Laura Deer, M.S. CCC/SLP, CAS
Coaching for Caregivers
What is coaching and why do we do it?
Coaching looks a lot different than a traditional therapy model. Sometimes parents are a little confused by this approach when they are used to the traditional model. This blog is to help you understand the differences in this approach, who it is helpful for and why it is a good fit for you and your child.
During a traditional / medical model of therapy, the clinician works directly with your child. You may or may not be able to observe the session. Sometimes therapists tell parents they are distracting and can’t be present during the sessions. Your child might be figuring out new materials they haven’t seen before. The clinician uses their knowledge of speech and language and implements strategies directly with only limited experience with your child. Sometimes parents say they aren’t really sure what goals the speech therapist is working on with their child. Your child only has 1-2 times a week they are working on those goals. You might get a brief summary at the end of the session on things you can try at home without really understanding how to help your child learn the new skill.
Some parents prefer this model because this is what they are used to. They want their child to get as much direct time with the therapist because they are the expert in their field (such as communication). However, your child is missing out on your expertise as their parent. You spend so much time with your child and will always know your individual child more than the therapist. Coaching allows both experts to work together to help your child.
Coaching is recommended for early intervention age children (age birth to three years old). This strategy can also be beneficial for older children with diverse needs who need assistance in generalization of skills. A traditional therapy model is more appropriate for older children with speech sound disorders like apraxia, children who stutter, and older children working on more complex language. A hybrid approach can be offered to children who can benefit from both approaches.
Coaching will not only give you the time to watch the clinician in action, you will have time to practice, problem solve and reflect on your exchanges with your child. You can learn about your specific needs at that moment and you can tell the clinician directly what will help your child the most. You will get to celebrate success and problem solve together.
This doesn’t only benefit your child but it benefits you. Instead of your child thinking about the new skill 1-2 times a week, your child can have multiple opportunities a day. Refer to this handout called “Do The Math” for more information.
Coaching often has different elements to it. Some sessions may have all of the elements and some sessions might just have one or two. The strategies used are individualized to you and your child that day.
The clinician will directly provide individualized information to you about your child. This may be teaching about your child’s diagnosis or specific strategies to help your child. The clinician might give you handouts or other resources to supplement what she explains.
During the session you will have opportunities to show the clinician how you interact with your child. You can learn by this interaction by the direct feedback the clinician gives you in the moment. You will end up getting a lot of praise on the amazing things you are already doing.
The clinician will also demonstrate some of the strategies and techniques for you to observe. The demonstration might be between your child with the therapist or it might be you, your child and therapist engaging together. During the demonstration together the therapist might model a strategy and ask you to copy it.
You might see the clinician sitting there and watching you and your child engaging in typical things you do every day like wash your hands, diaper changes, bath time, reading books, playing with your child, etc. This is a time when the clinician is getting information on what you are currently doing. They use that information to select new strategies or select new targets for your child.
Joint planning is necessary and a huge support to families. Learning about a strategy is one thing but knowing when to implement it into your busy life is another thing. Sometimes it feels impossible to add in and juggle one more thing. The clinician can help you select routines and activities when you can work on the strategies and plan on how to remember during your busy life. So you don’t need to find extra time to help your child, instead you can help support their communication during common every day exchanges like bath time and getting dressed.
This is the part of the session when you as a parent or caregiver get to share information about your child. This helps the clinician understand what is the most important for you, your child and your family as a whole. You can also fill the clinician in on when you were able to use some of the strategies during the week.
By sharing information with the therapist, you can explain what is most important to you that day. You are the expert in your child and you know their needs better than any therapist could. So you get to customize therapy to meet your needs that day!
The clinician will ask you some questions that make you think and reflect on your interactions with your child. You might hear the clinician say some things like, “How do you think that interaction went?”, “What do you think went well?”, “What was a challenge?”, “What helped your child be successful in that moment?”
Learning to reflect will not only help your child in this current moment, but it will teach you a skill you can use with your child at any age. The more you can reflect on interactions with your child the more you can fine tune and meet your child’s needs. It might be easier for you to understand what they do, why they do it and what supports they need to grow.
You can share problems you are experiencing during the information sharing part of the session or problems will naturally arise during the session. This is an opportunity you can problem solve with the clinician. You can think about specific things to try to help alleviate these problems in the future. It is so helpful to learn and gain new tools in your toolbox. Just like reflection, this might actually help sharpen your problem-solving skills with your child that can have lasting impacts in your child’s life.
You will also be empowered as a parent to problem solve directly with your child’s therapist. Sometimes parents feel they can’t question therapists or other professionals since the professional is the “expert”. Without the empowerment, it is harder to advocate for your child during IEP meetings and therapy sessions. Parents sometimes express how they needed to end therapy with a different therapist because the therapist wasn't doing something right for their child. If the family felt comfortable problem solving with the therapist then the therapist could learn from the parents.
Problem solving & reflection
This is the time when the clinician might ask you about specific problems that happened before that were discussed so you can reflect on how the new strategies are going. If the strategies you tried at first aren’t working then you can problem solve together on what to try next time.
Two brains are better than one when trying to figure out some of the complex needs of your child. While the speech language pathologist is the expert on communication, you are the expert on your child. Coaching provides your child with two experts working together and not just one.
Coaching is an evidenced based strategy. That means research has proved it to work for many families. I was lucky enough to have studied directly with Dr. Julian Woods the founder of Family Guided Routine Based Intervention (FGRBI). For more information about routine-based intervention go to the FGRBI website here.
Coaching can feel like more work for parents because they have to be involved and learn. Think of it as a time investment in your child's future. You are learning skills now that can help your child in many years to come.