Tagged "Speech Therapy"


How Music Therapy Became Our Next Best Step

Posted by Deborah Grauzam on

For those who have been following our story on this site, you know that Elizabeth has struggled with speech and language throughout her life due to her disorders of Dyspraxia and Sensory Processing Disorder.

And because of this, we have had some form of speech therapy throughout most of her life. I say a form of therapy because early on we did a great deal of oral-motor work. Later in life, we worked on articulation for her words to be well understood.

When I remember hearing her say no words and now I hear her saying so many words, I know how far she has come. There are still misarticulations but these are habits now, not words she cannot say. And because of her disorders, sometimes volume control is an issue. Even taking complete full breaths needs to be worked on. I always say “we are a work in progress.” But truly, we all are.

The thing is, she is 19 years old. So traditional speech classes are not necessarily the best fit for Elizabeth due to her age and maturity. So for us, we needed to find the next best step. So when a former therapist steered us to the area of Music Therapy, we took a good serious look.

The look led to a meeting, then to a class, then to several classes and now we have officially welcomed this therapist to the ever growing and ever changing “Team Elizabeth.” The best thing is seeing how excited Elizabeth is to go to the class. She loves the therapist, she loves music and asks to sing every night (we get homework each week) and it could not be a better fit.

I, myself, did not know as much about music therapy when it was first mentioned. But with some research prior to going, I found out some really great things. So I wanted to share it with you. Please check out the American Music Therapy Association's website. There is so much information about what music therapy is and what a music therapist does.

I am so glad our therapist could take some time to answer a few questions. So here is the interview. I hope it helps someone who is looking for the next step or even to add something into their current speech schedule. I thought I would share them with you, in the words of our therapist herself.

Can you tell me a little about music therapy?

What is most important for me as a music therapist is the personal connection that I make with my clients. If there is not a feeling of trust and security between the therapist and the client, there is little hope for growth. I feel so fortunate to be able to use music as the tool in which I help people make change. Music is a motivator for so many people, which makes this form of therapy successful when other forms may not have been. It can be used with ultimately any population or any goal area as long as the person is motivated by music. Whether the goal is speech based, emotional, or range of motion, music therapy can be successful.

What kinds of speech or language difficulties does Music Therapy most likely help with?

The beauty of music therapy is that it can be incredibly versatile. Whatever the area of need may be for an individual, music can almost certainly be used to address these goals. Examples of how it may be utilized are pronunciation, by making words rhythmic, oral motor goals, by playing wind instruments or utilizing a preferred song to address difficult words. These are of course, not inclusive, as music therapy will look different for every client.

What is Music Therapy?

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.

Music Therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals.

How would a person go about finding a music therapist?

On the American Music Therapy Association website, there is a directory to locate all certified music therapists.

-Michele Gianetti

 

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here.

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Elizabeth: How we made a medical team for ourselves

Posted by Deborah Grauzam on

Somewhere in my book I know I reference “Team Elizabeth” and at the time, it consisted of her OT, her exercise trainer, her tutor and her speech and language pathologist.  Her “team” has changed as Elizabeth has grown.  And the “team” reflects her needs at the time.

For example, when she was younger a vital member of her “team” would be her Ear, Nose and Throat (ENT) specialist.  And at another time, we would have added the name of the doctor who managed her brief, but productive and very costly foray into the area of biomedical treatment.

We now have an entirely different “team.”

It fits her needs perfectly.

They all “get” how Elizabeth works and know how to help her grow and achieve.

But how did we get these teams way back then? And how did we help them learn about Elizabeth’s disorders so that they in turn could help her?

Well, it all starts with getting through the first big block to this journey and that is to work your way through denial.   Maybe some were blessed to sidestep this feeling and maybe others were able to get to the other side of it quickly.  But for those like me, it was a pretty tough and pretty big force to face.  It took a lot of work on my/our part to allow the words about Elizabeth in, to face the truth that what we wanted to see and make real, was indeed not there.  It took us listening and not just hearing and allowing ourselves to feel the loss of typical and the acceptance of special.

After denial is behind you, the real work can begin.  Know that you as parents know something or things are not right.  You know in your heart the things you see each day are not what you are supposed to be.

Please begin by writing them down on paper:

  • When they happen.

  • How long they happen.

  • When you first noticed them starting.

  • How often they happen.

  • What you do or cannot do to help your child.

  • How these affect your child’s day.

These things are so important when you try to explain your child to a professional.  For two reasons:

  • You will NEVER remember them all when the moment arrives to tell them all.

  • It is easy to make a copy of the above and share it with professionals at will.

After all, you are the person with your child during a typical day, doing typical times.  How hard is it truly to have your child act like it is just any other day when they are in an exam gown or are in a waiting room for a long time?

Look up what you can about the signs or delays your child is showing.

I know that this can be unnerving but sometimes just trying to understand about a subject that is foreign to you can also be a bit of a comfort.  I know that reading about Elizabeth’s speech delay helped us make sense of some of the frustration we saw in her.

Print out what you want to share with the professional.

Talk with your child’s pediatrician.

This is where the things you have written down, the anecdotal reports, the internet information will help you help them understand.

Be honest and truthful.

Ask them for advice on where to go next.  Ask them for a referral for further testing if needed.  Ask them for a diagnosis if possible.  But do not allow the moment to pass, when you WISH you would have asked your tough questions.

Pediatricians currently are required to assess for developmental delays but when Elizabeth was young, they were not.  So they are more ready to offer suggestions of where to go and whom to call.

Please remember that you are your child’s best advocate.  And that if something feels wrong in your heart, then in my experience, it probably is not the right fit for your child right now.

Getting together the “team” that works the best for your child is a process.  Getting a diagnosis is important.  Getting the right professionals for your child is important but being able to present your child’s delays and needs to any and all who work with them and getting them to understand your child is by far more than important … it is critical.

Your “team” will be amassed over time and you will be the quarterback, managing them all.  

Please know that as the “team” changes it means your child has changed as do all children, those with special needs or those who are typical.   Change can be hard but change can be a very good thing.

Know your child, know their needs, speak for them and about them. And let them know you love them through it all.

Please know that a diagnosis is a very helpful thing to have for insurance purposes, school testing, IEPs, but sometimes before the diagnosis is made, your heart tells you what is “just not right.” For us, NO real language at age two. We saw a lack of motor skills.  Not walking, not sitting up.  And there were so many other things.

We made a list in our heads.  We knew we needed to find help for her.

-Michele Gianetti 

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here.

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Elizabeth: Our Summer Speech Therapy Schedule

Posted by Deborah Grauzam on

So many parents, at this time of year, find themselves throwing out old notebooks, half used crayons, semi-dried-out markers, ripped folders all with the excited feeling that it is summer! Time to just relax. Right?

Well, if you have a child with special needs, that time of sheer freedom does not arrive in quite the same way.

True, you have a bit less of a rigid schedule, a bit less to prepare for each day, but to simply throw out the old school stuff and grab a magazine, lawn chair and plan what to grill for dinner is not how it plays out, at least in my experience.

If you ask anyone who knows me what I love the most, they would answer when my children are home. So of course, I greeted summer with a happy heart, and of course I tossed many a backpack into the corner of the hallway, but then I turned my thoughts on how to make summer fun while still meeting the goals and needs of Elizabeth.

So how did I do it and truthfully continue to do it?

Well, I think one thing I do is to spend some time thinking about some of the goals from Elizabeth’s new IEP that I would like to focus on during summer. And since we adjust her IEP in the Spring, I could use it as a bit of a guide. Once I have some ideas I try to visualize how I can slip them into the day.

Then I think of the things I wish to put into our everyday schedule, like instead of the TV in the afternoon, we would have some music time or some quiet reading time. For those who are younger, we would color or do play dough. Just something to calm ourselves, especially Elizabeth who needs this calming time, and to take a break from the “go” of the day. This is usually around three or four in the afternoon.

We also build in a bit of rest time. So after lunch, we all go to our neutral corners to either watch a video (them, not me) or rest (me, not them).

Of course, there are trips to the park, pool and friends’ houses in our days but I like having this loose structure because then you can build in the therapy play around it.

Something that I think is important is to know that therapy can be built into the play or activities of the average day. And this holds true for speech therapy as well. It’s just that you have to see each thing you do as a potential learning time and/or find ways to incorporate therapy without making it a “therapy time.”

TalkTools | horn kitFor example, something we did to help with Elizabeth’s oral motor work was to blow horns. We would get a number of different ones like the ones of TalkTools Original Horn Kit.  We would sit on the driveway, put a CD in the player and have fun blowing horns to the songs. I would encourage deep breaths and proper lip placement but after that, it was just fun to do this. Emily, our oldest, loved it too and she and Elizabeth would especially love Horn #4, that has the little spinney thing on top.  So we actually bought Emily her own set of horns to use to eliminate any fighting amongst the ranks.

So see, you get the oral motor work, breathing, fresh air and all the while it is fun.

TalkTools | bubble bearSomething else that is fun is to be on the driveway or deck and to bring out the bubbles.  We used to have the largest supply of bubble soap in the neighborhood and ours were even scented! Anyway, we had big wands to use standing up and this would work her whole body to turn and twist and to run after the bubbles to pop them. Then we would use TalkTools Bubble Bear to have her work on her ability to blow bubbles. The face of the bear made it fun. I would actually look forward to this because it was simply fun … but still therapy. One caveat is that you need bubble soap that makes good bubbles, like TalkTools Bubble Refill. This instant gratification is critical when a child is working so hard to make it work.

TalkTools | straw kitEven when bringing your child a fun, summer drink, remember that using certain straws, such as those of TalkTools Straw Kit, will help work with your oral motor goals.

If you are working on language skills, remember the rides in the car are great places to talk, to use descriptive language as you do errands, to ask questions of your child and to help verbally highlight words they may say incorrectly.

If your child needs help with knowing left or right, this can be worked on when driving as well.

TalkTools | toothettesFor those times when more concentrated work needs done, say with oral stimulation like with Toothettes or lemon swabs and perhaps some work with letters or words, I have found that a visual schedule is so very helpful. It lets the child see just what you have planned for the session and allows them to see what comes next. Which will hopefully help with the transition from one thing to the next. And in the case of Elizabeth, knowing when she was DONE was huge to her.

TalkTools | schedule boardI made my own schedule chart but one that I love and only wish I had when we were early on in our journey with Elizabeth is the TalkTools Schedule Board Kit.  I offer that using one of these is something that is so worth considering.

There really is so much you can do, these of course are just a few that we did. Maybe they will help get some ideas flowing. Please feel free to comment with questions or additional summer speech therapy schedule ideas below.

I wish everyone a happy, safe, productive summer. Ours begins tomorrow and I will again toss a backpack or two and then look to having a fun time as Elizabeth and I begin our 18th summer together.

Blessing to all.

-Michele Gianetti 

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here. 

 

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Elizabeth: Speech Goals

Posted by Deborah Grauzam on

Goals.

My wish list.

Two things that I have carried with me since Elizabeth was born. Actually, more like since the minute she was diagnosed.

Goals and my wish list.

I have carried these things around like two best friends. I checked in with them often, planned things around them, and happily checked things off of them when Elizabeth did something new.

They have never left me in all these years, and I feel, if I am being truthful, that they will probably always be with me for Elizabeth. But they have changed shape, that is for sure:

  • - I just hope she can say the last part of her words.
  • - I want her to get the chance and try to go into this class room.
  • - I hope she will talk to some kids on recess.
  • - I want to work with her on her writing.
  • - I want her to learn to text her friends.
  • - She needs to learn to sign her name in cursive.

Yes! It has changed, but the one thing on the list that continues to be there after each flip of the calendar year is her speech goals.

Speech is this inherent part of Elizabeth needs. Her dyspraxia is quite severe and as such we have fought long and hard for any and all gains in the speech realm. 

But with dyspraxia, those goals took extra work because those with dyspraxia form habits very quickly. Be they good habits, like saying a word correctly, or bad habits, like misarticulations. Well, these bad habits are SERIOUSLY hard to break.  It is like once they are formed, they become so strong!  So we learned to learn things correctly the first time. Perhaps we learned this a little late in the game but we learned it nonetheless.

Speech Goal #1

So back to the goals and wish list… right now in Elizabeth’s speech life, we are working on social speech. The kind of thing that requires, among other things:

  • - Thinking about what someone said.

  • - Answering on topic.

  • - Staying on topic.

  • - Allowing everyone a turn.

The dyspraxic mind typically has trouble with organization of thoughts and information, so these goals are kind of tough for Elizabeth when she is stressed or too much is going on in her life. Someone will ask her a question about X and she will answer about Y. I know why it is happening but the poor store clerk does not. So we talk to her a lot about focusing and staying on topic.

Speech Goal #2

Another fan favorite on the goals is for her to OPEN her mouth when she talks. For her, any anxiety shows itself in her talking as if her teeth are glued together. Try it now. It is very hard to be understood this way, and that is for those of us who do NOT have dyspraxia, so imagine how hard communication is for her. So she hears plenty of “Open your mouth, Elizabeth, breath and talk.”

Yes, I am sure she is having a ball with me on those days.

Speech Goal #3

Directly related to the above goal is the new addition of singing lessons for Elizabeth.  She loves, loves, loves music and loves to sing, so we contacted a wonderful lady to work with Elizabeth. It is not just singing, it includes:

  • - Muscle work for her jaw and mouth.

  • - Deep breathing exercises.

  • - Focusing.

  • - Projecting her voice.

  • - Even reading, as they read and sing current songs.

Here is something to know, for those of you with older children: it is so important in my opinion to keep things age appropriate. Something that boosts their self-esteem is huge!

Elizabeth loves this and there is follow-up work for us at home! So win-win!

It is odd to think about it but we don’t GO to speech therapy in a pure sense anymore, we work on goals each and every day. (If you ask Elizabeth, she would say every minute.) But we do not have regular speech classes. We check in with Mary often, readjust a goal or two but we do most of our work in social settings now. Because that is where we find the need.

And that brings me up to the last update for Elizabeth.   

Speech Goal #4

Find the need. Once you understand your child, their disorders or needs, then you can start to find ways to help them. And as their needs change, so does the therapy. In our case, these needs lead us out into the world now. Into the world to talk, to engage in proper conversation, to communicate thoughts and needs. Actually, it is a pretty big undertaking now but this is where we find ourselves.

Speaking of which, I can hear Elizabeth loudly complaining that her brother took the T.V. and it was not his turn. So, I will go now to referee an argument, an argument that likely would not have happened had we not done all we did. We will keep working and encouraging because she is worth it all.

-Michele Gianetti 

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here.

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The Best Gift from Elizabeth

Posted by Deborah Grauzam on

As our journey continued, I was able to revisit the “to do” category of a preschool for Elizabeth.  We initially had tried a preschool in our area that had half typical developing children and half special needs children attending.   We had thought it would be a nice fit for Elizabeth as she would get OT and Speech services as part of her day, some nice socialization and a new experience.  But what we thought would happen and what actually happened were two different things.  Elizabeth started to pick up some behaviors and sounds that we had not seen before.  As this was our first foray into any preschool setting with Elizabeth, we were taken aback.  We came to see that the school did not truly understand how Elizabeth “worked” and as such we knew our time at the preschool had to come to an end.  The whole experience lasted less than three months.  We were quickly learning that our role in helping our child included education of caregivers and new therapists and advocacy.  We were also learning that every twist and turn on this journey was teaching us something….even if we were not in the mood to learn.

This time of Elizabeth’s life, in my mind, is kind of the one that pulls on my heart a bit more.  We really wanted her to have a place to go to be with other children….but we were quick to see that wanting something for Elizabeth and actually finding it are two different things.  We could not simply sign her up for another preschool….this would not be something we could all happily anticipate.  No, with her dyspraxia, speech delay and SPD,  it would be work….we were quickly coming to see that even though we had done so much work with her prior, more awaited us.

We continued to work on Elizabeth’s speech as well as her OT.  We discussed with Mary, that we were going to look for another speech pathologist, one who would work the muscles in Elizabeth’s mouth or a Myofunctional Speech Pathologist.  Mary agreed that this would be a good fit and encouraged us to find her.

This type of speech therapy seemed to be just what we needed next.  We went three times a week to start.  We told the therapist all about Elizabeth’s disorders and she seemed knowledgeable about them and was very willing to try to help Elizabeth.

With much work, think oral stimulation with lemon glycerin swabs, actual physical manipulation of her tongue and lips, many oral exercises to make certain sounds many times. We continued these exercises at home, purchased many glycerin swabs and also the boxer vibrator from TalkTools to help with the oral stimulation of Elizabeth’s mouth and lips. We had new work to do at home but we knew all we did was making progress…and soon I got the best gift from Elizabeth right before Christmas.

The very best day of my life with Elizabeth happened…..syllable by syllable, with the therapist guiding her…  Elizabeth read a sentence from a Dr. Seuss book.   It was AMAZING.  Yes, it was slow.  Yes, it was syllable by syllable.  But it was a sentence.  Our first one…clear and understandable.    I really could not hold back a tear as I held this child on my lap and heard that voice that up until now had been half words, occasionally whole words, when nervous no words…….but was now present and showing us a sentence.

Something else that was wonderful was that this therapist had tested Elizabeth’s responses as we had been going along these few months and shared with me, my second gift, something I had been saying to everyone who worked with Elizabeth.  “Mrs. Gianetti, this child is extremely bright and motivated and she wants desperately to be able to talk.”   It felt wonderful to hear it from someone else and I did not ask her for this information, it was offered to me.

This helped us feel stronger in our advocacy for our child and whatever the next step was on this journey. Sometimes we have to realize, as parents of special needs children, that we need to listen to our heart and to do what feels right for our child.  With that said, we found a wonderful preschool for Elizabeth.  It was run by a friend of a friend.  Elizabeth loved it.  And just like Kathy said, she was so wanting this social outlet. Actually, this is the place she first met her lifelong friend Erica.

I am a firm believer that there is good in every situation in life, that some good comes of all things.  In the case of our first preschool experience, the good of it was that we learned about our need to advocate for our child.  We learned the need for good communication as well as the need for us to fully educate that staff about our daughter.

Well, we did these things and that preschool proved to be a wonderful, happy place for Elizabeth.

I guess you could say we showed Elizabeth the world this year. It definitely took effort and the need for us to regroup and try again.  But ultimately, so much good occurred.  Elizabeth was enjoying life, she made a friend, she had a place to go that was hers and we kept on working hard at home….we even had a first sentence the will always be remembered….yes I would say it was a good year.   The journey continues…..

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-Michele

Michele Gianetti writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder. Follow her story since the beginning here.

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