How ‘Out’ Changed Everything: A Journey Through Speech Therapy
October 20, 2017
By: Cassie Wilhelm, MA, CCC-SLP, Speech-Language Pathologist
In June 2015, Blake came to Bridgeway Academy with his mother and little brother to begin Speech-Language Therapy at our Therapy Center. The family had driven over an hour to come to therapy. From the very beginning, Blake was interactive and socially-driven. He was using some signs and could make a ‘b’ or ‘m’ sound. His gestures, vocalizations and joint attention communicated meaning about his environment, and although he had a minimal expressive verbal vocabulary, he was commenting, asking questions and able to request assistance.
In time, Blake was soon running for hugs in the waiting room, had learned our routine (we always get a truck or a bus before heading to my therapy room), and loved “practicing” sentences. However, his speech progress was initially slow. Over the first six months, Blake had not made significant progress with verbal sound production.
That began to change in January of 2016, when he said the word “out” in therapy while playing with a puzzle. The production was labored and disconnected between the vowels and the consonant, but he did it! We celebrated and I reinforced what “out” meant for our activity: “take out the pieces.” Within weeks, he was saying “out” to request leaving the treatment room, to go outside, and to again take out the puzzle pieces.
Even with the acquisition of “out”, Blake still couldn’t verbally say many of his favorite things, which were often transportation-related including “garage” and “helicopter.” As part of his therapy, we trialed the LAMP (Language Acquisition through Motor Planning) Words for Life application on a speech department iPad many times during his first 8 months with us. Our focus was verbal speech production, as Blake knew so many words that he couldn’t produce verbally. During these trials with LAMP, Blake showed great promise. He understood cause and effect and understood that what he said on LAMP was relevant and meaningful. In April of 2016, I recommended that the family purchase the LAMP Words for Life application to use at home on an existing family iPad. Blake’s mother, Brooke, was agreeable to this plan, and we had many conversations about continuing to work on verbal speech, because the access to immediate functional communication was important for Blake to feel successful, and for him to want to continue to work hard.
For about 3 months, Blake consistently brought his iPad with LAMP to therapy. He was using it at home and his mother and I were discussing how to get his school on-board and educated about LAMP for the fall, when he would be going back to pre-school. He was combining words on LAMP or sequentially with verbal speech, by saying one word verbally followed by one word on LAMP. His word combinations were fluid, novel and meaningful.
Up to this point, “out” had been our first big verbal speech success, but remained one of the only. LAMP was proving to be a good option for Blake, providing him a way to communicate through the device – but then something special happened.
Something clicked for Blake and his world changed. His language exploded. I think it was the perfect storm for his stage of development: motivation, parental involvement (including Grandma Sharon who drove over an hour every week!), his relationship with me, and a holistic treatment approach that targeted words that Blake could use across environments and for a variety of functions.
It has now been over two years since we began working with Blake. He’s now using lengthy sentences, up to 7-8 words, and has developed many age-appropriate sounds., and is attending kindergarten this year! Blake has made so much progress in our program and I’m confident that he will continue to excel.