The experience of discharging children from phonological intervention

The ultimate goal of phonological intervention is to make unintelligible speech intelligible. Discharging children who have achieved this goal can be a rewarding experience. However, given the constraints of everyday clinical practice, not all discharge experiences can be happy ones. In this paper I compare and contrast the issues raised by Hersh (2010) about the impact of ending therapy on speech-language pathologists (SLPs) who work with adults who have aphasia, with SLPs who work with children who have unintelligible speech. Using the scaffold provided by Hersh (2010), I consider how ideal endings for children with phonological impairment are possible, reflect on the disheartening experience of having to discharge children before realization of the ultimate goal, examine the paradox of building authentic relationships with children and their families predestined to be broken, and, explore the dilemma of promoting client involvement in decisions while retaining professional control over the discharge process. The need to better understand the clinical expertise required to discharge children from phonological intervention in ideal and less than ideal situations is discussed. Finally, the need to determine ideal intervention intensity is addressed given the potential for children with a phonological impairment to be discharged with intelligible speech.