by Lori Riggs
You want to build a house, so you borrow a hammer. Every day you pull out your hammer and pound on something—anything—twice a day for two hours. And sometimes you just hold the hammer and look at it or set it close to a nail. Certainly at the rate of four hours of pounding per day, not to mention the extra time spent in the presence of the hammer, you should eventually end up with a house, right? After all, isn’t a hammer for pounding? Don’t you need a hammer to build a house? And yet, after a year of this, you see very little progress towards anything resembling your dream house.
Obviously this is just a metaphor; so let’s get right to the point. You probably have some goals in mind for your child, or you would not have come to us at NACD. Some of your goals may simply be about getting to the very next step—learning to walk, to read, to chew. And some may be about the bigger picture—your child becoming an independent adult, going to college, being employed. Whatever your goals are, we are here to guide you in your quest to achieve those aspirations. We’re here to give you some tools and teach you how to use them. NACD parents are the cream of the crop. You are the ones who are willing to pick up that hammer, roll up your sleeves, and get your hands dirty doing the work. You don’t have to be an actual carpenter or electrician or plumber. But you do need to know how to use your hammer effectively to do some of the things a carpenter does; and you do need to know how to use your wrench correctly when we ask you to tighten a nut. It is your job to do the work; it is our job to make sure you know how to do it well.
The activities, materials, and programs that we recommend on your NACD program are just the tools you need in order to work towards your goals for your child. They don’t magically produce results just by being on your program or even by getting the “done” box checked next to them. How you use them is all-important. In an effort to improve the quality and effectiveness of your implementation and use of the tools, here are a few pointers:
Men get teased for not reading manuals. As a woman, I want a manual for everything! I wish my kids had been born with their own personal manuals tied to their leg. Then I wouldn’t have to figure out what to do when their own little individual needs come up. Just open the manual and see what works for them. It would be so much easier.
Your NACD program activities may sound straightforward when you read the name. But you really can’t know what it is we intend for you to do unless you get the instructions. We provide links to videos and handouts right there on your program. If something has been customized specifically for your child, the note about it will be in the “comments” section just next to the name of the activity. Watch each video and re-watch them. It’s very hard—if not impossible—to remember every detail of what you watched the first time. Review them again after you’ve started implementing the activities so that you can check yourself and make sure you are implementing things correctly. I learned a long time ago that doing something poorly over and over does not result in doing that thing well. That’s why I don’t like the saying, “Practice makes perfect” unless it’s revised to, “Perfect practice makes perfect.” Repetitively doing your program activities incorrectly will not bring about the results you desire.
Frequency, intensity, and duration. At NACD we live and breathe those three words. You’ll read them over and over in nearly every publication we put out there. They are that important. You don’t have to worry much about frequency and duration— after all, it’s right there on your program, spelled out by your evaluator. You may not be able to achieve the recommended frequency or duration every day, but you don’t have to guess about what your goal is. But what about intensity? That is much more abstract; something that is totally dependent upon your performance. If you don’t quite have a handle on what we mean by intensity, go to our YouTube channel and watch Bob’s video titled, “Frequency, Intensity, Duration.” Even if you do think you have a handle on it, go watch this video anyway. It’s always helpful to be reminded.
If you simply go through the motions of doing your program and then check off the boxes, most likely very little change took place in your child that day. Your level of intensity can make the difference between changing your child’s brain and just taking up the time. You don’t have to be fun all the time. Let’s face it—some program activities just aren’t that fun. But you can have a high level of positive energy, whether you’re having a blast or not. And if you’re just not feeling it that day…well, “fake it till you make it,” as somebody said. It’s that important. If you act like an activity is a total drag, your child will believe it’s a total drag. If you’re just going through the motions, your child will rebel. Remind yourself frequently of why you are working this hard. Renew your commitment to your intensity, and therefore to your program, and to reaching goals.
Provide Input and Feedback
With your program activities being merely tools, they don’t change anything in and of themselves. It’s you who facilitates the change in your child by how you use those tools. Since electronic devices are all “the thing” in therapy these days, let’s use apps as an example. A child can drive on a racing app and have a great time, and the app has served its purpose. But for an app being used with a therapeutic purpose in mind, it is the tool, and you are the director of the activity. If you have used any of NACD’s speech apps with your child, hopefully you understand what I’m talking about. The app requires the child to repeat the syllable or word that is presented. However, the iPad has no way to respond to what the child said. As a matter of fact, the iPad doesn’t know if they said anything at all. If the child isn’t getting any feedback about how they responded, the tool becomes somewhat useless. It’s a great tool—it keeps you from reinventing the wheel and having to create all those materials yourself. But you have to sit with your child, encourage them to respond, and then give them feedback about their response.
- Praise: In an effort to maintain high intensity and show their child lots of positive energy, one mistake many parents make is in responding, “Good job!” when in fact the child didn’t do the activity correctly. Be careful of using “good!” all the time, unless their performance was actually good. Remember, you are trying to shape their behavior/performance/production so that it becomes more accurate and closer to what you are looking for. By telling them “good!” when it wasn’t good, they don’t know that they need to change anything. It is possible to remain very positive and yet be more appropriate in your praise. Here are some examples: “Almost! Let’s try that again.” “That’s a tough one, isn’t it?” “You sure are trying hard!” “Nice try!”
- Accuracy of feedback: In addition to providing appropriate reinforcers, it’s also important that you give your child feedback about what they need to do in order to change and improve how they did something. As a speech therapist, it’s easiest for me to use a speech activity as an example. Let’s say that your goal is to get your child to produce the /m/ sound at the end of words. So as a tool, I give you a list of words that end in /m/. If that list were magic, then you could just go through it and your child would automatically learn to put the sound at the end of words, right? That would go like this: “Say ‘mom.’” “mah” “Say ‘boom.’” “boo” And you continue to do this until magically your child starts putting the /m/ at the end. Except that it doesn’t work that way. You must give your child feedback—and accurate feedback—so that they can change what they are doing. Using the example above: “Say ‘mom.’” “mah” “MoMMMMM. Use your lips! Mommmm. Get the back on there….”
- Cueing: Closely tied in with the wording you use for praise and the quality of the feedback you provide is the way you cue your child. This is especially true for speech and language activities, as well as sequencing activities. If you are asking your child to do something, and things just aren’t working, change what you are saying. Have you ever seen someone try to speak in English to a person who doesn’t speak English? What do they do? They repeat themselves over and over, each time getting a little louder, as if somehow volume and repetition trump not knowing the language. Seems a little ridiculous, doesn’t it? In the same way, if your child doesn’t “get” what you are saying, say it differently. Change the words. Simplify. Restate. Provide a visual cue. You’re the teacher, so teach. Provide information. Provide help. Give them what they need to be successful with what you are asking.
Take Advantage of Us (aka, Ask for Help)
NACD’s model for working with kids is unique. But let’s be honest: the model only works if you hold up your end of the bargain and we hold up ours. We provide you with the tools, and you do the work. But what if you don’t understand something you are being asked to do? What if you think you understand it, but in reality you are doing it incorrectly? I doubt that any of you wants to spend three months working hard at doing something wrong. A critical aspect of making our NACD model work is the part where you ask us questions and you let us know what you are doing. There are three main parts to this:
- Initiate contact with your coach. Every NACD family has a coach. They are your direct access to your evaluator and all things “NACD.” If you have a question, ask them.
- Respond to your coach. Our coaches have a very hard job. When they ask you how things are going, they really do want and need to know. Not only do they have the responsibility of making sure you know how to do your program correctly, but they also provide your evaluator with important feedback that impacts your next evaluation and program. Please don’t ignore your coach. Interact with them and let them help you.
- Send us videos. We are good at what we do, but we aren’t psychic. We really do need to see what you are doing for a couple of reasons: a. If you are doing something incorrectly, we won’t know unless you show us what you’re doing. b. If something isn’t working and we need to switch gears, the easiest way for us to figure that out between evaluations is to see your child doing their program. We know that it’s hard to find the time to record your child and to post the videos for us. But believe us when we tell you that it’s time well spent.
NACD’s toolbox literally has over 3000 tools. And even with all of that, we frequently make up new activities on the spot, specific to a particular child we are seeing. Not only are we always trying to improve the tools we recommend, but we are also trying to improve your use of them and our education of you. We always say how we love kids. But really, we love our NACD families. We think NACD parents are the best, and we truly want you to be successful.
Reprinted by permission of The NACD Foundation, Volume 27 No. 5, 2014 ©NACD