Hello,
I haven't seen anyone else reply, so I thought I'd jump in. I'm an SLP in Ontario, and for preschoolers who are late to talk we use the formal Hanen Program as a first step. It is a structured training program (with handouts and homework) that may satisfy the parents need for 'serious' therapy. I find that parents who complete the full 12 week program take a bit more ownership over their child's progress, as they are the primary 'clinician' so to speak and I am more of a coach. In many cases, that is all the intervention that is needed. Some kids go on to require further intervention for a variety of language and speech issues, but even then parents seem more prepared for the homework portion of treatment.
For some families, if we don't have enough to run a full program, we often do a one on one Hanen, and give the parents the info and handouts in individual sessions. It's not the most efficient way to do it, but sometimes we have no choice. I find if the strategies are written down as goals, with homework attached, parents view it as 'real therapy' and more than just playing. I do also spend a fair bit of time stressing to parents that play IS therapy for kids. Play is children's work, it's how they learn and develop, and many parents don't seem to be aware of that.
There is another Hanen Program called Target Word that is designed for children who are late talkers with no other evident delays in receptive language or cognition, and it teaches parents focused stimulation techniques. I also find that imitation becomes a goal in itself for many of these kiddos who aren't yet doing it,as it's a necessary skill before we can go much further into more direct kinds of therapy activities.
Tina Gute Bowering
To: phonologicaltherapy@yahoogroups.com
Sent: Friday, August 27, 2010 11:14 AM
Subject: [phono-tx] toddlers in therapy
Dear group, I am the SLP in early intervention. I have been writing into the group because I have a large group of late talkers on my caseload now (all boys, except one girl) ranging in age from 21 to 26 months, all with good receptive language and appropriate socialization (no aut. spectrum type issues). They have between 10 to 35 words, but certainly not all words are clear (many approximations). I feel like I have my own little research study going on!
I live in an area of great affluence/educational level, but also some pockets of poverty (immigrants, usually). For some families there is an educational component to therapy that is fairly intuitive to other parents: talk to your child, play with your child, read with your child, and so on. I suggest developing language routines, encouraging imitation, repeating and recasting...all the types of things that the Hanen program recommends and other books that have similar recommendations: matching your child, providing balanced interactions, keeping it playful, affirming your child, and so on. We talk about what words are easy for babies to say, what sounds, what syllable combinations. Also what words are really functional for a young toddler. Using music, daily routines, and so on.
So I do all this and some families are asking me, "you just play with him/her?" "Is that it?" They want something that looks more structured or more "serious.' And, of course, they want results. I read about specific therapy activities members are using in this group with young children: various "programs," and I do not know what they are. Maybe this is because I am in the U.S. and many of the participants are in Australia and Britain. Just in the last groups of emails about ICD (which some of these kiddos do...very interesting, thanks for the discussion) a couple of things were mentioned that I am not familiar with: what is SAILS, Miccio stimulability program and "Word Flips?" Also not sure about the ear training (Van Riper?). I know I must seem like a complete idiot, but it has been a long time since my university days, and my continuing education has been all over the map as I have been a jack of all trades for years and am only just now focusing on the little ones.
As the kids all get closer to their second birthday and beyond, which structured approaches would be more effective with late talkers? And, what kind of parameters should I look for to know that a child is "ready" to do more than just "play?" Right now I can't see any of them repeating or imitating on command (verbally, at least). But I am thinking some 2 and a half year olds would be able to do this. I realize my question is general. I know I am not giving you the specific sound inventories of the individual children. I guess I am looking for a general answer: "most of the time, I find that..."
Thanks again, Kerry Wilson, M.A. CCC-SLP
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