With school being out for the summer, siblings have been a big part of my in-home therapy sessions.
From the older sibling dragging every toy he owns into the work space, to the youngest sibling climbing all over me to get my attention. It can leave parents and caregivers feeling a little uneasy and even apologetic when siblings appear to be consuming too much energy or bringing about more challenges than usual to a therapy session.
As a parent, I can see how you might feel the need to pull them away from the activity and that it may feel better to have them ski-daddle into another room, or, schedule all therapy sessions while the older sibling is at preschool and the youngest is napping. I get it.
I mean, if I wasn’t a speech-language therapist, I’d probably feel the same. It’s hard to imagine why a therapist, like me, might want siblings involved at all. Especially when I only have 45-60 minutes each week with a child.
This conversation comes up pretty regularly and it definitely seemed worth sharing a few reasons why I feel strongly about including siblings in therapy and how they can actually play a very important role in another sibling’s language development.
This stems from a belief that intervention and learning thrive in as natural a setting as possible. Essentially, I’m looking for the place that is -- as close to REAL LIFE as we can get -- and it doesn’t get more real than being at home with the whole fam.
I’m here to give you permission to let it go and trust that nine times out of ten, they’re providing so much more than they’re taking away.
Here are a few reasons why the chaos is welcomed with open arms.
Before we get into some scenarios, let’s give our child with a language delay a name for ease shall we? We’ll use Johnny as the child with language delays in all our examples below.
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| Picture from this morning's session. :) |
Siblings Help Establish a Starting Point
When Johnny’s siblings are involved, we can paint a clear picture of what Johnny’s communication looks like on an everyday basis. It helps me as a therapist see how Johnny gets his needs and wants met, which is what this whole communication thing is about, next to building relationships with others. ;)
Seeing him with his family, the people he’s most comfortable around, in a space he’s most comfortable in, allows me to find a starting point for therapy. I would argue it might be the fastest way to finding what to work on and how to begin working.
For example.
Johnny’s older sibling wants to be involved sooooo badly, he just can’t contain himself and takes Johnny’s dinosaur while Johnny and the therapist are playing. Johnny immediately goes into total meltdown mode and soars into a crying, screaming, kicking fit.
Frustrating as a parent? Maybe. As a speech and language therapist, this really is the golden ticket.
Currently, this is Johnny’s way of communicating:
“I’m mad that you took that toy, that toy was mine to play with and you snatched it from my hand.” -- Johnny’s thoughts, probably.
A typical reaction might be--Johnny’s older brother no longer gets to play or participate in therapy sessions. Why waste money and time to watch Johnny go through a meltdown every session?
What a bummer. Not just for Johnny’s older brother, but for me, the therapist too. You see, the best way to move past something, is often times to work through it and one of the best ways to work through it is if Johnny’s brother is with us.
Let’s think this one through and I encourage you to see these behaviors as Johnny’s way of COMMUNICATING.
Let me repeat. Behaviors = Communication.
Since this is the mode in which Johnny is currently using, it is from this place in development that we must build. So we begin with the tantrums and work from there.
Trust me, “behaviors” and “tantrums” -- kind of a specialty for most speech-language therapists. I've been bitten, scratched, hit, kicked, you name it. No apologies necessary, we get it.
So...maybe during the next session, we start to introduce words or signs like, stop and mine and phrases like, “my turn, maybe later, not now,” and “all done.”
Depending on Johnny’s age, we may or may not begin using words that describe feelings such as “frustration, mad, angry, upset,” and “sad,” in hopes that one day, Johnny will use these words to express his feelings and forego the tantrum.
Here’s an entirely different scenario in which siblings can help a therapist establish a starting point for therapy.
Johnny walks to the counter, he looks at his cup that’s out of reach. His older sibling says, “Johnny wants his cup” and walks over to grab the cup for him. Johnny has said nothing, his needs were anticipated for him and met. No additional work (words) needed at this point.
A few minutes later, Johnny’s milk is gone. He begins to fuss. Johnny’s older brother grabs his cup, goes to his dad and says, “Johnny needs more milk.” Dad fills Johnny’s cup, his brother brings it back to him, and Johnny stops crying. Again, Johnny did nothing past crying a bit to communicate his needs and they were met.
In a 1:1 therapy session within a therapy clinic, each of these scenarios would be hard to create without going through many therapy sessions and conversations with Johnny's parent(s).
At home or when siblings are in the arena, it becomes clear very quickly where the communication breakdown occurs.
Coaching
Once we have a baseline for therapy, coaching can begin and siblings are fairly easy to do this with when given the opportunity.
The study, Sibship Size, Sibling Cognitive Sensitivity and Children’s Receptive Vocabulary, published in the February 2014 print issue of Pediatrics, found that even kindergarten-age children were able to recognize and make adjustments to the way they communicated with their younger sibling, based on the needs of the younger sibling. They helped facilitate a language-learning environment with coaching.
My experience has been this too. After spending some time with the siblings, they many times follow my lead and make adjustments almost immediately to the way they communicate with the sibling who has the language delay.
Depending on the scenario, I may work with Johnny’s older sibling and practice saying “cup” before handing Johnny his cup, or waiting for a little bit while holding the cup until Johnny says, “cup.”
Johnny’s older brother goes nearly everywhere with him. He is at home with Johnny most of the day, every day. If his older brother takes away one or two ways to communicate with Johnny or “help” him, then therapy will be even more effective when I’m not there to reinforce it.
Children also learn from other children pretty easily; both good and bad. They see their older sibling(s) and/or even younger sibling(s) doing or getting something, and they want to do or have the same.
Functional
We can go over flash cards all day long, we can play the best games and learn language, but it only counts if Johnny uses it at home with the people he’s around most.
It works more effectively if we are targeting words and phrases that will be useful for Johnny, especially in the beginning when we’re finding ways to motivate him to speak more as he learns how helpful communicating can be.
Having Johnny’s siblings around during therapy allows us to know what those words and phrases he has trouble with are and create a plan to build communication skills that are functional in the environment where he needs it most to start -- at home. He will receive the most reward when he says “cup” at home and his brother hands him his cup, smiles at him and says, “Mom, Johnny said cup!”
This can be carried over again and again in the home and actually, can make it easier on parents when the siblings are on board too!
So…
If you’re a parent and/or therapist who is questioning whether it’s a good idea to have siblings involved during speech and language therapy sessions, I highly recommend you give it a real good shot. Maybe 5-6 sessions to see how things go and then make adjustments from there.
Good luck!
Michelle St. Aubin MS CCC-SLP
Owner of Michelle Lynn Therapy PLC
smalltownspeechie.blogspot.com
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