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Early Intervention Speech Therapy

Timmy's Triumph

Published May 8, 2009 10:59 AM by Stephanie Bruno
Yesterday I had the best session I've ever had with a little boy I've been working with since December, the same month of his second birthday. When I first met him and his family, I was informed that he had ear tubes surgically placed during the fall of 2008. Up until that time, mom felt that her son probably wasn't hearing at all although the family didn't realize it at the time.

Timmy (name has been changed) is the youngest of three children and mom openly admits that he often "gets away with murder"! He's adorable, funny and extremely animated. He's also very fast moving, feisty and fiercely independent. Thus, presents my challenge!

Tim's language skills are strong. He is what we call a "speech-only" kiddo, meaning that speech, specifically articulation, is his only area of delay. Despite his inquisitive nature and bold personality, Tim has tremendous difficulty following adult direction simply because he doesn't want to. Tim wants what he wants when he wants it, if you know what I mean. Tim loves to be in control and prefers to be the king of his castle all the time. Mom knows it, so does dad and I encounter this head-on for one hour every week.

Recently, however, we have seen a change.

Yesterday, we were using Play Doh, a Timmy favorite. He was VERY focused on using the "cutter" to slice the doh into a million little pieces. Instead of visually redirecting him, like I often do to gain his attention, I asked Timmy, "What are you doing?"

The response was silence.

I decided to ask again only this time I asked, "Are you cutting French Fries?"

With his head down and cutter moving at lightening speed, Timmy said "No, hot dog" (pronounced "ha gog").

I then responded with an excited laugh, "A hot dog?!" I understood him!!

He stopped, looked at me with an enormous smile and said, "Yeah!"

A minute or so later I asked, "What are you making NOW?"

The response I heard was "Cookie" (pronounced "cookcu").

I excitedly said, "A cookie?!!" and once again, Timmy's big eyes looked at me filled with a mix of relief and joy and replied back, "YEAH!"

Our session continued on for another 20 minutes or so without struggle. We had bonded. Tim's demeanor relaxed. He willingly participated in another activity and worked hard to try sounds and words that he often resists. At the end of the session Mom and I made a point of celebrating Tim's success with verbal praise, smiles and a big High-5!  Timmy looked so proud and mom and I are both looking forward to next week with a sense of hope and renewed possibility.

Yesterday's session was a beautiful example of how difficult behavior will often diminish when a child feels understood.

5 comments

Thank you Rita and Angie. That meant so much to me. I didn't realize how long it had been since I checked on here and didn't really expect any reply. You were very encouraging Rita. And I'll try, Angie, but it's when she wants something that is not her favorite that we haven't a clue what she's remembering! I realize music is great and I have a nursery rhyme songbook that I could have sung all morning today had there been time. She was chiming in with the last words.  I will try to zero in on something to focus on this summer. It may be building a tower of cups, which we did this morning--making her say "put" "on" "blue" or whatever color,  (approximations) and then she was delighted to put the doggie on top and knock it down and that was all the reward she needed. :)

Lois May 26, 2009 8:29 PM
Mishawaka IN

Hello Lois. One thing I have learned after 30+ years of working with "speech only" students at the preschool level, is the importance of "Mr. Development" knocking at the door. Don't worry too much about drilling your little Ashley over the summer. Consult her SLP and choose ONE thing to concentrate on. I look at myself and other SLP's as facilitators helping parents do this so that they do not feel overwhelmed. I do not mean to devalue what we do, but Mr. D. can work miracles with our help and yours.

Rita, Preschool - SLP, Public school May 15, 2009 10:07 AM
Nashua NH

Lois - maybe you could try making a selection of pictures to represent her favorite song then let her point to the picture instead of relying completely on her speech.  She can still say the  name, but with you knowing what song it is you can help her say it and eliminate frustration.  Good luck!  Sounds like you're doing a great job!

Angie, , Speech Therapist school May 15, 2009 8:17 AM
Cincinnati OH

Hi!  Wonderful story!  A quick question: did you try HearFones with Tim?  Why I ask is that I assume he was tested for hearing when he had his tubes installed, and passed.  So he is a bit late in learning articulation, and (maybe) a little behind in listening skills -- especially in hearing himself!  He could perhaps benefit from the better auditory feedback while he plays with his skills as he builds them.  Your thoughts?

Pete Mickelson, Engineer May 14, 2009 5:30 PM
Buxton ME

I have no clue if I'm supposed to comment on here or not! I'm grandma to Ashley, 3 last Feb, with what we are sure is apraxia (only) and is being treated for such using Nancy Kaufman's kit at her 1/2 hour therapy at school per week. I found this blog by googling Sharon Gretz I think. School is coming to an end and it looks like we won't get summer therapy and I was feeling panicky so started re-reading whatever I could tonight and started looking at the recent posts and the comments. helpful. Liked the part about plateaus, about encouragement, etc. Sometimes I can ride along thinking she's young and there is some progress. Other times, it's overwhelming again and I think will she make it? and when. We're trying to follow up with ideas from her ST and I watch her techniques and pass them on to mom and dad and she gives us some homework. But I have Ashley from 7:30 a.m. to naptime at 1:30 p.m. and I often feel guilty that I'm not working in enough drill (with fun--HAS to be with independent her!), enough repetition; that I'm not taking advantage of every situation  -- using the words she is performing, etc.

So I was reading about using the outdoors, etc. Another hindrance is that I have my own transcription to get done while Ashley plays by herself. My husband is now laid off and is taking care of her a lot while I work or cook, and I do hear him ask for words and phrases, but I don't think he gets the concepts as much as I do.

One more thing I was going to add. Ashley is so good at pantomime that (at least) she doesn't often get frustrated with her lack of words. She's made her own signs for a long time to add to ones she was taught.  she's probably most frustrated when she wants a certain song sung to her before nap or bed and we just don't know which one it is.

The day she flows 4 words together without a prompt for each one, you'll hear me whoop.

Anyway, just to say that I'm feeling tired and a little discouraged  tonight and I'll be following this to catch any idea I can, and thanks so much.  Now--on to explore whatever else I can find on here. thanks again.

Lois May 9, 2009 9:19 PM
Mishawaka IN

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