3/30/10

Speech Therapy at the Mall

Occasionally, I can take speech therapy out of the clinic. I’d like to share a visit to the mall this weekend with one of my students that was unusually successful.Seven strangers initiated conversation with us in one hour. My student took the initiative for an eighth conversation that provided just the right amount of stretch and for which he could be proud. Luck is the meeting of hard work and opportunity and we had good luck on this outing.

I’ve taken speech therapy out of the clinic only a handful of times. When I did, the student had been with me for more than a year, made excellent progress in the clinic, had faith in the therapy process, and trusted me to present this new challenge carefully. These conditions must be met because so much therapeutic control is lost in the real world. Internal and external fluency disrupters present themselves often without warning. I always seem to underestimate the power of the internal, emotional influences that lurk unseen within my students. The student who can express his anxieties, concerns and perception of events on a speech therapy field trip is a priceless asset! His feedback helps me to modify expectations moment – to – moment.

Our first encounter was with an elderly gentleman pushing a walker and his friendly wife. They were looking for ‘the main entrance’ to the mall so that they might find their car. “Hey there young fella!” the gentleman called out to my astonished and unsuspecting student. I paused, waiting for his response. He looked at me, realized I was not about to ‘save’ him, and then gave the man directions to one of the mall entrances. As they shuffled off, I chuckled to myself about how these senior citizens had unknowingly broken through my student’s anticipation anxiety right off the bat. We were on a roll already and it was only 10 minutes into the session.

We walked through the crowd for about 5 minutes to observe non-verbal behavior. Then, we stood at the railing of the third floor as I pointed out the significance of specific nonverbal behaviors we had seen. I described a young vendor’s attempt to sell us jewelry. The vendor moved into our personal space, made friendly eye contact, spoke slightly loudly, asked us to look at the jewelry she was selling to benefit charity. All of these individual behaviors synthesized into a gestalt that my student would later recall to aid in his own personal assignment. My resource for this discussion came from a book about children with learning disabilities. (1) This book recommends “Social Scanning Skills” in which an adult assists the child in “observing and analyzing the social interactions of others.” Then, the child learns to recognize, reflect, and react: observe his surroundings, think about behavior options, and then choose responses thoughtfully.

We spoke with 4 people at a video game store. Two of these interactions were distinct and gave us plenty to talk about later. One of these interactions occurred with a teen who looked to be about the same age as my student. He walked up to us and casually commented on a special mouse my student coveted. “That’s not worth the money,” he said. I responded quickly, hoping to invite the teen to stay and chat. He did. He made inviting eye contact, left plenty of silence for my student to speak, asked for clarification, maintained topic, and then wandered off. He couldn’t have offered a more perfect peer experience. The second interaction occurred with an employee, a man perhaps in his 30’s. He was abrupt, spoke and moved rapidly, never asked us a question, showed us a notebook full of type too small to read, and left no time for us to talk! His eye contact was cold and he appeared to have many better things to do besides chat with us. The contrast between the 2 speakers was almost comical.

It was my student’s idea to engage a sales clerk in conversation about a specific product. And so we entered a Brookstone with this goal in mind. I decided it was time to encourage some independence and suggested he have this conversation without me by his side. I was surprised by his reluctance to follow through once we were in the store. Again, I had underestimated the internal drama that can rage within people who stutter. Twice I nudged him to approach a sales clerk, direct him to a specific product, and ask for more information. Finally, I pushed, informing him that we were nearly out of time and were not leaving the store until he had performed this task. It was time to test the trust we shared. I felt this was a task he could succeed at, despite his apparent sudden paralysis. Thank goodness this time I was right. As I purchased a small item for myself, I noticed that he had indeed found his courage and achieved his goal.


(1) Lavoie, Richard (2005) It’s So Much Work to Be Your Friend: Helping the Child with Learning Disabilities Find Social Success, New York, NY: Touchstone, Simon & Schuster, Chapter 12, “Appropriate Social Skills in Public Places” pp. 293-304.

(2) Another resource for social skills information can be found at www.socialpragmatics.com

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.