CHAMBERSBURG — Misty Brown knew early on that her son, William, would need some extra help.
The Shippensburg woman said from the time the 11-year-old boy was young, she noticed his speech development was very slow and his processing was delayed. He would also struggle with understanding multi-step instructions, such as “go upstairs, brush your teeth and put on your PJs.”
“He might make it upstairs, but past that there would be a lot of frustration because he knew there were other things he was told, but it was almost like he couldn’t remember them,” Brown said.
Before he started school, he received some help through the Lincoln Intermediate Unit, but it wasn’t enough. So, Brown’s pediatrician referred her to Keystone Health for speech therapy.
A need for these services
More local children need speech and/or occupational therapy than there are spots to serve them.
According to the National Institute on Deafness and Other Communication Disorders, 8 to 9 percent of children in the nation have a speech sound disorder. In addition, about 5 percent of children will have noticeable speech disorders by first grade, with a majority of these having no known cause.
Keystone began offering speech and audiology services in 2013 after it bought out Easter Seals, a local company which also offered these two services and occupational therapy.
The health care organization then expanded its speech therapy services in 2015, and also started offering occupational therapy, which helps children with motor development, social and cognitive skills, self care, self esteem and other functional tasks required in everyday life. Today the therapy programs operate under the umbrella of Keystone Pediatric Therapies, and employ one audiologist who also operates as a speech therapist, six other speech therapists and three occupational therapists.
It is also currently the only major health care organization in Franklin County that provides these services to children regularly needing them. Summit Health has both speech and occupational therapy departments, but only treats children with acute injuries, a spokesperson said.
Since it started, Keystone has seen increased demand for its speech and occupational therapy programs. Together, they serve 300-350 patients—with more than 150 others on a waiting list.
“This service is very much in demand by our community, and we don’t have a lot of people offering it,” said Joanne Cochran, president and CEO of Keystone.
The therapy programs offer a variety of services, including hearing tests, hearing aid fittings, auditory processing evaluation, and help working on skills related to communication, understanding speech, expressing ideas and thoughts, answering questions and following directions.
In addition, Keystone is also in the early phases of creating social learning groups to increase social competencies for children who have social cognitive deficits, Ashton Pilkerton, a speech-language pathologist at Keystone, said. This means the groups build these children’s social attention to help them interpret the world around them and learn how to problem solve in social situations.
Within the program, one of the biggest populations Keystone treats is children with autism, according to Carolyn Coss, an audiologist at Keystone. Autism is the fastest-growing developmental disability, the Autism Society said, adding that more than 3.5 million Americans live with the disorder.
Cochran said the county is seeing more children with this diagnosis, but added she doesn’t know if this is simply because diagnosing techniques today are better.
Brown said she thinks the modern ways of diagnosing are the reason the area is seeing more children, not just those with autism, needing these services.
“I think this type of thing existed in days past, but went undiagnosed,” she said. “I think that kids like mine were probably labeled a little strange or a little off, and they were left to deal with that.”
Brown’s son has been receiving treatment for about two years. In that time, he has gotten help for an auditory processing disorder, and Coss taught him coping mechanisms and gave him exercises and assignments to help his brain recall multiple instructions.
“We really noticed a difference,” Brown said. “We noticed a difference in how he dealt with the frustration of not being able to remember them, and we noticed that actually he was able to, most of the time, recall them. So, for him, that was great.”
In fact, the program was so helpful that Brown also used the services for her 9-year-old daughter, Trinity. She has been in the program for about a year and a half and, like her brother, is receiving speech therapy.
Keystone made a difference in her social skills, according to Brown, by teaching her unexpected and expected behavior, and giving her different online games and worksheets to do throughout the week. Brown added one assignment required her to look through a catalog and pick out people’s faces with different emotions, and then cut out and paste that person’s face on a worksheet in a bubble with the name of the corresponding emotion.
“I don’t, honestly, know where we would be with her without early-on intervention,” Brown said. “I think we’d be frustrated.”
And the earlier children start these therapies, the better.
“The fact that (these kids have these diagnoses), doesn’t mean (they) will have it for the rest of (their lives),” Cochran said.
She added that many children who have speech impediments or speech problems when they are young, can be treated and rehabilitated.
For example, Coss said early intervention can help children who have an articulation disorder or who mispronounce words.
“You have a habit, you have a pattern, and it’s much harder (to change when children are older),” she said. “If we can get it younger, and they develop the correct pattern earlier, it becomes a habit, and so they use the correct pattern earlier.”
Coss also said for children with language disorders, who are not communicating well and expressing their wants and needs clearly in way that others can respond to, the therapists give them tools to prevent possible behavioral issues.
Sherry Walters is one parent who noticed her children had trouble communicating and relaying their thoughts. The Waynesboro woman said they weren’t picking up on the phonic sounds, and her son couldn’t think of words for certain objects, like “vehicle” and “fruits.”
The 12-year-old boy’s therapy included exercises to help keep certain words fresh in his mind, like asking him to name objects that are green or name three types of edible foods.
“He’s done so much better with just carrying on simple conversations and writing paragraphs where he can think of the words now, instead of staying ‘it’ or ‘them’ or ‘that thing,’” Walters said. “He actually knows the names of what he’s talking about. His brain can recall them much quicker.”
Therapy exercises for her 14-year-old daughter involved using colored blocks that coordinated with different sounds. Whenever the girl would say the sound, she would then move the colored block that coordinated with that sound.
Walters said this technique helped her remember the phonetic sounds, and allowed her the chance to enjoy reading.
“This was the catapult that just opened up the world of words to her,” she said.
Treatment still a struggle
Although these therapies are available in the area, there are still several factors that can affect those needing the services.
Simply getting to and from the appointments can be a challenge for some parents.
Coss said they might struggle getting their children to their sessions in between school and work. For others, they might have to miss work altogether.
This can be especially problematic because, according to Cochran, many children needing these services tend to come from low-income families with limited resources. So, missing work can have a much larger impact on the family.
For those parents who can’t make a session, they could also see this have a negative effect on their child’s therapy in the long run. Pilkerton said the therapists work on creating a rapport with the children, and if they aren’t consistently attending this can be hard to do.
Although Brown is able to get to and from sessions, she said would still have to juggle taking off work, taking the two kids out of school, getting to them appointment and then getting them back to school and going back to work. This was especially hard when the family was driving from Shippensburg to Keystone’s facilities in Chambersburg three times a week, in the morning and the afternoon. It wasn’t until recently the family was able to get back-to-back appointments for both of the children on the same day.
The costs associated with the therapies can also be a challenge.
Sometimes therapists may recommend purchasing additional materials, or going to another specialist for help, which can be overwhelming for low-income families, Cochran said.
In addition, affording the basic session costs can be hard for all families.
The co-pays add up, according to Brown, who pays for the services through private insurance and doesn’t qualify for federal aid.
“I do wish this type of thing were a little more accessible for people,” she said.
Despite this, she still feels the therapies were essential in helping her children.
“Honestly, I still think we would still be struggling with William with his ability to recall things,” Brown said. “I think we would still be dealing with a lot of meltdowns and maybe even some temper tantrums, which we did deal with some when he couldn’t recall them or he felt overwhelmed by multiple-step paths.”
Walters also said she “would encourage any parent, anyone that needs the help, to get the help for their children.”