Why Should I Spend the Money on Private Practice?

As a parent of a child with a speech or language delay, you probably have a lot of questions about what to do and where to go to receive help.  Here are some reasons why the parents who come to Speaking of Kids are especially pleased with their choice of private practice.
1.  The child is getting one-on-one attention once or twice a week.
Many times, especially for younger children, a school district will qualify a child for services, but only for 30 or 60 minutes a month.  In other cases, they are unable to serve a child because their needs aren't severe enough to meet their criteria.  Still, in other cases, the child is getting services 30 minutes a week, but they are being seen in a group of 3 or even more students, so the time spent in the SLP's room is not always super effective.  Please know, I'm not in any way trying to bash schools.  They have to set guidelines and procedures to help them accommodate such a wide variety of needs. Many speech therapists have anywhere from 70-100 kids on their caseload!!!  And I know MANY great things are done in schools to help students.  There are many amazing SLP's out there who make such a huge difference in the lives of the kids they serve. Frankly, I don't know how they do it sometimes!  But for the reasons listed above, some parents think private practice is an excellent supplement or replacement to the services in the school setting.  I always say - more is usually better!  And I am happy to collaborate with the student's speech therapist from the school so we can work on the same goals together.
2. They are "in the know". 
One of the main reasons why I have tried to hard to serve children in a private practice setting is because of my strong belief that parents need to be empowered and educated.  In a school setting it is much more difficult - almost impossible - to keep parents fully informed of their child's status and progress.  I love taking time to sit down with parents and explain their child's strengths and weaknesses, and brainstorm together ways we can help the child improve.
3.  They receive materials and support to continue the child's learning at home.
This goes along with number two, but in addition to receiving added information, I try to give parents ideas, materials, and resources so that they can continue helping their child fortify the skills they learn each week.  30 minutes/week isn't going to help a child progress as quickly as if a child also practices those skills at home with a parent who is confident enough to encourage and reinforce the progress.
4.  The child maintains progress because there are no breaks.
For some students, this isn't an issue.  But for many students out there, Christmas break, Spring break, and especially Summer break are times when a child completely forgets much of what they have learned and have to back up significantly to regain that previously-known knowledge.  In private practice, we don't take breaks.  Many parents find that private practice during the Summer only is a great addition to the services the child will receive in the school when it starts back up again.
5.  Parents are highly involved.
Depending on the child's needs and the family situation, I try to encourage the parents to be involved in the therapy, or at least to sit back and observe.  I often hand out notebooks to the parents so they can write down what we worked on that day, what strategies I give them on how to incorporate concepts at home, websites or other resources they can go to, or any questions they might have.  Then at the end of the session, I review what we did, how the child did, and answer any other questions they might have.

So there are some of the reasons why many parents find private speech therapy to be an excellent option for their children.  If you know anybody thinking about this possibility, please feel free to share this link!  If you live in northern Utah and would like to contact me about speech therapy, please see my personal website at speakingofkids.org.

Auditory Verbal Therapy: Part 10

Auditory Verbal Therapy: Part X

Principle X

Promote education in regular classrooms with typical hearing peers and with appropriate support services from early childhood onwards.

We're talking mainstreaming.  Children who are born deaf can definitely be placed in a regular classroom with hearing peers.  This is happening more and more often.  Parents and professionals should plan and prepare for this if they think it is a good fit for the child.  Many children who are born deaf are also born with other challenges such as Down syndrome or cerebral palsy and may require a specialized setting.  Work as a team to figure out what is reasonable.  Teamwork will be necessary.  The team should consist of: the parent, speech therapist, audiologist, classroom teacher, principle, resource teacher, and AV therapist.  Am I missing anybody?

Auditory Verbal Therapy: Part 8

Auditory Verbal Therapy: Part VIII

Principle VIII

Guide and coach parents to help their child self-monitor spoken language through listening.

Parents are encouraged to imitate any noises the child makes.  This can be a very fun game for mom and baby, and it helps develop the auditory feedback loop.  The child needs to have the skills of listening to what other people say, and repeat it.  This then transfers into the child being able to listen to their own speech and modify it.  This strength is crucial to developing proper speech and language skills.  All this from saying, "Goo goo" and "ba ba ba" and "mee mee mee"?  You betcha!

Auditory Verbal Therapy: Part 7

Auditory Verbal Therapy: Part VII

Principle VII

Guide and coach parents to use natural developmental patterns of audition, speech, language, cognition, and communication.

I think the key word here is expectations.  Parents need to understand that children follow a developmental sequence with regards to language, cognition, and speech.  The child needs to continue on that developmental path.  We can't skip steps.  We can certainly move through them more quickly, and we hope to catch them up to their peers, but there are no shortcuts.

 Another key concept is hearing age.  We have to take into account how long the child has been hearing.  AN important thing to understand is that listening and speech develop together - not separately.  This article is my favorite reference for further discussion on these important concepts.

Auditory Verbal Therapy: Part 6

Auditory Verbal Therapy: Part VI

Principle VI

Guide and coach parents to help their child integrate listening and spoken language into all aspects of the child's life.

Children born with hearing loss, especially if it is amplified late, are not natural listeners.  It needs to become a habit.  And habits can be taught!  Parents need to learn how to take advantage of everyday listening moments and capitalize on them.  For example, the mom and baby are playing with blocks and the doorbell rings. She could just get up and go answer the door, but she would be missing out on a great learning opportunity.  Mom should sit up straight and announce, "I heard something!" and point to her ear.  She is teaching the child to notice sounds as they occur around her.  She is also teaching her that sounds go through the ear/hearing aid/implant thus teaching the child the importance of the device that they wear and its connection with noises. 

Auditory Verbal Therapy: Part 5

Auditory Verbal Therapy: Part V

Principle V

Guide and coach parents to create environments that support listening for the acquisition of spoken language throughout the child's daily activities.

Dishwashers are loud.  So are air conditioners and fans and fish tanks and lights and washing machines.  A house can be a loud and distracting place, especially for a child with a hearing loss.  They need to hear conversations happening around them in order to learn language, and background noise makes that so much more difficult.  Therefore a big part of AV therapy is educating parents to be more aware of the noises that surround them and convince them how important it is to reduce it as much as possible.  Run the dishwasher at night.  Same with the dryer and washer.  If your lights hum (like the ones in my kitchen - so obnoxious) then just leave them off.  Classrooms are a totally different story but most teachers are open to trying whatever they can to help the classroom be a quieter place.  After all, it improves learning for all children, not just the ones with hearing loss (Nelson, Soli 2000).

Auditory Verbal Therapy: Part 4

Auditory Verbal Therapy: Part IV

Principle IV

Guide and coach parents to become the primary facilitators of their child's listening and spoken language development through active, consistent participation in individualized Auditory-Verbal therapy.

Auditory Verbal Therapy is a big commitment for the whole family.  Most therapists I know have a serious discussion with the parents before they start therapy in order to make sure that they know it will require lots of time and effort. Still, most parents I've met are happy to be involved and learn more.  They feel validated to know that lots of the things they are doing at home already (reading books, singing songs, telling stories) are providing necessary foundations for their child's learning.  They just need to be taught some strategies and skills to use along with those activities that can help strengthen specific skills such as: listening, articulation, auditory memory, sequencing, categorizing, and many more.

Auditory Verbal Therapy: Part 3

Auditory Verbal Therapy: Part III

Principle III

Guide and coach parents to help their child use hearing as the primary sensory modality in developing spoken language without the use of sign language or emphasis on lipreading.

This might be a therapist or a mom, but whoever it is they are doing it right!  She knows to talk next to but not in front of the child.  She is optimizing listening and inhibiting visual cues.

Guiding, coaching and teaching parents is a big deal.  In fact, my experience with AVT has really helped me realize the power of empowering parents in any type of therapy. Who knows the child the best?  Who spends the most time with them?  Who wants what is best for them?  Who has hopes and dreams for this child?  The PARENTS.  Therefore they are the center of AVT.  When the parents feel knowledgeable and confident, the child's is more successful and the parents no longer feel like helpless bystanders.  The importance of this is reflected in the fact that principles 4-8 also revolve around coaching the parents.