Evaluation and speech therapy: getting help for your child

Making the decision to get speech therapy for your child is along, arduous, painful process for many parents. Although making that decision is an important first step, the work doesn't stop at this point. Up to now, the focus has been on "should we or shouldn't we?" You've decided the answer is "yes;" now what?

Step one is finding a speech therapist. This is easier said than done, since there is pretty much no place in the world where speech-language pathologists sit around twiddling their thumbs and wishing they could find something to do. If an SLP is unemployed, it's usually by choice. Still, with perseverance and determination, it can be done. Click here for a few ideas to get you started.

Once you've found a qualified SLP, the next step is the evaluation. Before or during the evaluation, the speech-language pathologist (SLP) will gather information about your child's strengths by observing and interacting with your child, and by asking you questions about what your child can do now and has done in the past. In most cases, the SLP will administer standardized testing.

If the evaluation takes place at the child's school, preschool, or daycare center, the SLP will probably take some time to observe the child in the classroom, and often will talk to the teachers or caregivers to get information on what they are observing.

After the evaluation, once the SLP has reviewed and written up the results of the speech testing, she or he (usually she--most SLPs are female) will meet with you to discuss her findings and recommendations, possibly including speech therapy. The SLP will probably take a few minutes to talk you through the report. Then you will have an opportunity to ask questions about what you saw, or didn't see, in the report, or perhaps what you disagree with. If it all makes sense to you and you agree with the recommendations, the focus will then turn to setting up a plan for meeting your child's needs. In public schools in the United States, this plan is called an individualized education plan, or IEP. The IEP process can be daunting if you've never been through it, but it's pretty much a matter of putting into writing what services your child will receive, and what goals will be targeted.

If something just doesn't feel right to you at this point, it's better to speak up than to defer to the SLP's expertise. You might not have the same training and knowledge of speech and language that the SLP has, but you have the advantage of knowing your own child better than anyone else on earth, so your views and insights are extremely important. We SLPs take parent input seriously, and I have added, changed, or deleted speech therapy goals based on what parents said at this stage of the process, so speak up and don't be shy.

As a side note, I've also talked to parents who think that, since they did not speak up at this point, they no longer have the right to give input or ask for changes. This is not true! You never forfeit your right to make requests on behalf of your child. Even if you sign a document such as an Individualized Education Plan (IEP, used by public schools in the U.S.), you can always request a conference and suggest changes to the plan. There's no law requiring them to give you what you ask for, but you always have the right to ask.

Once all this is done, you're now at the point where your child can begin getting speech therapy. Your work is only beginning. If your child is getting therapy at school, you're at least spared the effort of driving her to the hospital or clinic for her sessions, but the real work now is going to be staying on top of her goals and progress by following a home program. Just as a child taking piano lessons needs to practice every day, a child receiving speech therapy needs regular opportunities to practice her new habits and skills. If she is getting therapy several times a week, a home program is less crucial than if her sessions are once a week.

If you can do it, I definitely recommend watching as many of your child's speech therapy sessions as you can, and even participating in them if you are comfortable doing so. Ask the SLP lots of questions about what is going on in speech therapy; learn as much as you can, and try to replicate it at home. For a home program, frequency is more important than duration. There is no reason to strain your child's attention span.

Home practice also doesn't need to feel like work. Don't tell my employer, but one of the reasons I love being an SLP is that I get to play all day long. With infants and toddlers I build with blocks, blow bubbles, and put train tracks together. With older kids, I play Go Fish, Connect Four, Guess Who, Battleship, and a bunch of other games I never got my fill of as a kid. If you and your child can spend ten or fifteen minutes a day playing together and practicing speech skills, she will make better progress than if you force her to work on them for two hours once a week.

As the parent of a child with a communication disorder, you are on what may very well be a long and often tiring journey. There will be times of difficulty, frustration and perhaps even anger, but there will also be breakthroughs and triumphs. Find other parents who are going through similar experiences. If you can't find them in 'real life,' there are online forums like this one that you can go to for support, understanding, and advice. Remember, taking care of yourself is part of taking care of your child, so be sure and do what you need to do to keep yourself healthy and sane.

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