What’s the Difference Between a Directive and Naturalistic Speech Therapy Approach?

Introduction

When you envision a speech therapy session, you often imagine a therapist sitting at a table with a child practicing sounds over and over. You may also picture sitting on the floor with some toys and teaching through play. The truth is, both ways are possible!

Directive therapy may include repetitive practice of target speech sounds, or cyclic question/answer interactions.

There are two main styles of speech therapy: directive and naturalistic. It is not an uncommon practice for speech therapists to use a direct or compliant approach in therapy. It is a very structured approach which may include repetitive practice of target speech sounds, or cyclic question/answer interactions. It could also include structured identification of pictured items. Direct Instruction is based on scientific principles of human learning. The principles of this type of approach include use of positive reinforcement, shaping, cues, signals, prompting, and fading. It is true that children can successfully learn a variety of new skills through carefully designed practice. The speech therapist might hold up an object, name it, and prompt the child to repeat the word.

Naturalistic therapy may look more like play and is often embedded throughout a child’s play or daily routines, like bath time.

In contrast, the naturalistic approach may simply look more like play. It’s less structured, and it often involves toys, arts and crafts activities, and experiential learning. Naturalistic therapy depends largely on the spontaneously occurring events, utterances, and communicative situations that occur throughout a child’s play, daily routines, and instructional activities.

How do you decide which type of therapy is best for your child? It is best to make an informed and collaborative decision with the speech therapist while keeping in mind the needs of the child. Some children learn best in a very structured and repetitive format. Others have more success when the therapy is more play-based. Play-based speech therapy is when a speech therapist plans speech and/or language activities around a play toy or activity. The therapist will create opportunities for the child to practice the target skill while enjoying motivating toys and activities that are relevant to the child’s interests. Some reasons that people prefer a naturalistic approach is because children are often motivated to engage and communicate when playing with materials of interest. Play-based therapy helps increase attention and build better positive interactions while also allowing the opportunities to strengthen social skills. Following a naturalistic approach will help the child to make better connections with real-life events and will improve memory.

It is important to have an understanding of both types of treatment approaches as well as what the end goal of therapy is before choosing which approach to employ. Learning styles vary by child and keeping an open line of communication with the speech therapist and anyone else who is part of the child’s “team” is critical to success. If you’d like more information on these therapy models we are happy to help you! Please feel free to contact us.