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Many people imagine speech therapy as interaction between the therapist and the child. The therapist models something, perhaps, in play or in drill, and at some point, the child repeats.
This is true – to an extent. But it is not enough.
This is because in order for speech therapy to be as quick and as effective as it can be, it must be happening every day – maybe even multiple times a day. The more practice, the better.
And, in order for speech therapy to generalize, it should also be targeted in daily routines and activities, not just with one specific desk and with one specific toy.
In other words, speech therapy is most effective when the family is an essential part of the therapeutic process. Speech therapy is most effective when it is family-centric.
The Research Backing Family – Centered Practice
The American Speech Language and Hearing Association (ASHA) states that families provide an “essential role” in all aspects of service.
Family-centered intervention is a goal for early intervention services for at-risk parents.
And, successful therapeutic frameworks like the SCERTS model are rooted in family involvement.
What exactly is a family-centered approach
A family-centered approach is distinctive because not only does the therapist observe and treat the child. Tthe therapist also involves family members in explaining observations / recommendations, brainstorming possible instances when a particular skill can be practiced, and following up on how practice over the week went.
In other words, the parents express their concerns, and they feel heard. They also understand exactly what the speech therapist is working on, and why. The parents learn certain strategies from the therapist. And by the end of the session, the parent is ready to “be the therapist” with a particular tip, for the rest of the week.
Why family – centered practice works
Family centered practice is effective because it crystallizes, in a caretaker’s mind, what exactly is happening with the loved one, and what can be done about it. This makes them more likely to view therapy as something positive, and something with a clear end goal.
Family centered practice also helps the therapist. This is because the therapist knows exactly what is happening in the home, with each goal, and tailors therapy in order to address deficits.
And finally, family –centered intervention results in more therapy and more practice. If a parent / family member / caregiver is trained to work on a strategy for the week, or for several weeks, then the patient is not just getting therapy for one hour once a week. They are getting therapy two to three times a day, for all seven days of the week. That’s many more opportunities to practice and generalize a skill.
If a child, for example, practices /r/s just one time a week, the likelihood of acquiring the sound and producing it consistently within a short period of time is low. But if the child does /r/s two times a day every single day, with proper corrections and helpful feedback that they would have received from a therapist, the likelihood of acquiring the sound quicker is much higher.
Tips for Family Involvement
There’s no denying that there are some settings are a little more conducive to family centered practice than others. For example, it is much easier to collaborate with in clinic, or in the home, than at school.
Regardless, here are some tips for parents and caregivers to engage in more family - centered practice.
1. Start strong
Build a rapport with your therapist :) Talk about what happened at home last week.
2. Sit in the therapy session, if you can.
Yes, you can do this! Follow your therapist's lead, though, so the experience can be positive for everyone. And, if this model makes you uncomfortable - you can find a compromise. Maybe you stay for half the session, to do tip 1 above, if appropriate.
3. Share what you know about your child.
You know your child's strengths, weaknesses, and motivators. Share this at the beginning of therapy so your therapist can customize the sessions appropriately. In a school setting, you can send a form home at the beginning of the year doing the same.
4. Learn techniques
If you see something your therapist does which you think is effective, ask if he / she can teach you, and try to practice in the session! This way, you can do the technique again. Which brings us to the next point
5. Homework!
Ask for a homework assignment you can practice with your child for every day of the week! If your therapist assigns homework, try your best to do it everyday. The more practice the better :)
6 . Report on homework at the start of the next week's session
This helps your therapist customize and target the session! A great time to review how homework went is at the very beginning, when your therapist asks "how was your week?"
7. Collaborate on goals.
Your therapist will try her best to write goals she thinks are appropriate. But if you are really concerned with one area, you can ask if a goal can be written on that area, and see what your therapist says. Note, however, that quality is better than quantity. Too many goals can mean less progress on each objective. 2-3 goals total is usually a sweet spot.
Go for it
Family centered intervention is a little extra work everyone, especially in the beginning.
But when you start to see more gains from your practice at home.... it is worth it.
Disclaimer : Smarter Speech is a pediatric speech therapy / speech-language pathology practice for toddlers and children providing in-home and teletherapy services in and around Mountain View, CA and Los Gatos, CA. Smarter Speech Blog aims to provide free speech and language tips for parents educators and therapists. However, this post is not providing speech-language pathology services. This is general information, not speech -language pathology or speech therapy. This article does not assume or create a client – SLP relationship. The author is not liable for any losses or damages due to actions or failure to act based on the content in this article. If you need assistance with a child’s speech or language needs, please contact a speech-language pathologist in your area.
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