How do you know if a therapist is good?

[Guest guest]

What factors do you look at in determining if you've got a good speech

therapist?

I know we all find people based on recommendations, etc. but how (besides

your child starts to talk) do you decide if the therapist that your child has

is good? (Same thing for those of you who have PT / OT).

Thanks,

SB

[Guest guest]

SB -

I can tell you my experience (not-so-briefly) and maybe it will help

you. You didn't state if you already had a st whose abilities you

were questioning or if you are just beginning the search...

We started taking my son when he was 2.5 to an SLP. He had been

evaluated about 4 mos earlier and had been completely non-verbal at

that point (except for DA and a VERY rare MA). By the time he began

therapy, he had added about 20 words, recognized and could identify

the ABCs, colors, and the numbers 1-10.

The therapist we were taking him to was at our local Children's

Hospital. We took him 1X a week for 1 hour. She never was able to

get him to focus - and he rarely would repeat for her. I had been in

the room with him for 3 weeks when she suggested I watch from

outside. I was fine with this but concerned bc she would let him get

away with murder - despite my pleas to use the word " NO! " . I began

to dread the sessions. He would scream at her, refuse to cooperate,

sit down, etc.. His behaviour at home had never been stellar (he's a

really active, demanding kid) but it had NEVER been like this. Then

we started to see this at home, too. He began to cry when it was

time to take him. The whole time, we never saw an improvement but I

kept saying to myself (and my husband felt exactly the same way) that

it wasn't hurting him - maybe it wasn't helping, but it wasn't

hurting either.

One day we had a student observing the session (at my approval).

We'd been going for about 4 mos at this point. The student sat

outside with me and she'd comment every once in a while - asking if

she was interpreting my son correctly. It was funny because he NEVER

spoke to his ST at all, but she had a fishing game he liked and he

kept telling her that he wanted the rod. I had been asking her to

try to use the alphabet for his sounds in isolation (which she never

did) and she was trying to get him to say " F " . He got mad bc she

wouldn't give him the rod and finally the session ended. She came

out and announced to me that he was definitely apraxic. We'd been

asking for a diagnosis for months - I went into his evaluation

suspecting apraxia and talked to the SLP who eval him about it.

Unfortunately, she didn't know this and took an arrogant stance in

front of this student. (I didn't think it was appropriate to discuss

a diagnosis for the first time in front of someone else with out

asking, but whatever.)

I immediately said, " Well, if he's apraxic, I want 2 or 3 more

sessions a week and I want you to start Kaufmann and actually DRILL

him... " She was so taken aback I think, rather than appreciative

that I understood what she was talking about. And then I asked her

about not using his alphabet bc he was losing the ability to make all

the sounds (he had 90% of them at one point). Her response was that

I was mistaken. He couldn't know his alphabet and all he was doing

was babbling. When I asked if she could understand what he was

saying to her in during the session (about the rod) she told me that

he wasn't communicating, it was echolelia (sp) - EVEN tho the student

could understand...

I went home. Cried. Called 4 other places for ST. Called my

husband and cried. Called the director of ST at the hospital.

Finally, after a couple of weeks of decision making, we got switched

to another therapist who we LOVE - all of us. I know that I made a

pain out of myself - and that the new therapist expected a harda$$

and an overly demanding mother, but some things happened after which

cleared that up (we had never gotten a progress report, a speech

plan, etc.). Finally, the progress report we asked for when we

didn't know who was going to treat him was MISSING A WHOLE PART!!

The one our new ST had included an entire section about how bad off

he was and how difficult he was to work with as well as the minimal

chart of his accomplishments - it was almost entirely a reprint of

his original evaluation. Our new ST had no explanation of how it

was " missing " but it didn't turn up in our pediatrician's, either.

So, how do you evaluate a ST? I would say " use your gut " - I knew

she wasn't helping him. I knew his behaviour in there was

atrocious. I knew he was getting better therapy at home. What

finally nailed it for me was when it stopped being just ineffectual

and went to being harmful - when she didn't recognize his potential.

She thought he had global delays - an inability to learn - and that

would have held him back more than anything. While our son learned

to talk on his own (thank god) the new therapist has helped him

refine his skills immensely - and he behaves for her. He said more

in his first visit with her than he the sum total of all his

visits. Both therapists called apraxia one of their specialties.

Both worked with kids that young. Both held their degrees from the

same institution. The difference? In my gut.

FYI - our son is now almost 4, speaks in complete sentences (albeit

difficult for most to understand), pretends, uses please and thank

you, asks questions, points things out, etc.. He's come such a long

way...

I hope this helps - sorry so VERY long - I'm outraged that they never

fired the other person and that I see her treating other kids. I'd

be devastated to think of someone continuing in such a bad

environment. I hope this helps no matter what stage you're in...

Good luck!

Marina

> What factors do you look at in determining if you've got a good

speech

> therapist?

>

> I know we all find people based on recommendations, etc. but how

(besides

> your child starts to talk) do you decide if the therapist that your

child has

> is good? (Same thing for those of you who have PT / OT).

>

> Thanks,

> SB