The following scenario is completely made up, but in a way that should be familiar to a lot of speech-language pathologists (SLPs). Miraka has been working on time concepts for, well, a long time. You, as the therapist, have worked on asking her questions like what she did yesterday, when she eats lunch, and maybe even differentiating between hours and minutes. Perhaps you’ve worked with staff implementing routines and visual cues so that Miraka can anticipate what’s coming next in her school day. You seem to be doing some good stuff, but you’re just not sure Miraka’s making progress, and you’re not even sure exactly how to tell when her goal’s been met. People ask how Miraka’s doing, and we say things like, “She’s working hard. It seems like you can understand her better,” or “Her sentences seem better.” Inside we squirm because we can’t be more precise.
I’ll just state it bluntly: a lot of SLPs do not like language therapy. It’s just not as neat and straightforward as, say, articulation therapy, where you know exactly where the kid’s at, and exactly where the kid’s supposed to be going. The practice of language therapy has often been messy, or more of an art than science. And though we don’t like to admit it, we tend to measure language progress more from the gut than from any chart. We go almost entirely by subjective measures, such as how we feel, and what others are reporting. We can’t quantify Miraka’s progress, and this makes us uneasy.
We can do better though. We have to make it more objective. One way is to look at ABA, or Applied Behavior Analysis, therapy for autism which has several good things going for it. One of these in particular, that could be much more widely practiced in language therapy, is its use of discrete trials. In discrete trials, language skills are divided and conquered. This division allows them to be better measured and managed. Although discrete trials is usually used with lower level language skills, the theory behind it can be applied to any learned complex skill.
Our language in real life is rarely this neat. It is usually the result of a combination of skills, that can be compared to other learned complex systems, such as music. No one ever just performs a chord over and over, or a different chord over and over, or a three note combination from a scale over and over, but to play good music, you must learn these components before then combining them into useful musical arrangements. Language is the same way, but because it is used so frequently we don’t realize this is what’s going on.
Language teachers can use objective statements when describing their students’ progress. We can use statements like, “Miraka is now labeling age appropriate time concepts with few cues,” or “Joe is using basic pronouns in sentences without cues, which is an improvement over when he was just identifying basic pronouns,” or “Susie’s goal is to use age appropriate conjunctions in sentences without help.” We can measure specific language skills and use this information to tell us where we need to be going with our therapy, and when we’ve gotten there. In my next post, I’ll explain exactly how.