This might seem like a strange thing for a speech therapist to say, but I don’t think more therapy is always better.
More sessions don’t automatically mean faster progress, and I’m not particularly interested in how well a child can perform a skill during a therapy session if they aren’t able to use it anywhere else.
I don’t want kids to get better at therapy. I want them to communicate more in their lives.
Sometimes children become excellent at therapy, but struggle to carry over their skills during other parts of their lives. And occasionally, the opposite happens: a child who barely seems interested in practicing something with me will surprise everyone by using it later on their own.
I want a child to be able to tell their mom what happened at school, ask another kid to play, tell someone they don’t like something, explain an idea, or get their point across when someone doesn’t understand them. Depending on the child, that communication might happen through speech, gestures, signs, pictures, or a communication device. What matters is that they have a way to communicate what they want other people to know. Most of that is not going to happen while I’m there.
A child might see me for 30 or 60 minutes a week. Their actual life happens during all of the other hours: at home, in the car, at school, on the playground, eating dinner, playing with their siblings, or trying to tell their parents something while everyone is rushing to get out the door.
So I care much more about what is changing in those moments than I do about what a child can demonstrate for me during a session. Are they talking or communicating more at home? Are other people understanding them more easily? Are they getting less frustrated when they need to explain something? Are they joining in more at school? Can they communicate when something isn’t working?
That’s also why I spend time working with parents, teachers, and other caregivers. It’s not because I want parents to spend their evenings doing speech therapy homework. I really don’t. Families have enough to do. No one needs another worksheet sitting on the kitchen counter making them feel guilty.
Instead, I want the people who are already part of a child’s day to understand what helps. Sometimes that means waiting a little longer before jumping in. Sometimes it means changing the way we ask a question or giving a child another way to respond. Sometimes it’s figuring out why communication seems easy in one situation and falls apart in another.
Those changes can happen all day long, without turning a child’s life into therapy. And this leads to another thing I believe strongly:
My goal is to make myself unnecessary
I don’t want a family to need me forever. I want children to develop communication skills that work without me there, and I want their parents to feel like they understand their child and know how to help when something is hard.
Sometimes that means a child is ready to finish therapy. Sometimes it means we meet less often. Sometimes it makes sense to take a break and see what happens without intervention for a while.
I don’t think keeping a child in therapy simply because we can find more things to work on is a good enough reason to keep going. There will almost always be another skill we could target. That doesn’t necessarily mean we should. If therapy is helping a child communicate more easily and independently in their actual life, then it’s doing what it’s supposed to do. My goal is for them to eventually be able to do that without me.
