Pivotal Response Therapy for non-autistic child?
March 11, 2019 5:23 AM
This is a longshot, but does anyone have any experience of pivotal response therapy for a child with language delay (but not autism).
My just turned three year old has a language delay. She is catching up, but still behind, is only now just starting to form sentences and can have a conversation. By some measures, she IS caught up (i.e, she can put three words together, etc.) but in practice, and in comparison to her peers, she still seems really behind. I suspect she's also behind in things like pretend play, etc. but her nursery says that in all respects (besides speech) she checks out normally. She does seem less sophisticated (to me) than many of her peers as well.
A friend whose daughter also had a speech delay told me she had a lot of success with pivotal response therapy. It's a kind of autism therapy, but is about motivating children (in this case to speak). My daughter definitely does not have autism, and the highly-regarded specialist who evaluated her agreed with this. But she did think the therapy would still have some benefits, and suggested several sessions a week. (The therapy is actually offered by a nonprofit, so I don't think there's quite the profit motive I have seen with other therapists, though of course they do need to keep their staff busy.)
I want to do EVERYTHING I can to help her (we also have an OT evaluation scheduled for hypermobility, ENT for hearing, etc.) but I want to make sure I don't do anything that hurts her. It just seems like more aggressive and directed play, but it is somewhat modeled on ABA which I am more wary about for a non-autistic child, especially one who seems to progressing normally, but at a more slower and later time than her peers. I'm just not sure if her problem right now is motivation in particular -- she just seems to struggle to put sentences together.
Would be helpful if anyone with experience of PRT (or just language delays) has thoughts on this!
My just turned three year old has a language delay. She is catching up, but still behind, is only now just starting to form sentences and can have a conversation. By some measures, she IS caught up (i.e, she can put three words together, etc.) but in practice, and in comparison to her peers, she still seems really behind. I suspect she's also behind in things like pretend play, etc. but her nursery says that in all respects (besides speech) she checks out normally. She does seem less sophisticated (to me) than many of her peers as well.
A friend whose daughter also had a speech delay told me she had a lot of success with pivotal response therapy. It's a kind of autism therapy, but is about motivating children (in this case to speak). My daughter definitely does not have autism, and the highly-regarded specialist who evaluated her agreed with this. But she did think the therapy would still have some benefits, and suggested several sessions a week. (The therapy is actually offered by a nonprofit, so I don't think there's quite the profit motive I have seen with other therapists, though of course they do need to keep their staff busy.)
I want to do EVERYTHING I can to help her (we also have an OT evaluation scheduled for hypermobility, ENT for hearing, etc.) but I want to make sure I don't do anything that hurts her. It just seems like more aggressive and directed play, but it is somewhat modeled on ABA which I am more wary about for a non-autistic child, especially one who seems to progressing normally, but at a more slower and later time than her peers. I'm just not sure if her problem right now is motivation in particular -- she just seems to struggle to put sentences together.
Would be helpful if anyone with experience of PRT (or just language delays) has thoughts on this!
If you're looking at PRT, definitely look into a modality called Floortime. My autistic daughter -- who frankly presented very similarly to your daughter at 3 y.o. and we were also told mild speech delay, maybe a little shy -- has done very, very well with this kind of therapy.
posted by stowaway at 7:50 AM on March 11, 2019
posted by stowaway at 7:50 AM on March 11, 2019
Can you clarify the type of language delay? Is it expressive language only, or is it both expressive language and comprehension?
My son had a significant expressive language delay, but no delay in comprehending spoken language. Our treatment approach would have been very different if there had been both expressive language and comprehension delays.
posted by Winnie the Proust at 10:15 AM on March 11, 2019
My son had a significant expressive language delay, but no delay in comprehending spoken language. Our treatment approach would have been very different if there had been both expressive language and comprehension delays.
posted by Winnie the Proust at 10:15 AM on March 11, 2019
Do you have any leads as to the nature of the delay or is it undiagnosed at this time? I have a 3 year old daughter with expressive delay and suspected apraxia. Is she expressing frustration with your inability to understand her?
The main thing that has motivated my daughter to try and speak more was enrolling her in prek. I went through the school district's Early Intervention and got her enrolled in essentially Pre-Pre K where a speech therapist works with her daily in a classroom setting. It was essentially peer pressure. She wants to play with her friends, so she needs to say what she wants.
That might be an avenue if you haven't explored that yet.
posted by skittlekicks at 10:47 AM on March 11, 2019
The main thing that has motivated my daughter to try and speak more was enrolling her in prek. I went through the school district's Early Intervention and got her enrolled in essentially Pre-Pre K where a speech therapist works with her daily in a classroom setting. It was essentially peer pressure. She wants to play with her friends, so she needs to say what she wants.
That might be an avenue if you haven't explored that yet.
posted by skittlekicks at 10:47 AM on March 11, 2019
Thank you all -- and sorry for the delayed follow up! I am absolutely frustrated to be honest as to what to do. It just seems to be an expressive delay, though the therapist who recently evaluated her thought she might have a slight receptive delay in terms of following two-three step instructions. But for the most part, I think she understands everything, and any receptive deficiencies are far outweighed by her expressive ones (I think). She is not frustrated, gives lots of word to two word utterances, and here and there a whole sentence and seems content with that. Doesn't seem to have apraxia. I was thinking today that she was caught up, but then spent the afternoon with a friend with a 2.5 year old and was quickly and very sadly disabused of that notion!
I do hope she'll just grow out of it, but the older she gets the less I believe that.
Stowaway, we haven't done formal floortime (yet) but I do have the book and I feel when I'm with her all I do is play with her! She is at a very nice nursery part-day and often with her big sister the other part of the day so I have a hard time squeezing it in, but I'd say on most days I do a few sessions of intense floor play. But probably not exactly what the floortime folks would do -- I just can't find someone where we live (in London) though I haven't looked that hard. Now I will!
Interesting also re: autism -- I've thought of this, but nobody has ever thought it was autism, including the autism therapist (who still thinks she should do this kind of therapy, so hmmm.) I know there are lots of different ways to be autistic, but she likes people, is socially great, great eye contact, etc. so there's never been any red flags besides the speech.
As you can tell from the length of this follow-up, I am just extremely anxious about the whole thing -- so I'm really open to any advice on this!
posted by heavenknows at 12:23 PM on March 11, 2019
I do hope she'll just grow out of it, but the older she gets the less I believe that.
Stowaway, we haven't done formal floortime (yet) but I do have the book and I feel when I'm with her all I do is play with her! She is at a very nice nursery part-day and often with her big sister the other part of the day so I have a hard time squeezing it in, but I'd say on most days I do a few sessions of intense floor play. But probably not exactly what the floortime folks would do -- I just can't find someone where we live (in London) though I haven't looked that hard. Now I will!
Interesting also re: autism -- I've thought of this, but nobody has ever thought it was autism, including the autism therapist (who still thinks she should do this kind of therapy, so hmmm.) I know there are lots of different ways to be autistic, but she likes people, is socially great, great eye contact, etc. so there's never been any red flags besides the speech.
As you can tell from the length of this follow-up, I am just extremely anxious about the whole thing -- so I'm really open to any advice on this!
posted by heavenknows at 12:23 PM on March 11, 2019
Would you say that other adults (do not / somewhat / most of the time / all of the time) understand the words she is using? If you didn't translate or say anything to give context, would someone else understand it? If people understand her, it seems to be more in convincing her to use the words rather than other methods.
One trick that got my daughter to start talking more was to get her a toy phone and to let her speak into it. I think it's less pressure that way, so while she would happily say "hello" to the phone, she didn't want to say it anywhere else until she felt confident we could understand her.
posted by skittlekicks at 10:34 AM on March 12, 2019
One trick that got my daughter to start talking more was to get her a toy phone and to let her speak into it. I think it's less pressure that way, so while she would happily say "hello" to the phone, she didn't want to say it anywhere else until she felt confident we could understand her.
posted by skittlekicks at 10:34 AM on March 12, 2019
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posted by maxg94 at 6:34 AM on March 11, 2019