Have you got a child who has his or her own agenda?

Tace is 2 and a half. She doesn't look at or seem interested in her parents or anyone else. She loves wheels or anything that spins. She plays alone and likes running around the room. She cannot be persuaded to sit with the others for a story at nursery. She is very independent and shrugs off all attempts to help her. She will reach towards objects she wants. She has no words and will scream when she wants something.

Tace is a child at the 'Own Agenda stage' according to Hanen. Not all children will go through this phase but for parents of children who do, it is extremely frustrating and worrying.

Tace does not realise that she can affect other people so her communication is mostly at a pre-intentional stage.We can tell what she's feeling by looking at her body movements, smiles, gestures and screams. She has been referred to the paediatrician.

So what can we do about it? Most parents just want the child to talk, after all that's what they should be doing at this age, surely? However, the goal of talking is a long way off for Tace. We need to get the background factors in place first so we can move the child from this stage to the next. In Hanen terms, this would be 'the requester stage' which we'll look at next month.

The initial goals for a child at this very early stage of communication development are to increase the child's attention/interaction with you and to increase the understanding of activities. I know that sounds too simple but it is vitally important to pick the right targets or we won't be successful.

With Tace, therefore, we looked at activities which she enjoys and turned them into games with her mother. She loves spinning so we put her in a spinner chair. We started the activity each time with, 'Shall we spin?', then we spun her a few times before stopping. She laughed and moved her whole body to show she enjoyed it. To begin with she didn't realise she could make it happen again. Then when her mother said, 'shall we spin?', and waited a little, she moved her body and her mother began the game again. Her mother had added meaning to the body movement and interpreted that it meant she was to do it again. This happened a few times before Tace realised that by moving her body she could get her mother to repeat the activity. She now regularly 'communicates' to her mother that she wants to do it again. She realises that the chair coming out means its going to happen and shows excitement when she sees it. She is also looking at her mother as another indication that she wants the game to start.

Tace's mother made it fun by using facial expressions and fun noises.

They are now generalising this ability with other games e.g. spinning her around or singing with action e.g. 'Row, row your boat'. She will soon be moving on to being an early communicator i.e. she sees that her actions can have an effect on someone else.

Tace's mother didn't see the point of my suggestions at first. 'What has this got to do with talking?' she might have asked. 'That's pretty crap!' she actually said!! As speech and language therapists we need to be able to look at a child and work out where we are and what the next step is.  It can seem a world away from 'speech therapy' but it's essential we identify the right level so we can suggest the right way forwards.So please bear with us if what we say isn't what you want to hear. The whole process of communication is very complex and it's our job to un-pick it. Tace's Mum now says, 'I thought Libby was mad at first. She was very nice but wasn't saying what I wanted to hear. Fortunately, she convinced me to try and showed me the stages of communication we'd need to work through. I feel like we're getting somewhere now. I still hope that one day she'll talk.'

If you have a child like Tace, try using his/her interests to make simple games. Whether that's spinning like Tace or flapping, flicking, jumping..... make a game out of it so you can start the process of communication today.

www.hanen.org

Why the Children's Centres need Smart Talkers Pre-School Communication groups

I've been looking at the facts and figures to inform my presentation for the next round of the tender process and I wanted to share these with you:

Why is there a need for early intervention?

• Good communication impacts positively on learning and vice versa
• A child’s language skills at aged 5 years predict educational success and outcomes aged 30 (Feinstein & Duckworth, 2006)
• At 22 months a child’s development can predict outcomes aged 26 (Feinstein & Allen, 2011)
• By 4 years the difference in the number of words different groups hear is 19million (Hart & Risley 1995, Roulestone et al 2011)

How big is the problem?

• 1 in 6 3 year olds has a recognised speech, language or communication difficulty while ‘many, many more have delays which are not officially recognised’ (Jean Gross, Jan 2011)
• At least 40,000 children start school each year without the necessary levels of spoken language ability (Professor Jannet Wright, 2009)
• 50% of children from some socio-economic areas  (75% in Stoke) according to the Bercow report (2008)

  There are 2 types of problem:

• Specific speech, language and communication difficulties affect 7% of school children (Locke, 2003). These are problems which cannot be prevented by good parenting
• That leaves up to 43% of children who have S, L a C problems because of parenting

Why is this?

• During first 8 months of a baby’s life,  there is an 8 fold increase in synaptic density, while the developing neurons in the brain are actively ‘seeking’ their appropriate connections (Perry, 2002)
• Extra connection brain cells grow or die depending on the response they get
• 75% of brain growth between birth and 2 (Hodas, 2006)

So?

Communication difficulties affect:

• Behaviour
• Social development 
•  Emotional development
• Learning (spoken language is the foundation)
•  i.e. everything!

"The ability to communicate is central to all that we do, to who we are, how we learn and how we relate to others“ (Ross, Leeds Metropolitan University, 2007)

Why look at before school?

Studies inc. Frank Field report (2010), Graham Allen (2011)  and the Ticknell  review of the EYFS 2011 conclude that early intervention:

• Improves outcome
• Helps identify communication difficulties vs. delay
• Is effective and cost efficient (ICAN)
• May maximise language acquisition
• May minimise secondary issues

 We work with the children on a framework:

We also work with parents

• Low key demonstration: powerful and non-threatening
• Reasons, means and opportunities to communicate (e.g. change nappies 5 times daily so 5 opportunities here alone!)
• Break it down into logical aims with appropriate activities which the children enjoy
• Available to discuss anything they’re worried about
• Consult with them over delivery and planning
• Can sign-post to other services inc NHS SLT

So, if you are reading this Commissioners, you know what to do.....

  www.smarttalkers.org.uk

Nearly one in six children - and almost one quarter of boys - have difficulty learning to talk, research suggests.

A YouGov online survey of 1,015 parents found only half of children with speech problems received expert help. The survey, for England's first "Communication Champion" Jean Gross, found some three-year-olds were unable to say a single word. Ms Gross said the proportion of children with problems is "high" and that getting help early was essential. "Our ability to communicate is fundamental and underpins everything else. Learning to talk is one of the most important skills a child can master in the 21st Century," she said. Click to play Click to play "The proportion of children who have difficulty learning to talk and understand speech is high, particularly among boys. "It is essential that all children get the help they need from skilled professionals as early as possible." Six out of 10 people questioned for the survey said the ability to talk, listen and understand was the most important skill for children to develop in the early years. This priority came ahead of the ability to interact with others (26%), reading skills (11%), numeracy skills (2%) and writing skills (1%). FIRST WORDS Dada - 15% Daddy - 13% Mama - 10% Dad - 10% Mummy 8% Mum - 7% Cat 2% No - 1% Dog - 1% All those questioned said they looked at picture books with their children, told them stories and sang nursery rhymes with them - all activities which boost language development. The survey showed that the majority of children (51%) did not enjoy looking at picture books with their parents until they were over six months old, but 18% enjoyed this at three months or younger. Children from more affluent families were reported to enjoy looking at picture books, and listening to stories and rhymes, at a younger age than children from less affluent families, researchers said. First words The most common age for children to say their first word, according to the parents surveyed, was between 10 and 11 months. More girls than boys (34% against 27%) said their first word before they reached nine months. But 4% of children had not said their first word by the age of three. There were no real social class differences in when children said their first word, the researchers said. Most parents (95%) could remember what their child's first word was. Among those surveyed, that word was most likely to be "Dadda" (15%) or "Daddy" (13%), with "Mama" (10%) and "Mummy" (8%) trailing a little behind. Speech experts generally think the "da" sound is easier for babies to say than "m". The YouGov research involved 1,015 parents of children aged one to to seven, questioned online in December. The figures have been weighted to provide a representative sample. Tweet

Tips for Talking from I CAN

"In the same way as your child does not learn how to walk straight away, he won’t know how to talk straight away either. He will, however, spend much of the time in his first few months, weeks and even days preparing for his first words. Communicating orally is a highly developed skill which depends on a range of abilities - the ability to understand the words being used by others; being able to think of the right word and put it into a sentence correctly; and being able to make the sounds necessary to form words. All of these skills rely on a whole set of underlying abilities that most children start to develop from the moment that they are born.
The stages of communication development are the same the world over and all children rely on those around them to help develop the skills of communication. As a parent, you will have a key role in helping your child to talk. The parent section of the talking point website (www.talkingpoint.org.uk) is full of hints and tips to help you when your child is learning to talk. There are many other useful factsheets, books, articles and programmes (some of which are listed below). This factsheet helps you with the basics – what you need to do to help your child communicate. The tips here will be useful to your child whatever their age and whether or not they are communicating at the same level as their peers:
Here are the tips:
• For young children, have fun with nursery thymes and songs, especially those with actions.
• Encourage your child to listen to different sounds such as cars, animals, the telephone
• Imitate the sounds you hear, make funny noises for your child to copy. This will help awaken an interest in sounds and help your child to understand that sounds have meanings
• Gain your child’s attention when you want to talk together. It is better to say “Ryan, please come over here”, than to say “Come over here, Ryan” because then your child will be focussed once you call his name
• Encourage your child to communicate in any way, not just through words, Actions and gestures will all help to develop words
• Listen carefully to your child and give him time to finish. Take turns to speak
• Always respond in some way when your child says something – no matter what it is that he says
• Spend some special time with your child every day. The level of talking will depend on the age of your child. Talk together when you are playing, or talk about school or make plans for the future.
• Allow plenty of gaps around the sentences that you are using to your child. This will allow him time to think about what you have said and maybe to formulate a response
• When talking with your child, use sentences that are roughly one word longer than the sentences your child uses.ie. if they are using one word, you use two; if they are using four, you use five. This will help extend your child’s sentences as they can hear what the sentence structures for longer sentences are like.
• If your child says something incorrectly, say it back the right way rather than “correcting him”. Eg. If your child says “Goggy bit it”, you can say “Yes, the dog bit it, didn’t he?”. He is more likely to change what he says in the future when he has worked it out for himself.
• When talking to younger children, try and think about how you are talking: use short sentences, vary the melody for interest, slow down slightly and pause after each sentence.
• Try to make TV time shared time – sit down with your child to watch programmes that are for children of his age".
More information is available in -
“Baby Talk : Strengthen Your Child's Ability to Listen, Understand, and Communicate “ by Sally Dr Ward Published by Ballantine Publishing Group (2001) ISBN: 0345437071;
“Listen to Your Child: A Parent's Guide to Children's Language” by David Crystal Publisher: Penguin UK; New Ed edition (June 1999) ISBN: 0140110151
“Chatterchart – a family guide to children’s communication development” Available from I CAN

The TV and talking: you can't do both!

I've just listened to the new Gary Barlow/Robbie Williams single where they sing about poor communication skills and attempting to discuss important issues in front of the TV and it occurred to me that it reflects the whole issue of the decline in human communication ability. The song is pure fiction but it's true, how many of us have attempted to bring up an important subject when the other partner is watching the television? They could not fully attend to what you're saying and would only be half listening. It sounds ridiculous and I'm sure many of you would say you wouldn't dream of doing it. Perhaps the TV is to blame for much of the decline in adult communication and even some relationships...I don't know, that's not my area of concern. 


What I do know however, is that we do do this with our own children  on an everyday basis. This is bad for many reasons and I feel needs much more research. In Australia, they have already looked at the issue and decided that TV should be banned for under 2s while watching for under 5s should be kept to an absolute minimum. They recommend no more than 1hour.  


The Australian Government support the guidelines drawn up by the Royal Children’s Hospital in Melbourne (which was actually part of a national anti-obesity drive rather than to develop communication skills).  The report advised parents and professionals to make a plan for reducing screen time.  “Screen time . . . may reduce the amount of time they have for active play, social contact with others and chances for language development. [It may] affect the development of a full range of eye movement [and] reduce the length of time they can stay focused.”

They found that that very young children in Australia spend more time watching television than in any other activity. Four-month-old children watch an average of 44 minutes of television daily, while children under 4 years with pay TV at home spend at least three hours a day in front of the screen.Nearly a third of children in Australia live in households that have a television switched on all the time and it was seen to be used as a “babysitter” from earliest infancy. “Face-to-face interactions and responsive, engaged relationships provide the foundation for all child development,” they report, ' so language and communication development is bound to be adversly affected'. 

I'm sure the viewing figures here would easily mirror the Australian ones so what are we doing about it? Let's have  more research about viewing habits and  some good quality guidelines to help families be aware of the problems they are creating and how they could help. Attention, listening, vocabulary and social interaction increase without the TV....in adults as well as children!