Kate and I were discussing our last few podcast topics and questions from our regular listeners, I came up with several resolutions which can make us all more effective in our practices.

We’re going to use these resolutions as the basis for the first couple of podcasts for 2012. My weekly show “Teach Me To Talk with Laura and Kate” airs live on Sunday nights at 6 pm Eastern time, and I’d love to have you join us for that discussion. 

If you’ve been a regular listener or reader, these will not be new topics for you. We’ve talked about these issues over and over since our first show aired in August 2008, but often to our surprise and amazement, these same issues keep coming up!   

The list below is based on the common themes that emerge when answering questions from parents and professionals here on the website, talking with callers on the podcast, or the comments I hear when I travel to speak to therapists in my conferences across the USA.

Following these resolutions will reduce many of the common challenges that seem to arise everywhere, whether you do home visits in a city like Chicago, work in a clinic-based practice in southern California, or serve in a preschool setting in rural Tennessee.

See if you recognize yourself in any of these situations: 

1. I will have FUN in my sessions! 

Having fun yourself in therapy almost always ensures that the child you’re seeing is having a good time too.  

Why is FUN more important than almost any other principle when working with young children? Because being FUN often eliminates poor participation, boredom, and even most of the other behavior issues we encounter during therapy sessions. When your little friends are busy having fun, they don’t want to run away, blow you off, or exhibit any of the other less desirable actions toddlers resort to when they’re not having a good time.

 

To put this a little more bluntly, if you routinely have these kinds of issues with many of the children on your caseload, the problem isn’t with your clients or their families…

 

Change yourself and you’ll see many of these challenges disappear.  

 

2. I will be warm, affectionate, and approachable during sessions.

 

In addition to being fun, establishing a social connection with a child is vital to success in therapy. If you treat children in their homes, this connection must extend to a client’s family too.

 

Although we’re trained professionals, a cold, aloof, and disengaged demeanor sends the wrong kind of message to a young child and his family. 

 

Think back to some of your own favorite doctors, teachers, or other service professionals such as your hairdresser, or the best servers in restaurants, or cashiers at the grocery store. What do all of those people, regardless of their job titles, have in common?

 

Without exception they execute their jobs with a high level of proficiency, yet they are friendly, easy to talk to, and make you feel welcomed and important.

 

Our little clients and their parents should feel that way about their child’s therapists. Often times an early intervention therapist is the only professional young clients and parents see on a regular basis, so taking the time to establish a very natural, unforced rapport is important. 

     

3. I will stop blaming parents for developmental issues!

 

Many professionals begin and end discussions about their clients with comments about a child’s environment or family’s lifestyle. 

 

There are certainly cases of severe neglect and abuse when we’d rather a child we’re seeing live anywhere but where he is. When substance abuse has occurred prenatally, this parental choice has determined the course of a child’s development, but I’m not talking about these kinds of horrific situations.

 

I’m thinking of cases when a therapist talking to a colleague says things like, “I think so much of this child’s issue is related to parenting,” or “If that mom weren’t so ___________, (fill in the blank with any number of descriptors), this child wouldn’t be so far behind.”

 

The truth is most of the delays and disorders we see with our clients in the USA can more likely be attributed to neurological or biological differences than where the child lives or who the child lives with.  

 

While parenting certainly plays a part in who all of us end up to be, it is often NOT the chief reason for a child’s developmental delays and disorders.

 

Haven’t you seen siblings of clients who are developing within normal limits or even thriving? These kids live in the same homes, have the same parents, and usually live by the same rules, or even lack thereof! Despite what can be described as lackluster or non-stimulating environments, these brothers and sisters seem to be coming along just fine. In these situations, nature must be the difference, not nurture.

 

Before dismissing a child’s struggles as something a parent did or didn’t do, examine the true causes, especially before passing judgment on a parent.  

 

While environment does play a huge role in helping a child improve, it often didn’t create the difficulty in and of itself. Even if a mom had been more responsive, or established a better routine, or enforced a stricter parenting style, or read to her baby more, or blah, blah, blah, there STILL would have been a developmental delay or disorder because that’s how the child came into this world. Perhaps there would have been a milder version of the same problem, but what a parent did or didn’t do would not have totally eliminated the issue.     

 

Making a parent feel guilty about a problem they can’t control and didn’t cause doesn’t help anyone.

   

4. I will stop blaming behavior for developmental issues!

 

Of all the “themes” that have emerged throughout my career and certainly over the website and on the podcast during the last 4 years, this one is the most pervasive and in my opinion, the most damaging.

 

Late talking is NOT due to behavior or personality traits.   

 

When I say that to most adults, they seem to understand and agree with me, yet go on to explain how their child is not talking because he’s lazy, or stubborn, or bad.

 

I am constantly amazed at well-educated adults, even therapists, who seemingly believe these kinds of false and dangerous statements. Every time we nod our heads or sigh when a parent tells us these kinds of things, we reinforce this serious untruth.  

 

Late talking is not a choice a toddler purposefully makes. That diagnosis is called selective mutism and necessitates that a child is using normal language consistently in at least one setting. Late talking toddlers do not have expressive skills that fall within the range of normal anytime, anywhere. If so, why would that child be on your caseload? 

 

When kids can talk, they do talk. I call this philosophy “Can’t Vs. Won’t,” and I talk about it often here on the website, on the podcast, and in my books and DVDs. Check those out to help yourself and parents make this important philosophical shift.   

 

5. I will develop tunnel vision (when needed) to decide how I can best help my client & family.

 

Many of the questions we’re getting from therapists lately take more time to explain a client’s complicated medical or social history rather providing information related to a child’s development or his progress in therapy.

 

In these situations sometimes the therapists seem to be using most of their time and mental energy to search for a diagnosis or seek treatment options that are beyond their scope of practice rather than doing what they are there to do which is to address a child’s communication needs.  

 

While we want to be mindful of all the challenges a child faces, and we certainly want to point parents in the right direction by referring to other disciplines and professionals, searching for answers to these complex diagnostic issues can distract you from your real purpose. Honestly, the outcome won’t change or affect what we will do for a child during treatment sessions.

 

That’s a fancy way of saying, “The diagnosis doesn’t matter.”

 

As pediatric speech-language pathologists and other early interventionists, we really don’t treat a specific diagnosis. As a child’s SLP or Developmental Therapist, do you really treat Down Syndrome, Autism Spectrum Disorder, cerebral palsy, or any other medical diagnosis? Nope.

 

What do you treat? You treat the developmental deficits in a child’s receptive and expressive speech- language skills.

 

From the most practical standpoint then, in reality, it doesn’t matter if a child has a diagnosis or doesn’t because you are assessing and providing intervention for what skills he needs help to develop and master.

 

A diagnosis is often much better from a reimbursement perspective and it can help a child receive more services. A diagnosis may provide prognostic information about a child’s long-term outcome, but thankfully, often it does not. A diagnosis will certainly help explain the “why’s” to parents.

 

But the bottom line is this: when you’re doing a great job clinically, a specific diagnosis won’t significantly alter your treatment plan or therapy strategies.   

 

Don’t let finding a diagnosis consume your therapy time with a child or his family. Your primary role is to provide intervention and address issues that you can help make better.

 

6. I will work the hierarchy for treatment with toddlers!

If you’re not sure what I’m talking about here, have I got a show, a website, and a book for you!

In a nutshell, many times we don’t see progress with young children on our caseloads because we’re working on the wrong goals or targeting skills in the wrong sequence.

Every week on the podcast “Teach Me To Talk with Laura and Kate,” we discuss (at length and ad nauseam) ways to prioritize your treatment goals and therapy strategies for toddlers with developmental communication delays and disorders. You can listen to the most current show by clicking the white arrow in the blue box with the blogtalkradio icon in the right side column on this page. You can listen to the last several shows by clicking on the show number listed in the light blue boxes below the blogtalkradio icon. For a list of all previous shows, click the blogtalkradio icon, and you will be redirected to the blogtalkradio site where the archives are located. Scroll down to find topics that interest you. You can also download the show FREE from iTunes and listen on your iPod or iPhone. If you’re a podcast novice, click here for detailed instructions for how to access and download shows to your iPod or iPhone.   

For a full explanation of my treatment hierarchy, please consult my book Teach Me To Talk: The Therapy Manual. Click this link for more information.  

Well, that’s the list of resolutions and those are my initial comments, but I’m sure I’ll have plenty more to say in the upcoming weeks on the podcast.

I’d love to hear your comments too! Leave those here for me on the website. Please know that all comments are moderated, or approved, before they appear here on the website or else the site would be overrun with irrelevant ads or worse. When I’m extremely busy, it may take several days for your comment to appear and a few more days for a response from me.   

Or better yet, call us! Our favorite shows are when we have real live people call us and talk to us on the podcast! For details about participating in the show, email me at Laura@teachmetotalk.com.