I went to a two day training conference this past Thursday-Friday with my wonderful Early Intervention (EI) team (we provide services for children, ages birth-3) as well as four parents of children whom we serve. Let me first say that I've never been to a professional anything with parents of my children. It was very interesting to say the least. Luckily, three of the four parents were nice, normal-type people who were easy to talk to. The fourth was a dad, need I say more?
The conference was called Play To Talk and was presented by Dr. James D. MacDonald. He, among other things, is very old. I realize that to have all of the knowledge and insight that he has with respect to young children, one has to have a lot of experience which is only gained by years and years of practice. However, this guy was OLD! When he slowly ambled in, I thought, "Oh crap, I hope that isn't the guy," but indeed he was *the guy.* His Thursday morning information piqued my interest from the beginning, however, when listening to him the listener has to filter out some words/phrases/sentences at times because his train of thought has a tendency to easily derail. Also, as a speech-path, I am easily distracted by (interested in) other peoples' speech patterns and language. Dr. MacDonald had some infrequent moments of disfluency which weren't all that distracting to me, probably not very noticeable to the lay-ear, and I just chalked them up to his old age...but kept an ear on them. THEN, just before lunch he pulls out his S-card! That's right, he tells the audience that he is a person who stutters! I knew it!
For those who don't know, my boyfriend is also a person who stutters. Actually, he is currently finishing up his Ph.D. in speech-language pathology with a specialty in fluency (stuttering). Needless to say, I consider myself to be more in *the know* about stuttering issues than your average speech-path. But that discussion is for another day.
Anyway, I gained a lot of knowledge at the conference. Some of his information/suggestions were actually things I was already doing naturally in a way and I just never had a name for them. That's always nice to hear though. While no one wants to pay lots of money to hear someone tell them what they already know, it's nice to hear that what I am doing is the *right thing,* at least in someone's eyes. I also wrote down a lot of great quotes from Dr. MacDonald which were sometimes amusing and at other times insightful. I also learned about myself as a professional. I kind of came to terms, perhaps again, with the fact that I am now a professional. I think having the parents there helped me to realize that.
While I am younger than some of the parents whom I serve (but certainly not all of them), I don't have children of my own yet (heck, I'm not even married), and I've only been practicing without supervision for two years, I am the professional. I am the speech-language pathologist for EI and no one else. When parents bring their child in for an evaluation, I would venture to guess that 90% of them have speech concerns. That's a lot of pressure if I really think about it. And the thing of it is that I don't have a magic pill/word/gesture/therapy to *fix* their child. Sometimes the child really is just a typical two-year-old and they do not qualify. But most of the time they do qualify with a delay in some area and the parent initially expects me to sit down 1:1 with their child once or twice per week and *fix* them. That's not how this works. Have you ever tried to sit a two-year-old down for more than five minutes to do any one particular thing? Yeah, not going to happen.
I take an observe, play, teach approach to therapy (at least in my mind). First, I watch what the child is doing/playing with, how they're playing, and if they're making communication attempts of any kind to anyone. Next, I play with the child. I follow their lead, get down on their level and play. If it involves following them to five different toys in five minutes, I go too (sometimes I wait to see if they'll return to me first). Then I teach - while playing! But it's not always a *repeat after me* teach, sometimes it's modeling gestures, sometimes it's withholding something for a communication attempt, sometimes it's forced turn taking, and sometimes it's simply finishing an activity and putting it away.
But like I said, this is the approach I take in my mind. I need to remember that parents are coming to me to learn (even though they don't know it). They need to understand that I cannot *fix* their child's speech difficulties by seeing them once/week or every other week. The things I do/show them are what they need to practice at home. And this is where I need to keep telling myself that I am the professional. They came to me for help, so I need to tell them what I think they need to do, and possibly give them a handout, which I'm already good at :) If they don't want to heed my suggestions, that's their prerogative.
I am the professional.
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