From the Clinic (July 2019)

posted Jul 8, 2019, 11:41 AM by San Jose Scottish Rite

Dylan is an adorable four year old boy who has been seen at the Scottish Rite Childhood Language Disorders Clinic secondary to delays with his expressive and receptive language and articulation skills. He also works on social thinking skills to address needs with pragmatics and social communication with his peers. 

Testing of Dylan’s expressive and receptive language skills revealed difficulty using a variety of grammar forms, answering questions, and using a variety of syntactical structures.  His articulation skills were mildly delayed and he demonstrated a variety phonological processes that impacted his intelligibility. The combination of reduced expressive language and diminished articulation skills made it difficult for Dylan to relay his wants and needs and was further impacted by his reduced attention to adult-directed tasks.

Since the initiation of therapy, Dylan has made tremendous progress toward his goals! He is working on following adult-directed activities using a visual schedule, following directions with age-appropriate linguistic concepts, and is using sentences with age-appropriate syntax and grammar. He has also worked hard with his /sh/ and /l/ sounds and is making fantastic progress at the word level. Dylan’s mother is proud of his progress. She stated, “We are very happy with your service and we see a lot of progress and improvements with Dylan. Thanks a lot!” We are very proud of Dylan too. His parents’ commitment to bringing him to his weekly sessions and working with him at home have helped Dylan blossom! Way to go, Dylan!

Pragmatics is one of the five areas of language development that helps us navigate our relationships with others, regulate ourselves to our environment, and maintain attention so that we can learn new things and interact appropriately with others. Indy participates in our “Social Thinking” program to learn social executive functioning skills, which helps our students learn how to collaborate with others and problem solve through situations using a variety of strategies.  The “Social Thinking” program is based on extensive research from Michelle Garcia Winner, a renowned Speech and Language Pathologist, who has studied social thinking and how best to help children who have difficulty navigating their social interactions at home, school and in the community.

Indy has been working on utilizing key concepts to practice his social executive functioning skills such as, following the group plan, thinking with his eyes, keeping his body in the group, using whole body listening, understanding hidden rules and expected and unexpected behavior, making smart guesses verses wacky guesses, using flexible thinking verses stuck thinking, understanding the size of the problem, and sharing an imagination.  Social communication and social executive functioning skills help us participate in group activities and to interact with others in a way that helps everyone feel comfortable.  Teaching these concepts has helped Indy relate to others using empathic thinking and perspective taking, two skills which relate to early developing skills for language and cognition, central coherence, joint attention and intention, emotional regulation, self-regulation and theory of mind. Without these basic building blocks a person will have difficulty collaborating, negotiating, and learning as part of a group.

Indy’s mom has seen an improvement in Indy’s social thinking skills since treatment was initiated. She stated, “Speech at Scottish Rite has been great. Rachel has a deep understanding of his needs in social/behavioral speech and has provided excellent tools to take home and share at school.” She further commented that the therapy Indy has received has been “wonderfully effective” and “fantastic”. 

Indy has made great progress understanding and using many of these concepts during our therapy time. And his mother is introducing the key concepts to Indy’s teachers at school to help carryover his skills outside of our therapy time together. I am particularly proud of his Indy’s perseverance and I am looking forward to continuing our learning time together!