Cake. Carrot cake. What makes a good carrot cake? How would your cake taste if you doubled the carrots and nothing else? How would it be if you forgot the eggs? Care of special needs children can be just like baking. You need to have the right ingredients and use the right proportions.
What therapies does your child need? Speech therapy? Occupational therapy? Nutritional approaches? What are the correct proportions of each? The following are some key ingredients parents should have on hand to help determine the correct proportions of therapies in their child’s cake.
1. Interpreting Test Results
Traditional testing may not accurately reflect your child’s true abilities. Most children with developmental problems demonstrate “scattered skills” along the developmental continuum.
Therefore, they may “ceiling out” during testing, before an examiner has had the opportunity to identify some of your child’s higher level skills. Knowing the specifics of your child’s skill level will help you accurately plan for teaching.
The narrative should go beyond numbers. Clinical observations are key to a good diagnostic report. For example, “Johnny received a receptive age equivalent of 24 to 27 months” is less helpful than “Johnny was able to demonstrate recognition of several verbs at the 24 to 27 month developmental level, including pointing to pictures depicting running, eating and sleeping.”
Identifying exactly what skills your child has achieved and what the next developmentally appropriate skills he or she should learn can be critical in your ability to work at home with your child.
2. Proper Stimulation
Children without learning difficulties involve themselves with language and play for most of their day. Children with severe learning problems fill their day with a variety of non-productive behaviors, such as hand flapping. If your child has trouble with basics like identifying a core set of nouns, for example, then being asked something like “How did you get to school today” or “What would you like to play” serves only to further confuse him.
Once you understand what your child knows, expect him to demonstrate that knowledge. A good rule of thumb is, if you are not sure that you have taught it, don’t request it. For example, if you have been working specifically with your child on object identification, and you have not taught your child to identify a “pen,” do not ask your child to give you the “pen” when you need to write something down. If you haven’t worked on verbal imitation, don’t ask your child to say “good-bye” to the speech therapist on your way out the door. Learning how to appropriately stimulate your child is critical.
3. Behavioral Issues
The causes of behavioral problems, and methods for treatment, can be both complex and varied. It is necessary to provide an atmosphere which is highly structured and conducive to your child’s learning style. Parents and caretakers can learn appropriate methods of reinforcement in an effort to reshape and redirect behaviors. They sometimes reinforce maladaptive behaviors without intending to do so.
Consider the following: Johnny is crying more than usual today and tantruming during a therapy session. His well-intentioned caretaker may suggest “let’s take a break”. Be assured that Johnny will quickly learn how to avoid working. This scenario would serve to encourage tantruming and increase crying episodes. Reliable and consistent reinforcement techniques provide your child with a stimulating environment conducive to learning.
4. Developing a Home Program
Successful development of a solid home therapy program can enhance your child’s rate of progress and enable you to become the liaison between your child’s school and outside therapies. You will need a skilled professional to help you coordinate such a program and to work in partnership with you and your family. Successful initiation of such a program can be difficult, time consuming and emotionally draining, but I think you will find that it is worth the effort.
Sabra Gelfond is a speech-language pathologist and cofounder of DDR. For more information on developing a home program for your child, contact her at National Speech Language Therapy Center, Wyngate Medical Park, 5620 Shields Drive, Bethesda, Maryland 20817 (301) 493-0023.