Doesn't she look GREAT? This was at the end of our session and she was TIRED but look at that smile...if you are an SLP, you will also notice that her left side weakness is improving nicely as we have an almost FULL smile here. Her dad was on the side making her LAUGH by saying "Blake Shelton." :)
Oh, hey...did you catch that?????? I said she LAUGHED.
Yes! Yes! Yes! Lauren is laughing. We don't always get voicing but mom reports that she is watching more T.V and that she is laughing appropriately.
I'll tell you, I don't think I'VE laughed as hard as I did, with Lauren, on Tuesday. Her entire body gets going with the laugh...NO SOUND...but the facial expression, timing and body shakes are there and well, it's FUNNY.
I am stockpiling jokes for our next visit which may a bit selfish because I want to laugh that hard again. In all seriousness though using jokes, riddles and puns in our treatment meets many of the goals we are working toward so it's a win/win. Jokes are great therapy for language comprehension, processing and of course all of those facial muscles used to do it. It also is a very natural, automatic vocalization which will hopefully encourage more vocalizing overall.
Oh, HEY. Did you catch that also? I said OUR NEXT VISIT. I'm so happy to tell you all that Lauren's family has asked me to stay on as one of her therapists because they like what I've done with her. I'm OVERJOYED and excited because I have SO many ideas and I think Lauren really responds to my crazy, outside of the box therapy ideas...
We WILL have to agree to disagree on one thing though...
She is a BEARS fan and I'm a PACKERS FAN.
How did we find this out? Well, you can see in the picture that she has a Chicago shirt on so I asked her "are you a Cubs fan?" She SAID "yes." Then she proceeded to spell out "I love the Bears too." I feigned disgust, as any self respecting Packer fan would do, and she proceeded to spell out "you like the Pack?" (complete with her own disgusted facial expression).
Ah, a match made in heaven. I can't wait to show up in my cheese head next week....
Keep an eye out because we are taking our therapy "to the streets." I have some community outings planned to assist Lauren with using her newly acquired skills in more functional settings. So, if you see us out and about be sure to stop and say "hi", tell a joke or tell her you've been reading about her. She would love that.
As always, thank you for reading and sharing my blog. I'd like to ask now that you go to www.missionsmallbusiness and vote for Therapy and Learning Services, Inc. I'm trying to win one of several $250,000 grants to start a program for families like the Pokutas who need a little help with therapy funding during periods of insurance lags. THANK YOU for helping!
I got another surprise when I arrived, on June 5th, to find Lauren sitting up in a dining room chair instead of her wheelchair and a hearty "HI!" when I turned the corner into the room. :)
During this session, we worked on really getting Lauren's voice to be "on" more than "off." She demonstrates many symptoms of motor planning delay which, in a nutshell, means that even though her brain tells her vocal cords to "voice" the message doesn't always go through. Add the breath support issue and muscle atrophy onto that and it is quite a task to vocalize!
For our session, I had decided that we would try "humming" and working on initial /m/ words...with Lauren's singing background I felt that this would be a great way to get her to vocalize more while also encouraging longer stretches of vocalizing. Cueing her to "hum" is also a great way to get her voice going instead of saying "say __________." Not surprisingly, this worked like a charm and she had GREAT success with a list of 10 or so initial /m/ words. In particular she vocalized a really strong MOON! I gave her "homework" which I'm not sure she was thrilled about.
Since Lauren enjoys her iPad and UNO so much, I incorporated our "drill" work into a more functional activity (playing UNO) by having her say "my turn" during our game. She not only said this but also vocalized a weak but audible "your" (turn) as well.
Here is some video of us playing UNO...she was getting tired by now but you CAN hear her say "mine" and "yours" pretty clearly.
I find myself needing to remind people that sometimes.....even if we are well meaning and have some experience in certain areas, that we should just leave well enough alone or refer to the "expert."
Case in point. I found that part of my job yesterday was "damage control" because of something a well meaning but non-SLP said to a family regarding their child's speech and language skills. What initially, for the family, was cause for concern and a sleepless night turned out to be a celebration after we spoke. One of the many things I LOVE about my job. The giver of the initial information was not trying to cause this family anxiety and I truly believe that they thought they were correct BUT in the end they were VERY incorrect and caused needless anxiety for my family.
I know we can't stop situations such as this from happening BUT we can try to become more responsible professionals and more responsible consumers by going to the "expert" and not accepting information as truth if it doesn't come from the person who is trained in that area.
As a professional that has worked on countless pediatric therapy teams...I may THINK I know what a child needs in terms of core support for feeding because I've dealt with this issue on other teams, with other therapists and perhaps with my own child BUT I should NOT suggest or state as fact that "this is what you need to do" because it is NOT my area of expertise. I should say "check with your child's physical therapist to see what they would recommend for increasing core support." ALWAYS defer to the expert in that area. This is ESPECIALLY true when "labeling" certain behaviors ("So and so did things like that and they have Autism") and stating age levels ("oh well, my child does the same thing and we were told that her language age is ______"). As an SLP, with many years under my belt of evaluation and treatment I STILL need to refer to my evaluation materials to get accurate age levels and I'm the "expert!"
In this time of being inundated with information from the internet, books and friends we must still remember that there are specialized professionals for a reason. Even IF you think someone may be on to an answer when they suggest something.....ALWAYS go to the expert/professional in that area to confirm or deny that information. Further as professionals(especially those who work on "teams" with other disciplines) we MUST, even if we have seen it a thousand times, DEFER to the professional who treats the condition or we risk a situation as I shared above.
My personal favorites????? "he'll eat when he wants to" "oh, my brother didn't talk until he was 5 and he's fine" "oh, she's just a pointer and grunter kind of child."
Bottom line.....BE A RESPONSIBLE COMMUNICATOR WHETHER YOU ARE THE GIVER OR RECEIVER OF INFORMATION.