Intro: This is Weekly Dose of Wellness, brought to you by Memorial Healthcare System. Here's Deborah Howell.

Deborah Howell (Host): So, did you know that speech-language pathologists do much more than help children say their first words? In this episode, Stephanie Davis, a speech-language pathologist at Miller Children's and Women's Hospital, shares what every parent should know about pediatric speech therapy, from understanding what it is and how it works to knowing when it might benefit your child. Welcome, Stephanie.

Stephanie Davis: Thank you.

Host: I am excited about this one. So, let's start at the beginning. What is pediatric speech therapy and how would you describe it to someone unfamiliar with it?

Stephanie Davis: Pediatric Speech therapy is a service that can help your child communicate their wants and needs. We can also help with thinking and planning and organizing, if your child's having difficulty with that. We also incorporate swallowing disorders and feeding. We can also help if your child's voice maybe is having some difficulty. We cover actually a wide range of areas in which we can be helpful.

Host: Yeah, it's a big swath. So, what are some early signs that a child might benefit from working with a speech-language pathologist?

Stephanie Davis: Since we are communication specialists, I would say that anytime you find your child is having difficulty communicating with you, that would be a great time to think about a speech-language pathologist referral. So for instance, if your child is having difficulty in school, because they're not seeming to understand the language concepts, that would be a great time. If your child is a toddler and they're not yet using a lot of words to get what they want, that would be a great time. If you have someone who's considered a picky eater in your household, that would be a great time. So, there's a lot of different signs in different areas. We can also be helpful with children who have had a concussion or a brain injury. We can help in integrating them back into school and tolerating schoolwork and getting them the supports that they need to succeed.

Host: Yeah. That's wonderful. I know you've mentioned so many, but what are some of the most common challenges you help kids with, whether it's speech or language or feeding or social communication?

Stephanie Davis: Most commonly, here in the Children's Village Outpatient, we work with birth to three with feeding and swallowing. And if they're not yet able to communicate in a way that we would expect for their age, that's most common. We also work with patients that have voice disorders, and also brain injuries, so cognitive communication difficulties.

Host: That's an enormous responsibility, Stephanie.

Stephanie Davis: It feels enormous a lot of the time.

Host: Yeah, I'm sure it does. Now, at what age should parents consider speech therapy if they notice a delay or concern?

Stephanie Davis: We love to get them as soon as possible, because part of what we do is training the families to assist in the progress. As soon as you notice something, it would be good to go to your pediatrician and ask for a referral. So, "My child is not breastfeeding well or taking milk from the bottle well," or "My child is not using a lot of sounds, but they're gesturing." So because we work with such a wide variety, it's difficult to answer that question. But I would say as a parent and caregiver, you know. You know your child and if something is changed or something's not going as expected, just ask the pediatrician for a referral.

Host: So, my next question to you would be for a little bit older kids, how does speech therapy support children with developmental delays or autism or other medical conditions?

Stephanie Davis: We can be really helpful in figuring out alternative ways to communicate. So if someone has had their child in speech therapy for a couple of years and they haven't made the progress that they thought they would make, we can work together with our specialists and uncover any issues that may be underlying and also help with getting in augmentative and alternative forms of communication, whether that be a speech-generating device or more low tech systems that they can utilize in school. And as far as autism goes, we have in the past conducted social skills groups, where we meet up and get to practice what we know, just being together and trying to make it so that the child feels accepted just the way they are and has some skills in getting along with others.

Host: And that is wonderful, and I'd like to dive into that a little deeper. Can you maybe walk us through what a typical therapy session might look like for a young child?

Stephanie Davis: Because we specialize in the younger crowd, we tend to get a lot of birth to three. I think I'll walk you through a session for maybe a 2-year-old. So, we generally like to keep a lot of things the same, because we know that we can create routines that they enjoy if we keep a lot of the aspects similar week to week, and then we bring in novel toys, a novel song, maybe a novel snack so that we can increase their engagement with a variety of objects and a lot of parent training in there.

So in particular, my sessions, we'll start with a hello song and a walk to the therapy treatment room. Then, we will maybe start with something less active, like read a book or start with some nursery rhyme songs that will have toys that match. Then, we'll go into some preferred play, maybe with a cause and effect toy or some emerging pretend play items. And then, sometimes we have the luxury of heading out onto the playground and doing some gross motor movement and kind of using the concepts that I introduced out in a different and very preferred environment.

Host: Absolutely. I mean, it sounds like a wonderful experience for parents and for the child. Now, speech-language pathologists often work as part of a care team. You don't work in a silo. How do you collaborate with occupational and physical therapists?

Stephanie Davis: The very best part about working here at Miller Children's and Women's Hospital at the Children's Village is that we're all under one roof. We all share the same building, and we're frequently calling specialists and discussing a case or how we could better help a patient and serve a family. And in particular, here in our department, we have occupational therapists and physical therapists, and we frequently will try to co-treat.

So, the family only needs to make one trip to us, but can be seen by multiple disciplines, either overlapping or one right after another. That makes it really easy to collaborate because everyone on the team is present at the same time, and we can discuss what's going well and what additional supports need to be put into place based on what's happening now. Because these kids, they're always changing.

Host: Yeah. Yeah, for sure. I mean, that sounds like the way to do it. I mean, to collaborate and to make it easy on the families during their visits. So, speaking of families, what kind of role do families play in therapy and how can they continue the progress at home or in everyday routines?

Stephanie Davis: The families are actually the most important players. We work with such amazing families. They come from all over to be here in their sessions. They have regular attendance, and it makes such a large difference in the life of our patients. We do a lot of parent coaching. So, we may in real time, during the therapy sessions, have them try out some new strategies and coach them on how to make some adjustments to further the progress. We work really hard, especially in our breastfeeding and in our older feeding sessions to increase the interaction and the engagement and the relationship between the caregiver and the child because that's really where it starts. And we also try to help to let them know how do they can infuse fun and get the child on board, because often we're asking them to do things they don't want to do, but there's just so many strategies to implement. And I think when you're a caregiver, sometimes you're making the meals and doing the laundry, and it's really hard to remember and to make time for the fun, but that's really what I think they want to be providing. I'm a parent, and sometimes it's just hard to remember that fun is how it gets done.

Host: Fun is how it gets done, and just to have some ideas that aren't your own to stimulate the process. What about siblings?

Stephanie Davis: Yeah. So, we do have siblings join us for some of the sessions. And personally, I really love that because I love to watch the interaction between the child and the sibling. And siblings generally really love each other, and they're spending a lot of time together. And if we can train the siblings, even really young siblings, if we can train them to bring in some of the therapy skills and techniques we use into the home environment, the patients just love it because they look up to their siblings, whether older or younger, siblings in such a special relationship that we're able to leverage. That was nice that you brought that up, yeah.

Host: So happy to hear that, because sometimes it's just the parent is always, "You got to do this, you got to do this. Now, let's do this." And sometimes if a kid just does it and it's your older brother that you look up to, you'll want to do it too.

Stephanie Davis: Yeah. And the siblings, they want to help. They want to engage, they want to figure out new ways to do things. So yes, having them in the sessions, especially when we're on the playground, it's really just fun for everyone.

Host: Yeah. That's wonderful. Okay, final question for you, Stephanie. Why is early intervention so important when it comes to speech and language development?

Stephanie Davis: Speech and language development is such a relational piece of our growing up. And early intervention is important and it works, because we're able to train the families and the caregivers and sometimes the siblings to make really small adjustments throughout the day that make a really big difference, because especially in language development, creating a rich language environment is pretty easy to do. But sometimes it's just things we don't think of, like more music and more gesture and more photos and storytelling pieces. And we can teach that in early intervention and then the families can keep that going.

Host: I absolutely love it. Is there anything else you'd like to add before we wrap up?

Stephanie Davis: Speech and language therapy is so fun. A lot of times the parents will say, "I bring them here, and we're just having a good time. We're just playing games." And that's exactly what we are trying to make it look like. So, I think don't underestimate the ability of fun. And I hope that any caregivers or parents out there will consider asking for a referral, even if they're not sure, because I think even during evaluations, if sometimes we're not going to recommend speech and language therapy, I think there are things to be learned.

Host: And it's worth asking the question, right?

Stephanie Davis: I think so. Your pediatrician can always say no or later or absolutely. I think it's worth exploring.

Host: I agree. And Stephanie, we want to thank you so much for your time today and for all the great information. Wonderful to have you on the podcast.

Stephanie Davis: Thank you, Deborah.

Host: And you can learn more about speech therapy and other rehab services at Miller Children's and Women's by visiting millerchildrens.org/rehab. That's all for this time. I'm Deborah Howell. Have yourself a terrific day.