Speech/Language Therapy with Special Needs.
A Speech/language therapist who provides services for students with special needs can have a very complex job depending on the needs of the student. Students with special needs can be categorized as verbal, minimally verbal or non-verbal. Some students with special needs can be classified medically as physically disabled with Intellectual disabilities, physically disabled only or intellectually disabled only; Students can also be on the Autism spectrum. The job of a speech/language therapist is very challenging depending on the medical classification and communication skills of the special needs students who are being serviced by the speech/language therapist. This paper will concentrate on a student with multiple challenges or disabilities. The medical classification is referred to as physically impaired with intellectual disabilities.
When a student is physically disabled in the school system, they usually have Cerebral Palsy. Other disabilities might be muscular dystrophy, Dandy-Walker syndrome, spina bifida, etc. The speech and language therapist become an active professional with most of these students depending on their level of functioning. If the child is physically disabled with Intellectual disabilities that range at the level of severe or profound. The student is usually non-verbal or minimally verbal. This type of student is a student that will need to use AAC(Augmentative Alternative Communication). Some students will communicate with picture symbols or photos. Mayer Johnson symbols are one of the most popular symbol systems on the market. Photos can range from an Ipad being used to take actual pictures; google symbols or commercial photos. Electronic communication systems use voice output. Some systems have a synthesized voice built into the system,or an actual voice can be recorded. The speech/language therapist evaluates the child to determine which system of communication is the best system for the child depending on their communication deficits.
The speech/language therapist will usually use photos or picture symbols to increase verbalizations in a child who is minimally verbal or non-verbal. When the child is non-verbal the speech/language therapist will recommend a voice output device. The voice output device can be one message; two messages; or 4 to 32 messages. A very high-tech device can be recommended by the speech/language therapist if the student has a high cognitive level. The speech/language therapist will frequently consult with the occupational therapist because the occupational therapist deals with the upper extremities. The speech/language therapist, classroom teacher and any other professional who works with the student need to know how the child accesses the device. The most common way to access an electronic device is with the hand, but some students need a switch to be placed near their head because they access with their heads. The speech/language therapist might know that a child can’t use their hands but consulting with the occupational therapist is the best way to decide. A student might use their foot, knee or elbow to access also. The speech/language therapist might also consult with the physical therapist because they deal with the lowerextremities. Positioning is very important when an electronic device is recommended for a child.
The speech/language therapist also deals with feeding. When the student has lip closure (bilabial closure) deficits; jaw control; swallowing, or head control difficulties the speech/language therapist is the best professional to deal with these problems. Positioning is also part of the speech/language therapist job. The speech/language therapist might consult with an occupational or physicaltherapist, but the speech/language therapist knows that the child should be positioned at a 90-degree angle three ways if they are a feeding expert. The elbows are supported by the laptray or table; the hips should be back in the seat or wheelchair, and the feet need to be supported by the straps on the wheelchair or a block on the floor.I admire the work of the speech/language therapist because they work with different speech, language, and communication deficits. I especially admire the speech/language therapists who service students with physical and intellectual disabilities.
Examples of communication systems
Mayer Johnson symbols
Big Mack or one message device
Two message device
8-message voice output device
4-message communication device
32-message communication device