Designing an Intensive Therapy Program

Suggestions for planning a course of action: I understand that as a parent it can be daunting and overwhelming when your child receives a diagnosis of dyslexia, language disability, or anything similar.

You wonder how you are going to find the necessary resources, including time and money, to get your child the services that he or she needs. How are you going to afford it? How are you going to fit it into your already busy schedule? In my clinical practice, I am often asked these very questions. Here are some thoughts to help you decide what course to take.

First, gather the data about your child. Guided by what research says about what good intervention should look like (see below), you decide what best fits into your child’s life at present, and you develop a plan that best meets all of your needs. So, what does the research say? Research has demonstrated that intensive and frequent language therapy is more effective than less frequent and less intensive therapy, so it behooves you to develop a plan that will get your child as much intervention as possible.

Research supports structured and systematic reading programs that highlight explicit connections between sounds (i.e., phonemes) and letters and offer guided support and practice in blending sounds for reading and segmenting sounds for spelling. Programs that help your child to come to understand and recognize spelling patterns and spelling rules, including morphological patterns, are also key.

Intervention should be evidence-based. Initially, careful baselining of your child’s skills (e.g., sound processing, letter knowledge, decoding skills, spelling knowledge, etc.) should be conducted so that specific therapeutic objectives in these areas can be set and initiated. Intervention should include explicit and systematic instruction, opportunities for guided practice, and specific feedback. Progress reporting should be a regular part of intervention. And, you should see progress!

So, you know that the more intervention, the better; but you also know that professional services cost money. For a family with financial resources, 60-90 minute sessions, 4-5 times/week would not be out of the question. We know that intensity works, but I am aware that people with these kinds of resources are the lucky few. Most of us cannot afford this type of regiment.

As you are designing a course of action and considering the financial costs, one thing to think about is the role of literacy in your child’s education – it is critical. He or she cannot succeed academically or in life without the necessary reading, spelling, and writing skills. Without foundational literacy skills, your child will have a challenging time when applying for college. So, you may want to divert some of those college savings to make the investment in your child’s education now.

I offer some scenarios that clients have used to design an intensive program that met their needs – both in terms of time and money. All of these clients could have benefitted from the intensity I describe above, but that was just not realistic.

One family, who had to travel a bit of a distance, came to see me twice a month for a 60-minute session each time. In this role, I acted in the role of overseer of his program – targeting specific skills and making recommendations to the family for next steps. He then saw a tutor at home twice weekly and received daily support in the form of accommodations and curricular modifications at school.

Another family, whose child was not receiving additional school support, came once/week for a 60-minute session. The client’s mother sat in the session so that she could work with her daughter at home 3-4 more times during the week. Again, I acted as both clinician and consultant. I typically do not recommend that parents become the primary interventionists for their kids – you have enough to do to parent! But, for this family it worked. They purchased one of the scripted reading programs designed for parents that we have listed on DyslexiaHelp, which the mother was then able to follow at home.

Another family whose son is in high school worked with the school so that he could leave school during his study hall and academic support class to come for therapy. This is an excellent idea for those of you with very busy schedules. In this young man’s case, after-school sports conflicted with coming for therapy. Think about times in your child’s school day that he or she might be able to miss – early morning or end of the day, recess, study hall.

For another athlete, we bundled up her sessions during the off-season. In other words, we worked very intensively for about 3 months. Then, we took a break and she received support from her LD team at school. After the season ended, we regrouped for another intensive round of therapy over the summer.

As you can see from the above scenarios, anything can work in the design of your child’s intervention program. Consider all of your resources – private clinician, tutor, school, even volunteers if you are lucky enough to live near a college or university with a training program. The most important thing is to get your child the help he or she needs now. If he or she is struggling now, it’s not going to get any easier. Literacy learning demands only increase as kids get older and progress through the grades – the vocabulary gets harder, concepts become non-literal and ambiguous, the amount of reading grows, and writing demands increase.

It is also important that your child has some fun in life! Most dyslexics have strengths in other areas – the arts, sports, verbal and interpersonal skills, analytical thinking, visual-spatial and mechanical abilities – the list goes on and on. It is very important that these skills are fostered in your child. Engagement in these activities can build self-esteem and confidence and are a source of enjoyment. Do not sacrifice these areas.

Last, and importantly, the course of action you design must meet your family’s needs. All members of the family, including you, are impacted and so you need to take that into account. Yes, it is a balancing act. What you decide today may not meet your child’s or family’s needs in 6 months. Have it in your plan to re-evaluate how things are going and make adjustments as needed. I am confident you will come upon a plan that works for all of you. Success starts here!

Joanne Marttila Pierson, Ph.D., CCC-SLP
April 2015