Expressive Language - Jack

 Date of Observation: 12/7/2024

Setting: Speech Therapy Office

On the Master Clinician Network, I observed a therapy session with a 5-year-old boy (Jack) diagnosed with expressive language disorder characterized by trouble with word retrieval and language form. The session occurred in a private room that felt intimate. It was clear that the client felt very comfortable and free. I noticed that the speech-language pathologist focused on activities that addressed expressive language (grammar, syntax, sentence organization).

Materials used:

Story Book

Preposition Photo Cards 

Toys (a giraffe and an ice cream cone)

Goals:

The primary goal of this session was to work with Jack, utilizing storytelling, toys, and photo cards to reinforce proper language structure, word retrieval, past tenses, and prepositions.

Impression:

I enjoyed Dr. Glen's temperament. He was positive and encouraging and did a good job engaging the client. I also liked that, at the beginning of the session, Dr. Glen took the time to explain the activities he had planned for Jack and what they were going to work on during the session. Dr. Glen was very good at redirecting Jack's focus on each task.

What I learned:

This observation introduced me to the language modeling approach. During the exercise with the storybook, Dr. Glen guided James through the story. While narrating the story together, the clinician offered feedback on correct articulation, question structure, and sentence organization. He used physical cues to show the correct place of articulation for certain phonemes and encouraged the client to speak spontaneously.

Repetition:

Dr. Glen: He saw a butterfly. Can you say that again?

Jack: He saw a butterfly.

Past tense:

Dr. Glen: What did he do?

Jack: He jumped in the pond

Spontaneous speech:

Dr. Glen: Do you have a dog?... Is it a boy dog or a girl dog? What did she do?

Word retrieval and vocabulary:

Dr. Glen: Do you know what that is? Let’s do some thinking

Jack: Tools

Dr. Glen: Correct. This is a tool, and it’s called a wrench

Another thing I observed was play-based therapy. Dr. Glen incorporated photo cards in a memory game to focus on prepositions. Toys also addressed verb forms, plurals, word retrieval, and past tense. I observed that he sometimes gently touched the client's arm to help them slow down, concentrate, and think more clearly.

Dr. Glen used the giraffe and the ice cream cone to work on giving and following instructions.

Dr. Glen: Tell me what you want me to do with the giraffe

Jack: Pick it up. Push the button in. Let go of the giraffe

Dr. Glen: Tell me what you want me to do with the ice cream cone.

Jack: Push the button on the ice cream cone. Push down harder

Question:

When you gently touched Jack’s arm to help him focus, was that a common technique you use to redirect attention? How do you determine when physical cues are necessary?

Sensory integration therapy is an evidence-based method that uses physical cues, such as touching the arm, to help the child focus when they seem distracted or overwhelmed. These cues are gentle and non-intrusive, allowing the clinician to redirect the child’s attention back to the task at hand without causing disruption. This technique helps children with attention issues slow down, concentrate, and refocus their energy on the task.

Reference: https://aussiechildcarenetwork.com.au/articles/child-behaviour/redirecting-children-s-behaviour

Link to final presentation: bit.ly/slpenthusiast