Speech therapy - 3 Sept 09

There were 3 objectives that the therapist was aiming for in the session.

1. To pace himself & ensure he gives equal emphasis on each syllable spoken.

Reason: he either skips a syllable or says some syllable very softly compared to the other syllables in the same word or phrase.

Method: She did this by placing a strip of 4 coloured squares in front of him & having him repeat after her, phrases that contained 4 syllables (e.g. my elephant) and pointing to each square for each syllable spoken. If he succesfully does it, he gets to play with the "pound-a-ball" toy.

Outcome: He participated for the first few words then created diversions by reading the letters printed on the toy, by naming the colours of the balls, by naming the animals on the pictures framed on the wall etc.

I thought the objective was about pacing (as what he did in previous session), so I brought out his phonic alphabet puzzle to get back his attention. I placed 4 random alphabets in front of him & had him point & say the name of the letter. He happily did this because he's just so interested in naming the alphabets nowadays. It's something he does very well & he knows it.

However, I later learned that this was not a good way because there isn't continuity between the letters, unlike the way you do stringing syllables to form a multi-syllable word.

I noticed that he uses the diversion tactic nowadays when he doesnt want to participate, either due to him perceiving it to be difficult or fear of failure or boredom or perhaps his way of coping with stress.

It reminds me of the early days of speech therapy last year when he could not say a single word. To coax him to merely produce the 'm' sound was very challenging. But the challenge now is different. The challenge now is to get him to participate, because now that he's older, he's exerting his independence more, which is a normal part of growing up.


2. To bring out the 'k' sound, by practising words with 'k' in the middle.

Reason: he could produce the 'k' sound if it was at the end of the word e.g. duck, but not if it's at the beginning of the word (e.g. cat). I'll elaborate on this towards the end of the blog.

How: She did this by showing picture cards of words with a 'k' sound in the middle. E.g. peacock, racket.

Outcome: He could do a few words but needed a lot of modelling & encouragement to say it louder. I think the loudness will come when he's more confident. But the therapist also has a point in that if he speaks so softly, he wont be able to hear that he mispronounced it & thus can't correct himself.


3. To practice speaking in sentences.

Reason: he's still speaking in very short phrases. Most of the time its 2-3 word phrases although I noted there is slowly increased frequency in saying 5 word phrases.

How: She placed several stickers on the table & brought out a paper cup. The idea was for my son to ask for the stickers he wants/state what he wants & he'd then get to stick it on the cup. E.g. he's supposed to say "Mama, I want the fish sticker please".

Outcome: I had to create the interest, to get him to participate. He did say the sentences after I modelled it for him. Noted he had difficulty with peeling off some of the stickers, which is expected due to his fine motor impairment.


My homework

To achieve objective 1 & 2. Objective 3 has been an ongoing which I build into his daily living activities. I still struggle with Objective 1, which was carried forward from the previous session. Objective 2 is new & struggled to think of activities to achieve that. But after lots of thought, prayer & a night's sleep, I've come up with some ideas. Will write about those in a another posting.