Springtime Therapy

My client A. is an 11 year old girl that has been seen in the clinic since fall of this year. She was referred from a diagnostic, and is currently diagnosed as being memory/language delayed. Some of the things we work on in therapy is mnemonic devices for memory, following three part directions, and reading comprehension.

In therapy we work on reading comprehension because children with language delay often cannot find the main idea or organizing frame even in simple texts. Structures of narrative and expository texts differ greatly and can affect comprehension and memory. (Owens, 2004)

I see this with A. because one of her goals is to read a paragraph and retell the story on a story board. Repetition in her case does seem to help. I have her reread the story to herself after she has read it out loud.

A. has improved, but still struggles in this area. The overall organizational abilities of these children may account for reading and writing problems. Incoming information needs to be organized for comprehension, because reading comprehension is fundamental to academic success. (Owens, 2004)

Owens, Jr., R. E. (2004). Language Disorders A Functional Approach to Assessment and Intervention (4th ed.).

All about my Client A.

My client A. is an 11 year old girl that is currently diagnosed as being language delayed. A. has been in therapy since she was first referred from a diagnostic performed this fall. Many potential causes could lead to language disorders, and hers is currently unknown. A school-age child who has limited language skills is likely to be considered as having a language learning disability or simply a learning disability. (Hedge, 2001) It seems that A. has been placed in this category at school.

A. is still working on the same goals she had last semester, which consisted of reading stories and picking out the main idea and details of the story and following functional directions. We have added a few more goals since then. She complains of having problems with remembering things in school, so we have started to work on mnemonic devices this semester. We have also started to work on rote counting, which is the storage and retrieval of numbers without comprehension. (Nicolosi, 2004) We feel that this may help her with multiplication, which is currently a problem for her.

So far I feel that A.’s therapy is going in a good direction. She seems to enjoy what we do and feels that it is a challenge. A. shows improvement and is moving to more complicated goals in therapy.

References:
Hedge, M.N. (2001). Introduction to Communication Disorders 3rd Edition. p155

Nicolosi, L., Harryman, E., Kresheck, J. (2004). Terminology of Communication Disorders 5th Edition. P. 194

Blog #2

My client R. is currently six years, six months old. He has been diagnosed as having delayed speech and language. R. has been in therapy since he was first referred in preschool screening. In the past the clinician has worked on answering “wh” questions correctly and articulation errors, while I am currently working on auditory processing skills and articulation errors with him.
I have been seeing R. since the first week of clinic and his articulation errors have improved greatly. He has gone from working on the correct production of the /f/ phoneme in words to conversation. And we are currently working in the /s/, /r/ and voiced /th/ sounds in sentences.
The /r/ phoneme has been by far the hardest phoneme for R. to master. However, I have found a few techniques that are very helpful. R. substitutes /w/ for /r/ in the initial position of words and I have found that using a mirror to call attention to the puckered lips can be very affective. You ask the client to smile in an exaggerated manner, or inhibit the movement by pushing the upper lip back against the upper teeth with your thumb and forefinger.
Another technique I have used for the /r/ phoneme is to have the client imitate a rooster, siren, or growl like a bear. Also by placing your hand on the top of the child’s head and say, “Try to touch my hand with your tongue as you make the /r/ sound” can be very affective. Obviously, this is impossible to do, but most children get the idea.
Overall, I feel these techniques have been of great help to me, and I have seen a lot of improvement since R. has moved from the /r/ phoneme in the initial position of words to the initial position of words in sentences.

Reference:
Pendergast, K. (1971) Building Good Speech.111,112

All about my Client R.

My client R. is six years old and currently diagnosed as having DSL. R. has been in therapy since he was first referred from preschool screening. In past therapy R. has been working on articulation and some language issues, such as answering “wh” questions appropriately. Current behavior and issues at school however, have led us into considering the possibility of him having CAPD (Central Auditory Processing Disorder) or also known as APD(Auditory Processing Disorder). CAPD refers to how the central nervous system (CNS) uses auditory information. Children with CAPD exhibit a variety of listening and related complaints. For example, they may have difficulty understanding speech in noisy environments, following direction, and discriminating similar sounding speech sounds. Sometimes they may behave as though they have a hearing loss, often asking for those around them to repeat themselves. R. does this on a frequent basis. This disorder is often confused with ADHD because of similar characteristics, which causes misdiagnosis in many cases.

One way a diagnostic team has tested R. is by giving him the TAPS (Test of Auditory-Perceptual Skills). To diagnose CAPD, the audiologist will administer a series of tests in a sound treated room, which will be the next way R. is tested. These tests require the individual to listen and attend to a variety of signals and to respond to them by repetition, pushing a button, or ect. However, even though the diagnostic team has been testing R. for CAPD an official diagnosis can not be administered until he is seven, which will be in seven months. The tests require the age of seven because of the variability in brain function of younger children. But starting the testing early will give us a better idea of what direction we should be going in treating him.

Even though the results of the tests have not yet been given, we have started to work on compensatory strategies. These strategies consist of assisting listeners in strengthening central resources such as following directions, memory, and attention skills. An example of the memory skills we have worked on is having R. repeat a series of numbers or words given verbally by the clinician. The following directions part of therapy is also given verbally. However, it is important to understand that there is no “sure-fire” cure for CAPD and different strategies may work well for one client and not for another.

Teri James Bellis, Ph.D., CCC-A (2007). Understanding Auditory Processing Disorders in Children. Retrieved October 16,2007, from http://www.asha.org/public/hearing/disorders/understand-apd-child.htm

This is orientation for SPA. It has been a very full day and a lot of information to take in. However, this is my test run and I hope it is ok.