Giving a Prognosis to Parents

By Pam Marshalla

Q: What do you say to parents who want to know how much longer speech therapy will continue? I have been seeing an 8-year-old boy for two years for auditory processing, and for both receptive and expressive language skills. He is making good progress but could honestly be in therapy for a few more years.

It sounds like this client may never have “normal” speech and language, and he could use help for as long as he can get it.

I try to help parents understand how the child’s overall process of learning is interfering with his speech and language development, and that he may always have problems. I say, “He may always have problems with speech and language. Time will tell.”

With an acknowledgement that he may always have problems, the discussion changes from “When will he be done?” to “How long will speech-language services be of benefit to him?”

The answer is that this type of client always can be helped by S/L services. But there will be a time when he will plateau for long periods, and it may make more sense to focus on other things then (e.g., reading, math, sports, etc.).

I tell my parents that I can work with their child as long as he is in school or coming to the clinic. But I say that there may be a time when they decide as a family that it is time to move on to other things. I tell them that I will check in with them approximately every three to six months, and that they simply should let me know when they are ready to move on.

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