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Thread: speech therapy advice

  1. #1
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    Default speech therapy advice

    DS is 21 months old and has recently started speech therapy through Early Intervention. He has a speech delay and didn't say his first word until about a month ago, but his hearing is fine. Anyways, he has therapy twice a month and then we are supposed to work with him in between. However, I'm kind of conflicted about the instructions the SLP has given us. She wants me to pretty much only do sign language with him and she wants me to sit him down for a minimum of 20 minutes, 3 times a day to work on certain activities (puzzles, sorting blocks, ect) and refuse to let him get up until he has finished the given activity. She wants him to do the signs for "more" and "again" during each activity. Along with a number of other signs. She also expects him to sit still with her for the entire hour of his therapy session and do all of her activities. I just don't understand how she can expect him to sit still like that for so long. He's not even two yet! Also, he has never once even tried to imitate the signs (its been a couple of months of trying now), and me (or the SLP) refusing to give him the next puzzle piece until I've done the sign myself a few times and then done the sign with his hands a few times just makes him upset and angry and even less likely to want to continue sitting there. He does say three words regularly and consistently now, and says a few others sporadically. He also tries to repeat back what I or DH say pretty often too, so I feel like he's getting there and learning to talk. He is also very good at communicating non-verbally by showing us what he wants.

    DH and I both just feel that what the SLP expects of him is not realistic or very helpful. I don't think sign language is the right thing for him, and forcing him to sit still that long just doesn't seem right to me either. I want to help him, but I just don't feel like this is the right way to do it. DS is my first child, so maybe I'm totally off track with this and she is right? Is this what speech therapy is supposed to be? What do y'all think? I am definitely planning on talking to the SLP the next time she comes to see what she thinks of it all too, but I'd like y'all's thoughts on it first, please. Thanks.
    Last edited by Adhafera; 07-11-2014 at 12:03 AM.
    Jennifer


  2. #2
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    It doesn't sound as though her techniques are age-appropriate. Have you asked her how much experience she has with his age group? Speech therapy with little ones, particularly toddlers, should be FUN first of all. 99% of it is building trust and learning together. I know what she is going for, but don't think her delivery is working for your son. I also (pet peeve and many would disagree) HATE teaching "more" as the first vocabulary word, because they don't understand the concept more (meaning I have some of this and I want more of it) that soon. They learn to say more when what they mean is want, and then later when they need to learn what more actually means, it's confusing.

    Are you able to switch therapists if she isn't able/willing to change up her technique?

    This book is an excellent resource for some FUN therapy activities and strategies to get your little one talking: http://www.amazon.com/Toddler-Talks-.../dp/1477693548

    ETA: Her chapter on how play, cognition, and language develop together is important to understand and possibly even something you should share with your SLP.
    Last edited by Gwenn; 07-11-2014 at 01:04 AM.
    Me (40) DH (47) & furbabies * m/c 7/08 4/12 11/12

  3. #3
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    Yes agreeing with PP and you.... The length of activities and expectation seems extreme for his age. Does you SLP expect these things to happen immediately or as a long term goal; sort of like an IEP, or 504 plan? From what you mentioned it sounds like you do prompt to help him.
    So for example your DS' goal is:
    Ben will complete a puzzle activity using ASL "more" to receive the next piece of the puzzle.
    Objective 1: Ben will ask for 3 puzzle pieces using the ASL "more" when prompted hand over hand 3x (a prompt for each piece)
    Objective 2: Ben will ask for 3 puzzle pieces using ASL "more" independently 1/3x (meaning he successfully signs "more" by himself 1x out of 3 tries

    Anyway, any type of therepy should have goals, and those goals should be broken down into objectives. Everything he does should be specific and measurable. The most important factor in goals is they should be APpropriate! Expecting off the bat for a 21month old to sit still for an hour in nutso! But if that is the overall goal, and he has small objectives to let say, engage in the activity for 5 minutes, then 8 mins, then 10 mins, etc. would make sense.

    Then I also wanted to mention.... The reason for the sign language is simply to jump start him. If Sign is not introduced and say in one year speech progression has not been what was expected, your DS is now another year behind (kwim?) it's just to help him figure out the communication aspect, and in a form that is understood universally. I know he is able to communicate with you now, but what about in school (pre-k) and such. It's like when a one or two year old talks, mamma knows what they are saying but to everyone else it's all jibberish. It's just a form of effective communication. At this point I am sure verbal skills should still be top priority with the therapist. If you feel it is not going that direction you should address it!

    Sorry this became so winded! I hope it works out!

    Eta: making things fun is all part of an attitude... Things get frustrating and some days are better than others! Just remember to keep clapping, saying yay! Watch mommy sign! Do it with me! Smile a lot.... Some sessions will be a bust, and that's just how life is. Avoid hungry times and around naps.
    Last edited by Brittany_Dawn; 07-11-2014 at 10:49 AM.
    waiting for our hearts to healBrittany(28)DH(39) DSD-(18) DS-Tristan(4) DD-Brooke(3) DS-Preston(1)*my miracles*

    12/05/07 14wks, 10/10/08 9wks, 12/20/13 8wks, 05/06/14 10wks

  4. #4
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    Thank you ladies for your responses. Mandy, I was hoping you would see this. I feel bad because he gets so frustrated, which results in the SLP getting frustrated so its just not working. Thanks for the book reccommendation, I just ordered it for my kindle! I am looking forward to reading it in the next few days! Hopefully I can get a better handle on this and how to help DS. Brittany, I wish that was how she was doing it, but no, she expects him to sit for the entire hour right off the bat. And do the signs for every single piece of the puzzle or game every time. The last time she came she seemed extremely frustrated by the fact he would not sit that long and was getting frustrated himself. She told me I needed to box him in with furniture and force him to sit there the whole time and do the activities no matter how frustrated he got. I was honestly kind of appalled. The only "goals" she has set is for him to use 10 words by the end of the year. There is only one other SLP, aside from our current one that does this part of the island (Hawaii). I'm planning to have a talk with her about it when she comes next and if she refuses to change her technique at all, I will see if I can get him switched. Don't even get me started on the scheduling. I've given her our availability twice now and she still schedules us at the wrong times. I get that she is stretched thin, but still. This whole thing is just stressing me out way more than I think it should.
    Jennifer


  5. #5

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    I'll re-read and respond later but, Cody had 18 months of speech therapy so I might have a few ideas for you.
    *** Lindsay ***



  6. #6

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    That is crazy that she thinks a 21 month old can focus that long! My DS will be 21 months on Monday and we are lucky if something holds his attention for 3 minutes! I feel your pain, and think you definitely need to address those expectations with the SLP.


    Anne (37) DH (37) Olivia (4) Harrison (1)

  7. #7

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    I think her methods are grossly developmentally inappropriate, not to mention if she is visibly frustrated with your child. Not cool.

  8. #8

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    an hour? thats way too long for a youngster to sit still and focus on the same task. early educators are taught that children have short attention spans and shouldn't be expected to focus for too long... 1 minute per year old. so 2 minutes would be your goal not an hour.
    call who you need to call, talk to who you need to talk to but your current gal is going about it the wrong way.



  9. #9
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    I would look for a different therapist... with DS1, the speech therapist always told us to never stress him about it. She wanted us to encourage him, but if he got up to leave or was frustrated to not push it.
    .~Becky~.



  10. #10
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    I'm working with 3-5 year olds these days and even with my most mature kids, no one activity lasts me longer than 15 minutes tops. When kids lose focus, I change activities. It blows my mind she can't do that with a one-year-old.

    And the strategy she is describing, I have had some (mixed) success with for nonverbal school age children. Never in a million years would I start with that technique with a toddler. If I did, I would change it up very quickly if I didn't see it working. I don't think she knows anything about toddlers.

    That said, if SLPs are in short supply in Hawaii, got any leads for me for a job opening? Ha!
    Me (40) DH (47) & furbabies * m/c 7/08 4/12 11/12

  11. #11

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    OK I had to think about this one for a while and reflect my memory. My personal experience with speech therapy with Cody was he did have it from 1 hour per week however she'll allow him to have about 3 tries when the signs and then move on. She would really want him to do it but, she didn't push it. He would do about 5 minutes per activity. I would do maybe a couple of tries and then determine if you want to switch. When Cody picked up speech he stopped the sign language. It will get easier.
    *** Lindsay ***



  12. #12
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    I'm not an SLP, but just being a mom it sounds like her methods are not developmentally appropriate.

    I am a sign language interpreter and both my children signed a lot, which was great because they were both late talkers. It helped us communicate until they started verbally communicating. The thing that helped them learn sign was to make it FUN. I mixed signs that *I* wanted them to learn with signs that *they* would be motivated to learn. And I agree with Mandy that signs like "more" and "please" are only confusing. I went with concrete signs: names of things or actions. Signs that were helpful for me were things like "eat" "milk" and "all done". Signs that were fun for them were whatever interested them. "Ball" "dog" "car" "bird", etc. I had less success getting my first DD to sign until I figured out I couldn't just focus on the signs I wanted her to do. Once I mixed in signs she was interested in, she picked up on signing everything I was teaching more quickly.

    I don't know if that would help your son, but my experience has been that forcing signs they aren't interested in doesn't work.

    I hope she can either change her strategy, or you can find someone new.

  13. #13

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    Wow, I'm really sorry that your SLP is getting frustrated with your 21 month old. I agree that the expectations are completely out of line with DS's age and it seems clear that she doesn't have any positive experience with this age group.

    I hope you are able to get in with the other SLP!!
    Dorcas (35) DH (36) 3/13



  14. #14
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    Thanks so much ladies for your responses. I really do appreciate it. I'm so relieved to know that this isn't how its supposed to be, it just didn't seem right to me at all. This SLP is actually the one that did his evaluation initially and even that day I remember telling my DH that I really liked the PT but the SLP just rubbed me the wrong way. Well, at this point I am going to read the book Mandy recommended and try to talk to the SLP when she comes next and go from there. Thanks again, so much, for your input!
    Jennifer


  15. #15

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    Could you try going through your pedi for an evaluation and see if you are covered by insurance for SLP if recommended by the pedi? Maybe there is another route you can take to get the services and then a better therapist. Or maybe there is an office that does out of pocket discounts? When we were taking DD to PT for her neck, we actually opted for the out of pocket pay scale because it was cheaper than if we went through insurance. But your situation might be different.


    Anne (37) DH (37) Olivia (4) Harrison (1)

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    I think the OP's husband is in the military?

    If so, here is what I found regarding Tricare and speech therapy: http://tricare.mil/CoveredServices/S...chTherapy.aspx

    Basically, Tricare covers speech if it is required due to birth defects, illness, injury, hearing loss, or developmental disorders (this is code for autism spectrum disorders). Typical late talking/language delay wouldn't fall under any of those categories - has your SLP given him a specific diagnosis?

    It's good advice, though, and worth bringing up with your pedi. Frequently families find that they can get more consistent services and unfortunately, sometimes higher quality through a private clinic. And if there is more going on than simply language delay, it would be the doctor's role to diagnose that.
    Last edited by Gwenn; 07-13-2014 at 12:33 PM.
    Me (40) DH (47) & furbabies * m/c 7/08 4/12 11/12

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    Thanks for the response, Anne. Mandy is right, my DH is military so we've got TriCare which doesn't cover anything. Honestly military health care is a joke, but thats another whole post, lol. His pedi is the one who sent us to EI because the military doesn't do speech therapy. She mentioned seeing a developmental specialist if the EI evaluation found anything else noteworthy, but they did not. He passed all of the rest of his evaluations with them just fine, the only issue was his speech. I don't have any diagnosis other than "speech delay." My DH also had a speech delay and required speech therapy, he did not talk until he was 3. That all said, I don't really have any options outside of EI right now, and we are moving out of state in November-ish anyways. So at this point, I can only hope for the best. Thanks ladies!
    Jennifer


  18. #18
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    Hoping it gets better and much easier. That hour thing is pretty shocking.

    I wanted to mention that I too (like KCs wifey) teach my kids sign language early on. "All done" is literally my 16 month olds favorite, and he has properly used it for about 3 months now. "Milk" is going okay but it's kind of guessing game for me right now because he uses it but wants either cows milk, water or juice (basically he is using it as drink, lol). "More" is going great too. All of my kids have this head banging issue because of communication until about 2 or so, so the sign helps deter that
    waiting for our hearts to healBrittany(28)DH(39) DSD-(18) DS-Tristan(4) DD-Brooke(3) DS-Preston(1)*my miracles*

    12/05/07 14wks, 10/10/08 9wks, 12/20/13 8wks, 05/06/14 10wks

  19. #19
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    Thanks Brittany. He has speech therapy tomorrow and I'm already nervous about talking to his SLP. In the last few days he's actually started signing "all done" or at least pretty close to it, so thats something. Honestly, even though he doesn't talk, he is really good at communicating other ways, like physically showing me what he wants, so he rarely gets frustrated due to communication issues. Honestly the only sign I really wanted him to learn was "all done" because that was really our biggest issue, and he did it! I guess we'll see how tomorrow goes. I'll let y'all know!
    Jennifer


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