Hi, I’m Vicky Poston Roy, speech-language pathologist and co-owner of Dynamic Therapy Specialists in Baton Rouge, LA. One of the things I often talk about with families is how we set therapy goals—and more importantly, what we’re really aiming to improve.
Are we helping a child build a skill from the ground up, or are we teaching them how to work around something that’s difficult? Both are valid. But understanding the difference and when each is appropriate can make a huge impact on your child’s progress.
Compensation vs. Remediation: What’s the Difference?
In thinking about intervention and thinking about therapy goals, it’s important to consider whether or not what you are addressing is a compensation. Are we compensating for the difficulty (finding workarounds), or remediating it (building skills)? And oftentimes we have to do a little bit of both.
It’s important to consider the things that can be remediated before we jump into a compensation-only focus. That would be where we’re saying, “A child has this diagnosis, so we need to teach them differently,” or “We can’t do anything about this, so we’ll just adapt.”
Before we look at compensation, or at least in addition to it, we want to also look at remediation. We should look at the bottom-up approach to intervention, at all of the foundational systems that come online in early development in order to support later higher-level skills. We should recognize the importance of both compensation and remediation, while knowing which one you’re targeting and whether or not it’s time to shift the focus from one to the other approach.
An Example of a Compensation Approach
Let’s take auditory processing as an example. A compensation-based approach for someone who struggles with auditory processing might include strategies like:
- Sitting closer to the teacher
- Taking tests in a quiet environment
- Using visual supports or written instructions
These are compensations. It’s not that the compensation isn’t necessary or helpful, it’s just understanding the difference. A compensation is when you’re attempting to circumvent the difficulty.
An Example of a Remediation Approach
Whereas from a remediation standpoint, we might be looking at:
- Are the ears working as they should?
- How is the tactile system functioning?
- What’s going on with visual processing, balance, or reflex integration?
Here, we’re looking at the underlying systems that support focus, comprehension, and interaction. And we want to determine, is the issue truly a skill deficit, or is it rooted in something happening earlier in the brain’s development?
When the Foundation Is Shaky, the Skills Can Falter
Something I often share with parents is that even a neurotypical adult like myself can show symptoms that look like disordered behavior under the right conditions. If I’m hot, hungry, dizzy, or distracted by an itchy tag, I might:
- Say something inappropriate
- Cry as a response to stress
- Don’t want to be around people
- Don’t want to answer the phone
- Struggle to find words
Those are not disorders. They are a symptom of other things that are going on. When our automatic systems (like temperature regulation or sensory processing) are taxed, higher-level skills like language, attention, and emotional regulation can fall apart.
They will start saying things that they don’t mean. They might have some emotional dysregulation issues. They might have word-finding difficulties. They might read an entire paragraph and have no idea what they just read at that moment. This is why we need to look at the whole system, not just the outward behavior, because these are things that can be remediated.
Reach Out to Dynamic Therapy Specialists for More Information
If you’ve only been given compensations so far and you’re wondering whether your child could benefit from a remediation-focused approach, we’d love to help you dig deeper. Call us at (225) 767-5032 to schedule an evaluation today.