Case study 2 – Delayed Speech and Language Skills

Issue

Child aged 4.4years/ female diagnosed with Delayed Speech and Language Skills secondary to (?) Attention deficit disorder has been attending speech therapy sessions for 3 months in Jewel Autism Centre.

When this case was assigned to me, as an initial step, I had gone through the case file and I found that she was having many difficulties such as lacking eye contact, poor name call response, poor listening, lack of communication skills in social interaction and poor sitting tolerance. She was communicating her needs through crying/one word. I have tried to build rapport with the child and I found it difficult to work for around 1 week due to her adaptation issues. The first thing I did was to build rapport with her and to make her adjust to the situation. For this purpose, I started singing rhymes & engaged her in play during the sessions. She gradually started to understand the situation and got adapted to the sessions within one month. Since the mother was motivated, she also helped me to interact with the child and also she did home training each day very well. Each day the mother informed me how the child behaves at home, it helps me to understand the child very well.

2020 January
Improving prelinguistic skills and verbal communication

 The next challenging goal was to improve her pre-linguistic skills (Eye contact, attention, name call response, sitting tolerance & object). I have given the child different activities to improving attention through play. This technique worked on her to improve her Pre linguistic skills.

The use of rhymes & Parallel talk was useful in developing communication skills. The child didn’t show much interest in rhymes initially and later on, showed some interest with repeated use of rhymes along with actions & thus she started giving verbal responses through rhymes. The parallel talk was consistently used in the clinic and home which helped her to increase verbal responses. Now the child can communicate her needs around 4 to 5-word sentences. She started narrating small stories with my help and her social interaction has improved. She also adapted to different social scenarios and gives appropriate social gestures. Now I can proudly say that my child can communicate her needs and her mother is happy.

2020 February
Improving meaningful play and social interaction

Another challenge she faced was a lack of meaningful play, initially, the child did not know how to play with the toys and also how to play with peer groups. Initially, she was only knowing rotating wheels/throwing/mouthing toys. For this, I started holding her hand and showed the child how to play with it. This was continued for a month & later on the child started to explore the toys & started to play. Each session lasted 15 minutes. I took the child for interacting with peer groups and elders, initially, the child was not able to mingle with others. Whenever she saw the elder she used to cry. Slowly after one month, she started looking to their face. Now she can talk with others and also we used to play with the peer group where initially she was not cooperative but now she likes to play with them. To the improvement of the child in between the sessions, I have given different positive and negative reinforcement.

I am sincerely happy to work for this lovely child. I also want to use this opportunity to thank the Child’s mother who was hard-working throughout the session and at home for the intervention process of her child. Without her support, I wouldn’t have been able to do this successful intervention within this short period.

Practitioner
Jini Thomas
Speech-Language Pathologist