Descriptive vs. Prescriptive

Auditory Verbal Therapists know a lot about the kinds of talk that build children’s communication skills, and parents of children with hearing loss turn to us for guidance and coaching. They’re not paying us to hold our tongues! The danger comes when we shift from being descriptive about strategies that support listening and spoken language development to being prescriptive about exactly what parents should say and how they should interact with their children. This is problematic for a few reasons:

• It implies that the professional knows the One Right Way to do xyz
• Parents who are “rule followers” might feel that they need to replicate what the professional says exactly and that if they only do it X number of times, they’ll get Y result out of their child (after all, if you take medicine as prescribed, it usually works, doesn’t it?). This ignores the thousands of individual child and family factors that may require us to “adjust the dosage,” so to speak, of a particular strategy
• It stifles the natural patterns of communication in the family that may vary by age, gender, culture, native language, etc.
• The perfect can be the enemy of the good. I love a good old-fashioned paper experience book chock full of printed pictures, glued-in receipts and brochures and artifacts, and clumsy crayon doodles. There are few things better for reflecting on past experiences to build language. I hate screen time for children. But you know what? Not every family may have the capacity to make such an experience book, and looking back at photos on a parent’s phone may be their alternative to work on discussing past events. Would it be my first choice? No. But would I rather them not work on this goal at all? Definitely not!

Let’s think of some examples.

GOAL: Encourage development of early literacy skills.
PRESCRIPTIVE: Read ten books a day to your child.
DESCRIPTIVE: Lots of different things help children develop the skills they need to be ready to read. Sharing books together, singing songs or saying nursery rhymes, telling stories, and reading signs while you’re out and about can all help. Which of these do you see fitting into your daily routines?

GOAL: Increase adjective vocabulary.
PRESCRIPTIVE: Instead of calling everything, “big,” say, “massive” instead.
DESCRIPTIVE: We want him to know lots of different ways to describe sizes. Big and small are how most kids usually start, but as adults, we use even more words for sizes. What are some you use that we could teach him?

For more information on descriptive therapy to meet the needs of diverse families, check out other articles on this work, which my colleague Dr. Jenna Voss and I call TWTW or, “Their Words, Their World” HERE and access printable resources with TWTW tips.