Saturday, April 09, 2011
"My Ball Died"
When I heard the words "My ball died" coming out of the mouth of a preschool boy I was seeing for speech therapy, I tried not to show alarm. "Tommy" didn't seem to be too upset, but he was clearly trying to tell me about something that mattered to him. I had not heard of any recent loss in this boy's life, but then again I only saw him once a week for speech therapy and didn't know about every single person in his life. I wanted to be compassionate and allow him to talk about what was on his mind. Tommy already had a very hard time expressing himself due to speech articulation (pronunciation) errors. Even to those familiar with Tommy's speech patterns, his speech intelligibility was poor. When I repeated his words back to him for clarification, he responded vigorously with head shakes and repeated insistently, "No. My ball died." Some children, when hearing their incorrect speech production repeated back to them, will recognize that what they are saying does not match the message they are trying to convey. As a result, some children will alter how they are pronouncing words in order to increase their intelligibility. Tommy was not one of those children. He kept saying the same thing in exactly the same way, over and over again with no change. Tommy still did not appear distressed, but was making eye contact and eagerly awaiting my response. As a speech therapist, I have been asked how to respond when you just don't understand what a child is trying to say. I think the correct response is usually dependent on the situation. If the child is just chatting to make a connection with another person, then it may be more critical to be responsive and caring than to determine exactly what has been said. Sometimes asking the child "Can you show me?" helps them use nonverbal means to get their meaning across. This is limited to messages that can actually be pointed out or demonstrated, though, so much of the time it isn't a very effective strategy. The strategy of pretending to understand the child can backfire, because you may be consenting to something you don't intend to or the child may try to continue the conversation and sooner or later the fact that you are faking comprehension will become obvious. Could this affect your relationship with the child? Another option when a child is clearly trying to convey a message to you is to begin asking questions to see if you can narrow down the possible topics the child is talking about. Even with barely intelligible children, knowing the context of what they are talking about makes it easier to discern what they are attempting to say. In Tommy's case, I started by asking him if someone in his family had died. Tommy looked uncertain, so I started naming possibilities by using yes/no questions since Tommy was able to respond accurately to them. "Did your grandpa die?" "Did your dog die?" and so on. Tommy continued to shake his head "no". When this line of questioning lead nowhere, I tried asking about his toys. "Did you lose a ball?" "Did something happen to your ball?" Again I was met with repeated head shakes and the verbal assertion, always pronounced exactly the same way, "My ball died." Tommy wasn't giving up on me, but continued to make eye contact with a hopeful expression on his face. I was feeling more and more inadequate to help this sweet child who apparently had some kind of loss to grieve. Through the open window of the room we were using for speech therapy, we could hear the sounds of children playing. Following a particularly loud vocal outburst from one of the children outside, Tommy cocked his head, grinned, and happily pronounced, "My ball died!" He certainly didn't look upset about a death, but instead looked at me in triumph as if he had just proven a point. Given the context, the words, and Tommy's speech sound error pattern, things began to fall into place. Hesitantly, I asked another question, "Is your brother outside?" Tommy responded with enthusiastic head nods, repeating once again with a look of utter satisfaction, "My ball died." Okay. So no one died and nothing was lost or irreparably damaged. What a relief! For whatever reason, it was very important to Tommy that I acknowledged that his brother was outside. Although it had to be frustrating for him when he couldn't quickly or easily convey his message, he was eventually rewarded for his persistence and I was relieved to discover that in fact, no ball had actually died.