How to Choose Your Speech Language Pathologist (SLP): Philosophy
Part 3 in our ongoing series How to Choose Your SLP.
You've learned about Setting and Location, two of our six key factors for choosing an SLP who will be the best fit for your child. If you haven't read those yet, check out the links above to see our related posts!
Now, we will delve into our third factor: PHILOSOPHY
No, we aren't talking about Plato or Descartes or Nietzsche. We know nothing about whether God is dead. And sure, 'I think, therefore I am' sounds cool on a T-shirt. But we aren't experts in philosophy tracts.
We are experts in communication, and that includes the philosophy we take when approaching our client's needs.
If you are a parent looking for an SLP, here are the five major philosophies that we suggest parents look for in a potential therapist:
Speech therapists work with kids who have delays and disorders. But when we look at what a child can't do, we can miss so much of what a child is already doing well.
A deficits-based approach is one that focuses on what is disordered or missing. Therapists who use this approach often mean well, trying to fill-in the gaps that they see in expected skills. But this can often cause children to lose confidence, become frustrated, and even withdraw.
In the worst case scenario, therapy is ineffective because the focus is on skills a child 'should' have rather than skills that the child is ready for or interested in.
A strength-based approach, on the other hand, acknowledges what your child is already doing well, integrating those skills into the treatment plan, and building off those skills so your child can access new or more challenging skills.
This type of approach supports your child where they are at and recognizes that treatment should not focus on achieving a predetermined set of skills. Rather, it focuses on what your child needs!
NOTE: Strength-based approaches do not only apply to communication skills. It is also an approach that can be applied to your child's behavior and socio-emotional skills. A child's brain is still developing; they may have tantrums or meltdowns, struggle with attention or impulsivity, and may have avoidant behaviors when things become too difficult. It is essential that we, as therapists, provide supports for the child based on their needs rather than seeing these behaviors as deficits.
When selecting a therapist, parents should ask the clinician about their treatment approach and evaluate whether they focus on your child's deficits or if they notice all of the things your child can do.
Therapy should be individualized. Always. Objectives selected for each period of treatment should reflect upon three main questions:
Is this child ready to learn this skill? Do they have the necessary prerequisite skills? What level of support to they need for success?
Is this skill meaningful to the child? Does the child want to communicate about this? Are we framing this skill within an activity the child enjoys?
Is this skill functional in the child's daily life? Is this something that will help them communicate their wants/need? Is this a skill that the child will use often in their routines? Will this reduce frustration for the child?
When choosing a therapist, parents should ask the clinician how they choose their treatment objectives and how they are adjusted over time. When presented with your child's objectives, think about whether these are skills that are meaningful to your child and functional for them.
The neurodiversity movement has been gaining more and more traction over the past few years thanks to neurodivergent voices who have been self-advocating for themselves and others.
Neurodiversity is the idea that individuals have natural differences in the way that they learn and think, interact with others, and process information. This includes individuals who have diagnoses of Autism and ADHD or those who stutter.
Neurodiversity-affirming care values acceptance and inclusion for neurodivergent individuals. It also values self-advocacy skills and authenticity over conforming to make others more comfortable.
IMPORTANT: This does not mean that neurodivergent people won't benefit from services and therapy!
This movement is a direct challenge to what many people call the medical model of care, where differences are often portrayed as part of a disorder or a deficit to be fixed. This model often centers around forcing neurodivergent people to act more like neurotypical people, forcing them to change rather than encouraging acceptance of their differences. This is called masking.
And, as more research is coming to light (especially for the Autistic community), it is becoming clear that the medical model of care leads to poor mental health outcomes and prevents these individuals from connecting in their authentic way.
A neurodiversity affirming therapist will:
Focus on strengths-based language in their assessment of your child's profile. They will not rely solely on standardized testing for evaluation as these tests are not designed for neurodivergent children.
Create goals for your child that supports their communication and fosters their authenticity. They do not choose goals based on what a neurotypical child their age "should" be doing.
Avoid any goals that simply seek to mask autistic traits (e.g., forcing eye gaze, eliminating stimming behaviors, eliminating echolalia).
Understand neurodivergent communication styles and ways that neurodivergent individuals prefer to show interest, engage in joint attention, and communicate with others.