
Jocelyn Burkholder attends the final augmentative communication group session with her peers. She was excited to pin the tail on the donkey as part of a birthday celebration.
Julie Burkholder has more than the usual concerns as she sends her daughter off to Resnik Community Learning Center for her first day of Kindergarten.
Her 4-year-old daughter, Jocelyn, has global developmental delays caused by a chromosomal disorder. She especially struggles with communication and paying attention.
To address the concerns of Julie and other parents of children with significant developmental delays, Akron Children’s speech pathologist Amy Sonntag and occupational therapist Lindsay Ripple started working together to help give young patients like Jocelyn the best possible start for school.
Ripple and Sonntag decided the best way to anticipate the needs their patients will have during the school year is to replicate that environment in the hospital.
“We were meeting individually and we were having a lot of success working with the kids here, but the parents were not having the same success rates in the home or preschool settings,” said Sonntag. “Then we realized we have to recreate this environment in the hospital and we needed other kids to help create the chaos of classroom. Then we could observe them in that setting and help give them the skills they need to cope in the classroom and put the right supports in place.”

(L-R) Occupational therapist Lindsay Ripple, Lucas Ransom, Jocelyn Burkholder, Lila Hilker, Wesley Radebaugh, and speech language pathologist Amy Sonntag.
The summer pilot group Ripple and Sonntag developed for pre-K kids with augmentative and alternative communication devices meets every week leading up to the school year.
They’ve been able to fine-tune their devices so they will function better, such as addressing volume concerns that arise when other devices and kids are in the room. And they’ve developed strategies that will help their new teachers instantly respond to their special needs.
Sonntag said Jocelyn is a very happy young lady and is “all smiles, all the time.” Many times her overall enthusiasm makes it difficult for her to follow commands, attend to tasks and stay seated.
Throughout the summer, Ripple has worked to increase her attention span and keep her engaged with the group, all the while introducing Jocelyn to the many concepts she’ll likely see during her first year of Kindergarten.
“The group is a great stepping stone for Jocelyn,” Ripple said. “She’s so social, and the group has let her practice being around other kids who also use devices for communication and helped her learn boundaries. They are helping her learn to sit and pay attention. That’s a big thing for Jocelyn.”
Same Kindergarten concepts, different presentation
At a recent group meeting, the patients practiced recognizing the letters in their names, identifying colors and turn taking. They also introduced other school-time concepts such as show and tell, celebrating classmates’ birthdays, and circle time.
Sonntag says some of her speech goals for these groups are to build vocabulary, expand communication partners, build confidence and increase conversational turn taking. Ripple’s goals for the patients are to increase attention to task, follow commands, gain self-regulation, and transition easily between activities.
Nicole Hilker adopted her daughter, Lila, from China. She has global delays and a repaired cleft palate.
Lila will start Kindergarten at Norton Primary School this fall and Nicole appreciates the fellowship of the other patients and their families as well as the opportunity to work out some of the kinks before the school year begins.
“Lila wants to do what all the other kids are doing,” said Nicole. “The group provides fantastic peer modeling opportunities for her and it has been fun watching all the kids interact. It is incredible the amount of preparation the therapists put into each session. They let them paint almost every week and they even each recently decorated their own T-shirts.”
For Lila, the therapists are focusing on making sure her speech-generating device has the right vocabulary for her needs and fine-tuning the technology so it is already to go with the first bell of the school year.
The therapists are finding that combining the speech and OT is equally effective for other groups of kids with similar needs.
Ripple is excited about the progress of a newly formed group for non-verbal school-age kids and plans for children with physical limitations and communication delays, who use switch access on their devices.
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