For Quality Therapy, Remember the Es!

For quality therapy, remember my five Es (and two to avoid):

Quality therapy sessions should be evidence-based, experiential, engaging, educational, and emotionally intelligent, not expensive or electronic.

  • Evidence-based: Good therapy is based on science and research.  The path to success is not magic or a guessing game, it requires careful application of research-based principles.  Anything less, and you’re providing shoddy services and cheating the child and family out of their best chance for success.


  • Experiential:  Therapy should be as real-life and uncontrived as possible.  Use everyday experiences and routines as opportunities to build language.  Therapy is hands on and participatory for therapist, parent, and child.


  • Engaging: Parents and children should be active participants in the therapy process.  Therapy is not a show put on by the therapist, but a language and listening experience that should involve equal input from all parties.


  • Educational:  Therapy should include parent education, helping parents and caregivers understand hearing loss and listening and spoken language techniques so that they can implement the approach at home.  Therapy should be educational for the child as well.  Activities should take into account the child’s cognitive development as well as listening, speech, and language goals.  Therapists should also help parent and child navigate educational choices for success in the mainstream.


  • Emotionally Intelligent:  Therapy focuses on developing the whole child and helping the whole family process the experience of hearing loss.  Therapy also focuses on the social-emotional elements of communication (pragmatics) and helping the child navigate relationships with peers.



Therapy should NOT be:

  • Expensive: Fancy toys do not a quality session make.  Using toys that are unattainable for families makes therapy seem like an experience that cannot be replicated in the home.  Using common objects and simple toys keeps the focus on the language and helps families see that therapy can be incorporated into everyday life.


  • Electronic:  Children live in a media-saturated culture, where “educational” shows, apps, and toys are aggressively marketed to professionals and parents without ANY evidence of their efficacy.  Therapists can and should continue to educate families about the negative effects of media on children and make their therapy sessions based on real toys and real learning experiences.

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