When clients need to take a break from speech-language therapy for family trips, schedule changes or other reasons, they or their parents are concerned about the effect of missing several therapy sessions. Depending upon the timing of the absences, missed therapy sessions are not always detrimental to the process. In fact, there are situations in which taking a break from therapy can be beneficial. If the client has attended intensive speech-language therapy sessions over a period of time and adhered to a home practice schedule, a break can provide an opportunity for the client to internalize all that he or she has learned. After a break, the client can resume therapy sessions with renewed motivation and commitment. Learning is an ongoing process; intermittent breaks from direct therapy allow for time to internalize and generalize newly learned skills in familiar and new settings. In fact, newly acquired speech-language skills should be practiced in as many varied settings with as many different people as possible in order for the skills to carryover to functional real-world contexts and become automatic. Taking a break from the therapeutic process can be very productive for many clients – a time for rest and renewal.
For some children, back-to-school signals back to frustration with writing. Difficulties with speech, language and reading are often inextricably linked to struggles with writing. Writing places so many different demands on the cognitive system that it is no wonder our children with speech-language disorders have particular difficulty with writing. Some have trouble formulating letters and therefore, their writing speed is greatly reduced, whereas others have difficulty getting started with writing due to problems formulating coherent sentences. Short-term memory deficits are often to blame for poor writing outcomes. It is important to begin remedial writing instruction with an assessment of the child’s current writing skills. Reviewing a child’s portfolio of written work that includes drafts of classroom work and homework assignments can be very helpful in determining their current writing status. Understanding a child’s narrative skills – spoken and written- is helpful when setting goals for improvement. When I work with children on writing, we always begin by talking and telling stories. Once their oral narrative skills improve, writing becomes much easier and definitely more enjoyable.
As a speech-language pathologist in private practice, I am often asked the question, “What apps or computer programs will help my child?”. My first impulse is always to say that while the child is going through an intensive period of speech-language therapy, the use of any type of screen media should be decreased as much as possible. After all, we are working on communication skills – speaking, listening, reading and writing. The apps or programs I recommend should be used only as supports to reinforce a skill, reward work or practice, or assist with drill and repetition exercises, sometimes helpful for articulation therapy. In some cases, when children have severe communication impairments, the new technological devices available are the best and most efficacious avenue to communication. For most of the children that I see in therapy with mild-moderate disorders, the Smarty Ears apps are excellent for reinforcing a wide range of communication skills. Additionally, voice record apps provide an easy way for a child to get audio feedback for their speech skills. Timer apps are useful for kids who need to set timers in order work within time limits on speech tasks or on homework assignments. Facetime and Skype can be used for practicing speech skills with grandparents or other supportive persons in the child’s life. Two of my favorite apps are Speech Tutor and Speech Prompt – both provide excellent visual and audio feedback for children working on articulation and phonological skills. You can watch demonstrations of most apps on YouTube before making a decision about whether to purchase them. When chosen well and used appropriately, technology can be another excellent way to enhance communication skills.
Learning to acquire a new skill requires good training, regular practice, a positive attitude and encouragement. Applying the new skill and using it in the real world under pressure is especially challenging. Whether it’s something that you use everyday or once in a lifetime, applying your skill outside the ‘classroom’ is often the most difficult step. For example, learning a new language and then using it to navigate in a foreign city, practicing parallel parking for the first time in a tight curbside spot or practicing a new piece of music and then, performing it in front of an audience from memory – using our skills when it counts is challenging. Speech-language pathologists are especially skilled at diagnosing a myriad of communication problems and recommending appropriate treatment programs. Most are very competent at teaching new skills such as how to overcome a lisp or a stutter, how to take turns in conversation or how to regain the ability to swallow after a stroke. However, many speech-pathologists would concur that helping their patients and clients use their new skills outside of treatment rooms and therapy sessions is the hard part. Carryover of skills to the real world outside the guidance of an encouraging speech pathologist can take time and varies greatly from person to person. Caregivers, parents, teachers and friends can be especially helpful at the carryover phase of therapy and in many cases, play a crucial role in helping promote use of newly acquired or re-learned communication skills to the real world. So if you are working to test out your new speech-language knowledge or skills or know someone who is, remember to keep practicing and keep trying – eventually your skills will become automatic!