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Top Ten Things Your SLP May Be Too Nice to Tell You…Tips for Parents for Maximizing Therapy Sessions at Home
TOP 10 THINGS YOUR THERAPIST WANTS YOU TO KNOW AND MAY BE TOO NICE TO TELL YOU –
1. Minimize the distractions from other people for your child, especially during initial sessions.
This means don’t have grandparents or your best friend or the neighbor’s children over if you’re doing home visits or teletherapy until your child has established relationships with her therapists. It’s much easier to keep a new client’s attention if the stressors are limited in the beginning. Grandparents can come to watch after your therapist has a good read on your child, and after a child already loves her and wants to play.
A crowd is not a good idea for sessions. Many times you can’t all fit in the same room anyway! I now live in a very rural part of Kentucky and run a mission-based therapy program. Sometimes 3 or 4 (very well-meaning and even excited) adults want to come to therapy with one child. I have a HUGE therapy room and it can still feel crowded with one kid, me, mom and/or dad, plus 2 other people! While it’s FANTASTIC that everyone wants to be so involved, you will need to let adults take turns accompanying the child to therapy.
2. Turn the TV off and take away the iPad before the session begins!
It’s so hard to start a therapy session when your child is having a melt-down because his favorite show or video on YouTube has been abruptly turned off. The exception, of course, is when you’re successfully using a screen or an app to address your therapy goals during sessions, but I don’t do that very much either with young children! It often shuts down interaction and defeats the whole purpose of therapy – learning to listen to and communicate with other people.
3. Put the pacy and cups away.
That is unless you’re working on feeding, oral motor with a straw cup, or your kid absolutely, positively has to have the pacifier to regulate. Your therapist may want you to keep the pacy and cup available (many times I do!!), but she should NOT have to be the one to have to pry it from your child’s mouth! It makes her the bad guy, and that’s really a parent’s job.
4. Do a “warm up” before therapy begins.
Act excited before she gets there or before you arrive at the office/school telling your child, “________ is coming to play!” Or “We’re going to see ____!” Do a movement activity like swinging or jumping on the bed or couch or running laps 5 minutes before the session begins. This serves to pep up kids who need to kick it up a notch to talk. Movement will also calm really active kids who have a hard time engaging and attending.
5. Follow your therapist’s lead with participating in the session.
I LOVE for moms to sit and actually play with us. It makes everything go better when mom can follow up after therapy is over and that’s actually the whole point of early intervention – teaching parents what to do all day every day! Parental participation is always, always, always the preference, but…
Sometimes mom is so chatty that I can’t get a word in edge-wise and we end up talking about her issues which is fine, but not every session. Or a mom (accidentally) sabotages therapy by answering for her child or is too quick to jump in to rescue her child (a little bit of frustration is sometimes good thing). Sometimes parents are too mean and the child remains upset (more about that below). Or sometimes an overly protective mom justifies every little negative thing that a child may do and very little gets done in therapy. (He’s tired today because he went to bed late. He doesn’t like that toy. He hates singing. He would play better with a purple balloon, not blue. I think he might be teething. He doesn’t like it when you ask him to do things. And so on…)
Do chime in and tell her why you think something may be going badly (i.e. “This is his 3rd day of antiobiotics for an ear infection.” or “He was up 7 times during the night.”), but don’t tie her hands or so lower the expectations that she ends up wondering why you didn’t call to reschedule if he’s truly having such a bad day.
If your child is clingy and won’t interact or play with your therapist, make yourself present, but maybe not quite as available. For instance, casually move away or stand up so he can’t sit in your lap. Be there so he’s not stressed, but don’t coddle him unless he really needs it. If in doubt, ask your therapist what she’d like you to do.
Read your child’s cues, BUT remember that challenging your child may be just what he needs. Don’t feel threatened if a therapist is not doing it exactly as you would. She’s there to teach you NEW stuff.
6. Cancel if you know you’re not going to get anything accomplished, and please cancel if anyone at home has an illness that’s contagious.
I can’t tell you how many times I’ve picked up a child and felt him burning up with a fever or sat while mom changed dirty diaper after dirty diaper and thought…. I hope I’m not going to catch this and take it on to my next 4 clients or home to my own famly! Speech therapy is important, but it’s not an emergency! It’s okay to miss a session when your child is not going to benefit anyway. This might also include the day you’re leaving on vacation and the house is a disaster or when the water heater has broken and the repairman is going to be going in and out of the front door 50 times.
This is also true for when Dad is home with the flu. He’s touched doorknobs. He’s sneezed out his germs into the air. Cancel or at least call and warn her!
7. Handle your child’s major behavioral issues, but not the minor ones.
I’d rather ignore little infringements than get off on the wrong foot with a kid. I almost always use gentle redirection in sessions rather than “disciplinary” stuff like time out or even verbal corrections. However, if your child is truly being horrible (i.e., purposefully throwing toys at your therapist, hitting, biting, destroying her toys, or hurting your other children), step in and parent. If you’re not sure how to handle these behaviors and also need coaching in this area, ask her to model what she would do for discipline in that situation.
One other pet peeve I have is parents who are constantly chiming in, “Tell her thank you,” “Say please or you can’t have it, ” “Say MISS Laura,” or using other politeness or verbal cues that are irritating for a non-talker and for me when we’re just trying to get ANY word! Ditch the etiquette lessons until he can communicate!
8. Don’t save all of your questions for the last minute.
I routinely ask moms how the week is gone, if they have any questions, etc… at the beginning of the session. Answering questions is what your therapist is there for, so don’t save a bombshell bit of information or a long question until she’s about to walk out the door. It’s not fair to her other families who may be waiting 20 minutes for their appointment because she feels like she must answer your question before she leaves. If it’s a complicated issue she may need to think about, leave her a voice mail or shoot her an e-mail a day or two before she comes so she can be prepared with a credible answer.
9. Be respectful of her schedule.
Schedule all of your other appointments around your therapy time. You wouldn’t call your pediatrician’s office and say, “I’d like to come in on Tuesday at 10.” You take what they give you. While it’s important for therapists to be flexible and respectful of your schedule, you may not be able to dictate exactly when you want her to come. If a therapist has a good reputation, she is going to be busy. If she’s busy, you’re going to need to take what appointment you can get, within reason of course. I am very careful to tell parents that I don’t want to come at the worst possible time of the day, but if you have to push lunch back a little and put your child down 30 minutes earlier for a nap so that your great therapist can come for an afternoon appointment, so be it. Not every client can be seen at 10:00 am on Wednesday. Be flexible.
10.Help your child love therapy!
Sometimes parents subconsciously sabotage their child’s good relationship with a therapist out of well, jealousy, or mistrust, or any other number of unproductive emotions. You need your child to love, or like, or at least tolerate, his therapist. Stay positive, even when it may be off to a rocky start. Don’t characterize the session as “work.” Don’t say negative things like, “Do you want _____ to go home?” Or “We’re going to leave if you don’t listen to her.” Don’t ask him, “Do you want to play with her today?” when the answer may be “No!” Expect that he and you are going to benefit tremendously from each session, and do everything you can to make it happen.
If your child hates therapy, consider switching approaches, times of the day, settings, or as a last resort, therapists. Unfortunately, there are good and bad SLPs just like there are good and bad hairdressers, car mechanics, preachers, cashiers, and math teachers. Find a good match for your child so he can get the help he needs.
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Three years ago, my then 2year old (adopted) was only saying two words - momma and boat. We had been doing speech therapy for 6 months, and he loved to play, but he was entirely uninterested in talking. A dear friend who is a SLP recommended I look you up online. Since then, I've read your emails, listened to hours of your podcasts, ordered two of your therapy manuals, and watched many of your videos.
My now 5year old tells elaborate stories now, and if you didn't know his background, you would never guess. And thanks to the hours that I have spent with your guidance, when our next son, now a 2.5yr old, didn't talk (after a craniotomy), I had tools to get started with him. His speech has just taken off in the last month or so.
Thank you so much for all that you do to help parents facilitate speech therapy with their kiddos. And thank you for your gentle, confident living of your faith.
God's blessings."
Rachel (mom to 3 boys in a now very noisy house!)
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