Having been a speech language pathologist for over 40 years, I have observed much about the treatment of speaking difficulties. One is the use of Cues with speech and language stimulation. A cue is a "prompt" or a way to help the person say a particular word or thought. Often in cases of aphasia or developmental speech and language difficulties in children, the individual may have what they want to say on the tip of their tongue or somewhere in their mind, but unable to say it. Therefore cues could include saying the word for the individual to repeat or giving a sound cue or even using written words.
I want to make this "Teaching of Talking Principle" rather short and sweet. And that is: Cues are fine and dandy, and the problem with many caregivers and therapists is, they don't think cueing the patient repeatedly is a good idea. I do. When you cue a person with a speaking difficulty, you give them the correct reply. If they did not need the cue, you would not have to give it to them. My suggestion when it comes to cues is that you give them the word cue by saying it and you continue to cue them with the word cue until they learn it. Family and therapists often want to test the person with the communication difficulty after just a few cues, and often find the person with the speaking difficulty still has difficulty saying the targeted word.
Again my suggestion is that you keep cueing the word that you want the person with the speaking difficulty to say, and just don't worry about whether they can recall it independently after a few practice sessions. Just keep giving them the cues, and you will see that they will say the word independently when they have integrated the word, word pair, phrase or sentence at an unconscious level.
It reminds me of my son Daniel, when he was about 6 years old. I was teaching him how to ride a bike. I had to repeatedly run behind him while holding the bike up, until he reached a certain speed and momentum, and then I would let go. He would do fine until he realized I was no longer holding his seat, and then he would crash! (ouch!). Therefore I had to continue cueing Daniel while riding his bike (holding his bike up with stability, and then would let go). For some reason, he took the darndest amount of time to get it right. My first son, David, only needed just a few cues, but Daniel required weeks of repetition.
The point is that everyone learns at their own rate of speed and will require cues until it's learned; then the cues may be no longer necessary.
The Yes No Confusion
One of the difficulties many people with expressive aphasia have is the yes/no confusion. Again, in this situation the family or therapist is often in a hurry to teach the concept, but does not spend enough time stabilizing the correct use of the word. In many cases people with aphasia may need a cue, for a considerable amount of time before being able to use Yes and No appropriately. Please, NEVER BE IN A HURRY FOR THE PERSON WITH A SPEAKING DIFFICULTY TO LEARN TO USE YES AND NO CORRECTLY. It is often a very difficult concept to re-learn, so when in doubt use cues because you want to remember that with cues the person gets the question correct because you have cued them. By repeatedly stimulating the correct answer, even with cues, you are helping them relearn how to answer the question appropriately. If you leave it up to chance, then they will experience both correct and incorrect responses. The way to stabilize a correct response at the single word, word pair or sentence level is to cue until it is learned, thereby having the person say it correctly each time you ask the question; even if you use cues.
Please do not hesitate to use cues in speech and language stimulation. When the system is ready to learn the concept it will on its own, but you have to give it lots of time, and cue it always with the correct reply. That way he or she is always answering questions correctly and there is no negative emotion or frustration, which is a real deal breaker in speech therapy. Hope this helps. More to come in the future.
Coming out of the Darkness
One of the problems we all face, especially if we have any kind of cognitive difficulty is the overwhelm that often occurs when there is too much of a cognitive drain on our nervous system. Have you ever gotten just too much information on a subject, or tried to learn something, and you just could not keep up with the information as it was being presented, or with time, just wanted to avoid contact with the situation because it just caused too much stress? It often happens for people who have any kind of brain processing challenge. It is often identified when the person with the speaking or cognitive difficulty starts feeling frustrated or overwhelmed.
When that occurs, the family member, therapist, or friend, has just got to BACK OFF, and present the information in a simpler way. When people with communication difficuties are frustrated, or want to avoid therapy it is often the result of the way information is being presented. We must remember that anyone with a cognitive concern or brain injury, will need to be approached simply and slowly. You will always know when the information being presented is too difficult: You will see frustration and avoidance. The truly elegant clinician or therapist will always present information to the person with the speaking difficulty in a way that will be easy to tolerate. When there is simplicity, there is success. When there is success there is a desire to learn more. Another one of the guiding principles of The Teaching of Talking Method is that you always present information with cues and in a very simple manner so that the person with the speaking difficulty has success in almost every verbal interaction. Hope that helps!
Vitamins for the Mind
One of my favorite authors and speakers, was a gentleman by the name of Jim Rohn. For some reason, whenever I read one of his articles it seems that he had written it just for me! In a recently article by this skillful practitioner of self development Jim pointed out that the person caring about another represents life's greatest value.
The people we care for must be cultivated like a garden, said Jim Rohn. Time, effort, and imagination must be summoned constantly to keep the relationship flourishing and growing.
In keeping with these words Mr. Rohn implores us to constantly grow and learn new things that will be beneficial for ourselves and others. By taking care of yourself, and feeding your mind with new ideas and ways of being, you will therefore be a better spouse, parent or caregiver for the people you love.
Please make it a point to be constantly learning. In the long run all those you love and care for will benefit.
Hope that helps!
Please share with friends and institutions
The Teaching of Talking was written in order to start a movement. A way of changing the way therapy has been traditionally done for so long. Many of you know that parents and caregivers are often left out of the loop when it comes down to really knowing what to do to help their loved ones talk. Our movement invites them in and enrolls them in the conversation of really knowing what to do to stimulate speech and language with clarity. To put it simply we believe those who receive the most stimulation from the home environment will be the ones who will make the greatest improvement. It's only natural the more stimulation in one's natural environment, by someone they love, the more forthcoming the improvement!
We ask that you forward our newsletter to any of your friends, acquaintances or professionals you may know so that they may learn of our work to help parents of children who are having difficulty speaking and caregivers of those with stroke, aphasia or head injury. We thank you for that.
The August Teaching of Talking Teleconference
During the month of August we had a 5 session Teleconference for those who had purchased The Teaching of Talking. I went through all the procedures with those on the call each week and heard wonderful stories from the participants regarding how the methods were helping them make speech and language stimulation so much easier for their spouses. Almost no frustration. Why? Participants are learning simple, and expert methods of what to do for their loved ones. In that way they didn't have to attempt to help their loved ones speak and make the countless errors people do when they are unfamiliar with the how-to's. Barbara told me that her husband no longer avoids her attempts to help him speak better. Sharon told me that she is now starting to get more spontaneous speech from her husband. If you are interested in finding out more about personal coaching or teleconferencing for those who have purchased The Teaching of Talking, please contact me by e mail at firstname.lastname@example.org
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