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om: Zevy initiates conversations now and we can have regular give and take. He’s doing better in school too but the real proof of progress is that Zevy is so much happier.

Rebbi: Zevy’s scores in Gemara went up from 65 to 85. And this week he came up with a great diyuk on his own!

Zevy: School is easier I chap it faster. And I can explain what I want to say better. I like reading now; I used to just read captions. It’s like everything got a little easier. I’m even more chilled with my friends. I can schmooze with the guys — it’s awesome.

Zevy’s mother and I meet to discuss his termination of therapy.

“Is he coming home from school in a better mood?” I ask reviewing notes from our first meeting.

“No comparison” says Mrs. Goldberg. “The anxiety and resentment have disappeared.”

“He’ll tell you about his day?”

Mrs. Goldberg nods. “Well he still grunts you know. But that’s just teenagers…” We both laugh. “Not only can he tell me about his day but he’ll also ask about mine. That never happened.”

Zevy can make small talk expand and keep the conversation going.

“What does his tutor say?”

“He’s doing better. The tutor says that now when they work together there’s ‘someone home.’” She pauses thinking. “Does he still need the tutor?”

“Therapy is not magic” I explain. “Therapy gave him tools for learning. Like the tutor says he’s able to learn now. But he may still need help. Stick with the tutor for now. His progress in therapy will enable the tutoring to be successful.”

Mrs. Goldberg looks uncertain. “Is his progress going to last?”

“You’ll need to follow-up” I confirm. “His tutor should ask him to identify main ideas on what they’ve learned for example.” An idea occurs to me. “Does Zevy have grandparents?”

“Yes” she says. “He calls them every Friday.”

Attaching follow-up exercises to specific times is a great strategy to make sure the work really happens.

“Great. Have him prepare what he is going to say. If he’s into the news let him read a news item write a summary and share it with his grandfather. If he has an interesting experience have him tell his grandmother practicing main idea and details. The idea is to find real-life situations to reinforce the skills he’s gained.”

I’m only giving a few suggestions so Zevy’s mother won’t be overwhelmed but the idea is to take as many opportunities as possible to incorporate practice into daily life.

I call Zevy in. “Well” I say with raised eyebrows “I know this is not what you want to hear but we’re kicking you out of here!”

Zevy laughs. “Seriously” I continue. “Are you going to miss therapy?”

“Of course” says Zevy. “I liked missing class.”

“You did a great job” I tell Zevy. “Not only did your skills improve but you’re not afraid to try anymore. Keep throwing those darts — even if you don’t always hit bulls-eye. I expect great things from you.”

Mrs. Goldberg sends Zevy to the car then says she wants to share one more thing.

“Our kids made a beautiful sheva brachos for my daughter who just got married” she tells me. “One by one they got up and said something — a grammen a vort whatever. When Zevy got up we all expected him to mutter some stilted sentences off a paper… like he delivered his bar mitzvah pshetl last year.

“But he stood up tall and proud shared a few memories said a nice thank you and ended with a beautiful brachah.” Mrs. Goldberg smiles at the memory. “My sister looked at me total disbelief on her face and said ‘Wow what happened to him?!’”

The goal of therapy is not to cure children but to develop them. Not to remake them just to give them skills and techniques for success. The Zevy who came to therapy was a great kid with poor aim. The Zevy leaving therapy is a sharpshooter.

TAKE IT HOME

If your child struggles with language processing and verbal expression here are some ways you can help him improve his skills:

Role Model So much of the day is consumed with fragmented conversation. Make time to have a full conversation with your child and take the opportunity to tell him about your day. Relate an experience or thought and model clear and organized verbal expression. Pick a time that facilitates sharing like bedtime or when walking to shul. Having a set time is also a great way to make sure it really happens.

Presence When your child talks to you maintain eye contact the entire time your child is speaking. Move into his proximity. Actively participate by offering feedback such as saying “hmm” chuckling or nodding. Show your child that what he is saying is the most important thing in the world to you.

Build and Elaborate It might take him time to get his thoughts out and you might need to help him. Give him as much time and help as he needs. Repeat what he says and help him elaborate by asking questions that include the words “do you think” such as “What do you think…” “When do you think…” and “Why do you think…?”

Possibilities Create opportunities for your child to think about multiple answers for the same question. Go around the Shabbos table asking everyone what country they would like to visit. Why do they want to go there? What would they do and why? Guide the child to offer many possibilities.

I Wonder Teach your kids to think and wonder. When you drive past a construction site initiate a conversation by wondering aloud what they might be building when it will be done and what that truck might be for. When you see a police car wonder aloud where it may be going and why.

Read and Discuss Have your child read something that interests them such as a news item or story and ask him to tell you about it. Help him with organization elaboration main idea or details as necessary. This exercise is also a good informal barometer to judge the child’s skill level or progress.

D. Himy M.S. CCC-SLP is a speech-language pathologist in private practice for over 15 years.