What's in a speech therapy session?

Some time ago, I brought Dumpling to a speech therapist. I have always been sensitive to diction and pronunciation and being phonics trained, I realized that Dumpling was stuck in a rut with a habit of sticking her tongue out between her 2 rows of teeth.

We did as much correction as we could - tongue placement and getting her to sit in front of a mirror to see and then mimic me. We were progressing well but I wanted to seek for professional help as I feel that it could be corrected faster and I wanted a professional assessment too. Interestingly, after a FB shout, I received many comments on my visit with many citing that they were very surprised to know that Dumpling needed to see a speech therapist as Dumpling seems very articulate. Over the next following days, I also received quite a few private messages that poured in asking me why, what was 'wrong' and some who also reached out to ask me for our experience and what to look out for.

That got me thinking a bit - why is seeing a speech therapist seen as such a big matter where there must be something 'direly wrong'? Why is it that articulation is seen to be the same as 'speech production'? And based on the responses, there seems to be a stigma towards seeking such assistance. 

For that, I am pleased to share that the Speech Therapist who assessed and guided Dumpling has agreed to an email interview which I will be sharing in a upcoming post. For this post however, I thought to share a bit more on what some of the more common questions that I received.

:: Assessment

The first session was an assessment for Dumpling which I sat in too. Our therapist, Joanne, introduced herself and chatted with me first. She asked for my input on what my concerns are, my observations and what we've been doing at home. All these while Dumpling was playing / reading for a while on a mat.

Once we were done, Joanne spoke to Dumpling on what she was going to run through with her - she took out some sheets with pictures inside and told Dumpling to tell her what those items were. The pictures were to get a sense of Dumpling's grasp of articulation (all her beginning sounds, ending sounds, consonant clusters) fluency, etc. 

After her assessment, I was relieved to know that I was spot-on: Dumpling basically needed a bit of guidance in one area and that was just on the contraction of her muscle and tongue placement so that she can feel the dip in the tongue the right sound for letter S.

:: Hands on 'exercise'

The next part of the session was focused on guiding Dumpling to let her feel her muscle and how it should contract (for e.g. when she smiles ~ below pic) and then saying the sound.

After that was done, Joanne wrote out a series of S and then open vowel 'sounds' where Dumpling had to work through with Joanne on - S, Sa, Su, See etc. Each time she gets it right, Joanne will stamp a print on that 'word' so Dumpling can see her progress and this encourages her on.

At the end of the session, Joanne advised on 2 things. One, was that I am to practise with Dumpling everyday on those isolation and open vowel sounds like how she did it in the session and she wrote it out on a sheet (as shown in above photo). The second thing that she did was to work out an agreement with Dumpling on the list of sounds she needed to do with me (basically to get her 'buy-in') and where Dumpling basically signed her life away on her very first 'agreement'! :)

:: Follow up session
I was asked this question a lot. In fact, all the FB PMs which I received ask about this. Is it necessary? How often would the child need to see the therapist? How many sessions of 'follow-up' are needed? Is home practice necessary?

Based on my understanding, follow up sessions are necessary since first session is really to assess. How many sessions thereafter and how often will depend from person to person and what the corrections are. And yes, if the therapist suggests for home practice, then it is recommended.

For Dumpling, it was quite a straightforward case of just one sound, tongue placement / contraction as well as habit correction. With the home practices after our first session with Joanne, Dumpling progressed a lot. So for the second session, Dumpling showed Joanne the 'homework' she did with all the sounds and Joanne basically moved on to the next step where it was to encourage Dumpling how to self-monitor.

This was a major concern for me at that point. If Dumpling were to think about it, she'd be doing the sounds right but the moment she started to get animated and speak really fast, she'd forget and start making the wrong sounds and placement out of habit.

One of the techniques taught was using a 'reward and cutback' method as shown here in this clip. Now, the 'surprise' sprang on me was that straight after this clip was taken, Joanne wanted me to do a 'live' practice (so that she can guide us along if we need to) where I had to work with Dumpling just like how they were doing the exercise in the clip below. :p

After our second session, Joanne felt that we did not need to visit her anymore as long as I continue to work with Dumpling from home on this, gentling reminding her. I am happy to share that Dumpling has improved tremendously where mummy friends have also spotted the difference (thank you Jen!). 

In an upcoming post, Joanne will be sharing with us on some of the 'hot questions' which I received: what are the regular speech and language milestones, when should parents be concerned and have their child(ren) assessed, etc., so please stay tuned! 

Note: Dumpling and I attended the speech therapy sessions as a regular paying customer and I am not compensated for this post. My sharing here is based on our own experience at The Speech Pathology Centre and also to address the concerns, questions which I have been receiving on this topic. Should you wish to find out more, the centre's details are as below:

The Speech Pathology Centre Pte Ltd

19 Tanglin Road

#05-29/31

Tanglin Shopping Centre

Singapore 247909

T: 6235 0037

www.speechtherapy.com.sg