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Speech Language Therapy- Three Common Factors For Lack Of Progress

I am often asked the question from well meaning people “How do you teach a child to…” with various endings to the question. If the question has to do with speech and language disorders very often it is not an easy question to answer, especially in a social situation. When it comes to getting a child to speak the answer is very complex and depends on so many variables. That’s the art of speech-language therapy, and what separates the good from the great. Being able to read and treat each situation differently according to the variables.

With any therapy the final goal is carry-over and independence. When it comes to articulation errors, the complaint I hear most often from parents coming from other speech therapists is that they did the work they were supposed to be doing at home yet their child did not make progress.

There are several factors that play into this scenario of frustration and failure.

The First Factor
The first being lack motivation on the child’s part. It is difficult to blame the child for this because as speech therapists we must learn to motivate even the most difficult child.

The Second Factor
The second factor is parents not having the time and/or patience to do the work sent home. Again, this is not always the parents fault as sometimes they read their child’s reaction to frustration and failure and avoid the activity leading to these feelings. Typically this is caused by the speech therapist giving the wrong homework.

The Third Factor
The third and most likely factor leading to lack of progress is the speech therapist and her inability to read and treat the situation properly. If there is no structural, medical or physiological reason for a child to not speak clearly, they can and should learn to speak perfectly clear.

In private practice children often come to me who have been receiving speech-language therapy elsewhere for many years but still have the same lingering speech errors. I always ask parents to bring in their homework book to try to figure out the problem.

A Mistake Speech Language Therapists Frequently Make
What I find most often is that the child had been working on the wrong thing. I also typically find that the homework they were given is almost always several steps ahead of where it should have been.

For example a child with a lateral lisp is given sentences containing the “s” sound to practice at home. I have even seen a child asked to make up stories with “s” vocabulary words. Not surprisingly, when probed, the child is unable to make the “s” sound in isolation.

If your child has an articulation disorder, or even an articulation delay, trying to teach him how to use a sound in a sentence before he can use it consistently in isolation is like trying to teach him to run before he can stand. It will just never work.  When it comes to articulation errors a child will never carryover or gain independence given this scenario.

Not Unique To Speech Language Therapists
Unfortunately trying to move too fast is a mistake that is not unique to speech therapists. For example, my daughter Maya has some developmental articulation errors that we have been working on. She can’t say her “k” or her “g” sounds and whenever we get around family or friends someone will always ask her to correct her speech with unrealistic expectations. I find that very frustrating. All it does is lead to frustration and make her less willing to try.

The same can be said of bad speech therapy. When a therapist has unrealistic expectations and places unreasonable demands on the child it frustrates him and makes him less willing to try.

As a Speech Language Pathologist it is my role to bring all parts of the equation together. I must know where to start and how to motivate each and every child. I must give appropriate homework which is achievable and leaves parents and their children feeling successful. I have to judge the pace accordingly and not move too quickly. When all these pieces are put in place then and only then, independence can be achieved.

Note: Should you have concerns about your child’s progress you may call 914.488.5282 to request a confidential consultation with Isa Marrs.

About the author: Isa Marrs is a board-certified speech-language pathologist who specializes in articulation, pragmatic language and feeding disorders in children. She is an expert in the field who is frequently sought after by institutions and therapists to provide training for working with these and other disorders. Isa also served as a guest expert on Nickelodeon’s ParentsConnect.com, and has been quoted by numerous top media such as Disney’s BabyZone.com, LoveToKnow.com, and Univision. She can be reached at 914.488.5282

  • Donna Wexler October 31, 2010, 8:48 pm

    Isa, Thank you so much for your website. I found myself exploring for a long time! You have such a way with words and ease of explaining your work. I am an SLP who has been working with children for nearly 40 years. I have a private practice in Palm Beach Gardens, FL. I was referred to your site by April Choulat, educational/RDI consultant.
    Donna
    PS I’d like to subscribe to your newsletter, however I am uncertain as to how to do that.

  • april January 1, 2012, 10:28 pm

    Hi Isa, My 5 yr old son has been in speech therapy for almost 3 years. He progressed some but has really not progressed much. He is in school now and we thought that would help but he has actually gotten worse since then. We have had his hearing tested by 3 different ENTs and he has passed all the test. He has had negative pressure at some points. I truely feel something with his hearing is wrong but can’t prove it and with 3 ENTs saying it isn’t I don’t know where to turn now. He is not really motivated but yet remaims extremely frusterated when you can’t understand him. I don’t know where else to turn… I read over your website and I’m looking for help, suggestions, anything to grasp. I have talked to a lot of people over the past 3 years and one day I know I will talk to the right person that will steer me in the right direction. Any advice you have would be appreciated. April

  • Isa Marrs January 2, 2012, 6:38 pm

    Hi April,
    I am sorry to hear about the struggles you are going through with your son’s speech. Is your son receiving speech therapy in school? If so have you been able to talk to the Speech Language Pathologist who is working with him? In order for there to be progress there would need to be quality therapy at school and carry over by you at home. Do you have a Hospital or University by you that might provide quality therapy? Maybe a private therapist in your area could help? He could have CAS; he could also have an Auditory Processing disorder which can’t be properly assessed by an Audiologist until he is about 7. I would look into all your options and stay involved.

  • Sandi Wisher April 10, 2012, 11:47 am

    As a practicing speech pathologist since 1967 and recently retired, I am wondering whether or not we are working on symptoms rather than the causes related to lack of articulation carry-over. I am questioning auditory memory or processing problems in some cases.
    I believe too much time and emphasis may be placed on developmental articulation skills, as studies have shown that once a student reaches 75% accuracy with self-correcting behaviors in place, spontaneous improvement automatically occurs and can be measured with talk probes administered a few times each grading period rather than weekly therapy.
    Also, I am discouraged by the lack of emphasis I have observed regarding literacy related problems. Reading failure may be due to poor decoding skills that are phonologically based, slow decoding due to auditory memory problems, or poor comprehension due to language disorders. Speech pathologists are detrimental in improving these skills and should be utilized more in helping those who are at risk for reading failure.
    Just speaking from experience, and thanks for allowing me to vent.

  • Sandi Wisher April 10, 2012, 12:05 pm

    It is also important to determine if an articulation disorder requires a phonological approach to treatment rather than a developmental one which is utilized more often. Use of gestures and basic sign language skills may be helpful with comprehension issues.

  • Isa Marrs May 22, 2012, 11:56 am

    Hi Sandi,
    Thank you for the comments.

  • maribel arribe October 23, 2013, 9:12 am

    I wish I had known all about these when my son was growing up. He is now in college and continues to struggle with his expressive math & or language. My husband & I are both therapist and have observed him to lack skills in communicating himself. When he was 18 months, he had almost 2 years of speech therapy sessions and 1 year of Occupational therapy sessions. These were all given because of his extreme delay in speech. His form of communication with us was through gestures & sounds, to present time, he still has had hard time finding his words we think, he loves the stage because his speech is rehearsed. He does not have to think of what to say. When we converse at home, he usually stay quiet and seems like does not know how or what to say. Most often times he would just be mad and go back to his room and be quiet.

  • Isa Marrs December 2, 2013, 4:35 pm

    Maribel,
    It is never too late to get help. Many schools will have Speech Language Pathologists available especially if they have a Speech program. If your son is open to the help there are many strategies he can be taught that will assist him greatly.