For many reasons, it is in the child’s best interest when SLPs are committed to working with and beside parents and caregivers. Creating professional-parent partnerships whenever possible enhances the opportunities for children with CAS. Parents can be valuable “therapy extenders”, with proper guidance from the SLP. It is not likely enough to simply spend a minute at the end of a therapy session verbally telling the parent what occurred. It is not likely enough to send home a homework sheet and think it is going to be helpful. As often as possible, parents should observe a significant portion of a speech therapy session so that they can receive direct instruction on how to elicit appropriate speech practice at home. Some therapy settings provide ample space and room for this to occur. For example, settings that have observation rooms with one-way mirror windows are a real bonus for providing parents with the opportunity to view therapy sessions. Creativity may be needed in other settings in which observation is not as simple. Some SLPs use video cameras to periodically record therapy sessions so the parent can view them. Minimally, some parents report taking baby monitors to the therapy room so they can at least hear the treatment session in progress.
While having oneself observed is not always comfortable, the real help it can provide to the family hopefully overrides any such discomfort. SLPs need to go beyond verbally reporting the help that parents can provide at home to also modeling it directly. It is through this modeling and direct guidance that parents will learn what their child is capable of producing independently or with cueing and that which the child is not yet capable.
As previously explained, the amount of practice will directly influence the child’s ability to achieve motor learning for speech. Without practice outside of the therapy room, many children will not receive the adequate degree of practice. Thus, if SLPs encounter parents who are not able or unwilling to learn how to practice with their child, a discussion of the ramification on long-term progress is certainly appropriate.
Many parents today try to educate themselves on problems affecting their children. Thus, SLPs will encounter parents who may have read more recent information on apraxia in children than the SLP has! It is important to understand that most parents are eager to engage with the SLP as partners in helping the child. It is perfectly fine to acknowledge when the SLP has not had much experience with apraxia; has an equal eagerness to learn about the disorder and its treatment; and express an overall willingness to include the parents as partners. Parents appreciate when the SLP can acknowledge that which they do not know and an expression of willingness to learn and seek training in order to help their child.
There may be times when the SLP is concerned that the parent is not, for whatever reason, following through consistently or providing appropriate support to the child at home. During such instances, a meeting without the child present and outside of scheduled therapy time may need to occur. It is important to sensitively and honestly share concerns for the child’s progress with the parent so that realistic understanding exists. The SLP may also need to provide referrals to other appropriate professional resources for specific children. For example, if the SLP suspects that the child has an underlying pervasive disability, disorder, or syndrome it would be important to refer the family to an appropriate developmental pediatrician or pediatric neurologist.
Overall, it is in the best interest of the child when the SLP is able to involve the parent or caregiver as a partner in the therapy process. All efforts should lead to that hopeful result. New resources to aide families are becoming available and can be used to help facilitate their investment in speech therapy for the child (see the new video resource, Hope Speaks: An Introduction to Childhood Apraxia of Speech).
- Teaching and Talking Together: Building a Treatment Team by David Hammer, MA, CCC-SLP and Ruth Stoeckel, MA, CCC-SLP
- The Importance of Parental Involvement in the Therapy Process by Ruth Stoeckel, M.A., CCC-SLP