1. Therapeutic Options: Speech Therapy
SSADH Symposium 2016
Therapeutic Options:
Speech Therapy

2. The Story of Three Young Men
Presented By
Marie Coakley, MS/CCC
Speech-Language Pathologist

3. Meet Sam

4. Meet Stephen & Thomas

5. Commonalities Very low muscle tone “floppy” Lack of body awareness
Understand more than they can express
Difficulty coordinating respiration with voice production and articulation
Difficulty imitating motor movements including speech sounds and words
Difficulty directing and maintaining eye gaze

6. Variances Severity of physical symptoms Cognitive ability
Verbal output and articulation skills
Reading ability

7. Total Communication Approach
Several different therapeutic approaches were taught simultaneously:
Gestures
Vocalizations / verbal approximations of words
Low tech and high tech augmentative communication devices
Sign language

8. Advantages of Total Communication
Enhanced development of communication skills across all settings
Provided fall back communication strategies when ill or very fatigued
Did not prove to be confusing to the children
Each system provided a platform for developing the next skill set

9. Scaffolding of Communication
1. Gestures and vocalizations gain attention
2. Sign-Language facilitates verbal output
3. Picture systems with words facilitated pragmatic interaction and phrase use
4. Reading led to spelling and written communication
5. Practice of all modalities improved articulation

10. Scaffolding of Communication
Gestures and vocalizations gained attention.
Power of the Point!

11. Thomas using gestures and pointing to communicate

12. Scaffolding of Communication
2. Sign-language facilitated vocalizations that are shaped into word approximations.

13. Thomas using sign language to facilitate speech output.

14. Scaffolding of Communication
3. Using picture systems with written words facilitated pragmatic communication and forming phrases. “I eat nana.”

15. Scaffolding of Communication
4. Use of written words led to word recognition, reading and spelling.

16. Scaffolding of Communication
5. Practice of all modalities improved:
- verbal output
- articulation
- speech intelligibility

17. Motivation is Key
Sam loved computer games, board games, books and trains.
Stephen loved music, music videos and books.
Thomas loved movies, books and Disney characters.
These loves were incorporated into every therapy session to increase engagement, focus of attention, and repetitive practice.

19. Therapy with Movies & Music

20. when therapy tasks did not engage
So what happened …
when therapy tasks did not engage
or spark an interest
in our young men?

22. Laying the Ground Work for Speech
Occupational Therapy to help organize the nervous system in preparation for speech work
Increase core strength, respiratory support and stamina
Oral-motor stimulation
Establish a non-verbal communication system
Gestures for Yes / No
Sign Language
Picture Exchange Communication System

23. Stephen signing & vocalizing

24. It’s a Family Affair!

25. Family & Community Involvement
Parents, grandparents, siblings and friends were integral to therapy sessions
Peer interaction and social skills groups
Open timely communication between home, school, medical community and private therapies
Don’t waste time dealing with the clueless!
Create a village of support!

26. Practice the Power of Patience
Progress may seem painfully slow. Do not be discouraged!
Lay the foundations first and build systematically from there.
Set achievable goals and don’t let anyone talk you out of them.
Motivation and determination make the magic happen.

27. Speak to the child as if they understand everything you are saying!
This lays down a foundation of mutual respect. By not talking down to them, you demonstrate your understanding that they are intelligent individuals trapped within an uncooperative body.

28. Stephen Today

29. Nothing
Nothing is out of line. Nothing is out of place. Nothing is right. I thought that I would get to say it out loud. I see now that nothing is as it should be. Nothing is as I wished. I thought that I would swear it to the world. I cannot say that I love you. But I still think it. I still think it. Stephen Kearney

30. Thomas Today

31. Sam Today