Play with a purpose: sharing the gift of communication

The Report: October / November 2005 vol.26 num.5


ami Nishi enjoys a lot of things about her job. For instance, the toys.

Tami Nishi
Speech Language Pathologist
The Centre for Development

-I go to work every day, open my materials cupboard, and its full of toys," Nishi said, smiling. -I love that."

What she loves even more is the way the toys can help a young child break out of the isolation that
often accompanies developmental challenges. As a speech- language pathologist, Nishi uses the toys ... along with a variety of other tools and techniques ... to help children develop their ability to communicate.

-I play a lot," Nishi said. -But its play with a purpose.

For the children Nishi works with, from birth to age six, development of effective communication skills can sometimes be extremely challenging.

-The children I work with often have neurological impairment or disability in multiple domains of their development. Some children I see might have cerebral palsy, autism spectrum disorder, Down Syndrome, global developmental delay, seizure disorders or other diagnoses," Nishi said.

Progress can sometimes seem slow, but small steps can be hugely significant.

-You notice the minute changes a child makes, and those are really celebrated. It may take six months or a year to get there, but its all very meaningful. Sometimes the changes are in the families and siblings, for instance in the way they gain insight into the childs ability," Nishi said.

And that points to another thing Nishi values about the work she does: providing intervention with a family-centred approach.

-For early intervention to be effective, it is important to integrate the families needs and goals and work closely with parents. We recognize that they know their children best and are a very important part in the treatment process. Im constantly ... constantly! ... amazed by the parents I work with and their abilities to adapt and to grow with their children.

-Another thing that I really value about our facility is the team approach," she said. -Its multidisciplinary and holistic. I work with occupational therapists, physiotherapists, psychologists, family service workers, technical staff, pediatricians, recreation therapists, administrative support workers, supported child development consultants, early childhood educators•as well as other medical and community service providers who are all members of a childs intervention team," Nishi said.

-Its an incredible group of individuals who share a common vision. Everyone has a strong sense of compassion, a lot of energy, and collectively contribute years of expertise to the team," she said.

But she cant help expressing some frustration about the circumstances those professionals, children and their families have to work with.

-The challenge today is a growing waitlist for services as well as other barriers that seem to be taking the ‘early out of early intervention. I find it unacceptable that young children are waiting two to two and a half years to be seen for speech and language services."

While she knows today that her mission is to deliver that support, Nishi did not know she wanted to be a Speech-Language Pathologist until she was in her late 20s. in many ways, shed spent many preceding years preparing for the job, without knowing it.

-My BA is in French and Linguistics and Ive always been fascinated by language," she said. She spent much of her early adulthood exploring the world, living at various times in France, Indonesia, Japan and New Zealand.

-While learning new languages, I got a sense of some challenges faced by individuals who have difficulty understanding and communicating in the world around them. It helped me appreciate how our ability to communicate effectively is so important to our development, our identity and our ongoing learning."

-Its very gratifying for me to be part of this process with others. Inherently in the work I do, Im reminded every day about the importance of communication," she said.

Communication doesnt always happen through spoken language, Nishi points out. For some children who are unable to develop verbal expression, non-verbal communication systems can be surprisingly rich.

-Augmentative and alternative communication systems can be learned to enhance verbal communication or instead of it. There are sign language or picture exchange systems, for instance, using manual language or pictures to allow children to develop and produce language. There is technology such as voice output devices. Children can push a button to convey a message."

Progress in such cases can be especially heart-warming, she said.

-I can tell you about a little girl I started working with when she was three and a half. She was diagnosed with a rare degenerative disease, and her prognosis was very poor, and based only on the little amount of research available. She was severely visually impaired ... plus there were delays in all areas of her development. Her life expectancy was around six years of age.

-When we first met, she was an unresponsive little girl to the world around her. The first two years we spent trying to connect, to have her be comfortable, and to facilitate her familys understanding of what she understood and how she expressed herself so they could support her development of language and communication skills."

-And then the last year and a half, there was a radical change. She started learning very quickly, and indicating awareness of her environment and others around her. She began showing her personality, her likes•and her dislikes ... she had a great sense of humour, even though she didnt speak words. I worked with her until she was six, at which time her health had really improved," said Nishi.

As someone who helps others learn, Nishi likes to keep learning new things herself. Thats partly what drew her to get involved with HSA: she jumped in three years ago to serve as chief steward, and is currently a steward for her facility.

-Theres a lot to learn from union involvement," she said. -Previously, I was quite apolitical, but something woke up in me. It has given me a lot of insights about how our agency is affected by larger decisions made by our government. I really appreciate having opportunities to attend workshops that help me develop new skills, as well as having the support from HSA to get involved in provincial elections," she said.

-Its been a stimulus for me in other parts of my life. Ive been more socially aware and active on a broader level. I certainly plan to continue being an active member."

Nishi counts the opportunity for union activism as another benefit of her job, along with many others: team-work, meaningful relationships with families, a daily focus on communication, and, yes, the toys. But above all, she is inspired by the children with whom she works.

-I love working with children. Their need and desire to learn is so unconditional. They really take in every new experience and draw from it. Im very lucky to learn from children," she concludes.