Speech Therapy isn't helping as ds won't cooperate

[themoos]

I posted a while back about my 3 1/2yr old ds2 who had at that point been diagnosed with a phonological disorder.

He has now been seen by a specialist and he now has the more complete diagnosis of Verbal Dyspraxia.

He talks a lot at home and school - and has made significant progress in recent months. He can make most sounds in isolation but struggles especially with final consonants and putting consonants in multi-syllabic words. Most sentences contain some degree of stammering and he drops essential words from sentences such as the "don't" in an "I don't want..." sentence. Despite him talking more and more, his grammar isn't showing any sign of improving yet - for example he uses "my" instead of "I".

He is currently getting weekly speech therapy sessions but they are little short of a disaster. The SALT is a young and presumably inexperienced girl. She just isn't engaging with ds and I suspect the set up is completely wrong. She sits on one side of the desk and he sits on the other and is meant to play games with her. He totally refuses and just sits in silence.

I have been given a copy of the games to try and work on at home. An example of the current worksheets is a picture of a bow, and then a picture of a tap (representing the "t" sound) and he's supposed to say them repeatedly, bringing them together to make "boat". He won't even do them with me and I'm suspecting that they aren't age appropriate for him.

So what do I do? How can I work with this girl to try to make the speech therapy worthwhile? Everything I read about verbal dyspraxia says that intervention is essential as it won't get better without therapy - but what should or could he be doing?

I resorted to bribery with DD#1 and her speech therapy - sounds like you are following the nuffield dyspraxia programme that we used too. I literally would have M&Ms out on all the pictures and if she said it/tried it she could have it. We gradually worked down to lots out but only getting one at the end of the task so it kept the chocolate intake more realistic. We did use games and winning puzzle piece to put in things like pop up pirate games etc for each attempt at the sounds - they had some but limited interest. You need to see what motivates him and have the bribe for him really - cars, stickers, DVD....etc

Ds needs mild speech therepy (some sounds missing after history of ear problems). We saw the therepist for the first time at 3yrs 2 months. They assessed him with the picture book, got him to blow bubbles and then played games on the floor with him encouraging him to speak.
At one point he wasn't wanting to do the book which was fairly essential so they could assess him, and they hit on bribing him with blowing bubbles. When he had said the words on a page he could blow a bubble.
But they did say to me that it's hard doing speech therepy for that age because they often just refuse to speak and they get much more out of it when over 3 1/2, and 4yrs is even better.

We had the same problem. Our son couldn't get any therapy because there was no compliance. He is now doing behavioural therapy alongside SaLT and is doing much better. I would recommend behavioural therapy or ABA. Intensive therapy programmes exist for children with ASD but can also be used to address specific behavioural problems with other children who have additional needs. UK YAP and Autism Partnership both offer tailored programmes. It is expensive and we made life style changes to make it work-it's worth it! Good luck.

I was about to say a bit of ABA/behavioural approach is what is needed imo.

Thanks everyone for the replies.
zzzzz - I think the problem with the therapist is more due to her lack of experience than anything else. It feels to me as if she's been thrown into the job without sufficient support and guidance. I've been in jobs like that and it's horrible - I can see that she's clearly hating it. Interacting with small children (especially the ones that don't talk!) is hard for anyone and I just don't know how to help her without undermining her. I want to just tell her to start the session by sitting down on the floor and playing a game following ds's lead to try to break the ice - but I don't know how to say this. I also wonder if it would help if I left the room for a little while, as he does tend to cling to me.

Interesting hearing about the ABA/behavioural approach. Reading up on it and from the other comments here, my gut feeling is that the problem is more to do with trying to approach the therapy in a more fun way. I do need to talk to ds's nursery teacher again. I've had comments in the past about how hard he's been working on his numbers etc - so he's clearly compliant for them.

We did see a private SALT a while back and I'm thinking that I probably need to get back in touch with her. She was very good at engaging with ds and was very imaginative. I think I need more ideas!

beautifulgirls - I've just tried the chocolate bribery route and it worked - he went through all the work cheats! THANK YOU THANK YOU THANK YOU!!!

Oops, I mean worksheets - not work cheats . Must have felt like I was cheating lol

brilliant. I have the same problem with DD2 and her speech and her not wanting to learn... think sometimes when you're with them all the time doing it all day every day you forget how to stop and make it fun. I'll take these ideas, thanks!

Why is it that private SALTs seem to know so much more/be more understanding?!

Great! It was such a breakthrough for us the day I got them out instead of some counters! Keep at it and you will find other ways to motivate him I'm sure. Having been there I know what a headache it can be and SO frustrating as the adult involved but of course you can't show them that. It does get better though I promise. DD has made tonnes of progress from where we first started and whilst she does have ongoing issues it has become apparent her issues are more than just verbal dyspraxia and these are playing a role in her speech and what we are now working on. She started therapy properly at 3yrs old and is now 6. For the most part she can now make herself understood to most people which is great.

"ONE lecture on ASD" ? Seriously? I thought speech therapy was a four year degree course. What on earth are they teaching them?

Thanks for the tips re:how to approach the therapist. Taking a nice squishy cushion and some smarties might move things along a bit. It isn't helped by the room in the clinic being a bit, erm, clinical - not the most inviting environment for a three year old.

Really looking forward to it all getting easier, so thanks for the reassurance. Will keep working at it!

They arent'[ age appropriate, and i don't think many of the things SALTS try to do with preschoolers are.

Ds1's psych nurse 'had a word' with the SALT after several sessions of the sort you have just had, (except Ds1 was literally climbing the walls and shouting "Bricks bricks bricks" into her cupboards) - and when we arrived at the next session, she had got the Elefun out, and allowed him to have a go with it after every 2 minute exercise.

Suggest something like this to her, explain that he is only 3 (something they forget), cannot read (again, they forget this), does not know his alphabet (they forget this too) and that all therapy needs to be sound and picture based with a LOT of reinforcement.

I have had 3 DS with different S&L difficulties. The problems i encountered mainly were that the sessions were not stimulating enough for their interests.
My DS1 was into transport, so i bought 2 What Car type magazines and made matching cars cards. So if we were practising 's' - we might use, Seat, Nissan and Lotus - to get different positions of the letter s. It was the only way i could get him to do the work. If i had of stuck with the SALT's words, we would have got nowhere.
Work on what your DS finds interesting - Trains (thomas/Chuggington), animals/insects - whatever he likes. Then work out some games to incorporate the skills. Let the SALT know, and show how much more readily your DS will work on things he likes. Hopefully she will then work along the same lines.

Managed again by bribing ds with the promise of a light balloon on completing all the worksheets and he was actually quite enthusiastic . It also seemed to help when I described it as "homework like ds1 has" as it made him feel all grown up. Guess the novelty will quickly pass on that one, though, lol.

But the key thing I'm getting from you all here is that I have to keep it fun to keep him motivated.

Zzzz - I will keep going with this therapist whatever happens. She's a nice girl so I do want to help her - I'm sure she has the potential with the right support.
at your sister, though.