In honor of Better Speech & Language Month, The Arc of Monroe is highlighting Emily and her Speech-Language Pathologist Mary Klimek, M.S., CCC-SLP.
Emily is a nonverbal communicator who uses sign language, gestures, and a speech generating device (SGD) to communicate her wants and needs and engage socially with others. Prior to the pandemic, I saw Emily once a week for therapy during day-program where we worked on expressive communication skills such as learning core word vocabulary and associating picture-symbols with meanings, specifically starting with core words “go” and “want.” During therapy sessions she had a difficult time attending to structured tasks and participating in functional conversational exchanges. Carryover of these learned skills from speech therapy, were limited across different environments (e.g., in her core room, in the community, respite, home, etc.). Beyond speech therapy, she typically used her SGD as a tablet to watch shows or play games. She was still a little bit hesitant about using the device for communication.
I worked with Emily on these skills for about 6 months, until our day-program temporarily closed due to the pandemic. Once day-program was closed, we began to have therapy sessions via tele-health (such a foreign concept at the time). Emily lives at home with her family, who have all taken on a huge role in supporting her communication skills using her communication device. Once we started tele-therapy sessions with Emily and her mom, Tonya, Emily began using her device more often and solely as a communication system. Therapy sessions were increased to twice a week to promote ongoing and continuous learning. These sessions were also helpful for Tonya, so she could sit in on sessions and learn about promoting effective ways for Emily to communicate using her device. Tonya and her family learned to carryover those skills into Emily’s immediate environment, during real-time events outside of a structured setting. For example, modeling specific requests on her device when Emily pointed to something of interest. The carryover of skills at home was such a functional and motivating factor for Emily, as the effectiveness of her communication became clearer (e.g., “want + read + magazine” or “watch + cooking show”).
Emily now uses her communication device as her primary mode of communication and is able to identify/use about 30+ words to request, comment, greet others, and participate socially with others. She still benefits from support and ongoing modeling to learn and use additional vocabulary on her SGD, but has displayed such significant progress over this year with tele-therapy. I am looking forward to resuming in-person services with Emily, but watching her progress and ability to independently express herself throughout this year has been a silver lining of this pandemic.
Update from Mary: I recently spoke with Emily’s mom who mentioned that this has definitely been the highlight of the pandemic. She mentioned that Emily is now responding in ways she never thought she would. She is motivated by communicating and socializing with others, and it’s so important that she now has the ability to speak for herself and that other people can communicate with her as well.