This is a common question that most parents ask when preparing to start their child in speech, language and/or feeding therapy. And my answer is always the same, “it depends on various factors.”
As a parent, this seemingly ambiguous response is frustrating! I get that. But please understand this is the hardest question for us to answer.
We understand that we are asking you to make a financial and time commitment. And we recognize that it’s a lot to ask without being able to give you a definitive answer as to how long we may need to work with your child.
That said, I would warn you against working with a professional that prescribes a specific amount of time for providing speech, language or feeding therapy without getting to know your child first. They may give you examples of how long they’ve worked with other children with similar goals, but they should never prescribe a certain number of months for your child until they have enough information based on various factors.
Here is the list of factors that play into how long your child may need speech therapy.
- Every child is different. First, it is important to realize children respond to therapy differently. Second, two children with the same diagnosis will rarely have the same treatment plan. As such, we tailor your child’s therapy to them.
- No two goals are the same. On paper the way a therapist may write a goal may look similar to another child’s goal (e.g., if they are both working on similar things), but the way we treat that goal will differ based on your child’s needs. Goals also vary based on the type of therapy being prescribed (feeding, speech, language), the number of goals, and the severity of your child’s delay or disorder
- Rapport and relationship with therapist. How your child responds (and how quickly) to a therapist is important. A child is not going to begin making progress until they have adapted to working with the therapist that is helping them to achieve their goals. Often times rapport is established day one, but for some children it may take an extra session or two.
- Carryover at school and home. This is a big one! The more you practice at home (if even just 5 minutes a day) the faster your child will master their goals and the quicker they will be dismissed from therapy.
- Behavior. Behavior is a means of communication. That said, behaviors can interfere with time spent in therapy sessions working toward goals. In turn this can delay progress toward goal mastery. If behaviors arise, they should be addressed accordingly.
- A dynamic and ever changing process. One session your child may make HUGE leaps in progress, while in other sessions they may slide backwards a bit. This is to be expected and is part of the successful process of learning and acquiring a new skill.
At Little Sprout Speech, we are data driven and use research-based practices in treating your child. We provide you with updates following each session so you can see exactly what your child worked on, how they performed and what they need to work on next. This is our way of staying accountable to you while helping to look at exactly how your child performed the prior week and strategically pushing your child to the next level in every single session.
Please understand this is not the “norm” in all private practices. We offer this service as we feel it helps us maintain the highest standards of performance while showing you we are serious about dismissing your child from therapy as soon as we feel they are ready.
This is why there are no pre-paid sessions or contracts asking you to commit to a specific number of sessions in our practice. When we feel like your child is moving toward dismissal this is a conversation we will have with you. The details are laid out so you know what to expect and we can make sure upon dismissal your child is truly ready to move forward without us!
If you have any questions or concerns regarding your child’s specific therapeutic needs, please contact us here.
Hallie & The Little Sprout Speech Team
Have you been hanging out with us over on facebook? If not, you are missing out! Join us!
One of our big focus points this month has been how to help your child succeed during their school day. One of the most important things that often gets overlooked is the importance of eating lunch! Why is it so important? Food is fuel! If your tank is on empty you are going to be hungry, cranky, angry (hangry?), more irritable and you lose your ability to focus.
Now think about your child. Do they eat lunch every day at school or is something preventing them from eating their lunch? You may send a lunch or lunch money for them to buy a lunch but they may just be sitting there trying to hold it together, unable to focus on eating their food.
Lunch rooms can be loud and the smells can be overbearing for some kiddos. This is true especially if your child has sensory processing disorder (SPD).
So what do you do? This is exactly what we spoke about here:
“No child should eat lunch alone”
And as a follow up, since the first video was so popular and sparked SO many questions, I did another free video answering questions and chatting MORE about helping your child succeed in school (especially during lunch hour)!
Check out part 2 here:
“When your child with autism wants to eat alone at school”
And here is that video I referenced in my Facebook Live: He Just Sued The School System
I hope you are having a GREAT day and your kiddo is having an even BETTER school year!! Sending lots of love and happy lunches your way!
April is National Autism Awareness month. There are many organizations out there that raise funds and spread the message of awareness, but one of my favorites is the Autism Society, who also promotes autism acceptance, inclusion and more. Since 1965, the Autism Society has made it their mission to “make it a better world” for all people living with Autism. The set out to improve the quality of life of those living with autism and I believe that while we have a ways to go they certainly have begun to pave the way.
There are tens of thousands of people (children and adults) diagnosed with autism every year. Currently about 1 percent of the world population has autism with 1 in 68 having autism in the United States (CDC, 2014). This means that more than 3.5 million Americans live with autism.
That said, there are still many people who do not know WHAT autism really is. As such I feel it is important to continue to educate the public. So here is a quick breakdown on what Autism is, according to the American Speech-Language and Hearing Association (ASHA):
- Autism or autism spectrum disorder (ASD) is a developmental disability.
- Children with ASD, have social, communication and language problems.
- They also have restricted and repetitive patterns of behavior, interests, or activities, such as flipping objects, echolalia, or excessive smelling or touching of objects.
- Autism may be mild or severe.
- If you know one child with autism, you know ONE child with autism. In other words, no two children with autism are the same or have the exact same struggles.
As a pediatric speech-language pathologist that specializes in working with families and children living with autism, it is important to understand and discuss the various characteristics or challenges that come into play when a child receives an autism diagnosis. Some of the most common challenges, people with autism face, include:
- Social skills: while some children shy away from interacting with others and prefer to play alone, many would like to play with their peers but simply do not how to go about the interaction
- Empathy: children with autism find it hard to show empathy to others (remember these characteristics are not true to ALL children with autism as some a very empathetic beings), but can be taught to understand and empathize with others feelings
- Physical contact: some children or people with autism do not like to be touched
- Speech: some children may present with echolalia where they repeat heard words/phrases/sentences without meaning or an intent to communicate through those verbal repetitions. Others may be nonverbal or severely delayed in their speech development.
- Sudden changes to environment; some people with autism have a hard time handling sudden changes to the environment like loud noises, changes in lighting and/or smells.
- Changes to routine & behavior: while many children thrive when there is a routine in place, children with autism can become very dependent on it. When a change in the routine or schedule occurs this can often lead to undesirable or challenging behaviors. An unexpected change in routine is very unsettling to a child with autism.
Please share this article to help others understand autism better. It is my goal to educate and create acceptance for people with autism, while encouraging people with autism to be themselves!
Note: This post first appeared on thedcladies.com on April 11, 2016.
Autism and behavior after school
Posted by Hallie Bulkin on Wednesday, March 30, 2016
The reality is that for toddlers biting is a stage many go through. It is one of many ways they communicate when they don’t yet have the words to express themselves. Unfortunately, it can hurt, break skin, leave teeth marks and/or a serious bruise. And of course if the biting is not caught and dealt with early on it can continue. That said, it makes sense as to why both younger and older children with speech and language delays/disorders sometimes become biters, hitters and/or hair pullers. They also sometimes become the victims of biting when they are unable to express their wants, needs and desires.
As a parent it is downright frustrating to be on either side of the situation. When your child is on the receiving end of the biting, you naturally want to fly off the handle and make sure that the biter is being dealt with appropriately. Give the child and their parents the benefit of the doubt. Try to remember that your child may at some point become the biter, rather than the bitee, and you want to be given a fair chance to handle this appropriately.
So what do we do when our child is bit by another child or bites another child at school?
- Remember this is a form of communication.
- Check with the school to see if they have a policy in place for biting and ask them to implement it.
- Understand that it is NOT the parents fault (or your fault if you are the parent of the biter) that the child is biting. After all, it is a form of communication.
- Remember not to go off on the teacher/daycare worker. Chances are it happened so fast it was not seen by the teacher since they didn’t know it was coming. Once the teacher knows they can keep a closer eye on the biter.
- Avoid putting blame on the daycare or school staff until it’s a recurring issue and no one appears to be doing anything about it!
- Observe the child in play to determine why they are biting (and stop them before they can bite) but look for the trigger. Once you know the trigger (e.g., the other child grabbing a toy out of your child’s hand or vice versa) you can deal with it more effectively. If grabbing toys or sharing toys in general is the issue, use these tools: http://littlesproutspeech.com/store/mini-stories-make-keep-friends/
- Work on teaching the child alternative responses. For example, if verbal or able to sign you can teach them phrases like “mine” or “my turn” to help them advocate for themselves.
- If the behaviors continue despite everything else, use these tools: http://littlesproutspeech.com/store/picture-guides-for-better-behavior-series-1/
So we mentioned to check with the school on their policy. But what is a fair policy for dealing with a biter?
Some schools have a 3 strikes and your out policy. Read your paperwork before signing and sending your kid to a program. If you KNOW this is something they struggle with (even if it is a result of limited communication skills as a result of autism), this is an important thing to know up front! It may help you choose your school site based on the behavioral policies they have in place so look for those!
Most schools and daycares will have a fair policy in place. For example, at one school I go into the biting was handled within the classroom. If it was a first time offense, the parents were not contacted during the school day and the teachers worked to prevent it from happening again. The parents were informed at pick up but no incident report was written and no parents were called at the time of the incident. After the first offense, the teachers observed the child and watched to see if they could pick up on what triggered the biting behavior in the first place. For this kiddo in particular, it was his reaction to a friend grabbing a toy out of his hand. The child didn’t have the language yet to say “NO, that’s mine” so instead they bit. This is common.
For kids that are old enough and repeat biters, the school may ask the parents to come up with a discipline plan for both home and school and share it with the teachers/school to make sure everyone was comfortable with said plan. Then if it continued to happen again, they would call a meeting for the school and parents to meet to see if everyone was on the same page. If they were, great, they made some tweaks to the plan as needed and pushed forward. Sometimes, however, if the school and parents were not on the same page, the school may ask a family to leave (e.g., I saw this in one particular case where it was clear the parents were not doing their part to implement the plan at home and it was a very one sided effort from the school team).
Just remember that if it is your child that is on the receiving end of the biting, the other parents are feeling embarrassed, mortified, upset, frustrated and possibly even more distraught over the situation than you do as the parent of the kiddo who got bit!
Remember these tips and you and the school team will be able to help your child work through their behaviors.
To bite-free children!