Early Intervention Speech Language Program
"Language is the single best predictor of future school progress in a young child"
(Capute, Palmer & Shapiro, 1987)
A Speech-Language Pathologist (SLP) is a highly trained professional who is
trained to manage all human communication disorders (pathology). At the Child
Development Centre (CDC), the SLP helps children from birth to pre-school age to
overcome and prevent communication and hearing disorders. The SLP uses a wide
variety of specialized instrumentation and procedures to screen hearing and
assess speech and language. The SLP participates in programs, ranging from
direct (one-on-one) therapy through group therapy to consultation sessions, and
on teams that provide consultative and direct treatment services. The SLP is
responsible for counselling of clients and families and for appropriate referral
to other professionals.
The SLP is concerned with children's communication skills, both verbal and non-verbal which include:
- Understanding and using language - using words, sentences and telling stories
- Social uses of communication - using facial expression, body language and gesture when greeting people, playing with peers, holding a conversation, etc.
- Clarity of speech, including the ability to produce and combine the speech sounds of the child's language
- Correct use of the voice · Alternative or augmentative ways of communicating, such as sign language or picture symbols
- Fluency
- Pre-literacy skills
- The Speech-language Pathologist also manages feeding difficulties in young children which involve the ability to suck, chew and swallow.
At the Quesnel & District CDC the SLP will:
- diagnose communication disorders (comprehension and expression) and swallowing disorders
- plan and implement treatment in language, speech, voice, and/or swallowing disorders
- design and employ augmentative and alternative communication
- consult regarding language stimulation, inclusion strategies and teaching adaptation for students with language impairments.
Communication is a skill which involves the whole child. It is therefore
necessary for the SLP to take a broad view of the child and are therefore
concerned with the child's hearing, general health, attention, memory,
personality, socialization, sensory-motor skills, movement skills, play and
concept development. Family needs and lifestyle are also considered in selecting
treatment content and options.
The pre-school years are the most critical for
speech and language development. Referrals to a SLP are made by family doctors,
public health nurses, Infant Development specialists, Supported Child Care
consultants, preschool teachers or social workers. Self-referrals can also be
made.
At the Quesnel & District CDC the SLP is required to have a masters
degree in Speech-Language Pathology, and be a member of both the Canadian
Association of Speech-Language Pathologists and Audiologists (CASLPA) and the
British Columbia Association of Speech Language Pathologists and Audiologists (BCASLPA).
Both associations demand adherence to a code of ethics as well as meeting
continuing education requirements. Their websites are:
"We have two ears and one mouth so that we can listen twice as much as we speak"
- Epictetus
The Speech-Language Pathology (SLP) program supports parents and caregivers
of children birth to 5 years with communication problems. Services are provided
within a multi-, inter- and trans-disciplinary team approach. The SLP work
closely with the CDC Physiotherapist, Supported Child Care consultants and
aides, Infant Development Program workers, Family Services worker, public health
nurses, Occupational Therapist and early childhood educators. Liaison with
referring doctors and other professionals are pursued.
The services include:
- Evaluating the communication and related abilities
- Assisting parents/caregivers to optimize communication development
- Provide individual or group therapy sessions when needed
- Provide home and/or day-care programs if needed.
Who Needs SLP Services?
Children who exhibit any of the following characteristics:
- unintelligible speech
- delayed language development
- hearing loss
- repeated incidents of middle ear infection
- poor listening skills
- presents with a syndrome e.g. Down Syndrome, FAS, Fragile X, etc.
- attention deficit and poor concentration
- acquiring more than one language simultaneously
- hoarse or soft voice
- not communicating using speech
- unfluent speech
Where Are Services Delivered?
- At the CDC - children may be brought in and seen with their caregivers, be seen in our pre-school, or they may be pulled out for a one-on-one or small group session.
- In the home, especially in the case of very young babies.
- Community preschools and daycares.
How Do I Access SLP at the CDC?
The CDC has an open referral system,
i.e. any parent or professional with a concern about a child can call us to
arrange for a screening. All referrals are accepted and will go through the
intake committee where the appropriate action will be discussed.
What are the Waitlists Like?
Initial consultations will take place as soon as possible.
Children needing periods of weekly treatment may have to wait for a vacant
suitable opening in a direct treatment timeslot, which can be lengthy. During
that time the child will be referred to an appropriate program within the CDC to
provide bridging support. The family may also meet with the therapist on a
regular basis for consultations during that time and some children are
adequately managed by consultations only.
Weekly/Bi-weekly Direct Treatment
Description:
The child is seen weekly or every second week by the
therapist for a set period of time. Caregivers are encouraged to be present.
Caregivers will be given strategies to reinforce treatment goals outside of
therapy sessions, i.e. caregiver consultation is an inherent part of a direct
treatment program.
Treatment sessions will most often take place at the Centre
but may be offered at home, in community daycares or preschools etc.
Purpose:
To
facilitate communication development or feeding skills in children who are at an
appropriate point of readiness, as determined by the therapist. Whether or not
this treatment model is offered may also depend on the caregivers' willingness
and ability to attend sessions and follow through with therapy strategies in
between sessions.
Duration:
Variable. Many children will receive periods of
direct treatment lasting several weeks or months.
Group Treatment
Description:
Each group (usually 2 - 4 children) will have a primary focus, e.g. language
skills or speech sound development. The therapist will select suitable children
based on the communication goals for the group. Some groups will require
parent/caregiver participation. Groups in a pre-school where the goals are
general language enrichment and fostering of good listening skills are provided
when needed and requested.
Purpose:
To facilitate communication skill
development within a group setting. This treatment model offers opportunities to
promote social interaction, incidental teaching, peer modeling, and functional
application of communication skills and generalization of skills.
It is an
appropriate model for children who are able to benefit from peer interaction,
who can comply with routines, and who are able to maintain sufficient attention
to task. The individual child must have communication skills which are at
approximately the same level as the rest of the group.
Duration:
Variable, from
4 weeks up to several months.
Consultation Program
Description:
The therapist
will meet with caregivers as often as once every two weeks or as infrequently as
once every 4 months. The child will usually be present.
Purpose:
To teach
parents and other caregivers to play the key role in the children's
communication development. The therapist's role is to provide information,
support, guidance about strategies and goals and to monitor the child's
progress.
This treatment model is suited to children who learn best through the
incidental teaching opportunities that arise during natural daily routines at
home and at daycare/preschool. It suits children whose progress is relatively
slow, so that time is allowed for change to occur before the therapist's input
is needed again.
It also suits children with mild disorders, who are able to
learn sufficiently from strategies carried out at home and at preschool or
daycare. Infants and children presenting with feeding difficulties as the
primary problem are well managed with consultations.
Duration:
Usually as long
as is needed, i.e. may be ongoing.
Waitlist
Description:
Children may be placed on a therapy
waitlist for services because there is currently no opening for them. During the
waiting time the child will be supported by generalists (IDP or SCC consultants)
in the CDC who will follow a therapy program with the child. While on the
therapy waitlist they may be reviewed from time to time. Parents may also
request consultations. Children are taken off the waitlist when a suitable
opening in a direct treatment or consultation program becomes available.
When a
weekly direct treatment spot becomes available, children on the waitlist as well
as on consultation programs may be considered.
Inactive
Description:
Children
are not receiving any form of treatment nor are they on the waitlist. The
child's file at the Centre remains open.
Purpose:
To keep a record of, and state
of readiness for, children who were in a treatment program but are temporarily
unable to access services due to:
- inability to contact
- family
circumstances
- lengthy illness or medical treatment
- poor attendance
- temporarily out of the area, with notice
- transportation difficulties
Where
possible, the decision to place a child in the inactive category is made in
conjunction with the parents and with the expectation that the situation will
change within months, i.e. that treatment will be resumed. The original waitlist
date is retained. If inability to contact the family or poor attendance persists
beyond a reasonable limit, the child may be discharged.
Discharge
Children may
be discharged for the following reasons:
- child's communication is
age-appropriate
- therapy goals have been met
- spontaneous progress is
expected to occur
- child should benefit sufficiently from another programme,
e.g. preschool
- compliance with treatment or attendance has been poor
- family no longer desires services
- family have left the region
- family
cannot be contacted
- child is referred elsewhere for speech therapy
- child
is entering kindergarten
When children are referred for services to the Speech-Language
Pathology program, they are assessed and either offered services immediately or
placed on a waitlist with the appropriate bridging support from a generalist.
Children who have been recently assessed by a Speech- Language Pathologist at
another agency, or have been receiving treatment from that therapist, may be
placed directly on therapy waitlist. Infants with dysphagia and incipient
stutterers are seen immediately.
When taking children off the waitlist, several
factors are taken into account:
- The length of time since being placed on the
waitlist.
- The match between the family's expressed wishes for a particular
type, time or place of service and the therapist's time slot which has become
available.
- The accessibility of the child and caregivers, e.g.
- family are still in town
- attendance is adequate at the Centre, if that is where therapy is to take place
- if the child is in a community placement or at home, there is reasonable access to the child.
- When contacted regarding treatment onset, the parents/caregivers are still desirous of treatment.
|
