Keeping Your Finger on the Pulse of Normal….Advice for Therapists

I am always amazed when I hear a therapist (Speech, OT, or PT) tell me that they don’t have regular contact with typically developing children. What? Then how do you gauge “normal,” and what do you call typical? Surely you’re not still relying on your grad school experience? Observation hours with typically developing kids is your only reference? Noticing kids as you whiz past them in the grocery store is the most contact you have with kids that you’re not seeing professionally? Then you’re in trouble!

For those of you who may be new to the field of pediatric therapy, let me break it to you, and not so gently. You can’t judge normal by the highest functioning kid on your caseload that you just discharged because he no longer met the eligibility requirements for your agency or program. While you can call a kid “within normal limits” when he barely meets all the skills on the criterion-referenced checklists you’re using, you can’t really reassure his mother that he’s “fine” since those are designed so that kids who barely make it to the shallow end of the bell curve still pass.

You surely can’t judge normal by comparing clients to your own children, if you even have any, unless you have a whole houseful of kids and wonderful genes so that each one of your children is without quirks! To top that off, sometimes a “mother’s love” blinds us to issues with our own children! We can diagnose difficulties in other people’s kids all day long, but some of the worst cases of old fashioned denial that I have encountered professionally have been in families whose parents have the credentials of someone who should?know better!

The only way to make sure you are keeping your finger on the pulse of normal is to see lots of kids and often.

How exactly do you do this? One way is to constantly acquaint yourself with mothers who have children the same ages as kids you treat, or involve yourself in a group with kids the same age. If you’re an elementary school SLP, this might mean that you find yourself a Brownie or Boy Scout troop to befriend. If you’re a preschool therapist, coach a sport at the Y or in your community leagues. Since I specialize in birth to 3, I volunteer in the nursery at my church once a month on Sunday mornings and teach a class of 2- year-old every Wednesday night during the school year.

Churches and community organizations rarely turn down a capable and willing adult volunteer. Just wait until they find out you’re a “professional!” You’ll likely get to?name the time or commitment you’d like to fulfill.

Another “must” that they don’t tell you about in grad school is to commit your milestones to memory. Know them so well that you can quote them verbatim when someone asks, “How many words should my child have by X months of age?” If you’re constantly saying or thinking that you need to “wait until I score the test to see if this child qualifies,” then you don’t know normal well enough. Learn your stuff! The parents of the children you see are counting on you to know!


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