Hand to Hold's Official Blog: Written by Parents for Parents

Speech Therapy at Home

Bryce with his Poppa

Bryce & Poppa – that’s “P-aahh P-aahh”

I recently had to come to terms with the fact that my 24-week preemie will no longer be able to continue with the same therapy regimen he’s followed for the last three years, since coming home from a five-month NICU stint.

We’ve relied heavily on therapy, from Early Childhood Intervention before Bryce turned three, as well as a variety of private providers.  He’s received physical therapy, speech language pathology, occupational therapy for fine motor skills as well as feeding issues, hippotherapy and developmental intervention.  But a change in insurance coverage means that Bryce will go from getting about four therapy visits a week to as many per quarter.

I’ve done a great deal of worrying, soul searching and praying about how we should handle this massive strategy change.  In the end, I’ve had to come to terms with the fact that there is only so much I can do.  And in the words of Bryce’s orthopedist, perhaps a little therapy break is just what he needs. Let’s hope.  While I still have plans that I hope will eventually result in a continuation of therapy, for now a break is just what he is getting.

Kind of.

Our therapists were all kind enough to take the time to go over their strategies with me and help me outline a home program that I think I can manage.  In my vast experience with therapists, I’ve found that they are care givers and will gladly give however they can.  Whether that means showing you for a fifth time how to do that one exercise or sitting down and mapping out a plan for going on without them.

Since I also have a new baby it was important that whatever we planned for our home program it be something that I could work into our daily routine. But even without another baby to tend to, I value this in any at home therapy program.

And so here are my top three tips for working on speech therapy with a non-verbal toddler, adapted from suggestions for a home program by Bryce’s speech language pathologist, Holly Cardiff, MS, CCC-SLP of SMCW Pediatric Rehab in Cedar Park, Texas:

  1. Model.  I’ve learned that children learn to speak by listening and watching how we speak.  So I model language by being sure Bryce is looking at my lips when I say a word we’re working on or that I think he can imitate.  And then I repeat the word slowly, several times with as much simplicity as possible.  For example, we call my dad “Poppa,” so when we go see Poppa, call Poppa or talk about Poppa we make a point to stop and show Bryce our lips as we say “Pa-Pa” with emphasis on the “p” sound.  We are able to easily work on several words throughout the day without taking any real time away from anything else.
  2. Praise.  And what could be more valuable then celebrating a word, sound or even attempt?  Nothing in my mind!  If Bryce says “Poppa” that is amazing and have no doubt that I will embarrass myself praising him.  But even if Bryce just makes a near “p” sound I’m sure to let him know how pleased I am.  It’s my mom-pinion (i.e. not scientific, I’m not a doctor or a therapist – just a mom) that praise is what motivates.  I clap for, cheer on, smile at and encourage sound every minute of every day.
  3. Require Language.  It can’t all be easy though.  And that’s where requiring language comes in.  Once Bryce began to say, or attempt to say, “up” I had to begin requiring that same attempt every time he wanted up.  As you can imagine with a little one who doesn’t yet walk independently – that is many, many times throughout a typical day.  But I try to slow down, take a moment to encourage that sound and see each of those attempts as another step towards language for Bryce.  Slowly over time I hope that the “p” sound will turn to a consistent verbalization of “up” and that “b” sounds will evolve into “ball” and eventually we will have required a full vocabulary from Bryce.

Good luck!

Katrina Moline About Katrina Moline

Katrina A. Moline (TX) is a special needs mom to her micropreemie, Bryce. He was born at 24 weeks at home, where she and her husband gave him CPR until medical responders arrived. He spent 150 days in the NICU at Dell Children's in Austin, TX. Bryce has hydrocephalus with a VP shunt, is legally blind with glasses, has mild cerebral palsy and severe, global developmental delays. In July of 2012 she gave birth to her second child only one day shy of 37 weeks and with no complications. She posts regularly on her personal blog about life with a micropreemie, her struggles, accomplishments and family.

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