Speech-language pathologist Phuong Lien Palafox anticipated a delicate approach for treating her close friend Nada’s son, especially when she realized he had childhood apraxia of speech, not an area of specialty for her. With the foundation of a trusting relationship, she rallied her resources and dove into treating him, learning valuable lessons about client relationships along the way.
Our speech-language treatment journey began like that of many other families. We trusted our intuition and had our 2-year-old son Sammy evaluated for a speech delay. He qualified for early intervention treatment at a speech and language clinic. After months of slow progress, our speech-language pathologist—who also happened to be a good friend of mine—sat us down for a candid conversation about a possible motor planning disorder. She diagnosed Sammy with childhood apraxia of speech (CAS) soon after.
This diagnosis felt heartbreaking and terrifying—especially after years of hearing people say boys talk later and our son just needed a little coaching. We experienced so many overwhelming feelings. Initially, I worried about Sammy and his feelings. Would kids mock him? How could he still make friends? Could the adult version of our sweet Sammy become confident and successful despite this uncomfortable and unfamiliar disorder?
We decided to make speech-language treatment our family’s priority. Sammy and his SLP—Phuong Palafox—met three times a week. The work continued beyond the walls of our sessions. We executed drills while in the car, during meals and during bedtime reading. Next, we built Sammy’s village among our family, preschool and even gymnastics coaches. Collectively, we believed in him and supported his goals.
Today, Sammy is one sound away from graduating from speech-language treatment! Working with an SLP changed our lives and I’m no longer scared for our son. I know we’ve given him the tools to be an effective and expressive communicator despite the adversity and uncertainty of CAS.
I met Sammy in 2013 a few months after his birth. His mother is a close friend. Two years later, they walked into my clinic and I became his speech-language pathologist.
The shift in our relationship made me nervous. As an SLP, my priorities with clients include developing trust and rapport with the family as their clinician and using evidence-based practices to make progress as quickly as possible. This case was no different. I realized, what an honor to use my professional brain and heart to support a member of my own personal village. And, ultimately, balancing our professional relationship included the same tenets as our 15-year friendship—leading with honesty and kindness once trust was built.
After months of treatment and delayed progress, I realized my initial diagnosis of expressive language disorder was incorrect. I suspected Sammy actually had childhood apraxia of speech. I needed to learn more information about this uncommon disorder. I also scheduled an appointment allowing plenty of time for a candid and difficult talk with his parents.
After our conversation, I quickly reached out to peers with expertise with CAS. I made changes in my treatment approach and Sammy’s progress soared. In November 2017, he walked into my speech room and said, “Phuong, I’m ready to work on my speech sounds today!”
My SLP brain heard all of his speech sounds, and my human heart was grateful for the opportunity to serve as an integral part of his communication journey.
5 Considerations for the Family-SLP Relationship
As clinical professionals, we focus on the communication needs of our clients and students. Our families share the same goal and provide us valuable, added perspective. From Sammy’s team, here are considerations for the family-SLP relationship:
- Building trust. Author and educator Stephen Covey says trust is the most essential ingredient for communication. I always take the time to build the relationship with my client and their family. A connection with the child contributes to their communication efforts. It also earns the family’s trust, which goes a long way toward success in home practice and generalization.
- Access to technique and research. I show clients and caregivers what a technique looks like and sounds like. I showed Sammy’s parents face-to-face after a session, for example. When working in a school setting, I would send short videos of a strategy to the family. I also send home easily digestible research using one- or two-sentence descriptions.
- Give functional homework. Families want to support their child’s efforts. They are also busy. I give parents one or two tasks to complete during parts of their daily routines—meals, play, baths, bedtime. For example, with Sammy’s parents I’d tell them, “When Sammy wants a snack, have him ask for it before giving him the crackers. We practiced this today, and he did so well!”
- Managing expectations. In all endeavors, unexpected events happen. In this case, when we weren’t making progress in the beginning, I was transparent with the family. I reported the data, recounted the steps taken to obtain more knowledge of CAS—reaching out to experts, reading articles—and developed an individualized plan for Sammy and his family.
- Better together. We are surely better SLPs when working together with our families for the client.
Sammy’s communication success astounds me, and I attribute it to the efforts of everyone around him. How do you build your relationships with caregivers and families to enhance client progress? Share your favorite insights and experiences in the comments below.
Nada is a proud mother to awesome Sammy and spirited Remy. She is also a public relations strategist in Austin, Texas.
Phuong Lien Palafox, MS, CCC-SLP, is a bilingual speech-language pathologist at Bilinguistics. She specializes in service-delivery models, literacy-based interventions, students from diverse backgrounds (including poverty) and social skills for children with autism. She is an affiliate of ASHA Special Interest Groups 14, Cultural and Linguistic Diversity; and 16, School-Based Issues. firstname.lastname@example.org