The American Speech-Language-Hearing Association initially published this blog on ASHAWire/ASHA Leader Live on June 11, 2018. Meredith Gennaro and Stephanie Sigal are speech-language pathologists who met in September 2017 when they began working with the same child.
This school year, I worked with another speech-language pathologist to help 4-year-old Michael improve his articulation and language skills. His parents wanted to supplement his school-based intervention—provided by SLP Meredith Gennaro—so we began working with him simultaneously. We knew we needed to work collaboratively. Using each other’s assets, we could enhance Michael’s progress.
These are the steps we took to help Michael along the way.
Reach out right away to the other SLP. Just as you would contact other disciplines, such as occupational and physical therapists, embrace collaboration with other SLPs! For Michael, we initially met face to face, but a phone call, email, or text also works. Now, Google Voice allows us to talk easily with each other and Michael’s parents. Be sure to get explicit, written permission from the child’s parents to communicate with any other professional.
Discuss the child’s goals. Meredith sticks to the goals listed on Michael’s IEP, focusing on expressive and receptive language and articulation. I primarily worked on speech clarity. Meredith used traditional methods to treat Michael’s articulation, while I combined oral placement with phonetic placements, such as using a tongue depressor to prompt Michael for lip closure to say /m/. When Meredith noted Michael’s gains with me, it made sense for her to jump in on these techniques for articulation.
In terms of receptive and expressive vocabulary, Michael began the year with limited comprehension and use of verbs, which made story comprehension and narrative coherence challenging. Meredith formulated a tailored list of action words to target within our sessions to increase Michael’s exposure to them, supporting vocabulary acquisition.
Work together to educate teachers, parents, and caregivers. One of us noted Michael’s teacher was referring to herself in the third person as “Carol” and the child as “Michael.” He needed to learn pronoun usage, however. We put together a five-minute video of tips on optimizing communication. We included examples of how to ask questions to elicit specific responses, how and when to use pronouns, what to do when Michael over-uses nonspecific vocabulary—”this,” for example—instead of more concrete vocabulary words. We also reviewed how to provide appropriate and functional praise. Instead of complimenting Michael by stating, “Good boy!” we recommended providing compliments on a specific skill. For example, “Wow! I’m excited to hear your crystal clear /l/ sound when you say “love”! Team members appreciated the easy format and suggestions given in the video.
Recognize growth. When we simultaneously noticed Michael showing signs of early reading, we put a plan in place to foster this development within the framework of his goals—increasing expressive/receptive vocabulary, increasing sentence length and complexity, targeting speech-sound production at the sentence level. We generated a list of functional sight words matching those posted in his classroom and shared the words with Michael’s parents. We also encouraged his parents to read as a family. Additionally, we addressed phonological awareness, including rhyming, initial word-sound identification, segmenting and blending of simple words.
Stay in touch. We communicate regularly about Michael’s accomplishments and future goals. We also write weekly notes to his parents, who write us back, sharing details about homework progress. When Michael began treatment, he hesitated to speak and struggled with reciprocal conversation. We asked his parents to send weekend updates with pictures or videos of Michael in action. In September, Michael described these pictures with one word, such as “basketball.”
Seven months later, he uses short sentences without requiring pictures, although his parents continue to send them, so we can enhance what he shares. Michael rapidly improved his narrative skills and regularly asks reciprocal questions in conversation, leading to longer and richer discussions. Michael’s improved speech intelligibility also helped him make progress with reciprocal conversation.
Collaborative team approach. As an SLP, you’re probably used to working with other professionals, but don’t forget about other SLPs! When working together as a team, Meredith and I saw rapid and long-lasting skill acquisition, and we each learned new treatment skills.