Family Coaching in Speech and Language Therapy (Part 1)

It’s difficult to speak about and implement teletherapy services in speech language pathology, without touching on the importance of parent education and coaching.

Many of our sessions as speech language pathologists are limited to a mere 30 minutes.

Some get lucky with 1 hour sessions, simultaneously hoping that some of our little ones can tolerate a session of this length.

Meaning that most of our kiddos are getting 30 minutes to an hour (maybe 2 hours) weekly of speech and language services.

The rest of the time is spent at school or spending time with caregivers at home.

The type of therapy and parent involvement allotted for each session can also differ greatly.

In my early days as a speech language pathologist in Miami, I took the client back to a small therapy room, and came out during the last 5 minutes to update the caregivers on everything I had done.

Sometimes I’d provide “homework” for the week.

But many caregivers I spoke to had little background or knowledge about what it was actually like to implement these strategies, having never sat in on a therapy session, siting busy work schedules, errands, siblings, etc.

Then, things shifted a bit when I began treating in DC Early Intervention, also known as Strong Start.

I began seeing kiddos from birth to 3 or 4 years old.

What began as a direct treatment kind of approach, slowly shifted to a “coaching model”, in which therapists would go into the home and teach caregivers how to implement strategies with their kids.

I personally found it really hard to go from what I had been doing for years (direct treatment, with a clinician or client centered model), to parent coaching.

I admit, I was horrible at it. I would step in, do the treatment myself, and save the last several minutes for parent coaching.

Fast forward to the times we’re living in now, I find that everything has shifted.

Practicing in a New Era

I took a few years off of early intervention.

After moving out of DC, I found myself burnt out and done with early intervention, eager to take on school-aged kiddos, whom I could actually have a conversation with.

I took on a caseload of 8-12 year olds, where we worked on higher order level language skills like problem solving, predicting, and inferencing.

Then COVID-19 came around, shifting the majority of speech and language therapy to completing online, including early intervention.

With little money coming in through my caseload in Austin, I decided to take on early intervention kiddos in DC.

Now I’d actually have no choice but to implement the coaching model that had been so difficult for me in previous years.

Turns out, when you’re forced to have a session over FaceTime or Zoom you realize the coaching model isn’t so bad, and dare I say it… might actually, really work.

A Road Map

I know many of you are practicing speech language pathologists and/or parents/caregivers yourself, who are struggling with this new normal.

Shifting to almost 100% virtual school, therapy, etc. can be extremely overwhelming.

Many I talk to are looking for some guidance, support, and encouragement.

So, I thought a road map of sorts may be helpful.

Although this is geared more toward parents and families in early intervention, this can easily be incorporated for sessions with clients of all ages.

Preparing for your virtual visit:

1. Think about how long you are available. An hour of telehealth feels a lot longer than an hour of in-person visits. It is okay to let your early interventionist know if you would like to end earlier or shorter of your approved frequency.
2. Turn off the television, radio or other things that may make it hard to hear. We want you to have as little other distractions as possible, within reason, so that we can focus on your needs and your child’s needs.
3. Make sure all your technology is working. Do a test run beforehand so you and your early intervention provider can start on time.
4. Have any activities or materials identified in your previous joint plan ready to go. This will allow you to jump right into the visit after reviewing your joint plan and what you’ve practiced.
5. Have your providers’ phone number available. If there are any glitches with technology, you can always call your provider.

During your virtual visit:

1. Identify the time your visit will end. Your time is valuable; we want to make sure you are communicating when and for the amount of time that is best for you.
2. Review what has happened since your last visit. This is the time for you to let us know what worked and what didn’t work.
3. Show what you’ve practiced, then practice new things together. As much as possible, we want to provide you real-time advice. It may feel strange, but we can help you best when we see what is happening.
4. REMEMBER TO BREATH AND GO EASY ON YOURSELF AND YOUR CHILD. If your kiddo runs away from the phone and out of view, it’s not the end of the world. We can either follow the child to where they might want to be, or get them back to the space by offering a preferred activity/toy. The session is NOT lost.
5. We’re here to problem solve and reflect. Bring up any questions/concerns and let’s talk through them. For example, if you’re finding it difficult to incorporate speech and language strategies within a specific daily routine, such as bath time, let’s talk about holding the next session during bath time, so we can try strategies in real time.

Ending your virtual visit:

1. IDENTIFY A JOINT PLAN. What would you like to practice in-between visits, and what do you want to work on at your next session?
2. Discuss any problems you had with technology. This will let you and your provider know what they may need to address or change.
3. Schedule your next session. Pick a time and date when both you and your provider are available.

Next time, in part 2, we’ll dive into the specifics of parent coaching, as they happen within the session… questions to ask, strategies to use, and ideas to try out will all be discussed.

Sol Speech And Language Therapy aims to incorporate all of these practices into our early intervention and regular speech and language therapy sessions.

If you’d like more information on speech-language teletherapy services or would like to consult with the speech pathologists at Sol, please feel free to book an appointment.