You Never Know What Will Work

By Pam Marshalla

I was recently reminded of a client I worked with decades ago who taught me a very important lesson about therapy when I was a young therapist. I wanted to share his story.


David was 6;0 and non-verbal.  He was a big clunky kid with fine and gross motor problems who was basically untestable, and everyone thought he had very low IQ.

I was using Bliss Symbols with him (it was 1976) to develop a home-made communication board (before personal computers).  Each card had a hand-drawn Bliss Symbol with the word written below.

Sample Bliss Symbols Cards

Bliss Symbols Cards - Speech Therapy

I was in an IEP meeting with the parents one day and was enthusiastically telling them how well their son was doing with the cards when the dad happened to say, “Wouldn’t it be wild if he was reading the words and wasn’t even paying attention to the pictures.”

The father’s statement hit me like a ton of bricks.  What if it was true?  Couldn’t a child sight-read the written words just as easily as he could sight-read the symbols?

I decided to test the idea.  I re-drew the cards in two colors: The symbols were done in very light yellow and the words were done in black.  Then I re-drew them again with only the written words.

Sure enough! The child was reading the words. Duh!

From then on we understood that David was much smarter than he appeared and we began to teach more to his real level, a level we understood better over time.  David was below average in intelligence, but not nearly as low as we thought.

The lesson? Great therapy often occurs when we think outside the box. 

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