By Teacher Edwin F. Tayab
When we think about our special needs children, we think of an endless list of issues. Most clients – children, parents, referring doctors, caregivers, and significant others – whom we have encountered at the center, would like to have their child talk, stay settled when seated, learn a lot, and be able to write. To present a simple and helpful resolution for these, I would like to focus on speech, behaving well in various settings and how an Occupational Therapist can play a big role to achieve such priorities.
We need to understand factors that may influence the development of speech. Being visual in nature, we appreciate things that are seen without realizing what’s beneath. When teaching and treating children with speech delay, we think of strategies to enable them to speak. We talk directly with them but end up frustrated when we don’t get any positive response. Others present simple pictures, cards, or actual objects to develop their identifying or labeling skills. For some, this can be achieved. For children with coexisting issues like behavioral, cognitive, sensory issues and neuro-motor (fine and gross motor) delay, this could mean a long-term and challenging intervention. Our role is to provide the proper occupational therapy assessment to identify the limiting factors of speech skills.
Various skills such as visual perceptual or cognitive, neuro-developmental & sensorimotor (fine/gross motor) processing, are all composite (but not limited) to communication development and are covert in nature. Unlike activities of daily living or self-care, work or play behavior (leisure, interests), environmental and psychosocial support systems are easily seen or observed (overt in nature) and are also important in the Occupational Therapy assessment. It contributes a greater impact to the achievement of speech skills. After competently assessing all these factors, careful planning of treatment and implementation will be employed. The following are essentials to effective speech development among our children:
“Effectively plan a simple routine during teaching or structured setting”.
Teaching opportunities are not limited to the center only.
For example in the house, assign an area (e.g. entrance door with chair and shoe rack) where you can adopt the “removing of shoes and socks” task that we do at the center before your child goes in to any area of the house. Ask him to “sit and wait” before getting his favorite things.
Rationale: The benefits of these simple yet substantial activities promote vocabulary development. Consider any repetitive or routine act, acts of discipline for compliance like lessening impulsivity or not grabbing things, to carry-out simple rules like behaving in the classroom, while in transit, or at the church, house or community. All of these can impact receptive and speech communication development, behavioral impulse control, attention or focus and concentration. If you are consistent in carrying-out these simple tasks it creates a great impact in the child’s general learning. We tend to ignore the implications of these basic things. It is only when we learn to appreciate the simple attributes (e.g. settled in sitting and complying with simple instructions) in life can we expect to appreciate the greater ones.
“Mean what you say”.
Children with special needs can be processing a lot of information in their mind (e.g. people around, noise, physiological needs-hunger and thirst) and to add some instructions to carry-out something could be uneasy to accommodate or can even be confusing.
For example, when you state, “Remove your shoes”, make sure that the child will really do it. Many parents/caregivers fall short of this since they are the ones who are removing the child’s shoes. Wise advice, don’t steal the child’s opportunity to learn and do this. As much as possible, allow them to initiate the task. In case the child is not receptive when delivering the instruction, you can do the activity with him. You can guide his hands to convey the message “remove your shoes”. Assistance level is very crucial in teaching. For kids who are learning to be receptive and to speak, it is best to try using verbal instructions initially to achieve this level of communication. If he displays inadequate response, then give at least 10-15 seconds for him to process and respond to the verbal information before giving the next level cues through gestures. When response is not achieved, only then can we employ physical cues.
Rationale: We want the kids to learn and respond by displaying receptivity to verbal instructions and later express this in words (speech). We also want them to respond by not depending on gestural and physical cue. It wouldn’t be a problem having you around as a parent in guiding them to do things but we must be very wise about this, what about in your absence? The child can be left inadequate doing their tasks (e.g. self-care, leisurely activities, play) and we don’t want that to happen. Remember that God made a wonderful creation including the brain – its wonders and abilities enable a person in life. In the medical profession, they always emphasize the principle of “plasticity of the brain”. The brain has the ability to adapt and impact other systems to be functional.
Note: Various Occupational Therapy approaches have been combined to come up with strategies/techniques. The principles stated are not limited to the examples provided but can be used with other treatment interventions.
Our team at A Child’s DREAM Foundation, Inc. is always happy to share our skills and abilities on a personal level to our clients. We hope that you learn basic, effective pointers in dealing with your children with special needs. Just approach us and we will be more than happy to teach you other practical techniques in managing your child’s issues.