I know that when Speech-Language Pathologists and Behavior Analysts collaborate well, these things happen:
- Children get many more learning opportunities.
- Speech and language goals are more individualized.
- Behavior Analysts better understand why they are teaching particular skills.
- SLP team members better understand how to teach particular skills.
- Parents are happy when team members are on the same page and their kids are talking.
I plan to elaborate on all of the points above over the next several weeks. Today let’s talk about Benefit #1: Children get many more learning opportunities.
I realize that every situation is different and there are always exceptions. However, I think we can all agree on some generalizations. If a person is learning a new skill, practice makes perfect. This is the case for playing basketball, swinging a golf club, or learning a new dance routine. If I practice playing tennis 25-40 hours per week as opposed to 1-2 hours per week, I will likely be better at tennis with more practice hours. Right? Speech, language and communication are also skills that typically improve with more hours of practice compared to less hours of practice.
In my experience, Speech-Language Pathologists (SLPs) are spread thin in schools and private clinics. Children with speech-language disorders have relatively small amounts of time with speech and language experts each week. This means they have less learning opportunities in the skills they need to communicate. Unless, of course, they have a parent with supernatural powers who works with them 40 hours per week! This is unlikely.
However, if a child is enrolled in a 25-40 hour per week ABA program and an SLP is working with the team, this allows for more practice hours. This means more hours of what the SLP determines is appropriate “speech homework” for the team. I realize some professionals will argue that Behavior Analysts shouldn’t work on speech goals. My answer to that is that ABA programs are language programs. Behavior Analysts working in ABA programs are already working on language all week long. This inevitably includes speech. Having an SLP closely involved with the ABA team is crucial so that SLP goals and progress generalize across environments. This happens with the presence of collaboration between SLP and ABA disciplines and increased learning opportunities.
Here’s an example of what can happen when SLPs and Behavior Analysts don’t collaborate:
1. It’s the rule, not the words
Billy had a comprehensive, standardized speech and language testing with an SLP who is not involved with the ABA team. Speech-Language Pathologists are specialists in speech development and therapy so they know how to diagnose particular speech disorders and conduct targeted treatment for speech issues. It is determined that Billy has a phonological disorder with final consonant deletion. This means that he does not have the phonological “rule” that consonants go at the end of words. It doesn’t mean Billy “can’t” produce the consonant sounds in question; it’s that he doesn’t understand the rule. So whether or not it’s a ‘p’ sound or a ‘k’ sound or a ‘m’ sound, he does not put consonants at the end of words. Subsequently, ‘cat’ is ‘ca’ and ‘dog’ is ‘do’.
2. Progress is slow
In speech therapy sessions 2 hours per week, the SLP works on teaching Billy to produce final consonants at the end of words with all the consonants the child can already produce with words the child already knows. She focuses on the “rule” system, not teaching single words. The child makes progress fine-tuning this phonological rule and starts putting the consonants at the end of words in speech therapy sessions. However, progress is slow with so few hours of practice per week. Even though he can produce words correctly in speech, it doesn’t generalize to the home, school or ABA clinic environment.
3. Too much time practicing the wrong thing
Meanwhile, down at the ABA clinic, Behavior Therapists work tirelessly 25-40 hours per week teaching Billy to say hundreds of new words in all the categories, foods, clothes, actions, toys. He is saying approximations of all the new words, but guess what? He doesn’t understand the phonological rule that consonants go at the end of the words. So the words are still ‘ca’ for ‘cat’ and ‘do’ for ‘dog.’ And now Billy is practicing so many words all day long without understanding the “rule.” He is practicing more and more errors every day. The Behavior Therapists try many different strategies but the words don’t shape up. Billy can say hundreds of words now, but most people can’t understand him. When he tries to speak in sentences, forget it!!! What is the point of saying words and sentences if no one understands you? That’s like teaching him French when his family and community speak and understand English only. It’s not really helpful.
4. The solution
The Behavior Analysts are offering countless opportunities for Billy to learn new vocabulary each day. He can say lots of words, but he’s not intelligible. What would it be like if the SLP and Behavior Analysts were on the same team and working together? That’s right. Billy would get many more opportunities to practice what he needs to be practicing so that people understand him when he says the hundreds of words he knows.
This is just one example of the way that collaboration between SLPs and Behavior Analysts could be life-changing for a child and his family. Seems worth it to make this happen. Don’t you think?
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