We were blessed with a pretty awesome team of therapists at our local branch of Disability Services Queensland and I have often said that it never felt like a chore to take Nicholas there because the adults always seemed to be having just as much fun as the kids! I was impressed with our “Speechie” Alison from our very first appointment and her knowledge, vision and passion was very visible when working with our children. I am so glad she could share some of her insights on the blog today.
When I introduce myself as a speech pathologist (we like to call ourselves Speechies), there is a tendency for people to assume I spend my days treating lisps and stutters. They think My Fair Lady and The King’s Speech. The misleading title of the profession discounts an enormous proportion of what we Speechies are actually trained to do. Speech pathologists can support clients through the entire lifespan, from babies who have difficulties feeding, children with developmental delays, teens struggling with social skills, and adults who acquire a brain injury, to the otherwise healthy elderly lady who has started coughing on her cup of tea.
Admittedly I too had no idea what a Speechie did when I enrolled in the degree. I wasn’t even entirely sold on the profession until I was allocated a clinical placement at Disability Services. My clinical educator and now close friend, Dom, had a contagious passion for supporting children with disabilities and their families. Suffice to say, as soon as I got my degree I eagerly went back to Nundah Disability Services and was lucky enough to get myself a job working with an incredible team and equally incredible clients (including the littlest Love!).
So where might speech pathology fit into your T21 story? Speechies are trained in supporting both the communication and feeding of children with disabilities. At best though, we might get to spend one hour a week with your child, which, although a good start is not the complete picture. This means we need to recruit the experts on the child: the parents! Unfortunately, the title ‘Teaching-parents-how-to-support-communication-and-feeding-ologist’ doesn’t so much roll off the tongue, so we run with Speech Pathologist instead 😉 So, how can we best work together? Our training starts here.
Most of us take our ability to communicate for granted. Let’s just imagine you had a crazy, unexpected experience while you were at the shops today. There you were just doing the groceries when a dog lion wandered into the shop and stole an apple out of your trolley. You get home and are desperate to tell your family all about it! Unfortunately, you lost your voice from all of the screaming and are too frazzled to write anything down. Your family try to guess what happened as you wave your arms around expressively but how could they? Eventually they might give up and if they did, this wonderful story would be lost to the world.
Communication consists of the sending and receiving of messages, so involves both a sender (in this case you) and a receiver (your family) who both need to work together. This process allows us to do things like direct attention (“Look, a lion!!”), make requests (“Get it away!!”), give information (“It went behind that shelf”), and express and assert ourselves (“I am NOT going back in there”). Even more importantly, communication allows us to build relationships and make connections with those around us (“Thanks for the hug, I feel much better now”).
It is important here to pull apart the entirely different but often confused concepts of ‘speech’ and ‘language’. Language is a socially shared code, whereas speech is the physical movement of voice box, tongue and lips to produce the words. Children with Down Syndrome almost always have delays in both their speech and language, and just like ‘typically developing’ children they understand more than they are able to express. That being said though no two kids with Trisomy 21 are ever the same. Thus the aim of communication intervention varies significantly between families and changes within a family over time. In essence though, our end goal is for your child to be able to say whatever they want to say, whenever they want to say it, to whoever they want to say it to.
While it is preferable for your child to achieve this goal using speech, delays in speech and language can mean this goal takes many years to achieve. To avoid years of frustration stemming from difficulties getting a message across (like in your supermarket story) and thousands of missed learning opportunities, a speech pathologist may recommend introducing an Alternative or Augmentative Communication (AAC) system.
AAC comes in many, many forms, but includes things like sign language and symbol boards. Just like you talk to a typically developing baby for over a year before you expect them to talk back, parents are required to ‘talk’ to their child using AAC for a long time before the child first understands and then learns to use the system. All this effort does pay off though, as a large body of research now shows that AAC supports language development and actually promotes the development of speech. Once your child is able to express themselves, the emphasis moves to building on their language (either verbal or through AAC) and refining their speech. Children may eventually no longer need their AAC, or use it just to get their message across to people who are less familiar.
So it’s time to get started! Here are some tips for supporting communication development:
- Watch and see what your child is interested in and talk to them about it. If you give them a pot and wooden spoon thinking they will pretend to stir but they’re more interested in the sweet noise it makes when you bang them together, talk about that instead!
- Wait for your child and give them a chance to communicate with you. How will they learn to tell you that their toy fell off the high chair tray if you pick it up straight away?
- Listen to your child’s attempts at communication. Maybe ‘dog’ sounds like ‘o’ or they used a sign that looks different to anything you’ve modelled- it’s okay! They are learning! Give it your best guess, and always respond like they’ve said something very meaningful. Your child has worked hard to tell you something and deserves to be rewarded.
- Expand on what your child says by adding to it. If they say ‘dog’ while watching the beloved family pet roll around in the mud, you could say ‘dirty dog’.
- Use simple phrases with your child at a level they are likely to understand and be able to repeat. “Soft cat” is much more likely to benefit your child than “Pat the cat, he’s so soft because he had a bath today. Actually it’s almost your bath time…”
- Always model the adult form of words/signs for your child, even if they say them a different way. No matter how cute it is when they say ‘dee’ for ‘teddy’, you keep using the word ‘teddy’.
- If your child has an AAC system, model it! Maybe it feels like you’re not getting anywhere, but you are. Have patience and keep on keeping on.
- Channel your inner child, play, and have fun!! Opportunities for communication are everywhere once you open your eyes to them.
For more information about speech pathology or to find a speech pathologist near you, you can go to www.speechpathologyaustralia.org.au . If you’re already working with a Speechie, ask them questions and get involved! Remember, you know your child better than anyone else!
Alison is a Certified Practicing Speech Pathologist with a passion for supporting the development of communication in children with disabilities. She owns I Have Something to Say, a private speech pathology practice on the Northside of Brisbane, and believes that all children do in fact have something to say! Feel free to get in touch via the website or email and follow her on Facebook.
We look forward to another post from Alison in the future on feeding, so stay tuned!