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Speech Therapy, its not about articulation… necessarily

April 4, 2014



Before I had a child with autism, I thought speech therapy helped children that mis-pronounced words. Kids with lisps or that had that wet sound when they talked.  So it was pretty eye opening to me to start speech therapy with my own child who had no articulation issues but just lacked concepts.


What happens at speech therapy?  The speech therapist finds something that motivates the child to work or that naturally brings out more speech.  For Rett this has ranged from art projects to games to stickers, magnets and books.   She takes control of the item that the child wishes to use and it becomes their reward for language.


Yesterday’s speech therapy session was 1 hour.  First Rett and Miss Amanda read a book together.  Rett loves books and its usually his first choice.  They worked on ‘what will happen next?’, retelling and making connections with the story. Why did the foxes need duck to help carry the pot? Because it was heavy.  We also talked about our favorite parts of the story and who the characters were.  After that, Rett worked on two part directions and his motivation was this bee game.  Rett has been having some issues cooperating with two part directions because its a new and hard concept for him but he hadn’t played the bee game in awhile and was highly motivated.  Amanda has a set of cards that give her examples of directions.  She’d tell him ‘get up, walk to the door and clap your hands’.  Once he did that, he then had to tell her to do the same thing.  After that, he got to take a turn at the game.  Then he had to do another round of two step directions.  After that he played a game on the ipad. It was a robot building game and he’s working on descriptive words, so Amanda held the ipad and had him tell her what kind of head, arms, legs and body he wanted for his robot. He used color words, size words, straight vs curvy or if the body had something on it like fire to describe what exactly he wanted.  Then he used his robot to go through a maze.   The last activity he did was putting girl face stickers on a worksheet of a scene with boys and girls.  He had to find a girl and tell us what she was doing using correct pronoun She and also possessive pronoun Her when it applied.  ‘She is drinking’ ‘She dropped her fork’ ‘She is talking’ ‘She is riding the Ferris wheel’.   His motivator was getting to take the sticker off the sheet and put it on the girl’s face.  Then at the end he got his sucker and we were off to an hour long OT session.


Rett hardly ever works on articulation. It is all concepts and forcing him to start make connections like pronouns and how they go along with if you know someone is a boy and a girl.  Everything builds onto another concept and a speech therapist knows what order to introduce things and also what activities will set up opportunities for practice.  Some concepts he picks up on quickly.  Some concepts (like these pesky pronouns) we’ve been working on for at least a year.  As soon as I think he’s got it, it gets mixed up again and we start over.


Where do kids receive speech therapy?  Most kids receive some speech therapy at school. This could be within their own classroom, pulled out individually or pulled out with a small group of kids. The amount of time and quality of therapy seems to vary greatly from state to state and school to school.  Some people have success getting insurance to cover outside therapy or receive deeming waivers like us. Our deeming waiver gives us an hour of speech a week.  Speech in our area typically costs from $120-$150 per hour.  This can add up quickly and many therapists don’t accept any insurance plans.


And of course therapy doesn’t end when you walk out of your speech office.  Correcting speech, asking questions, practicing 2 step directions, setting up your own opportunities and motivators is an everyday, all day activity.   Locating a good therapist, being able to watch sessions to see what works and what techniques you could use at home are invaluable.  Many concepts that Rett caught onto just took me really focusing on that skill for a solid week.  There’s only so much a speech therapist can do in an hour.


Its easy to feel sorry for Rett that he lacks the natural communication skills of other kids. That things that Thad can already just say, he is still struggling to learn.  He has to be conscious and work on things that we all just naturally did.  But this is his life.  This is all he’s ever known. He keeps trying, keeps practicing, keeps correcting himself and does all of that with a smile on his face.  We could all learn a lot from Rett.


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