Thursday, May 6, 2010

Parents Can Understand Communication Therapy Goals and Strategies

I am often surprised and dismayed by how little parents know about what their child's Speech Language Pathologist (SLP) is doing. When I do a consultation with a child who has autism, which I do often, most parents are unable to tell me even one communication learning objective on their child's Individual Education Plan or Treatment Plan.  This would not be so bad if parents had a general knowledge of what the current communication goals are for their child.  Usually, they don't. Parents need to understand and support learning in communication or the child will not do as well as he or she could.

I want to own the blame for this as a profession because I know we are not communicating well with parents when we write these documents. We write learning objectives in such a way as to confuse parents utterly. The jargon that we use causes parents to believe that therapists are doing something that is so technical and highly skilled that they must leave the responsibility for teaching their child to communication specialists.  And this is a real tragedy because parents can be much more effective at teaching communication skills than even the most skilled therapist. Parents have more communication time with their child, are more important to their child, and parents are in the right situations with their child to effectively teach new communication skills.  Sometimes, I hear therapists and school professionals reinforce the idea that parents need to leave all teaching to the professionals by saying something like "You need to be your child's parent, not his therapist."  I don't know if this statement ever makes sense but it certainly does not make sense for a parent of a child with autism in regard to communication.  It is normal for parents to teach communication skills to children and the only difference for parents of children with autism is that they need a few tips on how to do it.

Let's look at a few common communication learning objectives that a child with autism might have and see why it is so important for a parent to be involved.

  1. Your child will learn to express basic emotions using words.   During a therapy session, your child might happen to get angry and then the therapist can pull out a Picture Symbol for "mad" and show this to your child and say "You are mad!"  But think about how often you are with your child when he or she gets mad about something.  You have hundreds of opportunities to teach your child the word or picture symbol for mad.  
  2. Your child will talk to others about past events, future events and imagined events. Chances are, your therapist was not there for most of the important past events in your child's life.  Your therapist can and will talk about future and past and imagined events with your child but, again, you will have many more meaningful opportunities to show your child how to talk about the past, the future and the imagined than even the most creative therapist could create.
  3. Your child will learn to use time words like now, later, before, after, tomorrow, yesterday.  If you knew that this skill was what your child's therapist was working on, how many times could you use one of these words in a week?  "Now we will get ready for bed.  Come on upstairs."  "Now, it is time for supper.  Let's eat."  "I can't go to the park with you now, but we will go in one hour."  If you embed "now" into your child's experiences, and your child is developmentally ready to learn this word, your child will be using the word "now" in just a few days. It will take longer for your child's therapist to teach this word.

Parents may need to learn specific teaching skills in order to help a child with autism learn to communicate (See Parent Tips) and an experienced Speech/Language Pathologist can help a parent learn these skills.  It may be hard for a parent to know which communication skill should be taught next and helping to select the next learning objective is also a wonderful role for a Speech/Language Pathologist.  But no one should imagine that communication skills are best taught by an expert because communication skills are best taught in real life experiences with real life communication partners. 

Action Plan:
  1. Read and ask enough questions so you can understand your child's communication learning objectives.
  2. Ask for more detail on what you should teach if written learning plans are too general or don't make sense for home. E.g. Your child will initiate play with peers at least once a day.  This learning objective might become Your child will initiate play with mom or dad at least once a day.
  3. Ask for strategies so that you know how to help your child learn this communication skill. For the above objective, the strategy that you use might be to bring out toys that you and your child often use together in play but then wait for your child to communicate that he or she wants you to play.
  4. Tell your child's therapist when your child has learned this skill and move on to teach the next skill. If your child knows every skill on the IEP or treatment plan, ask for a new planning meeting.
  5. If your child does not seem ready to learn a particular skill, talk to your child's therapist so he or she can help you with another approach or help you choose a different learning objective. It can actually slow down learning if you try for too long to help a child learn a skill that he or she is not ready to learn.
  6. Never try to teach more than three different communication learning objectives at the same time.  It is fine to choose just one, in fact.  It is a lot easier to remember one and work on it often.
  7. If the learning objective is specific enough and you have a good set of strategies for teaching it, you should have the sense that your child is really learning and teaching your child new skills should be a happy experience for both you and your child.  If it is not happy, talk to your child's therapist about how to make learning language more fun for both of you.


michelle hays said...

I love you. This post was JUST what I needed to learn. I will ask my daughter's therapists what the "Learning Objectives" are. So far, I just hear about what she does in a particular therapy session. Its good to know what to ask.

My four year old daughter is in a PPCD unit (and I work in a second unit, right next door- as a paraprofessional). As my daughter's cognitive abilities have blossomed- so have her temper tantrums. She is non verbal. Now, all day long I hear her SCREAM angrily and throw fits right next door. Im sure its cuz they dont understand her and that she feels trapped inside herslef- knowing what she wants or needs, but is unable to communicate.

This part of parenting is hard. Im proud of how much she understands, and heart broken about how frustrated that makes her feel. This summer I will spend entire days with her and work towards a good communication system that will ease her frustration.

Its been hard these past few months. Thanks for people like you, who care to post things like these.

michelle hays said...


Jordan said...

Great article! I totally agree with you. I just posted this to share with others.

S- said...

This is a very practical post. If a speech therapist is new to the concept of involving parents, then their might be some hesitancy...not because they are unwilling, but just because they haven't thought about how and how much to communicate. I know that as a teacher, I have erred both in telling "too much" at once, leaving the parents feeling overwhelmed, and too little, thinking that parent(s) won't have enough time anyway. It can take a little while for everyone to figure out what questions to ask and what to share. But then the progress can be so much smoother!

Niksmom said...

Another wonderful and timely post! As a parent struggling to help my nonverbal son learn to communicate with his AAC device (Vantage Lite), I feel fortunate that i've been homeschooling him, that I have a direct relationship with his SLP (and PT/OT, too). We really work as partners. I am so afraid of how it will be when we decide to put him back in school. This post gives me some good questions to ask when the jargon starts flying and I'm told to "just be his parent." Thanks.

Therapist Directory said...

Nice post! I agree with you.

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