Let's Philosophize

Alessandra Spaulding
Nov 18, 2022
4 min read

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

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:

Strengths-Based

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.

Individualized

Neurodiversity-Affirming

Child-Led

Family-Centered

Scenarios

These are all fictional scenarios to help you in your decision to understand what philosophy might be best for your child.

Shiva

Shiva is a non-speaking 3 year old. Her parents brought her for an evaluation with a speech pathologist at a diagnostic center associated with a large hospital. After waiting weeks, the report came back. Shiva was "significantly below average" in all of her testing, and the report seemed to only talk about all of the things Shiva couldn't do. Her parents were in tears reading the report feeling like the therapist didn't truly see their daughter and all the things that she can do.

Shiva's parents are not alone. This happens frequently with large centers who use templated reports that list the results of standardized tests. When Shiva's parents look for a therapist, they should look for a therapist who is neurodiversity-affirming and provides a strengths-based approach who can provide qualitative assessment during therapy, looking beyond standardized test measures to understand Shiva's true abilities and build new skills from there. And someone who is neurodiversity-affirming will understand how to support Shiva and her family with acceptance and connection.

Emry

Emry is a 7 year old who has been in speech therapy for years. He is still working on his /l/ and /r/ sounds with his therapist, but he hates therapy. He is tired of doing flashcards with his speech therapist, and he refuses to do any home practice with his parents.

Emry is not responding well to an adult-led approach and would benefit from a hybrid or even a child-led approach to help him feel part of his therapy. Using flashcards for articulation drill isn't working well for Emry. Instead, his therapist should try building words into games that he likes or having him choose his own target words. Once Emry is given some choice in his treatment, he will likely feel more motivated to work on his sounds.

Hugo

Hugo is an 18 month old boy who is receiving Early Intervention services. The therapist comes each week to their home, and his mother watches the session. After several months now, Hugo's mother still feels like she hasn't learned anything, and there hasn't been a lot of progress.

Hugo's mother is looking for a more family-centered approach. She would benefit from more explicit parent coaching so that she can use strategies during the week when Hugo is not actively in session. Hugo's mother seeks out a private therapist who has more flexibility in their service delivery. The new therapist offers her one virtual 30 minute parent coaching session to learn hands-on strategies to use with Hugo during his in-home session. She also sends videos from home to her therapist to discuss at their virtual sessions.

Ready, Set, Talk Time

Talk Time private practice Alessandra speech therapy

So let's see how Time Boston fits into the Philosophy category.

Where does Talk Time Boston fall?

Strengths-Based: Talk Time highly values a strength-based approach. We create treatment objectives by building off your child's strengths. We also know that neurodivergent individuals will learn differently and focusing on deficits means we miss what your child can do.
Individualized: Talk Time individualizes each and every one of our treatment plans. We work closely with your child and your family to see what is functional, meaningful, and feasible for your child. And we provide progress notes approximately every three months so we can adjust the plan as needed!
Neurodiversity-Affirming: Talk Time is committed to neurodiversity-affirming practice. We accept neurodivergent individuals as they are, and we respect that their differences are not deficits. We believe in supporting these individuals using unrestricted access to multimodal communication and sensory supports, and we teach self-advocacy skills to empower these individuals as they navigate interactions in their life.
Child-Led: Talk Time generally provides a child-led approach. We believe in building strong relationships with our client based on trust and acceptance. And yes, we will be doing therapy even while we are playing with your child! We do use hybrid approaches when structured activities are necessary, but we always work with your child to make sure they feel heard and motivated to work on their goals.
Family-Centered: Talk Time values family-centered care. That's why we include families in every step of our process -- from goal creation to progress updates to therapy sessions to home carryover. We are in constant communication with families, and we are always open for questions and concerns!