This case study focuses on a 7-year-old child, whose identity remains anonymous to protect privacy. The child presented with speech clarity concerns, along with difficulties in academic skills. The complexity of this case stemmed from the child's age, as the critical period for speech and language development had already passed. Both parents, who were well-educated, expressed concerns about their child's speech intelligibility. The mother specifically mentioned that neighbors struggled to understand the child, resulting in her reluctance to interact with other children in the neighborhood. The father also expressed concerns about peers making fun of the child at school. Being the only child, the parents devoted significant time and effort to support and train the child at home, with the mother taking a career break for two years. Let's explore the therapy techniques for Delayed Speech and Language
Evaluation and Diagnosis
During the evaluation, we explored the child's academic skills and identified difficulties in reading, writing, and mathematics. To gain a comprehensive understanding, we assessed cognitive perceptual skills, including memory recall, reasoning, problem-solving, and overall cognitive abilities. It became evident that the child was a slow learner, with these skills lagging behind peers of the same age. Additionally, a detailed speech evaluation revealed a speech sound disorder, contributing to poor speech clarity. The child exhibited difficulties in producing certain sounds, indicating challenges in phonological processing and misarticulations. Receptive and expressive language abilities were also assessed to rule out language delays. Our approach involved addressing the foundational skills before progressing to higher levels of language development.
Treatment and progress due to therapy techniques for delayed speech and language
Recognizing the interlinked nature of various aspects influencing the child's speech clarity, we conducted detailed counseling sessions with the parents. It was essential to convey and help them understand the interconnectedness of the child's abilities, which ultimately contributed to her speech clarity issues. Setting realistic goals and maintaining parental motivation proved to be a challenging task. Initially, we started with four therapy sessions per week, primarily focusing on language skills. Within two to three sessions, the child adjusted well with the therapist and actively participated in the activities. Around the 20-25 session mark, we observed improvements in the child's language skills, considering her slow learning pace. We designed age-appropriate activities to engage and involve the child. After approximately 35 sessions, we reduced the frequency to three sessions per week and introduced therapy targeting phonological processing errors alongside language skills. Progression from this point was relatively smoother. After about 15 additional sessions, we introduced cognitive perceptual activities, expanding language goals from simple mean length of utterance to complex sentences involving conjunctions and different verb forms.
Transitioning to two therapy sessions per week, we witnessed notable improvements in the child's memory skills after approximately 20 sessions. The child demonstrated the ability to recall events in sequence with minimal or no prompts. Subsequently, we addressed articulatory goals, focusing on speech sounds that the child could pronounce clearly. However, we acknowledged that the child's high arched palate might pose challenges in producing certain sounds such as /l/, /sh/, or /S/.
Within 15-20 sessions, there was a significant improvement in speech clarity, with strangers now able to understand the child's speech with ease. Although the therapy sessions are ongoing, the frequency has reduced to one session per week, and we have implemented a home-based program. The parents have been trained to work collaboratively with us, allowing us to provide goals and work together towards the child's progress.
Conclusion
This case study highlights the successful management of a child with speech sound disorder and learning difficulty. By addressing the child's foundational skills and progressively advancing to higher language levels, significant improvements in speech clarity and overall language development were achieved. The collaborative effort between the therapists and parents played a crucial role in maintaining motivation and ensuring the child's progress. The findings emphasize the importance of a comprehensive approach, encompassing various aspects of the child's abilities to achieve optimal speech and language outcomes.
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