Speech, Language, Hearing: Assisting Non-verbal Children

Allison Jones, a graduate student in the Department of Communication Sciences and Disorders at Baylor, realized upon meeting three-year-old Tyler that she had her work cut out for her.
Rather than saying, "Hand me that, please," the little boy would point his finger at the desired item and simply grunt or say, "That!" Because Tyler was unable to differentiate between the words 'what' or 'when,' his answers did not correspond with the questions asked of him. And his unwillingness to make eye contact made the simplest instructions difficult.
"Many people think of speech pathology in terms of learning how to say the letter 'r,' or correcting a lisp-and that's certainly part of what we do-but it's only one component of a very broad science," Jones said.
Diagnostic tests conducted at the Baylor University Speech, Language and Hearing Center confirmed that Tyler has a language disorder in an area known as pragmatics.
A pragmatic disorder is characterized by an individual's inability to interact socially because he or she is unable to communicate appropriately. Autism is an example of a disorder involving pragmatics in a severe form.
Following an assessment to determine the level at which Tyler had the disorder, Jones and the Speech Language and Hearing Center's clinical director, Deborah Rainer, M.S., met with Tyler's mother to determine an effective plan of treatment. Together, they decided that Tyler would meet twice a week with Jones for 30-minute, one-on-one sessions.
A number of treatment methodologies were used during the sessions, including Jones withholding objects from Tyler until he requested them properly or until she was able to model the request for him. Modeling is an effective technique often employed by clinicians treating communication disorders. Jones used modeling extensively in Tyler's sessions, often with pronouns and possessives (i.e. Tyler's chair, Allison's car) and when introducing spatial and time concepts (i.e. next to, in front of, before, after). Jones persisted in having Tyler maintain eye contact with her during the sessions and instructed him on the proper way to respond when he heard his name being called.
"To be honest, we didn't expect to accomplish very much during the initial round of sessions," admitted Jones. "But Tyler exceeded all of our expectations."
Two weeks into the treatment plan, he was able to mimic Jones, saying "I would like the toy, please." Soon after that, Tyler modified a statement independently to reflect a desired object. In that moment Jones knew that, together, she and Tyler had accomplished something important.
"His mom was so thrilled," she said. "When parents tell you how much they appreciate what you're doing-or say, 'Everyone's noticed how much he's improved'-that's a really good feeling."
Tyler is one of more than 300 clients living in the Waco area who receive diagnostic services and treatment at Baylor's Speech, Language and Hearing Center every year. Five licensed professionals manage and supervise approximately 40 graduate students assigned as clinicians to the Center.
"The Center functions as a lab where graduate students put skills to practice," said Dr. Kathy Whipple, chair of the communication sciences and disorders department. "Each student is typically assigned six clients and treats a range of communication disorders."
Following a professional diagnosis, the student clinicians are responsible for designing and conducting a plan of treatment for their pool of clients.
"While we don't stand over their shoulders, we closely monitor their progress and feedback is immediate," said Dr. Whipple.
Clinical experience at the Speech, Language and Hearing Center constitutes one-third of an intense graduate practicum that also requires public school placement and a hospital internship before a master's degree in communication sciences and disorders is awarded.
"You can never really know something until you practice it," said Jones. "My knowledge has grown immeasurably since I started working at the Center, and I continue to learn more every day."
For parent Vicki Mitchell, it is the student clinicians' ability to make treatment enjoyable for children that is most impressive about the Speech, Language and Hearing Center at Baylor. Two of her children have been clients at the Center-13-year-old Jake received treatment at Baylor several years ago and daughter Mika, 6, is currently attending twice-weekly treatment sessions. The children were diagnosed as having an articulation disorder, which means they had difficulty saying certain sounds correctly.
"The students are professional and very knowledgeable. They know how to get results," said Mitchell. "Mika has become very aware of the correct way to say things-she'll even correct herself in mid-sentence now and feels very proud of herself for doing it."
Mitchell said that Mika thinks of the Center as a fun place to go-not as weekly therapy to correct a communication problem.
"For Mika, (speech therapy) is all about playing games and being awarded tokens for 'getting it right,'" she said. "It's a happy environment where everyone is positive and encouraging."
Parents have proved to be the Speech, Language and Hearing Center's best source of advertising. They will play an equally important role when the Center's newest extension of services-the Joy C. Reynolds Language Institute for Non-Verbal Children-opens its doors in the spring of 1999.
Named in honor of the wife of Chancellor Herbert H. Reynolds, the Joy C. Reynolds Language Institute will offer a morning program for young children, 2-to-4 years old, who speak few words or none at all. Dr. Whipple plans to include undergraduates as well as graduate students in the clinical work of the Institute.
"We are extremely excited about increasing our ability to assist children who are non-verbal," said Dr. Whipple. "The Joy C. Reynolds Institute will not only satisfy a great community need, it will allow our students to gain even broader practical knowledge to assist them on their professional path."
It is a path that Allison Jones is well prepared to tread.
"Baylor has equipped me with the knowledge and skills I need, plus confidence in my practical abilities." she said.
"I feel like a true professional in every sense of the word."