I’m new at orofacial myology. I know that I must individualize, but am not yet good at it. How can I improve my ability to look at each client with an open mind and be able to plan the program the best way for each one?
You will improve year after year with experience. But don’t think that even the most experienced among us always have the answer for every patient and situation that arises.
So, what I am getting at is that all of us have to evaluate someone from several perspectives:
- actual functioning as shown on the eval form;
- parental ability to work with child;
- age and maturity; time constraints;
- severity of “condition”; and
- anything else that might affect therapy.
I thought about some of the people I am seeing now and I think that giving you an overview of their needs might help you feel that you are not alone in having to constantly think through what is best for each one and each situation.
Here are a few examples just from the clients I have now….they help explain some questions about age and what to expect, etc.
1. I have a five year old whose mother is an SLP. We started off far too slowly for my satisfaction, but they are both content to meander along with the program for as long as it takes. I began working on her lisp once she had finally “passed” Prof #1.
She is into Phase 2 now, something which I would never have predicted. Even the insurance company has cooperated and will be covering as much as we need. She wiggles and giggles and bounces around, but we keep moving slowly ahead. I use stickers and board games, and lots of praise to encourage her and though it takes a lot of my energy, it is working beyond my wildest dreams.
2. I have a boy, 11 years old, who was tongue tied. We are seeing him post-surgery. He has been diagnosed with ADD. He doesn’t sit still for long. His mother sits with us, of course, and works with him all week. He has progressed very well, albeit just a wee bit slower than he would if he were not ADD. We are focusing strictly on Myo, not speech, with him.
3. I see a girl, 5.5 years old, for myo and lisping. We worked on myo to start and maximized her on Prof Exam #1. It was not perfect, but we decided she had enough of the skills to move on. We were able to move through Phase One and cover it completely. We eased into Phase Two, but she could not handle much of it. That is because of the remaining weaknesses from not having passed Prof Exam #1. Neither she nor her mother did well at scheduling her home practice sessions. So, she is working on her lisp and during each session, time is spent on DND with a “game” and we review and improve myo areas previously covered. We’re also going to “inch along”..adding myo exercises every so often. Again, there is no hurry in this case since she is making steady but very slow progress and there are no financial limitations according to her mother.
4. I see an 8 year old girl who is moving along like an adult. She has conquered a noxious oral habit, and continues to do all that would be expected from an older person. Her mother sits during the therapy session, mainly to ask questions and chat, but the child has been practicing entirely on her own and doing phenomenally…
Even though you are just starting, you still will still help your clients even if you stumble and fall and get up again…just like I have done!