The first image that comes to our mind when we talk about Speech Therapy is a small, closed room where therapy happens, with parents sitting outside the room. There is no way to see what they do inside the room, there is no way for the parent to be involved. But Online Speech Therapy can be done from the comfort of the home, between the parent and the child. That is what makes Sheena Thomas’ Speech Therapy unique. To be clear, we are not talking about making your child sit in front of a laptop or mobile and wishing that the child would sit still. No! We train parents to help their child overcome Autism and severe Speech Delay through Online Speech Therapy
“We are all about Online Speech Therapy
Sheena Thomas, Speech Therapist
for Autism and severe Speech Delay in children,
through parent-led activities that can be easily done at home”.
Get Personalised Parental Training for Autism and Speech Delay
But is this the best for your child? What about the traditional speech therapy center? What are the benefits of online speech therapy? Let us find out:
| Center Based Therapy | Online Speech Therapy for kids |
|---|---|
| Children especially those with Autism can be take a long time to adjust to therapy | Parents handle most of the activities, so the child would be comfortable. Being at a familiar place like home, will help them to be comfortable. |
| In most therapy centers, parents are not allowed to be with their children. This causes anxiety in both the child and the parent. | The parent is expected to take part in all the activities and help their children. |
| Frequent trips to therapy center would be difficult and wasteful. | Can be done at home. Save both time, and effort. |
| Usually expensive | More affordable |
| Importance is given on therapist, with the parent giving passive support | Focus on parent-led therapy |
When choosing between the two, ask yourself these questions, to help you decide between the two:
- I am willing to take an active participation in building my child’s future, or am I satisfied by sending my child to the best therapy center that I can afford, in the hope that the therapists would do their best and have our child’s interest in mind?
- Am I ok with my child getting just a few time-slots per week or am I willing to work with my child consistently.
Some people think that issues like Autism and Speech Delay cannot be treated through Online Therapy. However, mild-Autism, moderate ASD and severe Speech Delay are perfect fit for online speech language therapy. All of them require activities and strategies that should be implemented at home, which is why we focus on them. Merely doing these activities at a therapy center for a couple of hours at most doesn’t make it consistent enough for the child to pick up. But activities that are done routinely at home helps the child to build their capabilities. Moreover, the speech therapist would monitor the progress of the child closely through videos sent by the parents of the child and through observations made by the parent.
One of the highlights of Sheena Thomas’ Speech Therapy is that the therapy is parent-led. In a parent-led therapy model, the child benefits through the activities and strategies that the parent implements at home. These activities and strategies are given to the parent through live video calls and recorded videos. Each video contains clear guidelines on how to do an activity at home. It will also have a demonstration of the given activity using a child actor.
Here is an example video of the activities and goal sent to the parent. Notice that most videos have a demonstration using a child actor.
To make the Online Speech therapy more effective, the broad principles followed by Sheena Thomas’ Speech Therapy are inspired by Hanen which is well known for its early intervention programmes for the treatment of Autism. As a certified Hanen Therapist, her therapy integrates the notion of ‘Putting the Family in front and centre’. Parents get training on what to do to help their child develop. She believes that Therapy should be a part of family life, and it is only then the child begins to learn from their natural environment. The interactions between the parent and the child is the key to giving the child a good foundation for developing their skills. All this needs sensitivity and greater understanding from the side of the parent.
Sheena Thomas (B.A.S.L.P., M.A.S.L.P, RCI Registration no. A24-100) has 10 years of experience in the field of Speech Language Pathology. She specialises in online speech therapy for Autism, Speech Delay and other paediatric issues.
But are there any scientific basis for Online Speech Therapy?
There are plenty. A systematic review of Parent Implemented Early Intervention for Young Children with Autism Spectrum Disorder by Helen McConachie and Tim Diggle states:
Copyright: “Individual parent ESDM fidelity scores” By Laurie A Vismara, Gregory S Young, and Sally Rogers via https://www.researchgate.net/ [CC-BY-SA-3.0]
“Both randomised and controlled studies tended to suggest that parent training leads to improved child communicative behaviour, increased maternal knowledge of autism, enhanced maternal communication style and parent child interaction, and reduced maternal depression.” 1
Another research paper ‘Parent-mediated Early Intervention for Young children with autism spectrum disorders (ASD)’ finds
“some evidence for the effectiveness of parent-mediated interventions, most particularly in proximal indicators within parent-child interaction, but also in more distal indicators of child language comprehension and reduction in autism severity. 2
In the paper ‘Telehealth for Expanding the Reach of Early Autism Training to Parents’ which appeared in Autism Research and Treatment 2012, the authors state:
“Parents became skilled at using teachable moments to promote children’s spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practises more often in their daily interactions with children.3
The improvement seen in children from such home based interventions were also long-lasting. The paper, ‘One-year follow-up of the outcome of a randomised controlled trial of a home-based intervention programme for children with autism and developmental delay and their families’ states:
“Improvements following the provision of a home-based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.” 4
One of the best known evidence for Parental training for Autism is the PASS trail held in India and Pakistan. In the paper “
Effectiveness of the parent-mediated intervention for
children with autism spectrum disorder in south Asia in
India and Pakistan (PASS): a randomised controlled trial”, the authors say:
The findings also replicate the positive primary outcome treatment effects of a parent-mediated
communication-focused intervention. 5
Here are the answers to some of the frequent questions asked by parents about Online Speech Therapy:
Yes, Online speech therapy is as good as offline therapy when it is done properly. Doing Speech Therapy at home helps parents to work towards their child’s progress from the comfort of the home. This reduces stress in both the child and the parents. Finally, Online Speech Therapy activities and exercises will also help in improving the bond between the parent and the child.
Online Speech Therapy works in two ways. In the most common method, the therapist would have direct interactions with the child. However this is not often feasible in cases like mild-autism and ADHD. For such cases, an indirect approach via Parental Training is much more desirable. In both these cases, proper Speech Therapy Assessment and goal setting is required before regular treatment.
In the parent mediated method, children are first assessed through live video call. This is followed by planning and goal setting whether the therapist will assign tasks and activities for the child to achieve. Finally, follow up is done to assess how much was achieved by the child.
The first thing to do before joining any Speech Therapy is to see the qualification of the Speech Therapist. Large Speech Therapy centres often hire freshers for the least amount of salary at the cost of quality speech therapy. See whether the Speech Therapist has at least a bachelor’s degree. There are courses like diploma for speech therapy assistant and some centres are known to hire them for the role of main speech therapist. A masters in Speech Therapy or master in Speech Therapy and audiology is a desirable qualification, since many intricacies of speech therapy are taught only at the Post-Graduate level. Also see that the therapist is government recognised in the country that they work. Getting recognised means that they have both the requisite qualification and experience to work as a therapist. It also means that they have the latest knowledge as well, since it is mandatory in most countries to attend a minimum number of refresher courses, programmes and conferences. In India, this recognition is known as RCI recognition through Rehabilitation Council of India. You can search either the name (Sheena Thomas) or the crr number (A24/100) of the registered practitioner by clicking here.
One of the major criteria is experience. No amount of classroom education can substitute real hands-on experience. So, the more experience the better. Ideally, a therapist should have more than five years experience.
Thirdly, look at the type of therapy offered by the Speech Therapist. Decide whether you require a direct interaction between therapist to child or an indirect parent mediated therapy. A simple rule of thumb is: if your child cannot do the activities by themselves without outside, help then then require indirect parent-mediated therapy. Different speech therapists offer different methods of treatment, so it is necessary to chose the correct method that will fit your child.
In both types of Online Speech Therapy, it is important to see whether the therapist guides you appropriately. Oftentimes, the therapists would refuse to answer parent’s queries.They must be available to you. They should clear your doubts that may arise. If they make no attempts to explain what happens to you or are simply impatient and don’t listen, then it is time to move on to a better therapist.
A key issue with large Speech Therapy centres is that they may switch therapists at any time. This is quite detrimental to the development of the child. Each speech therapist may have a different style or approach and this would cause issues with therapy.
Finally, see whether the Speech Therapist has constantly updated themselves. Speech Therapy is a fast emerging field and so new scientific research is incorporated within a short period. A therapist who has attended courses like Hanen Therapy, Play Therapy, Oral-Placement therapy and other internationally recognised courses would be invaluable to you. These considerations help you to choose the best online speech therapy from Kerala for your child.
Parents play a huge role in ensuring the success of Online Speech Therapy. This is especially true for indirect, parent-mediated therapy. A parent must be sensitive to even the slightest change in their child. This can only happen if they spend time with the child. A parent should also be supportive and should make sure that the child gets the best possible environment. You should be able to know when your child is being unreasonable and when they genuinely need support. Finally, the parent should be proactive. They should be willing to experiment. Please don’t wait for the therapist to take initiative.
Online Speech Therapy is best suited for parents who:
a) Are willing to spend quality time with the child and is willing to give priority to their needs.
b) Should be proactive and willing to experiment. If your child cannot, or are unwilling to do a particular speech therapy exercise/activity, then you should try to make changes to the activity to make it even better.
c) Should be flexible enough to change their outlook and treatment of the child.
Lastly, Online Speech Therapy is ideally suited for young children, of below four years. As the child gets older, it becomes more difficult for the child to internalise what they have learnt.
While this is a frequently asked question by parents the answer is neither easy nor straightforward. It depends. Some children thrive quickly. Some would struggle to achieve even the most basic tasks. Yet another group would make quick improvements within the first few months, but then they reach a point of stagnation. Unlike what most people expect, the improvements are often not sudden, nor are they uniform. Children’s abilities grow in spurts and are not continuous.
Again it depends. Some Online Speech Therapists charge a fixed rate for half an hour to one hour sessions. The cost of Speech Therapy varies from less than 3,000 Rs Indian rupees to up words to 8,000 Rs per month for the best online speech therapy in Kerala. However, this is nothing compared to center based speech therapy, especially in countries like Australia, UK, and New Zealand where they may charge much more in a single session.
A final word of caution: Sheena Thomas’ Online Speech Therapy is meant for children who require fairly long term and intensive treatment. It means that the parent should make a long term commitment to their child.
All our therapies are taken directly by Sheena Thomas, who has 10 years of experience and has the recognition by the Indian Government (RCI recognized).
References:
- McConachie H, Diggle T. Parent implemented early intervention for young children with autism spectrum disorder: a systematic review. J Eval Clin Pract. 2007;13(1):120-129. doi:10.1111/j.1365-2753.2006.00674.x
- Oono IP, Honey EJ, McConachie H. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2013 Apr 30;(4):CD009774. doi: 10.1002/14651858.CD009774.pub2. PMID: 23633377.
- Vismara, Laura, Gregory S Young and Sally J Rogers. “Telehealth for Expanding the Reach of Early Autism Training to Parents.” Autism Research and Treatment 2012 (2012): n. pag.
- Rickards AL, Walstab JE, Wright-Rossi RA, Simpson J, Reddihough DS. One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families. Child Care Health Dev. 2009;35(5):593-602. doi:10.1111/j.1365-2214.2009.00953.x
- Rahman, Atif & Divan, Gauri & Hamdani, Usman & Vajaratkar, Vivek & Taylor, Carol & Leadbitter, Kathy & Aldred, Catherine & Minhas, Ayesha & Cardozo, Percy & Emsley, Richard & Patel, Vikram & Green, Jonathan. (2015). Effectiveness of the parent-mediated intervention for children with autism spectrum disorder in south Asia in India and Pakistan (PASS): A randomised controlled trial. The lancet. Psychiatry. 3. 10.1016/S2215-0366(15)00388-0. Link: https://doi.org/10.1016/S2215-0366(15)00388-0
Other Links:
About Sheena Thomas Speech Therapist
Online Speech Therapy in Your Region
Online Speech Therapy for Malayalis in UK
Autism and Speech Delay Resources for Parents
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