As a speech-language pathologist, I know how much successful treatment relies on parent involvement and home practice. We might work miracles during our treatment sessions, but we have only a couple hours with our clients each week. If a child spends one hour per week with us, they spend 167 hours per week OUT of treatment. Typically, the majority of this non-session time gets spent with mom and dad.
Think about it in terms of a jar full of jelly beans (we can all relate to candy, right?). Fill a jar with 168 jelly beans—one for every hour in a week. Now remove one jelly bean to symbolize the hour you as a clinician spend addressing your client’s communication goals. Look at the alarming amount of jelly beans left. In fact, it’s safe to say, the lay person might not even notice the single missing bean!
Getting parents or caregivers involved in the treatment process and designing home programs they can manage in their typically busy schedules is critical for successful carryover. We know this.
Before my children were born, I subscribed to the “more equals better” mentality and absolutely loaded my families down with speech-language assignments. Now I realize families simply can’t spare much time. So how can we create programs that families can weave into their already hectic schedules?
- First things first: Involve parents in sessions. Sometimes they prefer a waiting room to settling into teeny tiny chairs, but try to persuade them to join you. And I mean join you at the table. Talk to them about the activity and why you chose it. Deal them into the Go Fish game. Involving caregivers in your sessions and establishing a comfortable, open line of communication leads a solid rapport. Assure them your treatment room offers a safe environment where learning is your number-one goal for clients and caregivers.
- Start every session with some version of “tell me something new you’ve noticed this week.” This open-ended question affords caregivers the chance to tell you about specific situations related to communication. Remember to check periodically with caregivers about how they feel their child progressed and if they want to work on new or additional goals.
- Ask caregivers to bring a list of the toys and books the child enjoys. Knowing what your families work with at home helps you provide activities that address the child’s goals and assimilate easily into their routines. For example, my daughter’s current favorite activity is splashing around in her baby pool. This gives me ample opportunity to address spatial concepts (in, out, under), comprehension and use of present progressive verbs (swimming, floating, kicking, dripping, splashing), increasing use of descriptive terms (cold, wet, slippery), and following directions. Or if you really need your client to work on medial /p/, encourage an extra reading or two per day of “Hippos Go Berserk.”
- Ask caregivers when they can set aside time for communication activities. Share ideas or strategies to maximize speech and language practice during these times. If mom feels she can only devote the 20-minute morning commute to addressing communication skills, don’t despair. Toss out worksheets and sit down with her to create a list of activities they can safely complete in the car. Suggest categorization—“name all the animals you can!”—or expansion techniques to increase length of utterance, or acoustic highlighting and auditory bombardment. Create a speech book with target-sounds pictures to place in those handy-dandy seat-back pockets, so her child can talk about the pictures while practicing her sounds. Coach mom to elicit multiple productions when her little superstar gets it just right and to model and correct if her child struggles.
- Involve the whole family. It’s no secret older siblings motivate little ones. Encourage parents to recruit their big kids to play the role of “speech assistant” and turn speech and language homework into family play time.
Amanda Rhodes Fyfe, MS, CCC-SLP, works for the Mansfield Independent School District. firstname.lastname@example.org