Since my first post, I am now three weeks into graduate school for Speech Language Pathology and almost halfway through my first pseudo-semester at CSU San Marcos (pseudo-semester because the Communicative Sciences and Disorders program here breaks down six classes over sixteen weeks, to three classes over eight week). This semester, our 35-person cohort (34 females and one male, mind you) is taking Neuroscience, Language Disorders from Infancy to Adolescence, and Articulation and Phonology. Next month, I will start clinical observations at the Adult Neurogenic Clinic on campus, which I am looking forward to.
Compared to my undergraduate experience at UCLA, this program is not that much different in terms of class pace and workload. The drastic difference lies in high expectations of professionalism and success. As expected for a graduate program, my peers and I not only know what we want to do, but have clear-cut expectations of what we are working towards. Above all, it is incredibly refreshing to be in a classroom with people who are competitive and hard-working, but not at the expense of being helpful and compassionate. Truly, I think this is what sets our field and cohort apart from other specialized, higher education programs.
In my spare time, I have been conducting at-home speech therapy sessions with a toddler with a speech delay. So far, I have had six, hour-long sessions. The child is undoubtedly cute, but the experience thus far has been difficult and frustrating due to my inexperience. However, this past week, I experienced my first successful speech therapy session! This week, I checked out a Childhood Apraxia of Speech flashcard kit from the school library. I checked it out as soon as I saw a flashcard for "elevator," because the child has a penchant for elevators. Little did I know, this would be the beginning of child-centered therapy.
As soon as I took out the "elevator" flash card, the child ran off and took me to his grandparent's room. In his grandparent's room is a sliding closet, which he plays with pretending it is an elevator. We spent well over 45 minutes on this topic, enunciating the pronunciation of "elevator," talking about the function of an elevator, role playing what to do in an elevator, and taking turns talking about the elevator. Over six sessions with the child, I have not seen the child this elated and engaged, which is so encouraging. Tailoring the therapy sessions to his interest in elevators elicited natural conversation and a sense of liveliness that really turned therapy into play.
Child-centered therapy, as opposed to clinician-directed therapy, allows the child to lead the therapy session; the clinician follows the cues of the child and therapy is contingent on the natural sessions. As expected, many clinicians prefer clinician-directed therapy, because clinicians feel more comfortable relishing control of therapy sessions. However, the main disadvantage of clinician-directed therapy is that it is heavy with drills and results may not be generalized to real-world settings.
My first-time experience with child-centered therapy is not only an important lesson for myself, but also a constant reminder for all of as clinicians. As clinicians, we must be able and willing to relinquish control of therapy sessions. Child-centered therapy does not mean that the therapy session is unplanned or about to go awry; rather, the clinician must actively follow the cues of the child for the therapy to go as planned, and to redirect therapy (if necessary) to be effective. Sure, child-centered therapy is the more difficult route, but in the long run, it is a route worth taking.
