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| Mark A. Ittleman Teaching of Talking |
The Meeting
A number of years ago, I was approached by a group of people who wanted me to work with their loved ones; all of which had strokes, aphasia, no speaking.
The Question
These were people who wanted to know what could be developed if “price was no object” for their loved ones. I was in shock, and thought for a moment.
“You can think about it and get back to us.” they replied. Before I knew it, they were standing up and walking towards the door….
The Answer
“Excuse me, I have thought about it, and have a very simple solution to this.” I could not believe the words escaped over my tongue and palate, before I even consciously even thought about it.
But I knew the answer, and have always known it ever since I started practicing speech language pathology. Dr. Thomas Shriner, a prolific researcher and honorary member of The American Speech Language and Hearing Association was my professor and Mentor esp. when it came to language, the development of speech and language, and the approach to language remediation or what I refer to as Language Stimulation. (One of the things that was always saved until last when it came to courses in speech therapy was the actual therapy. (If ever we had time to address it.) Dr. Thomas Shriner alluded to some possibilities, but rarely saw the inside of the therapy room.
You see there are many things that we all know, but don’t think we know. Sometimes we just don’t give ourselves credit for knowing many things that we have not bothered to think about consciously.
“Come Sit Down”
So here we were in a room with the people who came to ask me about what I could come up with to help their loved ones speak again. They were approaching the door, and all of a sudden stopped, with dumbfounded looks on their faces, since I had a solution within less than 30 seconds from the time the question was posed.
I stood up and motioned for them to come back into the living room and take up their previous positions on the sofa and chairs. Inside I was screaming at myself, for being so xxxxx brash![1]
The Question is posed for the Second Time
I was doing all that I could to recover my composure. “OK Ittleman, what do you have for us?” the Chairman inquired.
My mouth started to answer before I was even ready!
And before you knew it, the words were just pouring off my tongue and palate once again, in a machine gun like, staccato style. But then I realized these were people who had no idea what speech pathology was all about, other than they had loved ones whom they wanted to speak again. So I shifted my speaking from overdrive down into first gear, and figured I would spell it out for them, like I had always done for caregivers and loved ones when interpreting a speech and language evaluation, or explaining approaches to therapy. Goals, rationale, etc. You know the drill! (or maybe you don’t!)
From the other side of the room, the chairman asked me again: “So Ittleman, what do you have for us?”
My “Answer.”
“Well Mr. Chairman, from what I gather, you want your loved ones to improve their speaking, and want me to come up with an apporach that could satisfy that intention.” I replied.
“Actually it’s quite simple, really. I’d have to move in with them!” As I said that rather tongue in cheek statement I watched the looks on their faces, and saw eyeballs rolling!
“You see, I knew in my professional opinion that speech and language therapy for people with severe to profound expressive aphasia, would never really make much of a difference if given the traditional, no brainer recommendation of 2-3x’s a week in a small therapy cubicle. I also knew 30-50 minutes would not suffice if one was really serious about getting the best clinical results!
“Would you please explain what you just said?”, another committee member chimed in? At the corner of my eye, I noted the chairman glancing at his watch as if he had a train to catch! The others in the room were sitting there fidgeting, wondering if the whole exercise was one of futility.
“I would be happy to explain, I replied. Your family members all have severe to profound aphasia. They really won’t make much progress with the typical therapy model. If money were no object I would come live with them and would stimulate their language all day long. I would get up in the morning and visit their room, and have them say everything that they want to do from getting out of bed, to taking a pee, or a BM, a shower, a shave, washing their hair, etc. And I would be modeling those words from the second their eyes opened.
“We would have meals where they would have to choose what to eat, drink and ask for what they wanted, or asking for more. They would dress, and choose the clothes to wear, and describe each item. I would help them say everything. Every morning. Every afternoon. Each and every evening. We would go shopping, go to the show, do some touring, etc. and talk about everything we are doing as we are doing it.”
“This is how children learn to speak, I continued. Why not go back to the simple developmental sequence of language and go through it again?”
Suddenly every eye in the place was on me. No more fidgeting. No more glances at the wrist watch. By golly, I had their attention!
And that’s how I came up with that expression: “I’ll just move in with You!”
So what’s the message to you?
I’ll teach you to do what I did, and I won’t come to your house and move in!” You wouldn’t want that anyway. I have a wife and a dog; a therapy dog. When Jackie was just a pup, I had patients learning commands, and although they could not talk, they were talking and saying: “Jackie come!” “Jackie sit!” “Jackie lie down!” “Jackie, roll over!” And you know something it wasn’t hard to stimulate them to say those commands. Why? Because it was fun and interactive, and they could give Jackie a treat when she followed their commands. Did I have them trying to find the banana, or the cup, or the brush, hammer, or screw driver, and then say it. Heck NO!
Been there…… and done that!
I tried the flashcards, and the vocabulary drills and having the patient find the flash card over 30 years ago and it never worked; That type of approach, for me, only put the patient and me into a deep stupor where we both could harldly keep our eyes open! (Yawn.) I vowed never to do therapy that way after realizing THAT DIDN’T WORK!
The Take Away
OK Mark, so Where’s the Beef? You mean what’s the meat of this message? Simple.
If you want the best possible result consider these points:
- Speech and language are learned at home.
- Intensive stimulation in the real world of living and speaking will address the vocabulary, expressions and comments that are needed in everyday living.
- You can do this, and you don’t have to have somebody who doesn’t know your loved one, his desires, fears, and aspirations, and goals do the work! And even if they did the work, THEY would have to move in and live with you. That’s what Annie Sullivan did when Helen Keller’s parents in a fit of desperation did for their daughter who was unable to see, hear or talk. They obtained the services of Annie Sullivan who spent countless hours each and every day with Helen from a very young age and on through adulthood. Miracles happened. Helen learned to talk, read Braille, and lectured all over the world. You know what her message was? Optimism and Courage. Do you know who were her best friends besides just about every American President from Coolidge through Kennedy? Mark Twain and Alexander Graham Bell! They were so enamoured with her; true admiration!
Take the Teaching of Talking Training Course, and let’s get to it! Registration will be for only one week and then the course will close. I will then be available to those who registered for the course and chose the option of weekly group coaching calls for the duration of the course.
http://www.teachingoftalkingtraining.com
Best!
Mark
Mark A. Ittleman, M.S., CCC/SLP
Senior Speech Langauge Pathologist
Author: Teaching of Talking
Creator: Teaching of Talking Training Course
Please make sure your friends register to receive an invitation to join the course. Registration opens in about a week!
[1] Mark - self assertive, overbearing, cocky, arrogant, strong, energetic
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