When Little Bear’s Speech and Language Therapist and I met one another things could have gone either way. There was certainly a high risk of a strained relationship. As I had already made two formal complaints about the Service and she knew I was a Speech and Language Therapist too, she probably came to the first session with some pre-conceived ideas of how I might be. I imagine she thought I would be hard work, difficult to please and all-round a bit of a nightmare parent to have on your caseload.
I also came to that first session with some concerns. Our experience of the Service so far had been appalling (hence the complaints) and I was feeling embarrassed by association. I was worried that Little Bear wouldn’t get his needs recognised or met and that every session would be cringe-inducingly awkward.
Fast-forward seven months and I’m pleased to report that we have weathered the storm. Just as I felt it was important to speak-up when the treatment we received was poor, I also feel you should give credit where credit is due.
Things did go fairly well from the beginning because she (let’s call her Helen) listened to me and tried to anticipate what I needed from the sessions, as well as being lovely with Little Bear. We have now been working together (and I truly believe that is how we have done it) for some time and Little Bear has made a lot of progress. We have targeted three different vowel sounds in turn which he has learned to articulate and has successfully generalised into his everyday speech. Helen has also set language targets and provided materials for school to work on.
Helen has recently re-assessed Little Bear to decide on next steps. Her assessment showed that Little Bear has moved from the 5th and 16th percentile on two comprehension subtests to the 16th and 63rd respectively, both scores now within the expected range for his age. He has also acquired a 4th vowel sound which we haven’t targeted in therapy. He has made incredible progress.
At the session before last Helen wondered aloud whether Little Bear might be ready to switch to the school part of their service now. As he has top-up funding he is eligible (in our area) for speech and language therapy visits to school. As he had made so much progress she wondered whether the time might be right.
I didn’t say much as I knew we still had further assessment to complete but when I left the session I had some nagging doubts. If he got seen in school, who would the therapist be? I’d have to get to know them from scratch and crucially so would Little Bear. How much involvement would I be able to have? Would the session take place without me being there? Although Little Bear has done really well with therapy, his speech continues to be peppered with errors and he is by no means ‘cured’ yet. I’d have to voice my thoughts next time.
However, when it came to the next time, I didn’t have to voice anything. Helen was one step ahead.
She had gone away and spoken with the school therapy lead and almost had a supervision session about Little Bear. I think it’s a sign of a good therapist when you can go away and reflect and ask other’s opinions. She is a very experienced therapist but knows that another perspective and some time to think can be really useful.
She happened to have some students with her during our session and took advantage of having someone to entertain Little Bear, allowing us the chance to talk. She suggested we had an honest discussion about how we both feel Little Bear is getting on and what should happen next. We went through each area of Little Bear’s communication and I told her how he’s doing with it, in real life, outside of clinic.
She told me that on reflection, she has some concerns about Little Bear moving to the other part of the service. She is worried about how he will cope, given his background, with getting to know another new person. She feels that both she and he, and she and I, have developed a good, effective therapeutic relationship. She is wondering about the benefits of trying to switch this relationship to somebody else. I wholeheartedly agreed with both of these things. I think it made it easier for me to be honest as she was so direct.
We agreed that although it is not ideal bringing Little Bear out of school to go to a clinic environment it is working well for him, he is used to it and it is manageable. We agreed we would continue in this way as it is better for Little Bear. It is not the usual protocol but Helen sees the need to be flexible to best meet his needs, as good therapy should.
As Little Bear is entitled to school input, Helen and her Manager have agreed to some flexibility about school visiting and Helen can do a classroom observation if I think that would be useful (she is usually clinic based only). I definitely think it would be useful to have another pair of eyes in the classroom. I have been desperate at points to go and observe myself but obviously as a parent it wouldn’t be appropriate. However, I value Helen’s opinion and it would be useful to know what is going on communication-wise in school, especially with Little Bear’s TA.
We then completed the prioritisation system particular to our local Trust. Helen allowed me to be a partner in this. We were mostly in agreement anyway but where we weren’t we went for the middle of our scores. I think it must be extremely difficult for her having another SaLT in all of her sessions and I find it hard knowing what involvement I should/shouldn’t have. I’m so grateful that she has acknowledged my background and we don’t have to pretend I’m not a SaLT. Ideal or not I am one and I can’t pretend that I don’t have knowledge that I do (although initially that was my intention).
I did acknowledge this with Helen and she said she is very mindful that Little Bear gets what everyone gets and they don’t just rely on him getting what he needs through me. She also said that if a parent had learning needs, they would adapt their approach accordingly. I happen to have a little more knowledge about communication than the average parent but this needn’t be a problem, they can adapt their approach for that too.
I know that not every therapist would have been able to take my profession quite as in their stride as Helen has. It is because she is confident and experienced that she knows it needn’t bother her. I have also been very careful not to comment unless invited and have acknowledged things like how difficult it is to transcribe vowels and that I would have found this challenging. Helen is the therapist and I am the parent and generally we stick to those roles. However, we do seem to have found a comfortable place in the middle where we discuss Little Bear’s needs on a level and plan jointly, as two co-professionals would. I suppose she has allowed me the role of professional parent, the specialist in my child, in a way that many parents, particularly adopters, are often denied.
We went on to co-write aims for the upcoming sessions of therapy.
Helen was clear that she will not be keeping Little Bear on the caseload forever. I know this and I don’t want her to but I do hope we are in agreement about when the time is right to stop. The prioritisation score we agreed on indicated that direct therapy is still needed so we are in agreement at the moment that the sessions should continue. We have two more vowels in our sights as well as some updated language targets.
I came away from the session extremely grateful at the way things have turned out. It shows that you can stand up for your child, make complaints and still go on to have a great relationship with a professional. As a parent you can get your views heard and you can get your child’s needs met if you persevere. I think Helen has been surprised that I’m not the nightmare I seemed on paper, I am just a parent who wants the best for their child and I am fully prepared to work together to achieve that. I will say what I think and I will point out bad practise but if things are going well, I will acknowledge that and praise it. We have a good working relationship and despite the odds I would even go so far as to say we that we really quite like one-another.
When we have finished therapy I will be writing to Helen’s manager to thank her for the service we have received and to recognise the great job Helen has done.
I have written a lot about Speech and Language Therapy and our experiences. You can read more here if you are interested: Developmental Language Disorder, Communication Difficulties: Update, SaLT, EP & an Assembly, Another try at SaLT, A bit of a rant, Living with Speech and Language Difficulties
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