Monday, June 29, 2009

Thought on speech therapy

We're having an interesting issue with Joey's speech therapy. He's been saying he doesn't want to see Ms. Nikki (his private therapist). Is this just part of him being tired from school and his tummy troubles, or are we seeing some therapy fatigue?

We're toying with the idea of going with a shorter session with a new therapist. Nothing against Ms. Nikki (who brought this to my attention and said she is not offended, it happens), she has really been working OK with Joey. Perhaps a new face, with some new things to do and approaches to try, will bring some novelty and fun back into speech therapy, which may seem too much like work as he gets older.

However, I think we ought to consider some of the other issues we have seen with the move to the new office. For one, there s now a mini-office in the therapy room- a desk with a computer and files and things. This computer has been causing a lot of headaches, and I think it is a serious distraction for him. The old rooms in the old office were just rooms, they didn't have the computers and things in them, and I think that worked better for Joey. Also, a lot of speech therapy seems to involve tables, instead of using the whole room and activity to promote speech. After sitting in school all day, Joey may not be too keen to sit around another room doing more table-top stuff for another 40 minutes.

One thing about the OT is though there is a general structure to the sessions (half fine-motor in the "small room" , half gross-motor in the "gym"), every session is a surprise. What will they make? What games will they play? What will they do? Our OT has a knack for trying new things, mixing up new activities with old favorites. There is a sameness to the speech therapy, you sit at the table and talk about what you did today, and work on asking and answering questions. This has been pretty effective, actually, but it may be getting old as he masters these skills in a basic way.

So what to do? Speech is a definite issue, and his oral communication is still seriously limited. His use of language still needs to be addressed so he can function and communicate with his teachers and peers. As nice as it might be to think the world will learn to speak Joey, its definitely not realistic. Right now, we're weighing the options, and making sure this isn't really about him just feeling bad in the afternoons; but I think a little freshening up might be in order.


Niksmom said...

I wonder if Jordan has any insights to offer. (I'll send her the link and ask her to weigh in.)

Maybe it's time for some "field" doing something outside the normal setting. The park, the mall, the store, etc...with Nikki or someone else? Just a thought. Or, maybe it's time for a short break?

Jordan said...

Thanks for sending me over here, Niksmom! I'm an SLP...

First of all, your son is so lucky to have you - you are obviously an insightful advocate for him.

I'd say you are 100% correct that Joey could use a bit more fun in his speech therapy sessions. There is really no reason his therapy has to be at a table the whole time - I don't know him, but there is very little that has to be done that way. It's very possible to mix it up and incorporate some of the strategies his OT is using successfully with him. She may be able to direct you to an SLP who does that, in fact. Our clinic in Chicago looks more like an OT clinic - we address the kids' communication needs more often in a lycra swing, ball pit, cooking project, or sand table than at the table.

If the kids are having fun they are engaged. If they are engaged, they are alert and attentive. If they are alert and attentive, they are ready to learn!

I'm happy to be a resource to you anytime:

Best of luck!

Sue said...

Hey it sounds like your doing an awesome job. After a very serious car accident I had to under go a long series of speech therapy, physical therapy, and occupational therapy sessions and they really helped. I go into detail about what it took and my feelings about it in my blog. It might help your son hear from someone else who had similar feelings. It'll also give you a heads up for what teenage years are like with a disability. Good luck to you!