Most speech-language pathologists agree that increasing family participation in treatment increases children’s success in communication. The tricky part is how. Obviously, the same approach may not work with every family, but I find two strategies—both backed by research—consistently succeed in increasing family participation.
For those of us working with young clients, we know our intervention work best when parents participate and actively helping a child reach his goals. My colleagues and I find these approaches so effective they also result in fewer cancelations or missed appointments.
Give the why.
When we share with families why we suggest changes in how they interact with their child, parents more likely will use these strategies because they know why they work.
A study of Mexican immigrant mothers’ perceptions of their children’s intervention found most participants felt SLPs just played with their children. By helping mothers—and all caregivers—recognize the importance of play in development, they more likely will see play as a way to incorporate new language strategies. Additionally, teaching how individual cognitive skills contribute to language development—such as understanding objects still exist even out of sight—encourages families to work on those cognitive skills in play.
For example, here’s how I explain to parents why rolling a ball helps their child develop language skills: “As people talk like you and I are, we take turns. I talk and then you talk and so on. Practicing this turn-taking with something fun for kids like rolling a ball back-and-forth helps them learn a basic conversational skill.
Use routines and objects from the child’s home.
Research and experience make two things clear:
- Incorporating treatment strategies into the routines of each family mean they can easily fit practice into them and the child is already familiar with this routine.
- Using toys and household items from the child’s environment are also found to be effective for increasing family participation in the use of intervention strategies.
Home-based service providers often bring in a bag filled with excellent intervention tools and toys. They then pack up the toys and leave with the expectation for families to carry through with suggested activities. Robin McWilliam found families often attribute their children’s progress to people outside of the family (and maybe their toys) rather than to regular interactions within the family. Many early childhood intervention programs are already encouraging therapists to make use of what is in each family’s home.
To accomplish this, I identify the most common routines and then find out when the family struggles most with communication. Then, I make the child’s goals fit into the family’s routine.
Some common routines goal examples:
- Greetings/Saludos—Greeting family members and making eye contact.
- Mealtime/La Hora de Comer—Requesting, utterance expansion by adding the word “more,” plus naming objects.
- Getting Dressed/Vestirse—Following directions and creating adjective plus noun utterances (mi/big/blue shirt).
- In the Car/En el Carro—Description games (I spy a: big truck, blue truck, loud truck)
- Shopping/Ir de Compras—Categorization: Here are all the fruits/vegetables/cereals/cold things.
Here’s one of the best pieces of advice I ever received about incorporating routines into therapy:
Ask parents: “When is it most frustrating to communicate with your child?” You will hear about throwing food or not getting in the tub and know exactly where to begin and how to get immediate buy-in from parents.
Bonus strategy: Write it down! Have you ever gotten back from your physical therapy visit or doctor and forgot what she said to do? Have you read great strategies in a magazine, but failed to reproduce them?
This whole speech-language treatment thing is new to these parents. And they’re probably also worried. We’re often the ones present when they find out their bundle of joy might have communication issues. When you leave, make sure anything you suggest is in writing. Create a set of general parent worksheets to quickly fill in. You can use the completed sheet to begin the next session as review.
Scott Prath, MA, CCC-SLP, is vice president of Bilinguistics in Austin, Texas, and serves a diverse caseload in schools and early childhood settings. He has written and co-written several books and apps, and is a lead writer for The Speech Therapy Blog. firstname.lastname@example.org