PLAY-BASED INTERVENTION versus STRUCTURED SPEECH DRILLS
Today I had my session with DJ, a 5 year-old boy with Autism. He communicates mainly with single words and gestures. He also has articulation difficulties, resulting in an intelligibility of about 60%.
For the past month, I have been losing sleep over him.
When we started therapy five months ago, I used a play-based approach. This decision was based on my experience working with children like DJ. Through his speech productions in fun activities, I used the Hanen approach to increase his language and PROMPT technique to work on his articulation. DJ was highly motivated to 'work' with me and Mum reported that improvement has been noted - he is talking more and with increased clarity. This approach boosts his motivation and confidence to talk.
However, three months into therapy, Mum requested for structured oromotor exercises and speech drills. Maybe play-based approach looked like too much fun. Maybe she felt that I was not doing enough 'explicit' work about DJ's speech, despite the improvement she noted. Based on the request, I changed my approach. I whipped out my token system, I whipped out my schedule board. I put in structure for oromotor exercises and speech drills.
This worked well for three sessions, I was delighted! If DJ can take the structured drilling, this would save my time and trouble to plan and prepare for engaging activities with embedded speech and language goals. Mum was absolutely delighted as well! Maybe she felt that her money is more well-spent, looking at the amount of drills which he is doing.
However, our delight was short-lived. By the fourth session, DJ's compliance reduced. As the sessions went on, he became more and more resistant to structured table-top tasks. He even started displaying aggressive behaviours a month ago.
I know that I have lost DJ. I have lost the rapport which I had built with him. His motivation to work with me is no longer from within. He just wanted to finish the tasks on the schedule, get all the 'smiley faces' token and then get away from me.
I need to reflect on how I can get parents to understand the therapy approaches which I use. I need to stand up for what I believe.
For the past month, I have been losing sleep over him.
When we started therapy five months ago, I used a play-based approach. This decision was based on my experience working with children like DJ. Through his speech productions in fun activities, I used the Hanen approach to increase his language and PROMPT technique to work on his articulation. DJ was highly motivated to 'work' with me and Mum reported that improvement has been noted - he is talking more and with increased clarity. This approach boosts his motivation and confidence to talk.
However, three months into therapy, Mum requested for structured oromotor exercises and speech drills. Maybe play-based approach looked like too much fun. Maybe she felt that I was not doing enough 'explicit' work about DJ's speech, despite the improvement she noted. Based on the request, I changed my approach. I whipped out my token system, I whipped out my schedule board. I put in structure for oromotor exercises and speech drills.
This worked well for three sessions, I was delighted! If DJ can take the structured drilling, this would save my time and trouble to plan and prepare for engaging activities with embedded speech and language goals. Mum was absolutely delighted as well! Maybe she felt that her money is more well-spent, looking at the amount of drills which he is doing.
However, our delight was short-lived. By the fourth session, DJ's compliance reduced. As the sessions went on, he became more and more resistant to structured table-top tasks. He even started displaying aggressive behaviours a month ago.
I know that I have lost DJ. I have lost the rapport which I had built with him. His motivation to work with me is no longer from within. He just wanted to finish the tasks on the schedule, get all the 'smiley faces' token and then get away from me.
I need to reflect on how I can get parents to understand the therapy approaches which I use. I need to stand up for what I believe.
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