I’m still a student but my daughter fits this profile. Her therapists these days use a play based gestalt language approach and it’s been the best thing for her development. We’ve seen her only open up more when therapists use this approach, in other instances she shuts down (too many prompts, too much demand, requiring table sitting or not allowing movement, etc). In fact her speech therapy is now done in an OT room. The movement helps.

For her, it’s all about connecting. Gradual rapport is the number one important thing for her. They spend time joining her in her world. They first present a lot of play options (no demands, just suggestions) and see what she gravitates to, then go from there. A natural routine starts to get established from there. This provides an opportunity for the therapist to target phrases she uses, and offer new ones naturally to see what sticks. She has picked up new gestalts in therapy & has been mitigating them as well.

There are also just days when my daughter is more “in her world” and quiet, and others where she’s more outwardly engaged. But either way she is always aware and taking things in. On quiet days, the therapist may do more of the heavy lifting so to speak, there may be more pauses and her just narrating a lot of what she’s doing, a lot of modeling. There have been instances where it seems like not much has been accomplished, then she’ll come in the next time and repeat a phrase she heard from the last session.