My Paradigm Shift…from traditional speech therapy to RPM

Now that I have introduced you to a few (and there are MORE) limited and non-speaking clients with autism who are using Rapid Prompting Method (RPM) to communicate, I thought it was time to share my story. Perhaps you have some doubts. Perhaps it seems just too incredible that a person with autism, who has never spoken at all, or who has never spoken more than a few words or scripted sentences, is communicating thoughtful, grammatically perfect messages on a letter board. I understand your suspicions. I too was skeptical when I first heard about RPM. Since April is Autism Acceptance Month, I thought it was time to share my journey from flat out doubt to whole hearted belief.

I will honestly admit that when a family I was seeing for speech therapy told me they wanted me to go through RPM training I did, what I hope was only a mental eye roll, as I thought to myself, “not another miracle cure.” Curiosity, a slightly open mind, and a sense of obligation to my client prevailed and I went to RPM training with Soma Mukhopadhyay. Soma is a woman of science. Without preamble, she launched into neurology and the various learning channels of the brain – auditory, visual, tactile, kinesthetic. I appreciated the science because I had expected some serious hocus-pocus and snake oil. (Going on 19 years in the field has made me a little jaded about “new” techniques). About a half hour into training, a 14 year old girl, who is a very limited speaker with autism, came in for a demonstration. She was a beautiful girl with an infectious smile. She appeared to be gazing off in space at things no one else could see and was bopping along to a sound track that only she could hear. Soma immediately began to present a complex cognitive lesson. I thought that there was no way this kid was attending to or comprehending the information. However, the girl consistently answered each factual question correctly, spelling her answers on the letter board. Soma did not touch her or influence her response in any way other than to encourage her to point on the board. I began to pay serious attention at this point. Soma started asking increasingly complex questions. One of the questions was something to the effect of, “have you been to the zoo?” The girl spelled, “I have visited the zoo but am uncomfortable with animals in cages because I live in a glass cage called autism.” THAT was the moment that changed my life and clinical practice! After nearly falling out of my chair, I picked myself up and started furiously taking notes!  Instantly, names of clients flew in my head that I desperately wanted to try this method with because I knew they were smart kids trapped by autism.

I started incorporating RPM into my therapy immediately. Of course, I thought that with my amazing skills as an SLP, my experience with autism and overall awesomeness – I could improve upon Soma’s methods. WRONG! I had some ego deflating to do and experience to gain. After a several weeks of trying things my way with limited results, I tried it her way. It worked! It still took me some time to get my first word out of a kid on the letter board – loads of alphabet soup at first. I became fluent in my rapid prompting skills. I learned to prepare cognitive lessons that engaged the brain and elicited insights about my clients – who they are and what they think. Words became phrases; then sentences; then paragraphs. Some of my clients began to access open communication, meaning that they can express novel sentences to respond to any question or express any idea (just like you and I do) by spelling on the letter board.

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When you see how non speaking people with autism can communicate and show what they know – you can’t un-see it!  Experiencing this has irrevocably changed me and my clinical practice. This has not been an easy transformation. It wounded my pride to realize how much I misunderstood about autism. I wrestled with guilt. Why didn’t I know this before? What would the lives of my clients be like if I used this method with them 5, 10, 15 years before now? I have had to accept the fact that I may lose credibility and respect in the eyes of other speech language pathologists as well as others in the autism field by embracing this methodology. I have had to unlearn everything that I have been taught, and then in turn, passed along to students in my years as a professor of speech-language and education.

It has been pretty much universally accepted (and defined in the DSM IV) that autism is a disorder of “significant language delay/deviance; restricted range of interest and/or repetitive behaviors; and a qualitative impairment in social engagement.” Most experts believe that the many people with autism have some degree of cognitive impairment. As I have been using RPM, I have found this to be completely untrue! Each client has demonstrated themselves to be intelligent, emotionally attuned, desirous of social relationships and communicative -using language skills better than most speaking people! I now believe that autism is a motor disorder in which there is a significant disconnect between cognition and voluntary motor control of the body. Now, the only experts I believe are those with autism.

Accepting this paradigm shift has been difficult, uncomfortable and surprisingly emotional. It has taken me almost a year to wrap my head around all of this and find the words and courage to start writing about it in my blog. My clients have been the tipping point for me. Watching client after client find their “voice” through RPM has been amazing and inspiring. Each client, without fail, has expressed an immediate desire to reach out to help other non speaking people with autism. I no longer use the term non-verbal because my clients have shown me that they are PLENTY verbal – they just don’t speak. One hundred percent of my clients have expressed dissatisfaction with their education. My clients are so eager to learn anything and everything. I am constantly struck by their incredible patience, courage, forgiveness, desire to communicate, interact and tell their story. My clients have inspired me into action! Their courage has compelled me to relay their words to anyone who is willing to listen!

My clients have more to say, I have more to share with you. Still doubtful? That’s ok. Just keep an open mind, listen to the words of my nonspeaking clients, and follow and share their stories. Draw your own conclusions and see where this journey takes you!



12 thoughts on “My Paradigm Shift…from traditional speech therapy to RPM

  1. Hi Elizabeth, I just came across your blog today. It makes me so happy and hopeful that professionals like yourself are discovering RPM and affecting the lives of many. I am a parent using RPM and have seen first hand the transformation it has made in my son’s life. My son has been able to be included in regular school and activities since being able to communicate. We are loving hearing what he has to say everyday. I hope others like yourself continue to discover and implement RPM. You have the power to change so many lives for good! Thank you for your work and powerful testimony in your blog!

    • Thank you Lisa! Your blog and your belief in your son inspires me! Our kids have so much to teach us through their powerful words! Thank you for your willingness to share Philip’s words with us!

  2. You have articulated the issues so well in what you say. The technical woven across the lives of yourself and your clients.

  3. I am a SLP who utilized facilitated communication back in the day. It changed my perception of my “CLINICAL CERTIFICATION of COMPETENCE” forever. People I thought were blind could SPELL. I was able to transfer most of those facilitating to AAC devices.
    Keep up the good work.

    • Thank you so much Sarah! As SLPs we need to be constantly rethinking how we approach communication! It is hard to deviate from what we believe that we “know” – but we have to be willing to embrace whatever allows that client successful communication! Grateful to have another SLP open to flexible communication!

  4. Pingback: A World of Letters – Part II | listentothemustnts

  5. My son was a RPM student. Graduated high school with a regular diploma. He’s now at community college with an aide. He’s taking calculus 2 using a number/symbol board and he’s got the second highest grade in class! Verbally he can speak what’s written and he scripts but that also improved with RPM. I adore Soma. She changed our world.

    • Thank you for your comment! We love success stories like these! Our RPM clients constantly show us how incredibly smart they are. That is why the neurodiversity movement is so important – when we stop comparing all brains to neurotypical brains, we can see the ways that people learning differently. Once we embrace those difference, accept and teach in the ways that each individual learns best, beautiful things can happen!

  6. Pingback: Keeping an open mind | OMazing Kids

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