Speech and Language Pathology in School Settings - A Typical In-school Speech Therapy Session

A Typical In-school Speech Therapy Session

The treatment of speech, language, and hearing impairments is handled differently by public and private schools throughout the country, although many programs have the same basic components. The model given below is that used by Mary Jablonski who has been working as a professional speech therapist in an elementary school for 22 years.

Therapy usually takes place in the speech pathologist’s office, although it may be conducted in a classroom. Students are put into small groups of three or four students of similar age and severity of disorder. Students meet for 30-minute to one-hour sessions from one to five days a week, depending on the diagnosis, severity, and disorder.

The children sit with the therapist and discuss any problems that they may be having or any progress that they have made. Students are encouraged to have a few minutes of conversation to loosen up their speech muscles. Also, the social interaction that results can be extremely beneficial to children with communication disorders who may be shy or socially withdrawn. The rest of the session is spent doing an activity. Students may play games, make crafts, draw pictures, sing songs, or act out short skits or role-playing exercises. These activities focus on improving students’ communication skills using several techniques, as noted by ASHA:

• improving coordination of speech muscles through strengthening exercises, such as pushing the tongue against a tongue depressor, and training exercises involving sound repetition and imitation
• improving communication between the brain and the body through visual and auditory aids such as mirrors and tape recorders
• improving fluency through breathing exercises

Games and activities can be tailored to each individual’s problem areas. For example, a game board might have pictures of familiar items along a path. All of the items will have the target sound at the beginning of the word, in the middle, or at the end. A board for the s sound may have images of socks, a whistle, glasses, scissors, or a horse. Players roll dice and when they land on a particular picture, they have to pronounce the word correctly, focusing on the target sound. This game can be reproduced using pictures with /f/ sounds or /th/ sounds, etc. Games such as The Entire World of R Game Boards and The Entire World of R Say and Sequence Playing Card System treat the difficult /r/ phoneme while keeping the children’s energy and interest levels high. They enjoy the friendly competition and small-scale social interaction.

Students can use mirrors to look into their mouths as they practice sounds to make sure that their tongue, teeth, and lips are in the right places. A child’s speech may be recorded and played back so the child can hear what they are saying. Often, a child may think they're producing sounds the same as everyone else. Hear their recorded voice helps them realize what they are doing wrong.

If a child is having a difficult time producing a particular sound, the speech pathologist may remind them of the oral cues that go along with the sound. Here are some common cues:

• For /th/, stick out the tongue and blow air through the mouth
• For /f/, bite the lower lip and push the air through the teeth
• For /r/, raise the back of the tongue to the roof of the mouth, or pretend the back of the tongue is an elevator and there is a little man on it who wants to ride to the top

At the end of the session students are usually given a reward for good behavior. This could be a sticker, a pencil, or a small toy. They are also given worksheets to complete at home with their parents. The worksheets usually involve verbal interaction through games and coloring activities. Parental involvement and reinforcement play an integral part in a student’s progress. When a child succeeds and improves through therapy, the benefits can be overwhelming.