Thursday, April 26, 2018


It's Thursday!

Typically, I do Therapy Thursday on the blog. If you came here looking for it, you won't find it today. Last week was my last Therapy Thursday for the time being. I enjoy sharing that part of my life with you, but I have to stop for now.

I have several writing projects that I need to free up some time for in order to get them completed. I'm a little busy being a wife, working mom, running my kids to appointments, and putting up a never ending pile of laundry. If you are a parent, you get it. Free time is minimal, so Therapy Thursday is being left behind for now for other things.

Which brings me to my big announcement........

I am currently finishing up my first book of my very own. Yay! I've contributed to two books before, but this one is all mine.

For the past 2.5 years, I have worked on this book at night or on the weekends. Sometimes, I had 30 minutes to devote to writing it. Other times, I furiously typed for hours. There have been weeks and months when I had to focus on caring for Jaycee and the book went untouched. My kids came first obviously, so there were times when the dream of the book had to be placed on hold. It's been a long and tedious task, but the book is finally coming together. My plan is to have it completed and published on Amazon before the end of the year.

So, you'll still find a weekly post from me on Tuesdays here. If you follow the blog's Facebook page, then you be linked to other articles I write elsewhere. Of course, I'll announce the completion of the book here first. Stay tuned....
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Tuesday, April 24, 2018

Jaycee Gets a CT Scan...Finally

A 15 minute test took hours and hours of our lives last week, and it almost didn't happen.

Jaycee's pulmonary doctor wanted an updated CT scan, since her last one was 5 years ago. The doctor asked me if Jaycee would be able to tolerate a CT scan of her chest. I'm glad she asked for my opinion, because simple things aren't always simple.

Jaycee has Down syndrome. She's minimally verbal. She has had many, many hospital admissions, and this causes her great fear and anxiety with most tests and procedures. It took 3 of us to hold her down for a flu shot last fall, for example.

"If it just takes a few minutes, she'll be fine. I think she can do it," I told the doctor with assurance.

I meant what I said. But then came the paper from the insurance company. The document gave the preapproval numbers for the CT scan with contrast.

With contrast? Wait, what?

Yep, I googled it. Google told me that an IV type poke would be necessary to deliver the dye.

That changed everything. Bloodwork, shots, and IVs are all terrible experiences for Jaycee. She gets scared and moves, which makes more people have to hold her down. It's a vicious cycle that has kept going for years.

I had reservations about the scan, but I figured we'd get through it.

To prepare Jaycee for the test, I used a technique called video priming or video modeling. The technique basically involves having the child watch movies about a specific topic in order to prepare the child for a new experience and teach the child appropriate behaviors during that new experience. (Yay for my speech-language pathology degree!)

On Monday, we watched a few YouTube videos showing children getting CT scans. I sat next to her and narrated what was happening using words I wanted her to remember. ("The girl is getting pictures. She is with her daddy. She is happy. The pictures don't hurt. She's not crying. She's done. She is going home.")

On Tuesday, we watched more YouTube videos with me narrating again. By this time, Jaycee was signing back, "Me. Doctor. Pictures." I showed one video of a person getting an IV for the contrast CT scan. She didn't like that. She whined when she saw the IV part even though it was brief. That was a bad sign. Still, I pointed out that the boy in the video wasn't crying.

On Wednesday, I did more of a mix of contrast and non-contrast videos. She still whined and did a fake cry when she saw the brief IV part. I tried to remind her that no one was hurt or crying.

Thursday was the big day. "Me, pictures," she signed as we headed to the hospital. She was prepared! We made the 3.5 hour trip to the hospital. When we arrived, Jaycee was calm and happy. Sometimes, she starts getting anxious as soon as we arrive in the parking lot and refuses to get out of the van. She got out and walked inside smiling. She was actually fine up until the nurse asked her to lay down to get the IV inserted. The nurse put on gloves, and Jaycee was done. She saw the tray of IV insertion supplies, and she wanted no part of it.

The next 10-15 minutes were spent trying to get Jaycee to hold still so they could find a vein. One person looked with no confidence. Another person looked and couldn't find a vein either. (This is the story of her life.) Finally, a third person emerged who thought they found a vein worth trying to stick. Jaycee was ready for this fight and began to wiggle and squirm to keep the stick from happening. There were only 2 nurses trying to do the stick. The last few times she needed an IV in the hospital it has taken 4 or more people to hold all the limbs that frail around. The nurses were all patient, kind, and compassionate. But, they weren't going to get the IV in this way.

They finally decided Jaycee just wasn't going to be able to handle the contrast part of the test. They warned that the contrast dye will make her feel like her chest is burning and the sensation that she's wetting herself but she isn't.

They asked, "Do you think she can lay still for the scan while she feels those things?"


They listened as I explained how I felt that I had adequately prepared Jaycee for a scan without an IV. I could tell they were unsure if she would be able to be calm enough to do a regular CT scan. Still, they decided to call the doctor and get permission to do the scan without the contrast. Then the waiting began.

At this point, I wanted to cry. I didn't want to come back and do this quick test under sedation. That seemed a little overboard. I also didn't want to go home without doing anything. I didn't want the 7 hours of driving to be for nothing!

About 2.5 hours after our appointment was suppose to begin, we got word that we could do a regular CT. We were called back into a different room. Jaycee sat right down and followed all the directions as she signed "pictures." They fastened a big Velcro seat belt around her waist, but she never tried to get up. My mom held one of her hands above her head while I held the other one.

She did awesome! She was calm and happy. There was no fear in her eyes. Success!!

Jaycee celebrating that she was finished!

A simple test is never simple! I wonder how many health professionals know what some parents go through to get these things done. I'm just glad Jaycee's doctor allowed her to do the regular scan that didn't create so much anxiety and problems for her. In the end, everything worked out. I'm glad that we all worked together as a team and got her test completed.

And that my friends is how a 15 minute test can turn into a 3 hour test! 
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Thursday, April 19, 2018

Therapy Tip: When is a Language Delay Something More?

Welcome to the Therapy Thursday on the blog! This is the day that I share a tip based upon my experiences as a pediatric speech-language pathologist and the mother of a child with special needs. Today's tip is:

When is a Language Delay a Sign of Something More? 

Last week, I wrote about factors that may contribute to a language delay. (If you missed it, click here.) From that, you know that there are many things that come into play that may contribute to a child having a language delay. As discussed, some children will make progress in therapy and eventually be discharged. Other children have underlying issues going on that will require intervention for years to come.

When your child is 2 years old and you're a worried parent, how do you know when a language delay is just late talking and when is it a sign of something else?

To answer this question, let's talk about red flags. Red flags in the therapy world are characteristics that may signal an underlying condition that has not yet been identified or diagnosed. When a child has red flags, it may indicate that something else is going on other than just a delay in language. There are many red flags I could discuss, but I'll go over just a few today. Here are some things I look for when working with toddlers in speech therapy that may indicate something more than just a language delay:

-Slow to no progress in therapy: Speech therapy is usually not a quick and magical fix for most kids. Change takes place slowly over time. If a child has been in speech therapy for 6 months, then I should see some progress. The progress will look different for every child because each toddler is starting out at a different point developmentally. However, at the six month mark, a child who has made little to no progress is a red flag for me. If we started out with one word, and still have one word six months later, then that's a huge red flag. Again, it's difficult to explain what constitutes as slow versus adequate progress in therapy because all children are starting with a different set of skills. A therapist who has been in her professional for a number of years will be able to make that judgment based upon experience. Don't be afraid to ask your child's therapist if their progress seems expected or slow. But slow-no progress is a red flag.

-Difficult to engage in therapy: There are some children who after just a week or two of therapy get excited to see me and want to see what activities we will do. They plopped down on the floor and are ready to start the session. This tells me that they are socially interested in me, have discovered our routine, and desire to play with toys. These are the responses I look for after I come for home visits for a month or two.

There are a few children who don't seem to acknowledge that I am there or notice my arrival despite our weekly sessions for months. There are some children that notice me but don't care. Little to no eye contact during activities may happen as well. All of these responses are atypical. On the flip side, a child who is excited about therapy but will only sit for a minute or two despite a few months of therapy is also atypical.

When I bring up concerns about poor engagement in therapy, parents are usually quick to remind me that their child is just 2. I understand that. I also have over 10 years experience with two year olds. I know when a 2 year old is acting like a 2 year old or having a bad day versus a child who is consistently showing poor engagement. If a child is never wanting to engage with me, that's a red flag. If I have to "work" to keep their attention, that's also atypical.

-Delayed gesture development: Poor use of gestures is another red flag. If a child is not talking, then I always want to know about what types of gestures and nonverbal communication the child uses. Pointing and waving are important early gestures that toddlers need to communicate a variety of functions. Nonverbal communication like leading an adult to a desired object or bringing a cup to an adult to indicate thirst show attempts that the child is trying communicate. The fewer the gestures and nonverbal communication, the more concerned I am that something else is going on besides just a language delay.

-Poor imitation: Poor imitation comes in many forms. There can be poor word imitation, which would be expected when speech therapy first starts. Eventually though, the child should start to imitate words. There can also be poor play imitation. If I show a child how to push a train around a track, then I expect the toddler to imitate it. If a child can't imitate actions that I do, motions to songs, or play movements, then this is a red flag. Again, this is something that I don't expect immediately when therapy starts but it should come fairly soon after some intervention starts.

If I have a child on my caseload who is having red flags, then generally I will make a referral to a developmental pediatrician or speak with the child's physician. They might diagnose a child with a developmental delay, autism, or run further medical tests. If I feel the language delay may be a specific speech disorder (i.e. childhood apraxia of speech), then I may decide the child needs more intensive tests performed by me.

The most important thing a parent can do if you see some of these red flags is to ask your child's therapist about them. Open communication is key in these situations. If you are getting no where with your child's speech therapist, then talk to your child's pediatrician or get a second opinion with a different speech-language pathologist.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice.
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Tuesday, April 17, 2018

Things That Make Me Go Hmm...

Parenting my daughter with Down syndrome, minimal verbal skills, and Intellectual disability is fun, exciting, challenging, and sometimes mystifying. 

Everyone in life seems to have certain preferences and routines. My daughter, Jaycee, is no different. Some routines in life, I have helped her develop. From an early age, she watched me pick out her clothes and place them on her closet doorknob. At some point, she started picking out her own clothes for the next day and placing them on her closet doorknob. She doesn't like to go to bed if her clothes are not set out for the next day. That routine is all me. I'm responsible for teaching her that. 

Sometimes, I don't know where my daughter's routines and preferences have developed. She has things that she does that just makes me go hmm. Why does she hate pillows on a couch so much? We have pillows on our sectional at home. The pillows aren't kept on "her" part of the couch. But still, where did her hatred of pillows sitting on a couch come from? She would rather see them on the floor than on the couch.

Speaking of the couch, she has her special spot on it where she likes to sit. She does her twice daily nebulizer treatments while she sits in her spot. Months ago, we had to start using a new nebulizer machine that had a shorter power cord. Suddenly, Jaycee couldn't sit in her usual spot to do her treatment. She needed to move to the other end of the couch. This threw her off for days. She was mad that she had to change spots and would get upset before each nebulizer treatment because she had to move. Her world didn't make sense anymore, but eventually she adjusted. Now, her new special spot is THE spot. 

Her glasses have a special spot too. Before she goes to sleep, Jaycee places her glasses on the nightstand parallel to bed. Never, never are the glasses perpendicular to the bed.
At the dinner table, Jaycee never mixes food. She always eats one food at a time. She will eat all her mashed potatoes, all her meatloaf, and then all her green beans. Jaycee never switches up bites of food. My son also eats this way, and I recall doing this as a child myself. This preference of Jaycee's carries over to when we are eating on the road. When I order Jaycee a happy meal from McDonald's, I can't hand her the box it comes in. That would be too simple. She will refuse to take it. She wants me to hand her the fries. When she's done with that, then I can hand her the sandwich. When I'm the only adult in the vehicle, it's kind of an annoying situation. Why won't she just take the box?!  

Here's my son when he was 5. He had to sort his M&Ms by colors before he would eat them. Kids develop funny habits! 

There's other things I can't figure out too. Jaycee hates it when I get into a vehicle before her. If we are all loading up to go somewhere, she cannot stand if I get inside the vehicle first. She will try to open my door in an effort to get me out. Sometimes, she will stand by my door and just cry. I don't know why this upsets her, but it does. I try to avoid it by letting her get in first.

As you can tell, there are some things my daughter does that I just don't understand. It makes life interesting and predictable for her and I. I don't know why or how some of the these things developed, but I've come to accept them. She is her own person and a pretty great one at that! Just don't sit in her spot when it's time for her nebulizer, and we'll all be fine! 
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Thursday, April 12, 2018

Therapy Tip: Why Does My Toddler Have a Language Delay?

Hey there! It's Therapy Thursday on the blog. This is a day that I share knowledge based upon my experience as a pediatric speech-language pathologist and a mother of a child with special needs. Today's tip is:

Why Does My Toddler Have a Language Delay? 

I've been working in my state's birth-three program for over 10 years now. I have had numerous conversations with families. Often parents want general reassurance that their child's speech and language delay is not an indication of a life long problem. For some children, their delays are short term and go on to do well in school. (I know this because I have been able to follow up with some of these kids later.) Some parents will flat out ask me on my first appointment if their child has something wrong with them to explain their lack of verbal speech. Usually, autism is specifically asked about.

Many parents simply want to know why their toddler isn't talking. This is a hard question for me to answer. Sometimes, there are things in the history that can contribute to a delay in language development. I'm saying contribute to a delay because there are many factors at play in a child's life as you'll read below and it's just not always easy to absolutely find a "cause." 

There are some children who have no one single thing that I can pinpoint to as WHY they have a delay. They just do. There are some questions in life that can't be answered nice and neatly. However, there are some things can contribute to a speech and language delay requiring speech therapy.

Let's look at some.

1. Prematurity
Premature births can lead to some delays in language and other areas of development. Babies born prematurely can have delays in motor skills and language, especially if their prematurity resulted in a lengthy or complicated NICU stay. Usually, we will adjust a child's age to account for their prematurity until they are age 2. After age 2, we don't necessarily "blame" the prematurity as the reason, but it is one thing to consider. 

2. Hearing Issues
Known hearing loss will no doubt cause delays in language. Repeated ear infections can also contribute to delays in language because ear infections mean the child's hearing is not 100%. Not every child with ear infections will have a language delay, but it is one thing to follow up on and consider. If a child on my caseload has a history of ear infections, I strong recommend a hearing evaluation. If there is no history of ear infections, then I still tell parents a routine hearing screen is a good idea, but I leave it up to them to decide if/when to pursue it.

3. Environment
Some toddlers grow up in very language rich environments. Other children do not. Some babies and toddlers grow up with little interactions from their caregivers, too much time in front of screens, or too much time being contained alone in seats, swings, or playpens. Environments that offer little social interaction can contribute to a language delay.

4. Family Dynamics
Sometimes, the baby of the family talks and advances to keep up with their siblings. Other times, the baby of the family is treated like a baby. Helpful siblings will get things for the child who never has to utter a word. Family dynamics do not necessarily cause language delays but they can contribute to a child's lack of verbal speech.

5. Personality
There are some children I have on my caseload that are just quiet kids by nature. Their personality is passive or shy. This doesn't really cause a language delay, but it may be harder to get quiet-by-nature kids talking and making strides in therapy. They simply aren't as motivated to talk as some other children.

6. Delays in Other Areas
If a baby achieves motor milestones later than expected, then delayed language wouldn't be out of the ordinary. If the baby has significant feeding issues or delays in any other area of early development, then language delays may happen too. Child development is usually sequential, so we generally expect things to happen in a certain order. If some milestones happen later than expected, then that may mean language may come a bit later too. However, delays in multiple areas for more than a couple of months is something that would be worth looking into more closely to find a reason for the delays via a developmental pediatrician.

7. Underlying Diagnoses (Identified or Unidentified)
There are many underlying diagnoses that are associated with language delays. For example, Down syndrome or a brain injury are both known to have delays in language. There are some diagnoses that are not evident at birth but may become more pronounced by the time the child is 2 and not developing as expected. These are the toddlers I see with large delays in language and display other red flags that signal that something else may be the cause of the delay. Diagnoses like autism or childhood apraxia of speech, for example, may start to become visible in 2 or 3 year olds. So yes, a language delay may be because of another bigger diagnosis besides just "language delay" that may or may not have been diagnosed when the child starts speech therapy.

In all, there are many things that may contribute to a child's delay in language or explain the delay. It is often hard to exactly say "why" it is occurring and give the worried parent reassurance that their toddler will catch up and improve. Time will tell just how the child will progress. Even though we may want to understand why a child is experiencing a language delay, the important thing is to seek intervention and follow suggestions of the treating therapist.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice.
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Wednesday, April 11, 2018

A Reading Must!

Last month, the book, Spring Devotions for Special-Needs Families, was released on Amazon. It was put together through Key Ministry and includes devotionals from Key Ministry's talented Christian writers. Sandra Peoples was the editor of this book, and I know many people will recognize her name.

Hopefully you know by now, I joined the Key Ministry writing team this year. So, I was able to contribute a few devotions to this book. Some other contributors were Barb Dittrich, Rev. Dr. Laura Bradley, Beth Clay, Tammie Hefty, Jonathan McGuire, Kathy McClelland, and Angela Parsley to name a few. 

If you have a child with a developmental disability or medical diagnosis, then I highly recommend this book. There is a short devotion that you can easily read daily for the next few months. Spring themes of Easter and Mother's Day are some topics of the devotions in the book, but most of them cover general parenting areas. As you read it, you are sure to be encouraged in your faith as you parent your child with extra needs. Consider checking it out if you haven't already.                                   

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Tuesday, April 10, 2018

Blessings and Adversities: Living Through Both with God

Have you ever read the book of Job in the Bible and just been puzzled? I mean usually the first chapter in Job just confuses me. In the past, I have been super focused on the fact that God is having a conversation with Satan that I couldn't see anything else in this scripture. Why would God allow Satan to talk with Him? And why would God "allow" Satan to torment Job?

I have always read those first few chapters that describe the beginning of Job's trial with such perplexion that I missed something important until recently.
If you aren't familiar with the story of Job, let's review it quickly. In Job 1 (NKJV), we find God being so impressed with Job that He brings him up to Satan as an example of someone who fears God. Then this happens:

9 So Satan answered the Lord and said, “Does Job fear God for nothing? 10 Have You not made a hedge around him, around his household, and around all that he has on every side? You have blessed the work of his hands, and his possessions have increased in the land. 11 But now, stretch out Your hand and touch all that he has, and he will surely curse You to Your face!”

Then Job's children were killed. He lost his donkey, sheep, camels, and servants. He lost most of what was near and dear to him that day. Yet, verse 22 tells us Job didn't sin or charge God with any wrong.

Then once again in Job 2, Satan is back again. God brags on Job's response (my interpretation) despite Satan's horrible attack on Job. Then this is said:

So Satan answered the Lord and said, “Skin for skin! Yes, all that a man has he will give for his life. But stretch out Your hand now, and touch his bone and his flesh, and he will surely curse You to Your face!”

Job then suffered painful boils all over his body.  

These two chapters have always baffled me. Really, I still don't have good answers for some of my questions, but I have realized something new. These chapters show how and why Satan attacks.

Satan wants to draw people away from God. Specifically, he wants them to curse God. Job's wife took the bait because she encouraged Job to curse God and die (Job 2:9). Apparently, she had all she could take and thought Job should give up completely. She had lost her children, wealth, and watched her husband endure pain. Job's wife wondered where God was in all this suffering and time of need. She fell for Satan's tricks because she had lost sight of the bigger picture. Her husband did not, however. Job replied in Job 2:10: 

Shall we indeed accept good from God, and shall we not accept adversity? 

Let's go back to Satan's strategy, which was to get Job to curse God by first taking away everything he had. Satan told God that Job had lived with so much protection and blessing that he would curse God if it were stripped away. It's a trick that works on so many people but not Job. 

How many people in life do you know that have given up on God because of a tragedy in their life? A loved one unexpectantly dies, a natural disaster destroys property, one's child is diagnosed with cancer, a couple has infertility issues, or financial difficulties become the reason why people question God. It's easy to serve God when things are going well. The harder time to push through is when things don't make sense, life doesn't seem fair, and our heart hurts. Satan knows this too well, and he uses the bad stuff in our lives to trip us up and make us believe God doesn't care, God isn't near, and a loving God would never allow such evil to happen in our lives. 

But Job was not rocked by the first attack. So, Satan came at him again attacking his own health- making his life miserable and painful. Satan knew that Job would be pushed to a new level if his own life and health were in jeopardy. The rest of Job does go on to explain how he feels, reacts, and copes with all his loses, but Job knew the secret to worshiping God- do it in good times and in bad. 

Here again, we see the second attack and can think of people we know who have struggled with it. How many men and women have lost their faith because of a personal health crisis, chronic pain, or life threatening diagnosis? Satan knows that these are the moments when you will have doubts, fears, and questions about God. He is banking on you to curse God and give up.

(By the way, don't read into what I am not saying. This post today is not describing why bad things happen. That's another topic all together. Most people want to know: Is it God, the Devil, or something else? This post is about our reactions to situations that aren't pleasant. To read more about figuring out the "why" behind events in our lives, please read my post: Does God Make Down syndrome?)

I have to say I have fallen for one of these strategies. When my daughter was born with Down syndrome, a heart defect, and in congestive heart failure, I was so confused and crushed that my innocent child would be born with life-long and life-threatening conditions. I let the questions and doubts infiltrate my mind and thinking until I was in such a confused state about my faith. I wondered where God was when my child was suffering through open heart surgeries. I have never cursed God and given up, but my faith in God couldn't grow because I was too focused on my own pain and situation to simply believe.

Time and time again, I have had many doubts in health crises with Jaycee. Illnesses that required time in the ICU have been emotionally and physically draining, and it is easy to question the goodness of God when a loved one is suffering in the hospital. I think the normal response to bad events in our lives is to lose hope, drown in fear, and reflect on unanswerable questions. But God calls us to something else. We are after all suppose to live in the world but not of it.

We have to know that the foundation of our faith is abiding in Him no matter what happens in life. God is the answer period. He is not the person to get frustrated with when things aren't going right. He is the person to lean into when things don't make sense.

If we only believe the gospel is here to help us or prevent tragedies in our life, then what do we believe anyway? If we are only with God when He is "blessing" us, then what does that say? If we are with God to only receive His blessings and protection, then we aren't loving God with the right motive.

The feelings we have in challenging situations should not dictate our relationship with God. If challenges take us away from God, then the true intentions of our heart are revealed and our spiritual roots are not deep. We must endure with God through the good and the adversity. If we give into the doubts and all the other tricks of Satan, then we are falling straight where he wants us to be. He wants our relationship with God to be destroyed. Don't let him do that! When you feel frustrated, continue to pray. When you are confused, keep going. It's too important to stop growing in God.

Job ended up with more possessions and wealth at the end of the story than at the beginning. He had to endure much pain and time to get to that point where what he had was restored, but he made it to the end. He didn't give up when it looked like there was no hope.

Believe in God. No matter what happens. Don't fall for some of the oldest tricks in the book. 
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Thursday, April 5, 2018

Therapy Tip: When and Why to Use Withholding

It's therapy Thursday! By now, you should know the drill. This is the day that I share a tip based upon my work as a pediatric speech-language pathologist and my time at home with my child with special needs. Today's tip is:

When & Why to Use the Withholding Technique

What Is Withholding
Before we get into this post, let's first define withholding. The withholding technique is simply when an adult withholds an item that a child wants in order to encourage/force a child to say a word before receiving it.

This is probably the number 1 speech therapy technique that most parents report trying. If they are seeing me for an evaluation though, their use of withholding has not helped their child start talking.

Similarly, withholding is what I seem to hear non-speech therapist people recommend to mothers worried about their child not talking. They say something like this: If your child wants their cup, don't give it to them until they say "cup." These lay people may not know the actual technique name or exactly when and why to use it. That's when I have to explain why that may or may not work.

Sometimes, withholding is a good technique and sometimes it's not. It's just not an appropriate technique to use with every toddler who isn't talking. Plus, if this is ALL it took to develop speech, then why would so many children need speech therapy. Withholding isn't the answer for every child who is not talking.

When Is Withholding Helpful
I use withholding when I have a toddler in speech therapy who has a beginning vocabulary but isn't quite using words as their primary communication mode yet. Sometimes, the toddler is pointing, grunting, or gesturing instead of using their words despite having the ability. Other times, they are just quiet and not using their words consistently.

I do use withholding when I know that a child can say a word but they just aren't. So, if I have heard them say "more" or "please" multiple times, then I may decide to use withholding in order to get them to use that specific word. For instance, I will give the child one goldfish cracker. After he eats it, I will say, "If you want another one, say more." (Again, I have chosen a word that I know the child can say.) Then I wait. I may repeat my prompt, but I wait for the child to say 'more' before I give them another cracker. No word, no cracker.

Knowing what word to choose is important. If I have never heard a child say "cracker,' then I won't demand that they say that in order to get their crackers.

If you choose to do withholding, you have to follow through. You can't tell them to say a word and then give them the item whether they say it or not.

Why Is It Helpful
Withholding can be useful to help teach a toddler that words are powerful. Hopefully, we are showing them that pointing or grunting will not work anymore and that words are the prerequisite for getting the desired object. We want to teach the child to be consistent with their words in order to get their needs met. Getting consistent word use is important before adding more and more words into the child's vocabulary.

In all, withholding is a proper speech therapy technique that can be helpful when used properly, but you need to understand when and why to use it.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice.
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Tuesday, April 3, 2018

The Doctor is Not Always Right

Thanks for stopping by today.

It took me a long time to realize that a doctor's assessment of my daughter wasn't the complete and whole truth. I wrote a piece on this subject for Key Ministry that was featured last week. If you missed it then, check it out today:

Things were simple the day my daughter was born, at least at first.

As soon as she entered the world, I did my own assessment of her: ten fingers, ten toes, two eyes, a nose, and a weak cry. Everything seemed fine.

My husband and I were thrilled to be first time parents. We remarked on how “beautiful” and “perfect” she was. We joyfully called people to announce her arrival. We smiled in pictures.

To keep reading, click this link: When I Mistook a Doctor's Word As Gospel

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