Saturday, November 28, 2015

I Needed Help (and I got it)!

I suspect we have all been in the situation I am about to describe, the situation where you feel you are at your wits end with a student/client. It's the kind of situation, where despite your best efforts, nothing seems to make a difference and what's even more distressing is that the situation often escalates.

I found myself in that scenario last school year and for a brief period this school year. For obvious reasons I won't offer too many specifics as I don't want to identify anyone. I will call my student "Joy." Suffice it to say I could make NO inroads with Joy. Everything I did was met with push back. I was frustrated, annoyed and just plain done. Every therapy session was an exercise in frustration. I began to dread her scheduled therapy session. Progress was nonexistent and the question of continuing services was brought up by many, including me. I know this can be a tinderbox of controversy; "When speech-language therapy is not productive, do we quit?" I just wasn't ready to give up. Joy was just a kid and I felt an obligation to make both a professional and human connection. I was in desperate need of advice. I talked to colleagues and mental health professionals. I read as much as I could, I did an ASHA self study, but made no progress.

Late in September our state organization, NHSLHA held our Fall Conference. I am fortunate to work with an amazing NHSLHA board, including the talented and funny Cass Chapman. At the Fall Conference, Cass introduced me to her business partner. Cass and Annie DiVello are the co-owners of New England Pediatric Services (find them here and here) which offers mental health counseling, occupational, speech, play and physical therapies. I began to speak to Annie about my challenges with Joy, in fact, just that week Joy had entered my room belching repeatedly and loudly and behaving in a confrontational manner. I was at a loss. Clearly no speech-language therapy was going to happen that day. I gave Annie my phone number, unsure as to what would follow and went home happily exhausted after a successful conference.

Later in the week Annie gave me a call (YAY!!!) and explained that with children similar to Joy she has found this descent to base behavior fairly common. Additionally, this adversarial posturing was also typical behavior. The challenge was going to be in my response. Annie suggested that rather than behaving "teacherly" I meet Joy at her level and spend some time truly establishing relationship. For me that meant that when Joy entered my room the next time belching, I challenged her to a belching contest. I downloaded a "fart" app and I became ten years old. I really wish I could paint a picture for you of Joy's reaction. It was priceless. Her icy demeanor cracked. That child reached down into her soul for the belch of the century and let it rip with utter abandon. For several weeks, therapy was very general. Following Annie's advice, there was little pressure. We did language-based crafts but there was no "direct" therapy. As Joy and I began entering into a relationship, I introduced more structured therapy activities, being mindful of her response. If her body language suggested anxiety or tension, I backed off and limited my questions and any perceived pressure for performance.

Since our initial belch-off, Joy and I have been been working well together. I walk a fine line between adult, speech-language pathologist, and ten year old. I don't judge. I don't reprimand. I leave my notion of what therapy should look like in the hall. I interact. I guide. I direct. I provide a space that allows for Joy's individual qualities. Annie's suggestions changed my work with Joy. I gave her the pseudonym "Joy" for a reason. I am no longer dreading my sessions beforehand and regretting them afterward. I am finding joy in my work with her.

As professionals, we might find ourselves in situations where we falter. Situations where we want to have the answers, but don't. Situations where we want to give up. Situations where asking for help may appear as an admission of a lack of no-how. That is just not the case! We cannot possibly know everything there is to know and in my adulthood I have no problem saying, "Help me. Please help me. I am floundering." Those with expertise in stuttering (I emailed Dr. Scott Yarrus last week), AAC (I emailed Gail Van Tatenhove last school year), selective mutism, ASD, dysphagia and so, so much more are ready and willing to share their knowledge and experience. Just ask. I needed help, and I got it. Thank you so much, Annie!


  1. I had a similar situation with one of my 10-year old students this year!

    There was no belching or farting involved-instead we just had a heart-to-heart and I just asked her what was wrong.

    She said things like, "This just isn't a priority," or "I just don't think I can do it". It was an articulation student who has been in speech for years.

    We came up with an agreement, we signed a contract, and once I gave her a little autonomy her attitude completely changed.

    1. It's always wonderful when you can have that type of conversation with a student. It can make all the difference. I'm glad things improved for you without having to resort to bodily functions :)

  2. Oh, Annie! What a WONDERFUL story! Was that farting site that bat fart site that Erik X. Raj mentioned on his blog the other day?
    You do what you gotta do, right??? :)

    1. No, it's just a toot app I found. I can't tell you the difference in the relationship I now have with this student. I no longer dread her therapy session!