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Faces and Places at All Children's Hospital
New All Children’s Preschool Language Class Thriving
Feb 04, 2013

Scottish Rite Preschool Language Class
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Mr. Potato Head is the man of the moment on a recent morning inside the Scottish Rite Preschool Language Class, a new addition to the landscape of development and rehab service programs at All Children's Hospital.

"Ears ON," says speech-language pathologist Maria Sansone to a little girl named Baela, simultaneously placing the plastic ears on the iconic toy. In her high-pitched voice, Baela mimics the simple phrase with gusto.

Seconds later, fellow speech-language pathologist Jenn Ziemak repeats the exercise with another toddler, a curly-headed boy named Samuel. "Hands ON," she states while sticking Mr. Potato Head's hands into place. Samuel follows the lead and blurts the words out as best he can.
 
It is all part of a unique soundtrack for teaching young children with communicative disorders at All Children's.

Inside a second-floor room of the Child Development and Rehabilitation Center, you see what looks like a typical nursery school  class - fully equipped with kid-friendly art supplies, building blocks, peg boards, a puppet theater and Barbie house, a pint-sized wooden kitchen and boxes of  cars, trains and dolls.

But what you hear is another story altogether.

"What's our letter of the day?" Jenn asks the three students in attendance this day. "DOUBLE-u.  Say it with me, DOUBLE-u."

Pointing to a picture of snow, Maria helps the class describe the color: "Wu-wu-WHITE."

"BUB-bles," the two teachers call out later as they blow bubbles that float amid the excited kids, who cheerily pronounce the hard consonant while trying to catch or pop the soapy spheres.

So it goes on another morning in a new program created by the All Children's Speech-Language Pathology Department - under the supervision of Speech and Hearing director Therese Montanari and taught by the talented and passionate tandem of Maria and Jenn.

The class, made possible by funding from the Scottish Rite Foundation of Florida, meets for 90 minutes one morning a week. Children can continue attending without a set timetable, allowing them to be discharged at an appropriate time. The goal is to work with patients ages 2-4 on improving language and social skills, which are often inextricably linked in a preschool environment. The initial Monday class of eight kids has been so successful after only a few months that a second class will be added in February.

"We sometimes will take a child a little before the 2-year-old level, so if they're 22 months, we'll take them," Therese explained. "They all have an expressive language delay, so their verbal skills are not where they need to be. And a lot of times, it's their first experience in a group setting - and their parents are very concerned about putting them into a classroom where they can't verbalize what's going on.

"What happens a lot of times is that these kids have tried to start in a regular preschool and they may bite other kids because they can't verbalize, 'No, my toy!' or ' No, my truck' as another  2- or 3-year-old would. And then the teacher has to do something about it because it's behavior you can't accept. So the child spends a lot of time in 'time out' or whatever because they don't have the expressive skills - and it becomes a downward spiral."

That's where the Scottish Rite Preschool Language Class comes in - as an early intervention in what could otherwise be a progressively negative educational spiral. The class works on myriad levels. Its broader objectives, beyond improving speech, sound and social growth, is to enhance concept development, help the youngsters learn through arts and crafts and music, build vocabulary, teach them to follow directions and get them prepared for a structured preschool environment.
 
To accomplish these goals, Maria and Jenn introduce the kids to a new theme each week - such as "Winter holidays" from this past December, with a focus on words starting with 'W.' Each session includes activities that target both "receptive" language (that which is heard) and "expressive" language (verbalizing thoughts and feelings to others).

The class on this particular day begins with the teachers reading a book called "I Like Winter" and discussing the winter season in circle time. The letter of the day takes center stage, with Maria and Jenn underscoring the sound that the letter makes, using it in different words and finger painting 'W' in the art center. And the parents play a crucial role as well. They receive a recap of the lessons from each class and the theme for the week or month.

"We let them know how they can continue to work with their child on these things during the week," Maria says. "We'll let the parents know how we focused on a particular theme that day and give them some ideas on how to follow up at home. Being really specific about what you're working on allows the parents to be more involved."

Tara Harrell, mother of 2-1/2-year-old student Delaynee, has seen some improvement with her daughter in only a few weeks of class. Delaynee has trouble putting two or three words together to form a sentence and tends to mumble. Concerned , Tara and her husband discussed the situation with their family pediatrician, who referred them to the program at All Children's.

"It's been a little hard dropping her off, because 'Laynee' has separation anxiety, but she does like it here," Tara says. "She makes pictures and she likes to take them to her daddy. She'll remember the letter of the day and then she'll say it all week long. She hasn't really been much of a talker, but she's slowly coming around. This is definitely helping her."

Separation anxiety is a common hurdle early, but the kids have been adjusting well. "When Laynee started here, there were tears throughout the entire class, but she's really come a long way in the last three weeks," says Maria. "Even when she did stop crying, she'd stay away from the group. But now she's completely in there."

Laynee initially had trouble with the concept of turn-taking and would get upset if she didn't get to go first every time. But through the games Maria and Jenn utilize and frequent interaction with other kids, her sharing skills have improved drastically and she's even trying to imitate putting several words together in a sentence.

"It's difficult without socialization and it's hard not to say what you want," says Jenn. "In another setting, they might get kicked out of school. This class gives them an opportunity to be around kids similar to their level, and they see we're working with all of them. They're not singled out like 'I'm the only one.'  I really think socialization and learning about  turn taking is essential."

That's what makes this preschool program different - and vital for the children who participate. The two therapists, assisted by language and speech aide Morgan Hughart, are able to give the children the intense, focused attention and teaching that that can make all the difference.

"You don't always know the cause - you deal more with the problem itself," Maria says. "But this preschool allows the children to deal with separation, and to replace negative or aggressive behaviors with something that's more socially acceptable before they enter school. And that's big. I don't know where their language skills will be when they enter school. But if we can get the social skills to something that's more appropriate, then they can go to school and be more successful at it."

The therapists bring a wealth of experience and dedication to the program. Maria, a Tampa native, had planned on a career in microbiology. But her best friend's sister was doing a hospital speech therapy internship working with children, Maria spent a day with her on the job and that was all it took to change directions. She switched majors and got her college degree in communicative disorders, and earned her master's at the University of South Florida. She then spent 16 years in New York City working as a bilingual group therapist before coming to work at All Children's last year.

"The progress you see in group therapy is really amazing, because the kids are motivated by their peers," she says. "It's really amazing to see how kids respond to other kids in this environment. For instance, I'll always put Baela last in turn-taking because she's more likely to imitate if she hears two other kids do it first."

Jenn, who also comes from Tampa, wanted to be a pediatrician at first and began college with a major in  microbiology. But her sister had some experience with speech therapy and that influenced Jenn's career course. She earned her undergraduate degree in communicative disorders, got her master's from Florida State University and did her graduate internship at All Children's 13 years ago, leading directly to a staff job. "This is what I'm meant to do," she says.

The class might not be possible, however, without the support of Florida's Scottish Rite Foundation. Not all insurance covers the cost of group therapy and some parents don't have insurance at all. The organization's funding allows those families to benefit in the life-enhancing program.

"The Scottish Rite Foundation has done such a wonderful job," says Jenn. "The funding is there if the insurance isn't. If it wasn't for them, this wouldn't be happening."

The results of the first class have been so encouraging that there's talk of adding a bilingual class, and possibly expanding the program to All Children's regional Outpatient Care Centers . Maria and Jenn are getting the word out to the Early Steps (birth to 3) program at All Children's to make parents aware of the Scottish Rite preschool class.

As another lively class session comes to an end, Maria and Jenn assemble the children in a circle and sing a farewell song with each child's name - getting the kids to pronounce "BYE, BYE."

Laynee is the first to leave and the therapists use it as a teaching moment: "Laynee is going HOME."

And she, like her fellow classmates, will be taking along vital new skills to better cope in school and life.

"Faces and Places" is a regular column highlighting those people, places and things that make All Children's Hospital special. If you have an idea for a story, please contact writer Dave Scheiber at ext. 72490 or dave.scheiber@allkids.org. For a full archive, click on the Faces and Places icon on allkids.org.


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