We are most concerned with HIGH QUALITY materials that will last through many clients, but are also functional and appropriate. Today, I am going to tell you the story of a little guy that stole my heart. One day, I went to work and a folder for “Bryan” came across my desk. He received speech in school and home health services as Mom did not have a car to go to a clinic. Bryan's folder had multiple Speech Therapists who had worked with him. All of which stated that he was severely unintelligible, he had severe ankyloglossia /tongue tie and he needed to have surgery if he was ever going to make any progress. The problem was the Doctor did not feel he needed the surgery. He was able to say some sounds, but not others. He did have most of the vowels correct, but he left off word endings, slurred his words, and did not say blends at all. He had over 15 therapists in his 8 years of life. He had dozens more referrals for SLPs who said they could not help him. Bryan was at that age where he was realizing he was different from his peers. At school, he was being asked to use a communication book in order to talk with his teachers as they could understand about 5 words. He was devastated. He knew he was different and worked like a dog from the minute therapy started to the minute it ended without complaint. He could hear that he didn't have all the sounds, and he used prosody as a way to compensate. Mom admitted to me that she understood about 30% of what he had to say and most of that was rote conversations (e.g.: I'm hungry, School was good, I hurt here, etc.). She played guessing games with him. “Do you mean... Do you want...” and if she didn't understand she would smile and say, “OK love”. His little face would drop, Bryan knew Mom didn't understand. It was heartbreaking to watch. I, of course, started by recommending a communication book. Bryan looked so frustrated. It was the only time I heard him say "No" in therapy. Mom explained the school asked him to use one. Mom said he was starting to get tired of the communication book and was refusing to even touch it. He was having significant difficulty making friends because no one understood him when he talked. I asked if he liked the book and he slowly shook his head. Bryan's eyes started to water. He said one word. “Habla/Talk”. It hit me like a ton of bricks. He wanted to talk. I told him I would do my best to make it happen. I ran into several problems that all bilingual speech therapists run into:
Pre-made cards have words that are WAY TOO LONG. Pre-made cards aren't always functional. Pre-made cards aren't always the same version of Spanish that we speak (Puerto Rican Spanish vs. Cuban Spanish, vs. Spanish from Spain/Mexico). He wasn't a baby, he didn't want to talk about shapes and counting so starting with first words packs wasn't going to work. Mom only spoke Spanish so teaching him English was a disservice to the family. I needed something that was FUNCTIONAL, had SHORT WORDS, and COMMON across multiple dialects of Spanish. I needed something like a Kauffman Apraxia set, but in Spanish. And like always, I needed it now. I developed these cards to meet the above needs; it took us over a year. Every session, we reviewed the first sets, then we added new cards. We started using phrases (e.g. Veo/I see...Quiero/I want...) on the first sets of cards that we had mastered before we moved on to the new words. Every session he got a little better. It was a testament to him WANTING to speak. He desperately wanted to be “normal”. He wanted to be understood and have friends. It was a year and half later and something happened that I could not have foreseen. Out of the back of the house comes this quiet, older gentleman I had never seen before. He said, “You're the speech lady?” I nodded in confusion as I thought I knew the entire family after spending so much time in their home. “ I want to tell you something. I usually don't come out here because I don't want to bother you. But I needed to say thank you. I used to only talk TO my grandson. I would tell him to do his chores and such. But recently, I have been able to talk WITH him. He tells me how he did on his tests at school, he tells me what he wants to eat, he tells me stories about his friends. I never thought that would happen. He's not just a listener anymore. He's a talker. I wanted to thank you for that.” As quietly as he came, he left. He made me think. I can always talk TO my patients, but can I talk WITH them? Do they have the ability to tell me what they need, what they dream or think about, or are they only following directions? I knew what I had to do. I had to see if Bryan's cards worked for others with different speech problems. I tested them with my small kiddos to my adults in the nursing home (I choose appropriate cards based on the patient). Wherever I went, the cards went. They worked! They started conversations, triggered memories, and even helped some kids learn new vocabulary they should know. I was hooked. I showed my peers and they asked for copies of my cards to use with their patients. That's how one child changed my views on speech therapy. And why I offer these cards to help all the Bryans out there.
