October 22nd, 2005
Genre 5: Observation Report
ADVANCED THERAPY OBSERVATION REPORT # 1
Name: Chris Stout
Client's Initials: M.B.
Date of Observation: October 20, 2005 Age: 10
Length of Observation: Two Hours Indiv. Yes Group
Client Disorder: Articulation (Developmental Apraxia of Speech)
1) Describe 1 segment of the session you found to be effective (What appeared to go well? What was successful?).
While observing the client, I noticed he was able to articulate two-syllable and three-syllable words more appropriately when the clinician tapped out the rhythm of his speech on the table. When she tapped the table the client was to say a syllable of the word. It sounded like this: "ki," tap, "tty," tap, "cat." Before using rhythm, the client could only say "ki-at." I also noticed the client relaxed somewhat after some initial shyness about listening to the tapping. This was a major improvement because previous to this the client was getting frustrated. I noticed he was starting to avoid meeting our (the clinician and myself) eyes and his cheeks were starting to redden. However, after following along with the clinician's tapping, the client started to smile again in response to the improvement and our praises.
2) Describe 1 segment of the session you found to be less effective and/or confusing to you. (What do you think did not produce a desirable result? What did you not understand?)
Simple repetition of the entire word appeared to be
the least effective. The client could barely make an
approximation of the words and was obviously getting frustrated.
He was unable to clearly say any word and this lead to him
withdrawing. As I said before, he started to stare at the floor
or the word lists and his cheeks began to turn red. After he
attempted to repeat each word three times, the clinician decided to
move onto another method that could might be more effective and boost
his confidence again.
I don't think this was the most appropriate method for this client or at least not at that time. I don't think he was fully aware yet of where his tongue was during speech and where it should be. This was causing (I believe) a lot of his problems.
3) Discuss 1 element of the session that surprised you and/or you found contradictory to your understanding (information you have from class, common sense, experience, or expectations).
I was surprised that the clinician didn't go back over tongue placement with the client after he did so poorly on the repetition of words. I recall from a previous class that in order to ensure the client can correctly form sounds, he should first be able to know how the sound is correctly made and what it should sound like. the clinician didn't do any of this, she simply went on to another exercise.
4) Write about:
- What you learned from this observation
Before observing this client, I had read about tapping out the rhythm to aid a client's articulation but I had never actually seen it used. It surprised me how much of a difference it made for this client. Although the words he said were not perfect, they were noticeably better than any of his previous attempts.
Another thing I saw during this therapy session was the discomfort DAS causes in children. I have seen several sessions of therap for DAS but they all involved very young children who did not appear overly concerned about how their speech was. This child was very uncomfortable with his inability to say the words.
- Your feelings/reactions of the impact of the therapist's intervention on the client
I thought the clinician did a great job of responding to the client's feelings. When she saw his discomfort she moved onto another method that was much more successful for the client, which relieved his discomfort. She was also very good about praising him when he did a good job which made him more responsive.
- Your feelings/reactions of the impact of the client on you as an observer
blackwell3
2. Audience: clinician, clinician's colleagues, family of client
3. Say Back: This is the report of an observation of a 10 year old who is in therapy for apraxia. It describes the treatment methods that were most and least effective. The observer gains a better understanding of what its like having apraxia.
4. Bless: This obervation report is very detailed and well written - it looks like a real report. It gives a good illustration of what an actual therapy session might be like.
5. Address: Look over for typos. Under #s 1,2, and 3 you may want to spell out the word "one" instead of 1.
Stalnaker
Audience: Other clinicians, general public, and those who know someone suffering from apraixa
Say Back: The clinician saw a therapy session of a 10 year old with apraxia, and he observed that the tapping of syllables method appeared to be the most effective. The repetition of whole words was the least effective, and the observer was surprised that the clinician doing therapy did not go back over tongue placement when the child struggled. Overall, the observer felt that the clinician did a good job of responding to the client's feelings, and the observation also helped the observer to realize how difficult it is for a child to have DAS.
Bless: This observation did a great job of giving readers a chance to see what a therapy session entails. I liked how it was really decriptive about the feelings of the client too (for example: he started to stare at the floor... and his cheeks started to turn red). It let the readers know how difficult this is for the child.
Address: I found a few typos that you might want to take a look at. Under question 2, it said, "he started to stare at the floor or the word lists..." (the or). In the second paragraph under "what you learned from this observation," you left of a "y" in therapy. You might also want to look at the wording of your last sentence under "your feelings/reactions of the impact of the client on you as an observer."