Any SLPs around?

[Momling]

I'm re-posting this from the general board...

We're fostering a new little guy who has cognitive and speech delays. He's aged out of the 0-3 services and won't start services until he starts Head start in the fall. Do you have any suggestions for what we can work on? He's in the 1st %ile for both expressive and receptive speech. I don't have much more info than that. He usually uses just one word, but will occasionally produce a 2 or 3 word phrase. His syntax is weird when he does combine words (putting adjective after the noun). He doesn't use or understand pronouns or prepositions. We're working on animal noises and greetings and colors and numbers and stuff like that in our daily life.

I asked the current IFSP coordinator for ideas and got some disappointing generic brochures that give kind of obvious suggestions. I guess I'm more interested in reading up on the literature -- I have a good theoretical background in linguistics (particularly phonetics/phonology and language acquisition) and also in educational assessment and statistics and things like that. I just don't know much about the practice of speech therapy. Do you have any suggestions for a book that would be useful? Maybe a textbook or manual used by SLPs? Thanks!

[PeterPan]

Momling, my ds sounds like a similar age, and I can tell you how our therapist has us work with him. He has verbal apraxia (motor control problem), so there's expressive but not a *receptive* language problem. However the techniques should work well. The technique we use is called PROMPT, but the important thing is that they want the speech in context. She has us create routines and use the same phrase over and over for a while. When you do this repeated, predictable dialogue, it helps them *anticipate* what they need to say next.

 

So for instance you might work on speech in bath time. You create phrases, questions, interaction that use whatever speech he has. If he has no words (like my ds before therapy), then you get them to reply with sound. Want the water on? Say /a/! What do we do now? Take shirt off. What do we do now? Hop in tub! (Say hop hop while hopping him in.) Mmmm, water is warm. Swish, swish!

 

But the point is you require him to give speech to get what he wants. He wants the water on, he has to say something. He wants a toy, he has to say something. He wants to eat, he has to say something. That something can be a sound or ANYthing he has. And by creating predictable routines for this breakfast speech, dressing speech, getting in car speech, you're letting him know what to anticipate. The repetition helps.

 

We also play board games this way. A lot of our speech therapy is with games in fact. He may only have a sound, so he says /a/ every time he wants the next piece of the puzzle. Or he may be able to give actual words like up, on, put, more, me, do. Just see what you've got and work with it. But whatever he has you get him to use in order to play the game. Who goes next? Me do! I got a 3! Hop 3! Hop, hop, hop.

 

Sometimes the therapist would play with him with something artsy like glitter glue that you squirt out or the peg stackers (Lauri?). He'd say the target, play, say the target again to get another piece, and so on. So don't think too in the box about what the activity has to be. Once you see your goal as getting out speech in context and building routines and repetition that he can predict and memorize, it makes more sense.

 

I too had some linguistics in college. Definitely helpful with the speech stuff! With PROMPT we're actually touching the articulators and telling the brain what to move. It's really amazing. Even though I *know* what she wants after she explains it, I don't necessarily catch it myself ahead. For instance we had a session a couple months ago where she pointed out that he was devoicing final consonants. Dude, you never win, eh? But at least I UNDERSTOOD what she meant, lol. But even though you know what they mean, you don't necessarily catch it yourself till they explain.

 

Well all the best to you in getting therapy for him. Hopefully it won't be too long and he'll be back in his sessions! :)

 

PS. Signing Time is AMAZING. :)

[Guest]

I am far from being an expert but have been reading:

 

- Teach Me How to Say It Right, Helping Your Child With Articulation Problems by Dorothy P. Dougherty, MA, CCC-SLP

 

I originally borrowed it to see if my little guy is up to date with articulation since I don't have any evaluations yet. We don't have an issue there (he is fine with his sounds and is actually very verbal), in our case, but my little guy speaks mostly about things that interest him. We have to really push for other communication. I have found this book to be a really good resource but it might be old news to you. I am not sure! I have not finished reading it yet. I got it from my library, so take a look if you don't get any better suggestions for books :).

[ElizabethB]

There are some good PROMPT videos that would probably be helpful for you, hopefully OhElizabeth or someone will link them for you, I've seen them linked here before.

[Embassy]

You may want to read over the strategies found at http://www.helpmychildtalk.com/

 

Hope that helps!

[PeterPan]

There are some good PROMPT videos that would probably be helpful for you, hopefully OhElizabeth or someone will link them for you, I've seen them linked here before.

 

Yes, there's a 45 minute video on youtube of Deborah Hayden giving a workshop on PROMPT. However it's not really teaching a person how to *do* PROMPT. PROMPT is meant for motor control problems, which may or may not be part of the issue for the op. The way we work together (contextualized, use what you have to get what you want, repetition and routine to improve predictability and memorization) work more broadly.