As a speech and language therapist I work a lot with children that have difficulties with their sounds. These difficulties vary and some children have few substitutions and others are totally unintelligible.
This story has been personally written by a dad. It is his account of the experience of having his child diagnosed with SEVERE PHONOLOGICAL DISORDER, as well as his journey with therapy, progress and much more.
It’s a story of trying to implement therapy in everyday life; practicing in every context.
The name has been changed to protect the family’s privacy.
When I first met him, he was very reserved, and once we started to play I realized that he could only articulate vowels. He was having a full conversation, and using lots of words, however only vowels.
Hi dad starts by saying…
“Although he appeared tired or not fully engaged, I knew that he was absorbing all the information given, through games and fun times. I loved my time with him and the challenges of teaching sounds.”
Children like Jack need a lot of practice and repetition as due to the fact that he only used vowels, his tongue forgot how to move, and there was little coordination.
Jack developed normally in his early years, babbling and gooing with the best of them. As our second child his recognized the normal milestones kids go through and Jack was no different. However at about 2 ½ his language development had stalled. He spoke as most children do at that age, but we were the only one that could understand him but he continued to make little improvement.
He was approaching his 3rd year, his language had largely remained the same – he spoke with his mouth open all time so all you heard were the vowels in a sentence; however cognitively he was accelerating as expected and asking more and more complex questions but we struggled to understand what he was saying.
The first warning signs we observed were:
- he didn’t interact at nursery
- he started to whisper when asked to repeat what he said.
- nursery staff commented that he was putting items into a container and taking them out repeating the same sounds to himself – Jack could count to 10, but the nursery staff didn’t know that this rang serious alarm bells.
After an initial assessment, we sought a 2nd opinion. Contacting Anna, I explained the symptoms as above, my concern was that Jack was being left behind socially and not engaging with others except his close family. Social isolation is a precursor to many later issues in life.
I received Anna’s initial assessment of a Severe Speech Sound Disorder as great news, as many other parents would have been dismayed. To me it was confirmation that what I saw as an issue, was recognised in a professional context. It meant we could leverage resources to help, it provided a description of the condition, a progression in the event of a failure to act and that an intervention could be shaped.
In the first sessions I had the opportunity to see what the treatment was in practise but more importantly, how it would work. Initially Jamie was exposed to simple sounds, P and B, which were repeated. The first breakthrough came when he was given a binary no escape choice “would you like the Pea or the Bee ?” and he said “Bee” – for the first time !
From that initial sound I worked with him every day adding all the vowels from Bee to Boo, to Bow, to Boy, Ba[t], Bo[t] and Bu[m] – and then adding them to get BotBoy, BooBum, BeeBat and finally Bumble Bee. To this day he still refers to himself as BotBoy when most kids would say Batman.
I continued to reinforce the sounds being worked on that week. He and I made a habit of going out on Saturday and Sunday morning:
- sitting in a cafe
- repeating the sounds to each other conspiratorially, like jokes,
- using them in nonsense sentences, “but bumble bee bit by bit botboy”.
Once he had the idea of the game, he caught on very quickly, we extended it with other sounds and sounds in different places in the words.
Going through this experience was exhausting, mentally and emotionally. I hadn’t realised that the process would be so intense. I suspect that normally pronunciation correction is continually undertaken through interaction with other people in a feedback loop, but we had to do all the feedback. But despite the acting out when confronted in lesson, my overriding impression was that he was really trying, and for a child of that age to put in such a proactive and sustained effort took me by surprise.
About half way through the therapy we started to notice a change in his approach to the teaching. Whilst in the class with Anna he still appeared a little inattentive, sometimes more than a little – after the class he would try to practice what Anna had shown him by himself. At night we would hear him in his bed talking to himself, often using the nonsense sentences but to himself rather than another person.
To me this was the next breakthrough I was waiting for, his mental model of the sounds and what they should be were now much more advanced than his ability to say them but this meant he was able to self correct and the acceleration from this point became exponential – we struggled to keep up. The format of the lessons included a lot of re-enforcement and I could see that this was becoming a problem because it wasn’t challenging and it wasn’t new.
Anna recommenced therapy after a break and I was really gratified to hear her concurrence that he had progressed fantastically. A number of follow up sessions commenced and Anna recommended a conclusion to the therapy as Jack was now in a position to continue as any child of his age.
As an addendum, we continue to notice progression in his language skills – but much more critically to me is the confidence in social interaction he now has. He will answer confidently to a stranger who asks a question of him, with eye contact and sometimes showing a maturity that takes me (and them) by surprise. This learning how to deal with others, to negotiate and to interact is complex, and being able to express yourself and learning how to cope if you don’t get your own way is critical at an early age to ensure balance in later life.
I worked with them for over 7 months and as a speech and language therapist, it is amazing to be part of a child’s journey of communication and support his development as well as supporting his parents. I am grateful