New client, New Blog #1 (due 3/3/08)

Wow, already Semester 2 in grad school.On to more Blogs


I am working with a client J. he is 1 year and 11 months. He has been at WVU since last semester and is currently enrolled in Birth-to-three. He is as of now, diagnosed with delayed speech and language. His brother who is 8 is diagnosed with Apraxia and selective mutism. J. is a very challenging client to work with. He is pretty much nonverbal, he produces the sounds m,b,v. As of words I have noticed him saying, wee, voom, and more during play. His mother has noted 10 words at home but during therapy they have not been observed. He also uses signs for more, done, open, and close. He will use about 2-5 signs during a 50 minute session.
Our therapy goals this semester are 1. To express basic wants/needs during play when provided by choices, verbal cues, and sign language from the clinician. In this goal he has been pointing to the toys and using the sign more when given choices. For example we color and I give him one crayon at a time and if he wants more crayons he has to say/sign more.

The second goal is to increase vocalizations and oral/sound imitation skills following moderate to maximum cues. As of now the sounds are/m,v,b/ He uses the sound m numerous amounts of times throughout the session.

The third goal is to expand vocabulary to 10-20 words. I am showing him pictures of animals, objects, and showing him a wide variety of toys and introducing him to new words. Most of the therapy revolves around play. I talk and try to expand his play skills. Before this semester J. was having trouble even playing with toys. He now is playing better and interacting more. I usually talk/play for 50 minutes of the session and get very few verbal sounds. But he is doing better and we are getting more verbal approximations.

Our fourth goal is to improve attending skills during play. This is slightly difficult considering that he isn’t even two years old. It’s hard to keep his attention for more than a few minutes. Each session varies on what he wants to play with and for how long but that is understandable for such a young client. He does have a problem going in and out of the therapy room to go see his parents. It started to become more of a game rather than for comfort. Now I move the table in front of the door and it keeps his mind off wandering. At first I thought it was going to be upsetting for him. He did not cry, he becomes discouraged for a few minutes of the session and then he forgets about the table and continues to play.

Our last goal is to follow directions with 80% accuracy. This is observed by me telling him to do things like hand me the toy, put the crayons away, or put the toy in the box, and so on. He is doing this with about 60% accuracy depending on each session.

In the end the methods and techniques are working well. For such a young client it’s hard to keep their attention. Playing is very important and he has been learning a lot through play and is also developing better play skills. Play therapy has been established very early and is essential for J. to see improvements in speech and other aspects. There is an article about the importance of play therapy and how it was started if anyone would like to read it. It is very informative and explains the importance of play therapy. Some people think that it’s only ‘playing’ and they wonder how they will ever learn anything from that. This article and study shows just how playing can be beneficial in therapy.

Reference
Bratton, S.C., Jones, L., Ray, D., Rhine, T. (2005). The efficacy of play therapy with children: A Meta-analytic review of treatment outcomes. Professional Psychology: Research and Practice, Vol 36 (4), pp376-390. Retrieved February 25.