Speech Delay: Post-Diagnosis

After Bradley's first ARD (at age 3) he began receiving speech therapy from Mr. Clint. I had heard wonderful things about Clint and was excited to begin to see, to actually see (and hear) progress in Bradley's speech.  Bradley met with Clint 1-2 times a week from March through May, but when the school year ended for summer break, Bradley's services were "suspended" (for lack of better terms) because he was making progress and not regressing.  As a college instructor, I totally understand how awesome, amazing, and crucial summer break is for educators and school officials.  On the other hand, we were making progress and I was afraid it would end.  After all, it took Bradley a few weeks to warm up to Clint and I didn't want to have to rebuild  rapport in September when services resumed.

I expressed my concerns with Clint and he shared lots of ideas with me that gave me hope about what I could do for Bradley's speech, as his parent.  Here are some things that Clint suggested I try, that really did help Bradley.  I have to be honest, I hoped for results a lot sooner than I actually noticed improvement, but I stuck with our plan and in (God's) time, Bradley's speech has noticeably improved and is approaching near 100% intelligibility.  Parents- hang in there. I wasn't sure about what progress we'd see in Bradley, but we didn't give up and I don't want you to give up either.  Talk to your child's speech therapist about these intervention ideas:

Practical Speech Therapy Treatment Techniques
1. Model speech for your child in first person. At age 3 Bradley would express needs and desires in one word requests.  Sometimes the word was not clear to strangers, but as parents we knew what Bradley wanted. Here's an example: "whaahhher" was once "water." When Bradley would request water we would model what he should be saying/asking, "Mom, I want a drink of water please." You want to model language in first person, as if you are speaking what your child should be speaking.  We modeled speech for any and every other desire and need Bradley expressed.  When Bradley would get excited about something, like a train on the train tracks we passed while traveling down the road, we would model what we anticipated Bradley would want to say.  "Wow! Look at that train! That's a diesel train."  For months and months and months and months we narrated and commented and modeled and talked and talked and talked the way we wanted to hear Bradley communicate with us.  I had parents in my junior college class with older children with high functioning autism tell me that they did this for their children and that it really did work for them.  You would think that I'd be able to pin point the exact day I finally got the full sentence request from Bradley, but the truth is that Bradley's speech slowly progressed and there was gradual improvement that eventually led to Bradley being able to effectively communicate those needs clearly, meaningfully, and politely.  Now when I ask Bradley what he would like to drink with his meal I clearly hear, "I want a drink of water please" without any modeling from us.

2. Encourage speech through limited options.  We all like choices. We enjoy things even more when we feel like we are in control of the decisions being made.  We like rewards.  Presenting limited options does all of these things as well as encourages speech.  Here's an example, "Bradley- what would you like for breakfast: waffles or pancakes?"  It is important to wait and pause for the child to respond.  If they do not respond you can present the question again.  In the beginning of speech therapy, a communication book may be helpful to offer a visual cue for the choices presented.  *Check out my previous post about the communication book I created for Bradley.  It's important to make this fun for the child while still providing limits and boundaries. Obviously we don't want to give our children french fries for breakfast just because they verbalize that desire.  However, we want to be sure to use an upbeat tone and offer verbal and non-verbal praise when our child responds in a desirable way. Once Bradley responded I would articulate his answer back and cheerfully talk about it with verbal praise. "Pancakes. I want pancakes please mom. Yes sir Bradley. You did a great job asking for pancakes so let's make some pancakes for you." Yes- you start to feel a little silly (or even crazy) answering your own questions, but this really can help.

3. Borrow speech therapy material from your child's therapist.  Mr. Clint was kind enough to loan me decks of speech articulation cards to work on at home.  Bradley wasn't always willing to practice the cards or worksheets, but with adequate reinforcement ("Bradley- do you want to watch television? Then we need to work on these flashcards and do a good job first.")  we were more successful.

4. Encourage and model appropriate non-verbal, expressive communication.  One of the most common social/communication challenges seen in individuals with Autism Spectrum Disorders is poor eye contact.  At age 3 Bradley was making very little eye contact with non-familiar people and inconsistent eye contact with me.  I made it my mission that summer to really work on Bradley's non-verbal communication, specifically his eye contact.  When we would interact I would kindly, verbally request for Bradley to look at me when he spoke to me ("Bradley. Bradley- look at Mommy's eyes please.").  Sometimes I would gently tilt Brad's head up so that his eyes would meet my eyes.  This needs to be done with finesse, because many ASD children have anxiety and poor eye contact might be a coping mechanism.  Another intervention technique to try is encouraging your child to play with other children. I know this may not sound like treatment, but many ASD kids need encouragement to play with children and really engage their peers during playtime.  I set up play dates with my friends who had children close in Bradley's age.  When none of my friends were available for a play date, I took Bradley to public places that were popular for kids his age to try to get him to interact with new children.  By the end of the summer I noticed significant improvement in Bradley's eye contact and interaction with others.

Some of his favorite places include local parks, the Stomping Grounds, and Jumpin Jacks. Check out their websites:
Stomping Grounds: http://stompinggroundsplayland.com/
Jumpin Jacks: http://www.jumpinjacks.org/jumpin_jacks_web_site_001.htm

          

Bradley at age 3 years 3 months at a local park             

5. There's an app for that.  Yes- there are speech therapy apps for your smart phone or tablet.  If your child is tech savvy like Bradley is, they probably swipe your smart phone or tablet every chance they get.  Bradley is now better at Angry Birds than I ever could be.  With fun apps available, speech therapy apps may not seem so cool.  However, we make it a point to do our speech therapy work first and then reward with a train game or another approved activity.

My favorite Speech app is called Articulation Station. We have used it for almost two years now and Bradley really has fun with the flashcards. He calls it "the honey bee game," because a honey bee is the main picture of the app.  The downside to the app is that you have to "purchase" additional sounds, but I think the purchases are worth it. You truly get what you pay for and the free speech therapy apps on iTunes are not as good as this app.  For more information about what the app offers check out:
Articulation Station:  https://itunes.apple.com/us/app/articulation-station/id467415882?mt=8

We also like the "See Touch Learn" app.  It too requires in-app purchases to expand the pool of words, but I think it too is worth the cost.  One word of caution- Bradley is a bit sensory sensitive and in the past he would be anxious about getting an incorrect answer because the app will produce a buzzer sound for incorrect answers.  The buzzer is not terribly loud, but for whatever reason Bradley does not like it.  Still to this day, he is a little anxious about the buzzer, but it actually offers another great teaching opportunity. We work on the speech and comprehension aspect of this app, along with auditory desensitization.
See Touch Learn: https://itunes.apple.com/us/app/see.touch.learn./id406826506?mt=8

Parents Flash Cards is an app that includes learning lessons and quizzes.  It offers verbal and visual positive feedback periodically throughout the lesson and quiz.
Parents Flash Cards: https://itunes.apple.com/us/app/flash-cards-by-parents-magazine/id390789905?mt=8

Fun & Educational Apps we enjoy
Railroad Lite (Bradley likes the Sing Along version of this app): https://itunes.apple.com/us/app/working-on-railroad-train/id431192905?mt=8
Wheels on the Bus: https://itunes.apple.com/us/app/wheels-on-bus-all-in-one-educational/id543545550?mt=8
Amazing Breaker is good for hand eye coordination: https://itunes.apple.com/us/app/amazing-breaker/id421088863?mt=8
Talking Tom: https://play.google.com/store/apps/details?id=com.outfit7.talkingtom&hl=en