A Case Study

When working as a Speech Language Therapist in primary schools, I would sometimes work with a child on developing their understanding of their diagnosis, often in Year 6, as a part of their secondary transition work. It wasn’t however, until I worked with Sofia and her family that I was able to see the amazing impact that supporting a child to fully understand their diagnosis can have.

I first met Sofia, who had a diagnosis of language disorder, when she was in Year 5. She had significant language difficulties affecting her ability to access learning so, following the changes to language terminology, I updated her diagnosis to DLD. Sofia’s family were originally from Romania and she was bilingual. Her parents mainly spoke Romanian at home but were able to understand and use English well.

Following assessment, I arranged a meeting with Sofia’s parents and school staff, to explain the change in terminology from language disorder to DLD. During the meeting, Sofia’s parents repeatedly asked about her behaviour in school (which was exemplary) and about how hard she was working within the classroom. They requested additional homework to be provided and spoke about getting a tutor for her to support her learning. Despite reassurances that Sofia was working very hard in school and that her difficulties with her learning were due to specific difficulties with language, I left the meeting feeling that parents did not fully understand Sofia’s difficulties.

Sofia’s class teacher was very concerned about comments made by Sofia’s parents during the meeting, particularly their focus on behaviour. She didn’t feel that the comments made were appropriate and that parents were presenting as very ‘resistant’ to any support or advice. They wanted to have discussions with parents about secondary placements for Sofia, as there were concerns about her ability to manage within a mainstream secondary school but didn’t feel that parents would be accepting of this. In addition, Sofia was becoming more aware of her difficulties in class and had asked her class LSA whether she was ‘stupid’ or ‘deaf’. I knew that I needed to do more to support everyone to understand the diagnosis and what this meant for Sofia.

In collaboration with her parents, I completed a block of therapy with Sofia focusing on supporting her to understand her diagnosis of DLD.

During the therapy block, Sofia was supported to:

  • Identify her areas of strength and difficulty
  • Understand how language works
  • Understand what DLD is
  • Identify strategies that help her within the classroom

I felt it was paramount that Sofia’s parents were able to attend the sessions to support their understanding and her Mum agreed to attend some of the sessions.

At the end of the therapy block, Sofia and her Mum had a much better understanding of DLD and, in particular, Sofia understood that she is not ‘stupid’ or ‘deaf’, and her parents understood that it was not caused by them speaking Romanian. This was a brilliant enough outcome in itself, but there were so many other positives of completing the work that I hadn’t predicted.

First and foremost, Sofia was able to understand why she had difficulty with some tasks within the classroom and was now aware that if the task contained words, she was going to find this more difficult and may need some support. Although she was always very well behaved and attended well in SaLT sessions, she now understood why she had therapy sessions and was much more engaged in working on and developing her language skills.

Sofia’s parents were so grateful for the time taken to support them in understanding her diagnosis and were then able to open up about their initial concerns and misconceptions about DLD. They explained that where they came from in Romania, children with any difficulties are often viewed very negatively and thought to be just badly behaved. They had found the information about DLD very difficult to understand and accept initially, because Sofia is very well behaved and works hard. Sofia’s Mum expressed that before she was unsure how to speak to Sofia at home about her difficulties because she “didn’t have the right words”, but after attending the sessions, Sofia and her parents were able to talk about her difficulties and the support that she needs.

Going forward, parents and school developed a very positive relationship and were able to have open discussions about support for Sofia, including supporting parents to think about secondary placement options. Sofia’s class teacher was able to reflect on the assumptions that she made initially about the reasons for the parent’s reactions to the diagnosis. By taking the time to ensure parents fully understood the information presented, with the opportunity for open discussion and questions, parents and school were able to work together to support Sofia and ensure her needs are met going forwards.

Completing this initial therapy block also enabled me to really get to know Sofia which had a positive impact on further sessions of therapy she had with me. Often, I was only able to see a child for a block of sessions every other term and although I had a good understanding of their language ability, this wasn’t always enough time to really get to know a child, particularly if, like Sofia, they are very compliant and quiet. Through hearing Sofia’s views of her strengths and weaknesses I learnt so much more about her. I knew more about her personality; she had a wicked sense of humour that caught me off guard a few times. I found out what a brilliant friend she is, how much she loved sports and just how much she detested drama! I had a more holistic view of Sofia and how the diagnosis of DLD fits into her, which I could use to adapt my therapy sessions around her to develop her language skills in a more functional and successful way.

Please send any questions for our ‘Ask a Therapist’ feature directly to our SaLT Team at: therapist@speechlink.co.uk

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