Next Step Therapy Blog: ‘Tell Me, Show Me, Help Me’

Tracy 1Tracy Cowles, CEO and owner of Next Step Therapy, submitted the following article: “Tell Me, Show Me, Help Me.”

Twenty-five years ago, I was doing Speech Therapy for a company in Pittsburgh. I worked in nursing homes and smaller hospitals on contract. I was surprised one day to get a call from the office asking if I would see a private pediatric patient in their home. It just wasn’t something we normally did. The child was a nine year old boy with an articulation problem. The parents did not want him to get Speech in school, and were willing to pay privately. I took the case.

After calling the home and speaking to mom that evening, we made an appointment for an afternoon a few days later. I followed the explicit directions to the home, and found myself at a gated community with a security guard. Yet another new experience! (We don’t really have such things where I’m from.) The guard let me drive in, and I pulled up to a modern day mansion. A gorgeous house right out of a magazine. I grabbed my tote bag, and hustled to the door. The door was answered by a kid who would later be compared to Harry Potter. Pale, tousled hair, big glasses. He greeted me like a butler, “You must be Tracy, the Speech Therapist?” I greeted him with, “And you must be David, my new client.” We entered the exquisite home, and he directed me to a study, where he had apparently been doing homework. His parents were not home, which surprised and alarmed me a little, but I’d been in strange situations before.

In the study, David moved books out of the way, one of which was a Physics textbook. I asked David what he had been working on prior to my arrival (I needed to hear him speak), and he replied that he had been working on his Physics homework. I thought he was joking. I asked him where he went to school, and he informed me that he attended the highest level tuition based gifted school in Pittsburgh. I nearly fell out of my chair. The child was a genius.

I pulled out an articulation test, which he completed quickly and efficiently. Indeed, the child had some articulation issues, specifically not using the /f/ or the /th/sounds correctly. I pulled out a workbook, introduced him to a correctly made /f/ sound, and we began to practice. He was a quick study, and within the hour I had him properly saying words that began and ended with /f/, and he was even able to do short phrases with that sound. I made an appointment with him for five days later, and left.

When I returned, same situation. David answered the door, no parents around, and we headed to the study. When we sat down, David turned those big glasses on me, and said, “Miss Tracy, after tinking about what we worked on last week, I have come to de conclusion dat I have some sounds dat I do not make correctly. Is dat why you are here?” I replied, “Well yes, David. Your /f/ sound and your /th’s/ are being made incorrectly.” To my utter despair, David’s eyes welled up with tears, and he said, “Why didn’t someone tell me?!!” And he cried. And I was beside myself. I was twenty-two years old, a relatively new therapist, with no children of my own, and I am suddenly providing counseling for a child who was light years ahead of me in IQ.

I told David that I wasn’t sure why no one had mentioned this to him, and why it hadn’t been dealt with sooner. I told him that his parents most likely expected him to “grow out of it,” or that because he was so smart, they probably figured that he would figure it out on his own. Most likely, they didn’t want to hurt his feelings, make him feel bad, or damage his self-esteem. As hard as this part was, when he sobbed out, “Is dis why kids make fun of me and call me a baby? Because I talk baby talk?” I just wanted to hold him and rock him until that hurt went away, which was probably never. I told him that he might be right – maybe that was why kids made fun of him.

I want you to understand that this story is about David. This was David’s’ life, and David’s heartache. However, it also tremendously impacted me. I had spent a grand total of seventy minutes with this child, and suddenly I was dealing with all of his pain. I was not prepared, and I was probably not qualified. I simply did my best, like all therapists everywhere.

I told David that he was a quick study, and that I felt that we could eliminate this problem within a few months. I told him that the harder he worked, the faster it would go. I told him that no matter what the other kids had said, he was smart, and funny, and sweet, and that I was proud to be his friend.

Believe it or not, David required a grand total of six therapy sessions. Only six. That is unheard of in articulation therapy. Once David understood the problem, understood the solution, understood the benefits to making this “fix” and took responsibility for handling it, he accomplished all of his goals in only six weeks. It was fabulous!! When we were done, he thanked me profusely, and shook my hand like the little gentleman he was. I hope wherever he is now, at NASA or as a professor at an Ivy League University, that he doesn’t still carry the hurt of his classmates belittling him for something that he didn’t even realize was a problem.

I learned a lot from this experience, and I hope that you do too. Whether you are a therapist, a therapist in training, or a parent, I hope that you get what I got.

Children (even the brightest ones) cannot be expected to know what is “normal,” “socially acceptable,” or “age appropriate” behavior on their own. They have to be taught.

As a therapist, I learned from this experience to tell all of my clients, even the littlest eighteen month olds, what I was there for. “Mommy and I want you to talk more.” “Daddy and I want you to use your words.” “I need you to talk louder.” Children shouldn’t have to guess what is expected of them. It should be clear.

A year after David, I was working at WVU’s Ruby Memorial Hospital, and I had a little boy in outpatient therapy for the exact same thing. I told him up front that we were working on the sounds he made because they weren’t quite right, and people would understand him better once they were right. He was around four, he was adorable, and his parents were both physicians. Therefore, “Jeremy” came to therapy with his nanny.

We had been working on his /f/ sound for about five weeks, with good progress, when I walked him to the waiting room one day. The waiting room had an aquarium. Jeremy and I stopped to look at the tank, his nanny walked up, Jeremy said, “I love the pishes.” And Jeremy’s nanny said, “I love the pishes too.” I nearly had a stroke. I asked her to come back to my office, and kindly explained what she had done. She looked at me and said, “Oh my God, I did.” She got it immediately. I could put this kid through years of articulation therapy, but if the people surrounding him did not correct his mis-articulations when he said them, and in fact, continued to model incorrect articulation, therapy was pretty much a waste of time. It turned out that his parents did the exact same thing (Doctors!!) and the nanny had to re-instruct them. As soon as they stopped mimicking him and started to correct his errors, he made huge progress and was out of therapy quickly.

Based on these experiences, I have made it a practice in therapy, and with my own kids to say, out loud, what my expectations are. Whether it relates to bed time, potty training, speaking clearly, doing homework, or learning to drive, I express my expectations.

For other therapists, teachers, pediatric workers in training and parents, I recommend this mantra: Tell Me, Show Me, Help Me.

It means, tell me up front what you want me to do and how you want me to do it. Then, show me, by example, what you mean. Then, help me to overcome any obstacles to my success.

Examples: I am three years old, absolutely adorable, and going to a sit-down restaurant for the first time. TELL ME what a restaurant is, and how you expect me to behave when we get there. TELL ME about how we have to order the food, and then it will be cooked, so we’ll be sitting at the table for quite a while waiting for the food. TELL ME that I’m expected to sit in my seat and not whine while we wait. When we get to the restaurant, now that I’m in this unfamiliar place and a little overwhelmed,

TELL ME again what the rules are and what your expectations for my behavior are. Make sure that you now SHOW ME where I am to sit, how I am to sit….point out other kids that are sitting. Now, HELP ME to achieve our goals of me sitting at the table without misbehaving for the next forty-five minutes.

HELP ME by letting me look at the menu, HELP ME by taking the knife out of my reach, and the salt and pepper shakers. HELP ME get through this next 30 minutes by pulling out a coloring book and crayons, because you planned ahead. Better yet, HELP ME behave by engaging me in conversation about the décor, how many tables there are, explaining that the waiter is taking care of five different tables, not just ours. Play a rhyming game with me. Play I Spy. And at the end of the meal,

TELL ME how well I did, and how proud you are.

SHOW ME by giving me a smile, a hug, or a high five.

It has been my experience that children, when given at least partial responsibility for “fixing” something, are much more likely to do it than children who are clueless about what they are being asked to do.

Tell Me, Show Me, Help Me. Thank you.


Copyright © 2023 EYT Media Group, Inc. All rights reserved. Any copying, redistribution or retransmission of the contents of this service without the express written consent of EYT Media Group, Inc. is expressly prohibited.

Comments are temporarily closed. A new and improved comments section will be added soon.