How many times a day do you say this? Is it one or two million?
It’s a large number to be sure, but let’s talk about the science behind why.
The why is SO important in our field- both to us, and to our families. The why is what keeps us on track with evidence-based practice. The why is also what helps us get buy-in and home carryover.
Enter: The Mirror Neuron
When people watch an action being performed, their brain begins to process it as though they were performing the action themselves. Let’s break it down.
Person 1: picks up a glass of water, “zone 1” of their brain lights up
Person 2: watches person 1 pick up a glass of water, “zone 1” of their brain also lights up
Person 2: throws a ball, “zone 2” of their brain lights up
Person 1: watches person 2 throw a ball, “zone 2” of their brain lights up
It. is. SO. COOL.
This applies directly to our therapy. When your kiddo watches your mouth produce a proper /f/, or watches your tongue lateralize while chewing, or watches your hands sign “car”… their little brains begin to light up as though they were performing the action themselves. .
It’s that simple! Seeing is doing. (kinda)
Tell your colleagues. Tell your parents. Tell your mama. Get those eyeballs on you when teaching a skill – whether it’s related to speech, language, or feeding. If they are watching, they are (fingers crossed) attending and therefore learning.
Besides, throwing out cool terms like “mirror neuron” will not only educate… it will impress. You can even direct them to this article on the American Psychological Association’s (APA) website.
P.S. If you would like an easy FREE handout to give parents of late talkers that emphasizes the importance of children watching our mouths when modeling words, as well as strategies to achieve their attention, click here.
Sometimes we get a little human who is painfully shy or perhaps just flat out unwilling to speak.
I am not talking about a language disorder. I am talking about those kids who have something to say, but are not saying it for whatever reason. I particularly run into this with my kids who have severely impacted intelligibility. I cannot count the number of times I’ve gotten a shoulder shrug or an “I don’t know” from bright kiddos simply because they know their words may not be understood. They have learned from countless attempts to communicate that people will not understand and that it is painful to try.
Not only does this break my heart, but it actually impedes our progress.
If my little friend is too shy to say anything without me modeling it first, we cannot scaffold. We stay at the same level of cueing and nothing changes. Furthermore, I cannot get a full picture of their errors when I have never heard them at the conversation level… or even sentence level.
It’s a “chicken or the egg” situation.
These kids are likely not as talkative because their errors make them self-conscious. Yet, spending months working on skills in imitation is bound to make our progress much slower than needed.
The speech errors are the cause- we can treat that with good ol’ therapy and drill work. However, the symptoms… we need a new plan. We need our kids to TALK in speech.
Makes sense, right? Here are a few ideas:
Be SILLY: Your best bet to win over a shy kid is to be a big ol’ goofball. Make them laugh! Being loud and crazy may not be the way to go… but have a silly game on hand to get the giggles going. Ham it up so you can set up a fun, relaxing therapy environment. Even if they’re not laughing yet, even if they’re just watching out of the corner of their eye and smirking, keep on doing you and being as fun as you can muster.
For kids who will tolerate it, and this is probably after a few weeks of therapy, we practice shouting our answers. I model a loud response (which usually gets me at least a giggle) and they do their best to match. This little game typically gets them to a normal speaking volume at least!
Enlist Help: Have the caregiver email or jot down a few notes about what the child did over the weekend. You can ask guiding questions that will allow your kid to answer and be understood. Imagine a child being able to share pieces of their life with you for the first time? Not only is it a confidence-booster and a rapport-builder, but it will allow for a few opportunities to clear up errors along the way.
Provide Comfort: You know how at a party, you may feel awkward without a purse to clutch or plate-o-snacks to hold on to? Give these kids something to do with their hands. Let them pick out a soft, squishy friend to hold during your treatment session. You can even encourage them to bring a “lovey” from home.
Pace the Conversation: There is a chance that you may do most of the talking for a while with these kids but try not to overwhelm the conversation. Give them plenty of time to respond but after 10 seconds of them staring at you, they probably just aren’t ready.
Give a Cheat Sheet: Whether or not a kid is a reader, you might provide a script for them to learn the basics of a conversation. “Hi, how are you, good, how are you.” This is a great go-to that they can not only use to greet you, but they can use it in their communities. Another option is visual conversation cards. Even if they’re not ready to say a whole sentences, maybe they could fill-in-the-blank. Perhaps you can even provide them visual choices and they can point to their answer. It’s okay to use a safety crutch for now.
Keep it Positive: Do everything you can to make your time together fun and enjoyable. Lower your expectations to a level where they can be successful – whether that’s nodding their head, giving a high five, or answering a yes/no question. When they participate, make sure they know it’s a good thing. For different kids that may mean a big smile, and for some it may mean a big ol’ “WOOHOO!”. We are speech therapists and therefore we are chameleons. Shape your responses based on the needs and personality of this particular child.
We need to be patient with our friends… but also provide them with the support to get things movin’.
Give them the benefit of the doubt for as long as possible. This type of quietness is usually not a negative behavior. Often, it’s a legitimate response to anxiety. You may also consider the possibility of selective mutism, depending on the severity.
Just imagine yourself at your most shy and awkward stage of life. Remember that feeling of loneliness at the idea of not being understood by anyone… or being afraid to connect with other people. I am a firm believer that if we had a world filled with confident people, it would be a better, safer, happier place. With your help, our friends are learning how to become effective communicators. Help them build their confidence along the way so we can speed up the process and have some FUN.
Think back to (insert number here) years ago when you were a young therapist. Now take it back to your CFY… and then grad school.. and then undergrad… and then back to a day before you knew anything about cueing hierarchies, Brown’s stages, or the alveolar ridge. That is where most of our parents and families are.
Let’s clue them in and teach the parents… not just the kids.
It’s easy to forget just how much we, as speech therapists, actually know. We can get lost in professional jargon and in our own thoughts during therapy. Sure, WE know why you chose that activity and the level at which you’re cueing your kiddo to answer a question…. but our families don’t. If they are present in the session, they will likely miss many of the nuances of your therapy.
There are 3 people who should always know a child’s goals: you, the child, and their caregiver.
When everyone works as a team, knows their job, and knows the goal… we are a cohesive unit. Of course there are exceptions, but this trifecta brain-share is the ideal. This way everyone can see the big picture and home programming is no longer a chore- it has a very specific purpose.
I recently had a chat with a ROCKSTAR parent. She is all on board with treatment and so supportive of both me and her sweet kiddo. I realized one day we had been in our groove for so long that I needed to check in with her and remind her of the big picture. In this case, our little guy is a late talker. We have been working on songs with gestures, vocalizing during play, and adding a few signs to our expressive vocabulary. But I needed to remind mom WHY. WHY we needed to start with gross motor imitation and vocal play. WHY we weren’t hitting it hard and demanding words from him. WHY WHY WHY.
Of course, we can always ask parents if they have any questions…
but you can’t ask questions about things you don’t know exist.
(i.e. cueing hierarchies, Brown’s stages, or the alveolar ridge)
It’s our job to put ourselves in the parent’s shoes (or the child’s, depending on the situation) and anticipate their needs and questions. Some parents may feel like it’s not their place to question our methods… even though maybe they don’t understand why we’re having their child do something that seems counterintuitive to them. Some may just feel so overwhelmed that they don’t know where to start.
We are part therapist, part playmate, and part hand-holder.
It’s easy to forget that we literally have a masters degree in COMMUNICATION disorders. We should be *awesome* at communicating… but we’re also human. I’m sure we could all take a little more time to explain the intricate process of speech, language, and feeding development now and then.
(OH DARN, we have to talk more about the most wonderful field on the planet? )