10 Years of Speech Delay Advice in 30 Minutes

Hey, this is ming here from agentsofspeech.com we teach parents how to do home therapy for the speech and language delayed child. So here I want to share with you my 10 years of experience through being a therapist, through being a parent coach. And these are the things that I often find myself repeating and it's very important to repeat because everyone needs that reminder. So even if you've been a long time viewer of this channel, I really want you to sit down and listen to me for a bit. So I don't know how many minutes I'm, I'm gonna have to go through all these things that I think are super important. And so the first thing is a lot of parents come up to me and say, oh, is my child autistic? Is it apraxia, is it speech delay, Is it like dysarthria, Is it yada yada yada, Is my child is hyperlexic, cannot speak, but he can read, write and whatever. These things aren't really that important because when you go to a professional, a lot of the things cannot be confirmed unless your child is at least 3 years old at the very least. A lot of things, especially apraxia, there are protocols, there are things that can point towards a suspicion of certain diagnosis or whatever. And for you to think about all these things is not helpful at all. And I've mentioned this over and over again and a lot of parents will come up to us and say, yeah, I think what stuck with me a lot, what Ming said, I'm just telling what they said is that I, I tell them to not care about the diagnosis, which is the next point I want to make. But I want to finish it here first. So a lot of times when you go to a professional, what they say will trick you and go into a rabbit hole and look at a lot of stuff. Is that going to be helpful towards the whole problem? Not really because like in the beginning for all therapy, right? It all looks around the same, right? If you have a non verbal child, you're always trying to engage them, understand what they like, what are they communicating already, how are they communicating, be it a tantrum, hand pulling, whatever, right? What are the things that they're doing already and how do we go on and facilitate them and build a relationship so that I can teach them other things, right? It's always like that. No matter if it's a speech case, it's a language case, it's apraxia, it's autism, it's adhd, whatever. It's always going to start with, building a rapport, right? Understanding what they like, understanding what kind of what can I use to make them want to communicate with me. Right. So it's obligatory, as my supervisor would like to say, as if they know by communicating with me, they get what they want. So all these labels will go, will make you go into a black hole. And obviously it is helpful for people like me, a therapist who would go through and understand exactly what that means and how it would actually affect the therapy. But for parents, it doesn't really help because it will make you think about, oh, what type of therapy should I do? Oh, I should get this kind of supplement. Oh, I heard that oxygen therapy will actually help put them in a space shuttle thingy, like a capsule. And, and the child will learn how to breathe properly and we'll get the oxygen into their lungs or whatever. So all these things are okay, yeah, it might be helpful, it might be not. But then if we stick to what we know is that you should go ahead and do the therapy right away. Okay. The second point, obviously I just said is diagnosis doesn't really matter for parents. And why I say this is because whether whatever diagnosis is, we're always, it's always a working theory. We're always trying to work towards a better outcome. And in intervention, right, we call it intervention, not assessments, right? The, the reason why we call it that is because intervention is a process. Assessment is if, if you're into math. Let me give you a math analogy. It's like the X axis is the child's age, right? The Y axis, the long one, is the child's language ability. And assessment just means at that time, at that place, at that point, they were like this. But that doesn't mean anything. It just means that's a starting point for therapy and intervention, right? And we must have a starting point and therefore assessment. The, the sole purpose of assessment is to know where to start, right? We might be wrong. We might be right. 80% of the time. A therapist who has some experience will be right. They'll be okay, this is the right place to start therapy. And you might think, ah, like the therapist when he was doing assessment, he was like very demanding. He wasn't interested. My child wasn't interested. He kept on like pushing and pushing with no rewards. My child doesn't care. So at the end of the day, my child didn't respond. He knows that. But you have to remember, as I said, assessment is at that time, at that place, at that particular circumstance, they were like that. And then if the Therapy is going to be conducted in that certain time at that certain place, then it's correct, is the correct thing to do at that moment, right? And then whether if it's the true ability or not, we will know later. And that's why a lot of times when we're doing therapy, the diagnosis is a working hypothesis. We're always dynamically assessing the next steps. We're like, oh, did this and we might change the assessment. As a matter of fact, we do assessment every six months for a lot of children just to make sure that they're improving, number one. And the initial diagnosis was correct or maybe it was incorrect. And that's totally fine because whether you have a correct diagnosis or not, it's forms the basis of the therapy. And then the most important thing is that it springs everyone into action, is that we do intervention, we go ahead and deal with it or, and in the process of dealing with it, we'll learn a lot more about the child instead of just, ah, no, it's, it looks like you got autistic characteristics, right? As if we're doing some type of crystal bally thing, right? Oh, you, he looks like this, he has this whatever characteristic, he might be apraxic. And I've seen it many times, man, a lot of times we had parents in our coaching program, the child can speak sentences, right? And then when we went into from play we went into doing some flashcards and I know that now through this experience I know it's the wrong move for, for some kids. And since then we've deleted flashcards all like just flat out just deleted it off of our program. And she went to this therapist and the therapist said, I think he's apraxic, we need to do some speech work. And I'm scratching my head because obviously therapists will have disagreements a lot of times. So I disagree with that diagnosis. To be very honest. I feel like apraxia is donor round too easily nowadays as a way to explain something that we don't know why about. So at this point in time, if you ask me if I have any regrets through these 10 years is that I didn't stand my ground firmly enough for parents who get swayed away by thinking, oh, I know the answer now. Another example is we had my very first client, I was working in aba and the child started off non verbal, hit everyone, big fit everyone. After half a year he was a lot better start talking in sentences. He was like, he could hold my hand and walk down the street without freaking out. He wouldn't bite me Anymore. He wouldn't scream. Out of nowhere, he was toilet trained, yada yada. And the mom was like, nope. Because like Aba is super expensive back then 10 years ago, man, like you think about it, just seeing that child for every day for a month, it costed the parents like 6,000 USD. And now it's obviously a lot more than that, like 7 or 8,000 USD. And obviously I worked in Hong Kong, one of the most expensive cities of the world. So that family who came to us all had money. So then they decided, okay, we're going to USA and we're going to do some biomedical stuff. And despite however hard, my supervisors pled and said no, we have results, just give us some time. It didn't work. They left. I don't know. To this day sometimes I still think about that kid because he's just super nice. Whenever I said hi name he would say hi Ming. Right? He wouldn't do that to anyone else other than me. So to think about that's my only regret. So what I'm trying to tell you is that don't buy into the different diagnosis that are shown around and focus on what's been working. Obviously if you're working with me or anyone, it doesn't need to be, or whoever, if you don't have results, obviously could go ahead and do something else. Right? But therapy is a long and and hard journey and we'll talk about expectations later on. Okay? The third point I wanted to talk about is the two to six year old golden period that doesn't exist at all. So a lot of the marketing stuff out there is to push you into action the parent, right? And say, oh, you're going to FOMO during this two to six years old, if you don't do therapy, your child isn't going to catch up, they're going to do blah blah, blah blah blah. This is common sense, right? You have early intervention. The earlier you teach someone to do something, the faster they will get it right. And that, that person will thank you later on because they're like oh, thanks for getting me early. Right? It's oh, thanks for getting me started with doing homework on time, right? It's, it's a good thing for sure. It's form a good habit. But to say during two to six years old is the best time to do therapy and if you don't do it, it's gonna be less effective. I'm not sure about that and I think it's a little bit too pushy. So what happens is like the opposite Is also true when children fall outside of six years old, right. They're going to say, oh, what's the point of doing all this? Does your program even work? Why do it? Would I do it now? And so it turns parents off and they have this because of this marketing thing, right? I'll talk about why it's called the marketing thing later on. It pushes a deadline on parents because 6 years old is where they go into school, right? In a lot of countries nowadays, it's getting younger and younger for some reason, as if we need to be good enough for something. I don't know why, but six, right? There's this hard deadline for everyone inside their brains and then when they can't get it, what happens is what I said before, they're gonna go for everything and everything. Like anything and everything. Like acupuncture I've seen before. I'm not smiling because I think it's doesn't work. I just think that this kind of thing is imposed by the society and I don't think you should buy into it. Right. Acupuncture in the brain, as I was telling you, oxygen therapy, cryotherapy, getting them to swim more, play piano. Oh, they can't talk. Then I should get them to draw more because I saw on YouTube an autistic person has like photographic memory or whatever. Parents will start freaking out right at that. Six years old, I'm telling you, it doesn't exist. Therapy will always work if done right at different ages. I've seen a 19 year old start talking, I've seen a 30 year old get toilet trained. And I can only tell you that if there's people who can get value out of therapy at different ages, then there is a chance, and I will quote one senior therapist who told me, I remember I was working with a 17 year old girl, woman, teenager, and then my supervisor was saying, oh, I think she has roofed like to the limit. So I didn't know what to do given what my supervisor said. So I went to that senior therapist and said, okay, what should I do? And then she's, if you believe that she has roofed or whatever that means like a glass ceiling, then whatever you're doing is going to convey that's the amount that she's going to achieve as a therapist. I should never think that way and I should always think about how to improve her. So that should be the same case for parents because if you're not on the same page, the kids will know. Oh, oh, that's where I am. So I should Stay where I am. As if we're tracking, trapping them in. In a glass box that doesn't really exist. Okay, so the next thing I want to say is what type of therapy isn't as important as effective learning? So this very woo kind of topic here. So the type of therapy doesn't really matter because like at the end of the day, even in speech therapy there are different styles. So we have prompt therapy, we have talk tools, we have naturalistic floor time, we have more structured, more follow. You follow morphology. Like those color coded sentences. We have all these things, right? And obviously these things I'm saying obviously a lot, but it's not obvious. All these ways of doing therapy, they're not mutually exclusive. A lot of parents will say, oh, it's going to clash. I'm not going to do your stuff because it's clashing with the way that we're doing this. Dude, this is not medicine, right? It's not like you taking this medicine with this medicine might clash and it might kill you. Therapy is different. We're on a behavioral level. Then you shouldn't be learning philosophy with physics, right? This, this doesn't make sense. So it's not mutually exclusive. You should do things that work and do things that don't work, right? That's the criteria. Not because it's gonna clash. That's literally wrong thinking. Because at the end of the day, on a behavioral level, we do things that are contradictory every day, right? Are you going to agree with me here? I don't know. If you think yes, then we can say yes yourself. But what I mean by it's not as important by effective learning is that I can have the best idea about how to. I can have the best way of teaching someone. This is the best way of opening a can, right? This is the best way. But if you don't want to learn and you didn't want to open the can, no matter how good the way that I can deliver it to you, you're not gonna learn it. It's. If I didn't speak in a way that would make you listen to me, it doesn't matter what I said. It doesn't matter if within my words, within what I'm teaching already has what you need to know in order to achieve what you wanna achieve. If you don't even listen to me in the first place, right? So effective learning is like this. Is your child able to sit down with you? Is he able to put your fo his focus onto what's happening right now? And you have what he wants and he knows why he's supposed to do this. Right? How's your working relationship with your child? Right. Are all these things are super important much more than the type of therapy and how things are done? Because if I have a really relationship with a child, I can sit them down, I can do some really boring color coded grammar work. Right? It's just as simple as that. If you try to do at home, they'll probably run away. That's the reason. But obviously everyone's dynamics are different, right? You have to fix that dynamic first. If you're gearing the dynamics towards sitting down and doing work, then you better do that. If you're gearing your dynamics to do some play stuff, then obviously you can as well. But then if you become a master of, of having a good time with your child, they don't really care what you're going to do with them. It's. This is exactly what I'm trying to say. It doesn't matter. You can go out and teach them how to play something that they really do not have any type of interest and they will still love it because they're having a good time with you. All right. A lot of parents are looking for what type of thing should I do? What? Oh, can you tell me, Ming, give me some examples. I don't see examples on the YouTube channel. Okay, I can show it to you. I can do things, I can play with children and then get them to talk. But then after you see it, are you going to be able to do it with your child? Right. They're probably going to run away. And I don't want to do this because I see this so many times that in the beginning I really do, I really do find someone for free in the city. I tell them to come over to the clinic, I get their consent, I shoot the whole thing and then I send it to my then clients and then they're like, I can't do it doesn't work. Your child's different. That child's different than my child. Why should I listen? So there's always these kind of, these kind of things, right? In the YouTube comments, like, oh, it's a better dude if you had some examples, right? And, and if you saw the examples, so what? When you do it, you don't have a working relationship with your child. That's why I need to talk you through about how, why this is important, how you should do it. Every child is different, but at the same time, they're all the same. It's very Philosophical. So that's why you have to keep on being reminded about these things. Right. So anyway, the next thing I want to tell you is the number one predictor of therapy success is parent involvement. There's no other. This is an actual fact. If you just look at it, no one, like the therapy world might be arguing about a lot of things. They do not argue about parental involvement. They really don't. Because it's the absolute truth here. If you spend more time as a parent with your child doing things that enrich their language, they will get to their language goals faster. That's just at the end of the day, that's how it is. So that's why I want you to learn. I want you to be the person who's doing the therapy. Right? That's why therapists will take a lot of time to give you homework. And when you don't do the homework and the therapy doesn't go well, they're gonna, like, try to put the blame on you. And I'm not going to say whether this is right or wrong. I'm just going to try and explain to you, like a lot of parents will say, especially the mothers will say, oh, it's my fault. I didn't give them enough time. I didn't give them enough, like, screen. I give them too much screen time. Didn't give enough toys. I was too soft with them. Don't make it your fault now. It wasn't your fault before because you didn't know. And now that you know better, it's time to pick it up, all right? Because no one's gonna do it for you, Right? Like I've been saying this for many years, you know, like, you can get a helper, right? But do they have the chops to teach you? Teach a child the, the language skills. And what if you do get a helper and the child only talks to the helper and doesn't talk to you? Then isn't that even worse? So think about that. I'm very happy that you're here with me, that you're listening and learning here. All right? So anyways, the next thing is stuff's chasing for milestones. I've talked about this a lot. Symptomatic approach doesn't really work in therapy. What do I mean by symptomatic approach? Child doesn't respond to name. Teach. Respond to name. Right. Child doesn't have eye contact. Make them look right. Child cannot. Follow three step instructions. Teach three step instructions. Right. Child cannot. You get my point? So anyway, like, one of the stories that I share a lot is that during the pandemic we had a lot of parent coaching and that's how it started, actually. And some of the ABA centers in Southeast Asia, I won't name any names, they also do a lot of these virtual screeners or virtual parenting, like advice, suggestions, coaching, whatever you call it. And so they would send a folder, this thing to the parents, their parents, and, and, and say that, oh, if you don't check all these boxes every time and tell me how they do these goals, which are like 20 something in Aba, then I'll kick you out. Because there's a whole line of people who need it. Because back then all the therapy centers were closed, right? So obviously there was a huge demand. But at the same time, that doesn't mean it's correct. Just because you have a huge demand doesn't mean what you do is right. So at the end of the day, a lot of those goals were not functional. Like for instance, if you do like a three to four step command, when are you going to use a three step command? Anything that has a, like a recipe or a piece of instruction will be written down. If it's more than three steps, right? You're not going to remember that, Are you training the child to remember? Are you trying to increase the working memory? Are you trying to get them to learn the language? I much rather that we give a super crazy instruction and we teach a child to say, hey, can you write it down please? Or can you simplify that? Or can you say it again? Or give the child some something to learn, like something more functional, right? If I hear someone, I ask some, some. Okay, this is a real story. So I went to Japan, right? I'm not very good at Japanese. I can order some food, but then I go up in this mall and I didn't know what toilet is. So I asked, where's the toilet in Japanese? And then to my surprise, the instruction was so long, so I was like, okay, go in front, turn left, go down the stairs, whatever, okay? And then I had to say, okay, sorry, can you please say it again? And then he said again, still couldn't. So I took out a piece of paper and he drew it. So that's functional, right? If you cannot communicate and that's as much as your language goes, the best thing that you can do is to teach compound compensation, right? Is, oh, can we have another medium, another way to communicate? Maybe it's like through Google Translate. Google whatever. Like use a pen, use a map, use a whatever, like all these things are super. A lot more important than actually going in and teaching them to actually memorize the whole thing, right? It's better to actually teach the child to say, that's too long, I can't remember, than to actually do, go ahead and do those like three, four step commands. All right? So the functional goals is that the goals that will actually help them. And a lot of times what happens is if you follow a symptom approach, right? You go from, oh, cannot do this, cannot do this, so I'll do that. That's not the way. You need to find a goal that will help. All goals in one goal, right? In speech therapy, that would be teaching them to ask a question, right? Play with toys. Can. Can they describe an event? Some things that are very generalizable, if that's a word, and also at the same time useful in their life. Functional, okay? So these goals, you cannot just go ahead. Like I've seen mothers who say, in 2013, yeah, 2014 was when I started, right? The mom was like, in 2014, I have five goals for my catch child. They have to talk, they have to write, they have to blah, blah, blah, okay, these five things are what you want, but it's gonna help them in real life anyways. So this ties into what I'm gonna say now is what is your expectation towards this whole thing, Right? What is your expectation? Are you trying to teach your child to become what? Right? Because a lot back then in 20, 20, 20, there's a mom who came to me and yes, the child had some apraxia going on. And so he was five and he was still non verbal and in fact we were still doing vowel sounds, right? Think about that. And so the mom was very unhappy, obviously. And the things that she told me was like, can he go to university? I'm like, that's a very hard question to, to answer. If I had a crystal ball, I can see through it, I'll tell you the future, I would, but I really don't. And then she started crying. I don't know how long this is going to be like with the improvements that we have, it's not like we didn't have, right? You start to imitate sounds a lot more accurate. But I cannot see when he's 20 what he's. He's going to be like. I'm like, no, it doesn't matter how your child is, whether he's on the spectrum. Praxic, typical developing IQ of 2000. You still don't know what they're going to Be like, you really cannot tell, right? I don't think my mom would ever know that I'd be speaking like this on YouTube about child therapy. When I wrote on my, you know, that time capsule thing in primary school that I would become a writer and an inventor. Well, to some extent that's actually true, but it's far fetched. It is very different from what I or my mom would have imagined. So your expectation needs to be, and this is something that I learned myself. Like therapy is just what is six inches in front of you, right? Teaching a child is just what is right in front of you. Okay? As we can do the best we can do, it's all foggy in front, but after doing an assessment, which is the first thing that I was talking about, we know at least what we're dealing with, like where we are, like we're, we're pitch black in front, right? Don't know what's going on. Just six inches in front. We know what the next step is, what next two steps and at most. And that's it, that's good enough. And I'm sorry, because if anyone says that, oh, your expectation, it's okay, he's gonna start talking in two years or two weeks or whatever, I sincerely hope that they better get a lawyer, first of all, because that would be illegal. The second of all is that you shouldn't listen to those things. Everyone has their own journey, right? And even to typical developing children, they have their own struggles. And I don't need to tell you, everyone grow, growing up had their own troubles. And obviously adding a speech and language delay or whatever onto it is going to be harder and tougher. And yeah, that's true, but it's just that the problems will be different. And so I just hopefully let you understand, expectations should be like, every culture is going to be different. And what I heard from one of the mothers say makes the most sense. As long as they can be happy on their own in the future, then it's okay. We know what's best for them right now, which is to do the work, to teach them to at least know why they're supposed to communicate. Whether they want to or not, that's up to them. But at this point in time, I think like you and I as adults, we know better than what they know. So I do think they should listen to us and get going, learn some things about speech and language, get their skills up to par and then they will have a better life in the future. That I know is true. Okay, so the last Thing I want to talk about is. Is parenting. I'm not a parent yet. I only have three cats. They're naughty as well. They were screaming as well just now, if you could hear it. And I just want to come from a place where I'm telling you might not be the best person to listen to. All right. But I also have a lot of experience teaching children. Right. No matter if it's typical, developing school age, whatever. And I can tell you that after working in this industry for quite some time now, I do have a grasp about how to be both a teacher, a friend, and also be someone who the child looks up to. And the first thing is you gotta treat your child like a real person. Yeah. Not because you want your child to catch up or whatever that you're doing all these things for. Right. You're doing it for them, and they need to feel it. Right. Which is all these soft skills are very difficult to develop. Good for you. You only have one client in your life, which is your child. Right. So that's good. So there's something called gentle parenting nowadays. And after reading up with. I'm not an expert, so you can go ahead and watch whatever it is. Right. I think a lot of them is correct. Some parents nowadays are taking it the wrong way. And I see it a lot like, just because how I grew up as well was that I grew up in a verbally abusive family. The Chinese, as an Asian, they get reprimanded for literally everything. We don't put our hands on the table whilst we're eating. My mom would say, is your other hand, like, amputated? That's what she would say. Like, my dad saw me, didn't know how to. I was like, what, 17? And I would. And I bought, like, an extender thing, electricity thing, I don't know. And I didn't know how to extend it myself by opening the. The thing and making a longer wire or whatever. And he was like, I told you, do. Do one simple thing. You didn't even know how to do it. He was an electric engineer, so what can I say? But my point is, just because of that, like, our generation, the millennials, I'm a millennial, Tend to overcompensate. When I came into the workplace, I was like, why do children nowadays, if they do something wrong, we cannot say something about it. And saying that something that content need needs to tell them what's right or wrong, and you need to tell them that it's wrong. But how you say it is where all the juice is you cannot, like, make them feel really bad. But there's no point in scolding as well. I don't think through this 10 years I've ever scolded a child. In fact, if I. Because I never scolded a kid at all. Like, never. The moment that I actually be quiet and just not talk and only look at. Not even looking at the child to get really scared already, from my experience, I, at least I know that scolding and being negative is an option. We don't have to go there. But gentle parenting doesn't mean that we have to say everything in such a caring way that becomes a greenhouse. A lot of times, the way we say something is going to be like, this is very important. In therapy work, we call it feedback. When something is wrong, we have to say it. We have to give negative feedback, but in a way that is still full of love. And this is very hard to do. A lot of people who cannot do it take the easy way out and just either not say anything or just only praise. Which is nuts, because at the end of the day, if someone doesn't get the appropriate feedback about a particular behavior, they'll keep on doing it. Right? So I just want you to know this. In my 10 years of work, in the beginning, children would not listen to me. They would open doors, they would hit me, they would bite me. But three years in, I realized that it's because I didn't listen to my supervisors. I didn't give feedback fast enough. I didn't praise and also reflect on when they did the right thing about the bad things that they did before. If they decided not to punch me anymore, I would say, thank you so much for. For keeping your hands so nice. I feel so safe and like, I. I know you're not violent. That's all. You're a really good boy. Thank you for keeping your hands to yourself. I don't see you punching anyone anymore, which is great. And when it does happen, you need to tell them in a stern way as well. And you say, I'm, I'm very disappointed at what happened. I'm not going to punish you. But then the reward that we were, we're saying we're going to have. I think we have to delay it just because of that. So at the end of the day, you are like the boss of your child and they are your subordinate, right? They are working and doing something to make us happy to a certain extent, so that we would give them something in return. Not a salary, but maybe like, positive regard, love Like a snack even. And at the end of the day you have to understand this is the relationship, this working relationship that does exist between you and the child. Whenever you want, you're teaching them something. So remember that. And all this kind of feedback, this kind of telling what's right or wrong also is important for non verbal children. So non verbal children, even though they don't understand totally what you're saying, they can still get your tongue. So instead of trying to say everything, oh yeah, it's okay, yeah, no need to hit me. Oh, don't bite, don't bite. It's just today some a parent sent me of their child like pinching them and saying oh, no pinching. And then the kid's like pinching all the way. The first thing is why? Why allowing the pinching to happen. Second of all is no pinching. But he's pinching at the same time. Meaning when you say no pinching, it doesn't work. And then the parents say what should we say so that he will stop. The first thing, you shouldn't even allow that and you shouldn't even say anything. And, and then, but in between the no pinching is, oh, you're a good boy, come here, it's okay, we do this, finish and whatever. There's no negotiation. Would your boss come up to you and say you're working and then, and then say, oh, it's okay, you're not doing your work, it's okay, but please don't play with your computer, okay? No, no gaming when, when I'm away. Okay. Where's the authority? There is a lacking gentle doesn't mean that you're not authoritative figure. Because when you want to teach someone something, they must look up to you. Okay, I think that's all I wanted to discuss in this long video that I don't usually do. But if you want to learn more, discuss this among parents who know who have done these things before. We have a whole community of parents. You can go to www.comcourse where we have a community and also a bunch of free courses that teaches you from zero all the way to sentence building and more. Okay, that's all for today. I'll see you next week. Bye.