5 Things That Are Limiting Your Child's Progress in Therapy

As a speech-language pathologist in home-health, I have spent a significant amount of time with kids from a variety of backgrounds. All of my families are different in terms of social-economic backgrounds and I've spent times in homes where I've spent thirty minutes shooing away cockroaches and thirty minutes marveling at the beauty of homes grander than my own tiny, yet well-loved apartment. However, there are a few things that remain true across the board- for one, all parents want their child to make progress in therapy, and there are a few, stand-out "obvious" ways to facilitate this: for example, regular attendance! However, I've begun to rack up a few not-so-obvious factors that may seem minor but I have found have a MAJOR impact on a child's ability to participate and benefit from therapy.

1) HAIR. HAIR EVERYWHERE. 

This goes for mainly my little girls, but if you have a child who already struggles with sustained attention and is easily distracted both in life and especially in therapy, I recommend doing a one-over before therapy starts and making sure there is nothing on their PERSON that could potentially add to the list of distractions. Hair is first on the list. Making sure their hair is either tied back or in general, not hanging in their field of vision. I can't tell you how many times I have had kiddos with the cutest but longest hair cuts who are distracted by trying to look at me through their hair or constantly re-adjusting it throughout the session. Ponytails and trimmed bangs are my best suggestions! I keep an extra ponytail holder on hand for occasions such as this.

2) CLOTHES THAT ARE EITHER TOO WARM OR TOO COOL, OR DISTRACTING IN SOME WAY OR ANOTHER.

Going back to a one-over on clothing- it seems obvious, but if children are too hot or cold during a session, especially those who may be less verbal/communicative and can't TELL you their uncomfortable, they may become agitated, whiny, and/or easily distracted during therapy. I understand laundry days, and some times it's just about wearing what's clean, but if parents can help it, I recommend SEASONALLY-APPROPRIATE CLOTHING, based on the outside temperature not just how it feels in the AC. Also, therapy days may not be the best day to let little Sally Sue wear her favorite new shoes that can be velcro-ed and re-velcroed and taken off by her independently multiple times, or the shirt with doo-dads on the bottom. I have kindly confiscated shoes, for the sake of child's attention and progress in therapy that session, given the parent's permission. :)

3) BACKGROUND NOISE/ENVIRONMENTAL DISTRACTIONS.

Now is not the time for doing the dishes. Loudly. Or having the television on at a even a moderate volume, especially if it's a show the child likes and even if it is in a nearby room. Kids will CRANE their necks to see what's on the screen. Also, for children with autism or sensory processing disorder, any small, auditory or visual distraction can be a hindrance; i.e., the sound of the washing machine/dryer, someone getting themselves a cup of ice, or sibling shrieking down the hallway. While a quiet playroom is often an optimal therapy space, sometimes too many toys can be a visual distraction and prevent the child from focusing on what the therapist has for them that day. The best place for therapy is a quiet, calm setting, and although I am all too-aware as a home-health therapist sometimes siblings and noise are just part of the deal, minimizing distractions in anyway possible is going to ensure a better outcome overall.

4) SLEEP.

I don't know about you, but if I went to bed at 2am, and had to get up at 8am in order to participate in therapy (which I have) I would be one unhappy camper. Beyond general grumpiness, I would also display some level of slowed, cognitive function- lack of alertness, ability to attend to sustained tasks, and difficulty with memory retention; in this case, those vocabulary words and language concepts we work so hard to master!

In other words, when kids haven't had enough sleep, they simply aren't ready to learn nor are they able to benefit from what therapy has to offer them in the most optimal way. Parents- if your child is having trouble getting on a sleep schedule or is experiencing medical issues that prevents them from sleeping soundly through the night, please ask your speech therapist or doctor regarding possible forms of intervention.

5) CONSISTENCY IN PROMPTING YOUR CHILD OUTSIDE OF SPEECH.

Last but not least, and in fact, perhaps the most CRUCIAL thing in ensuring your child makes progress in speech, is to follow-through on your therapist's recommendations OUTSIDE of speech. Most children only receive therapy two times per week for 30-45 minutes, and this is LITERALLY 1% (0.01339...you get the picture. And yes I did the math) of your child's total waking hours in a given week. It may be a pain in the behind, but the greatest thing you can do for your child's success is to make consistency king. Prompt them to tell you about what you all are doing that afternoon, using their verbs or their target sounds, or whatever their goals may be. Work on these skills at least 50% of the time and your child will progress much faster during their 1% of therapy time per week.