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What people have to say about Naada Clinic
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Jeff Philips, Primary Years Program resource co-ordinator, Copenhagen international school, Copenhagen
"I have worked with Dr. Bhat for the last two years as she has been a valuable part of our Student Services team. She is deeply knowledgeable about her field and applies this knowledge effectively and in a caring manner. She has provided just what our students needed to progress and she is active in communicating with teachers and parents about methodologies to employ at home/school to support student growth and progress. She develops students in many areas: pragmatics, expressive/receptive language, articulation and social thinking. She frequently assesses student progress in order to gauge learning and any changes in support that are needed. Sapna is very proactive in communicating with staff and parents and is always available for consultation. Her engagement with students is genuine and responsive. It is wonderful to have such a professional connected with our school and we have benefited in so many ways from this relationship"
"Our son had just turned three when he moved countries to Denmark to an International School. English was not his first language then, but even if it has been, his language and speech development was behind when comparing him, even on an amateur level, with his peers. It was difficult for anyone, sometimes even his parents, to understand him. The fact that he could not be understood of course had implications for his ability to make friends, make himself clear to teachers, pay attention in the class, etc. That first year was quite difficult for him.
The school also noticed the issue and suggested speech therapy: the therapy could be given at the school without any picking up or late bringing to school required. This was a very unobtrusive and child friendly facility.
When our boy did his initial assessment, as expected he came out as being pretty far behind in all respects. However, even a few months into the therapy made a big difference. Now, a good year into the therapy, he is completely changed from the solitary boy unable to communicate. He has school friends, play dates, he speaks in full-blown sentences with all the grammar and adjectives etc. how they should be. He makes word jokes and is known for his often funny if not cheeky remarks. All in all, and without going into the technicalities of what he has learned, improving his speech has greatly improved his appreciation for and quality of life. We're very happy to see him like this!"
"I had the pleasure of working with Sapna, for over 2 1/2 years. My son was diagnosed with a learning disability, where he could not concentrate for long intervals. He started at age 5, and with the help of therapy he was reading before most of the kids in his class. Therapy challenged him and he loved to attend the weekly programme.
If it was not for the therapy he would not have been so confident about himself and to date, knows nothing about his disability.
She is a star !!"
Case studies
At Naada Clinic we believe that communication influences the quality of life. So we strive to improve our clients communication by involving their schools (for children), family and community (for adults) in speech and language therapy. Following stories demonstrate how this has been accomplished with some of our clients.
Young boy with articulation difficulties
A 6 year old boy was referred for a speech and language assessment as he was not very clear while speaking. Teachers were not sure if the boy needed help or if his speech clarity would improve with age. Speech and language assessment showed that he had not acquired some of his sounds that are mastered by 6 years. He had articulation difficulties on 5 sounds and his oro-motor skills were normal. A hearing testing was recommended and showed hearing within normal limits. Although he had multiple misarticulations, 3 sounds that he had difficulty with followed a similar manner of articulation. Thus an approach which dealt with the manner of articulation was used. Teachers were asked to reinforce this work in regular classroom activities. Other 2 sounds were worked on separately wherein the focus was tongue placement for the sounds and listening practice. At the end of therapy the boy was able to use all his sounds age appropriately and also was a very confident speaker as he knew that people could understand him better.
Language delay and articulation difficulties in a 7 year old
A seven year old girl was brought for a speech and language assessment. She had difficulty following instructions, staying focused, using appropriately organized sentences for expression. A speech and language evaluation showed a delay of about 2 years in all the aspects of speech and language development including speech sound acquisition. Limitations in working memory also seemed to play a part in her poor linguistic skills. Increasing the auditory memory and improving the ability to follow directions were taken up as primary goals of the therapy. This was followed by work on articulation of some late developing sounds and improving the expressive skills. She was explicitly taught grammatical rules and sentence structure. Gradually the focus of activities shifted from verbal to written modality. Her introduction to literacy was carried out during speech therapy sessions along with a tremendous support from the mother. She loved activities involving reading and writing. Her speech and language skills blossomed and the ability to read and write helped her stay motivated. She is currently integrated into a mainstream school with limited support.
Middle school student with language learning difficulties
A 14 year old student was referred for a speech and language assessment. His teacher reported that he had difficulty in humanities and languages. His scores on working memory, vocabulary and comprehension were below average as per the psycho educational testing. His scores on Clinical evaluation of language fundamentals (CELF) showed that he had slightly below average performance on vocabulary and sentence structure. Data from working memory sections on CELF supported the results of earlier tests. It was also noted that he had difficulty keeping his attention focused and was not very motivated to carry out the tasks used. It was noticed that his working memory was interfering with his comprehension as well as his ability to learn and use new words thus limiting his vocabulary. This was especially evident in his written expression where he used only simple sentence structure and limited vocabulary. During the therapy it was also noted that he was not able to use contextual help to enhance his vocabulary. Keeping all these things in mind, several following therapy goals were set up:
* Enhancing auditory closure (using auditory context to compensate for missed information)
* Improving auditory memory using strategies like chunking
* Usage of strengths in visual memory to compensate for auditory memory difficulties
* Enhancing higher linguistic skills like inferencing, interpreting humor and sarcasm
* Usage of context to improve vocabulary
* Formation of compound and complex sentences
* Organization of written information
He received speech and language therapy and this work was integrated with school activities and a regular follow up was also carried out at home. A noticeable change was evident in the quality of his work as well as his motivation. His school grades also reflected this positive difference. At this point of time a reassessment with CELF showed that he was performing at an average level on all the skills tested.
An adult with brain hemorrhage leading to Broca’s aphasia
A 40 year old person suffered from a brain injury leading to the loss of language i.e. aphasia. He had previously been fluent in 3 languages and worked in a managerial position. Aphasia not only led to a loss of language but also his independence, as he had to rely on his family to look after him. His language difficulty was pronounced in expression known as a condition called Broca’s aphasia wherein a person can understand verbal communication but had difficulty putting thoughts into words. A decision was to be made on the selection of a language as therapist could not provide therapy in client’s mother tongue and the client was multilingual. After a discussion with the client, using all communication modalities (gestures, written information, drawings etc) it was decided that English would be the language of therapy. Initially a lot of drilling concentrated on getting him to use his automatic speech, in his case this included some greetings and some songs even though they were not in English. Melodic intonation therapy that relies on the ability of intact right hemisphere to process melody was used too. Here an aphasic is made to tap, hum, tunes that he/she is familiar with and later on phrases like come here, give me water etc are added on the tunes. He showed an increase in verbal expression using these two techniques and started using simple phrases spontaneously in a couple of months. As his expression improved therapy focused on improving the grammatical structure of his utterances. Different grammatical structures of English were worked on and he started using more grammatically intact sentences in some time. Towards the end of the therapy, all the resources were focused on getting him ready to go back to work. His linguistic and cognitive status did not allow him to get back to his previous job so alternate options were sought. Therapist guided him in choosing a job that suited his communicative and cognitive profile. He is currently gainfully employed and an effective communicator.
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