Q: Do you recommend therapy breaks for preschoolers with phonological delay? For example, summer off after the year of early childhood in a public school?

I have usually found that a break from therapy (especially in the summer) is a fruitful experience for kids. Most often they come back to therapy having made considerable progress on their own. It always seemed to me that all that sunshine, gross motor activity, and new experiences helped them move along. Plus, they are free to talk as much as they want without someone prodding them all the time.

Remember, we are not teaching the client phonemes. We are teaching them how to learn phonemes. We are teaching them how to pay attention to speech, how to discriminate one phoneme from another, and how to identify a well-produced phoneme. We are also teaching them how to get their jaw, lips and tongues to make appropriate and more mature movements patterns for speech. We do this within the context of working on phonemes.

When we do all that, the client carries over our work outside of the therapy room. Thus he will continue to learn new phonemes during the time off from therapy. My experience is that most of my clients come back with even better speech after a break. How do I know they have improved? I test their speech (do a sample or a formal test) both before and after the break.

In 30 years of therapy, I never saw a client regress except under the following conditions:

1. The client had a medical problem or trauma during the break (e.g., ear infection, newly diagnosed medical condition, mouth injury)
2. The client had a neuromuscular disorder that was not handled well during the break (e.g., a client with severe cerebral palsy who was in the care of less experienced handlers during the summer)
3. The client had a degenerative disease that caused loss of skill over time