This week developmentally-based Speech and Language Pathologist (SLP), and DIR Expert Training Leader, Melanie Feller of Alphabet Soup Speech Consultants talks about providing speech and language therapy for verbal and non-verbal children and working with parents and families. She is also the first speech pathologist in the U.S. who is Self-Reg certified, a method to support self-regulation in individuals of all ages.
Developmentally-based Speech & Language Therapy with Melanie Feller
Melanie starts by describing what it means to be a developmentally-based speech and language pathologist. A developmentally-based model uses a bottom-up approach which works on the foundational capacities of the Developmental, Individual differences, Relationship-based (DIR) model. The children she works with will understand that there’s a wonderful purpose to communication and she’s not just teaching talking but supporting their ability to communicate in the world around them.
This differs from a behavioural model where you use a ‘top-down’ approach by teaching a child how to ask for “I want more, please” or “more cookies, please“, teaching words to say without having an underlying structure to support those words. Melanie provides direct therapy, evaluations, and parent coaching consultation services in NY, NJ, and PA to support children and advocate for and involve parents.
She works in a strengths-based model. She aims to get into this great dynamic play situation with the child leading and her participating. She meets them where they are, then gently but firmly moving them up the developmental levels. So if the child says “baby” and she’ll say naturally say “little baby” or “my baby“, with affect to help the child go from one word to two words, for instance.
Making Learning Generalizable
I shared the example of our son who loved those little gumball machine bouncy balls. At school they would bounce them and they would go behind, under, in front of, or over the plant in the corner, for instance. He was so motivated and emotionally involved that he would learn his prepositions and be able to understand them in other contexts.
Melanie doesn’t use flash cards or worksheets, or make children sit at a table, especially when they don’t like it. Instead they laugh together and share joy. Dr. Greenspan would say that an apple is the experience of biting into a crunchy, juicy fruit, not a picture of a red ball on a flashcard. It’s about feeling it and sensing it.
When young children are non verbal and parents are wondering if they will ever speak, it may be a very emotional and sensitive situation. I asked Melanie how she helps parents come to know their child’s strengths and limitations, come to accept them, and learn to support their children to find a way to communicate that works for the child.
Clients come to her when other therapists have told parents their kids can’t learn anymore and will never speak. She’s learning about how she can support non-speaking children with augmentative and alternative communication (AAC) including augmentative communication devices and finding the right communication method for that particular child.
With non-speaking children Melanie will work on the precursors to language: intentionality, sharing attention around something of interest, reciprocity, engaging, and relating. It’s all play-based, fun, dynamic, and exciting for the child.
For the Love of Speech Parent Consulting
Every Child Has Unlimited Potential
Melanie gave an example of a child in the school district who was 10 years old and whose speech therapist said he couldn’t make any progress and let him go. The next school year the new therapist picked him up and got him an AAC device. Now he’s putting together two-word phrases. He’s so excited and his mother’s so excited, but she was grief stricken to think of all the time she thought he couldn’t say anything because of what the first speech therapist told her.
This made me think of Carly Fleischmann in Toronto who is a celebrity now. When I heard her father speak after the release of their book, Carly’s Voice, he talked about how horrified he was when he realized that Carly understood everything they had talked about for years. Now she has her own talk show, Speechless with Carly Fleischmann, and has been on the rounds of the celebrity talk shows and network TV news shows.
It certainly is a different world today with the voice of self-advocates and these devices that help communication. Parents now have the hope of helping their non-verbal children find their voice. It’s what we all want for our children: to be able to communicate freely and interact with the world around them. I like that Melanie said it doesn’t matter if you’re two or twenty-two; there’s no timeline on development and there’s no rush in Floortime.
The Brain Changes
The brain changes with development in all mammals. And with DIR/Floortime the goal is to guide the brain’s development to help children reach their authentic self: their potential in this world. The curriculum in DIR/Floortime is not about changing the child in a way that we want them to be a certain way like us. Rather, just like any parent with any child, we challenge our children to grow and develop by moving them up developmentally from infancy through to adulthood to see them blossom.
The Interdisciplinary Council on Learning and Development (ICDL), the home of DIR/Floortime, consults with self-advocates in all of its dynamic curriculum. We presume competence. We empower and support children and young adults to thrive and grow, but not to make them into something different that they’re not comfortable being/doing. It’s about harnessing the child’s interests and taking them a step further, respectfully.
The Trickier Part of Her Practice
Like many developmentalists, Melanie began as an ABA practitioner (Applied Behavioural Analysis). She shifted to a developmental approach about 8 years ago. What she offers now is different. She’ll take the child for whom (s)he is, and not try to change them into something else. She’ll try to enhance what they have and work through their strengths, respectfully. It’s very parent-friendly and very easy to do at home.
I asked how does she work with parents to bring them around to see the potential in their child which might be different than their expectations, or with parents whose children are receiving ABA therapy. She stresses that DIR/Floortime is evidence-based and that the research done on ABA doesn’t look at how the child interacts with the world around them. It doesn’t support their real foundational goals of relating and communicating with more ease.
It’s about intrinsic motivation: being intrinsically motivated to communicate. She’s the ‘no sticker’ lady. The ‘prize’ for going to see Melanie is having so much fun in her 45-minute session and in the joy in communicating. I shared with Melanie that the biggest hurdle I have found with parents is getting them, including myself, to step back from directing and orchestrating things all the time and letting our children tell us what their ideas are.
It’s natural to be that way as a parent, but to get our children to share their experiences with us, we have to pull back from directing them in Floortime. We don’t want them to be discouraged to communicate with us because they didn’t pronounce something correctly. We don’t need to control what a child is saying or doing all the time. And, Melanie adds, children don’t have to be sitting to learn. Melanie runs around with her clients who need to move, plays chase if the child wants to, and it’s a dynamic and fun session.
Stress Behaviour versus Misbehaviour
Melanie and I ended our podcast discussing Dr. Stuart Shanker’s Self-Reg method that she is certified in. Self-Reg is based on the first functional emotional developmental capacity of the DIR model, Self Regulation. It identifies that what people often categorize as misbehaviour can actually be stress behaviour. That is, if a child acts out it might be because there is too much noise or light in the room and their sensory system cannot handle it. It’s another part of Melanie’s training that helps her support her clients and their families.
Note: Stuart Shanker, D Phil (Oxon), is the Founder and Chief Executive Officer of The MEHRIT Centre and a Distinguished Research Professor Emeritus of Philosophy and Psychology at York University and the CEO of the MEHRIT Centre, Ltd. His affiliation with Trent University, as mentioned in the podcast, is only as the Founder and Science Director of the Self Regulation Institute.
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Until next week… here’s to affecting autism through playful interactions!