Team work makes it so much easier...... the A Team!

On Tuesday I went to see a little girl aged 4 years at home, who I'll call 'A'. This time last year, she was at the 'own agenda' stage of development where she didn't really see the point of communication. Her attention span was extremely short and she was more interested in my bangle than me. I couldn't see any verbal understanding. Her only expression was echolalia.

This week, we have a bright, little girl who will be starting school in September: she has a developing attention span, can understand  short instructions, uses language to get what she needs and to express herself. She can even tell you what she doesn't want very vocally! Her social interaction is developing well with children and adults. She now has a diagnosis of ASD. The only thing I'm worried about now is that she will be overlooked as she is so well behaved. 

Is this a miracle? Yes in a way it is, but it's actually the result of fantastic team work. At the centre is a parent who has done absolutely everything suggested, even when that meant making life harder for herself e.g. as part of getting A from 'own-agenda' to the next stage there was no helping herself to chocolate, she had to request a piece at a time, which was in a clear plastic box which she couldn't open on her own. As you can imagine, A wasn't happy!

• The key worker/SENCO who had worked tirelessly to achieve all the targets set, 
• The nursery who allowed it to happen
• The extremely knowledgeable, Early Years Advisor who co-ordinated everyone
• The lovely and very patient, NHS SLT who reviewed, set targets and saw as often as she could
• An excellent paediatrician who recognises ASD in girls
• me: I've worked through individual coaching for More Than Words and then worked on components of language and communication.

We've all worked together for the good of A. Well done to the A team! :-)

www.private-speech-therapy.co.uk

0844 704 5888

office@smalltalk-ltd.co.uk

Reasons, means and opportunities: choice making opportunities

Children will not develop language without a reason, a means and an opportunity. One of the best ways a parent can give the opportunity to communicate is by offering choices.

It sounds a really simple thing to do but it helps  children understand that they can use language to have an effect on the world around them. Once they see they can have an effect or see the power of using language to help them to get what they want, this is powerful motivation. A motivated child will communicate more and in turn learn more skills. Even children with no spoken language can be taught the power of choice making by pointing.

To help your child make more choices try the following ideas:

 Develop the habit of offering choices as often as you can,  wherever possible.    

Choices can include:

§  which piece of fruit eg apple or banana

§  Which drink to eat eg water or juice

§   which cup to use eg green or red

§  Which book to read eg Grufello or Squash and a Squeeze

§  Which DVD to watch

§  Which toy to play with. If toys are freely available they don't need to request one, if they're up high, they have to request so its better for developing communication. Unfortunately for communication development, nurseries have to allow free choice now so they don't always have the scope that you do at home.

This simple change can have a big effect! Try is today!

The power of snack time.

During some of our Smart Talker pre-school groups we like to include a snack time. During which, children are encouraged to sit around a table together to enjoy a drink and healthy snack. This isn’t just so we can have a rest and parents can have a good chat with their friends. It is actually a fantastic and powerful opportunity to encourage communication.

This situation provides children with the following opportunities:

·        having a good reason to communicate i.e. the motivation of food or drink

·        making a choice of snack and drink which is really important

·         Increasing their confidence

So what should we be doing?

·        Working on language and communication skills is most effective when done in real, everyday situations. We need to make sure we are giving a child a reason to communicate, an opportunity and a means. (The means can be pointing first, then answering a forced alternative e.g. ‘do you want water or juice?’, ‘... banana or raisins’ etc. Put the one you think he/she wants last to begin with so he can copy easily at first.  

·        When you are offering them a choice of snack or drink, get down on their level; make sure you have their attention by saying their name first, or tapping them on the arm.

·        Try and only give them a little bit at a time so they have to ask for more. The word ‘more’ is a good word to build from 1 to 2 words; e.g. ‘more juice’, ‘more banana’ etc. Be careful to look out for non-verbal cues as some children may not feel confident to ask for more, or have the language skills or vocabulary to do it. For example, a child may look in your direction holding out their cup, I would respond positively to this communicative attempt and model the language to the child i.e.       ‘ you would like more juice, X would like more juice’; repeating key words i.e. juice will really help your child  learn new vocabulary.

·        A further point, although it is lovely for us to hear children expressing their P’s and Q’s, this can be very confusing and hard for some children. If a child is saying single words it means that they are at an early stage of language acquisition. If, therefore, you ask them to say 'Please' or 'Ta' before you hand over the required toy, piece of food, drink or whatever, they will be very confused. If you want to encourage a child to put 2 words together, ‘more + biscuit' is more functional, they won't be able to say 'more+biscuit+please' until much later because this is actually 3 words together. (please read Libby Hill’s blog for more information on please and thank you, http://www.smarttalkersblog.com/2011/12/please-dont-teach-your-child-to-say.html)

·        Snack time provides an opportunity for children to request something in the best way they can, and push them to do a little more in a safe and motivating way. Therefore, working on their expressive language skills.

·        Children will also benefit from the social aspects of eating together, such as turn taking. If you take time to watch and listen, you will often see children sharing their snacks, or talking together.

One of the biggest causes of language delay today is that we don't expect enough of our children and we give them what they want without making them work for it. We take away the opportunities and reasons to communicate so their means of communicating doesn't need to progress.

 Take a step back and see every day activities as opportunities for communication...

So don't just provide food and drink, use snack or mealtime to help your child's language skills!

We can show you how if you come to one of our sessions www.smarttalkers.org.uk

Georgina White

Mobile phones are a huge barrier to communication development!

I just wanted to take the opportunity to respond to another report in a newspaper:

http://www.dailymail.co.uk/news/article-2420526/Parents-ignore-mobiles-talking-children-know-views-important.html

Head teachers have accurately said that parents shouldn't check their phones when their children are talking to them, as this can make sure they feel important and valued.

Why is this so important?

Communication is a two way interaction between people, children need to have the opportunity to interact with people that will listen to them; and respond to their questions and comments about the world around them. This will help them to learn how to communicate and use language skills that are appropriate and expected by others i.e. turn taking, listening attentively etc.; and also why we communicate i.e. for our needs and wants to be met.

Realistically can this be done if mum or dad or, our child’s carers spend a large proportion of this valuable time texting, responding to emails, accessing social media etc. Previously, a large impact on a child’s speech, language and communication was the effect of ‘wallpaper television’ i.e. the television being on constantly in the background, impacting on effective interaction and communication between children and adults. Today, I think another challenge is the mobile phone, as this can be taken anywhere.

What affect can mobile phones have on effective communication?

·        Reduces the time spent talking to each other, face to face

·        Reduces vocabulary expanding opportunities

·        Reduces effective modelling of social interaction skills i.e. listening attentively to the speaker, turn taking, ending conversations appropriately etc.

·        Reduces opportunities for parent-child interaction, affecting the quality and quantity of that interaction

·        Prevents good eye contact

·        You may not be aware of non-verbal communication i.e. pointing, body language, gestures; your child may be using to support his/her communication

Fortunately, I have not come across many parents in my pre-school language groups who regularly access their phones rather than join in with the session. However, I do know that many of my colleagues have. So if you work with parents and their children, think about talking to them about the use of mobile phones and the impact it can have on their children’s speech, language and communication skills.

Georgina White

Who has the most influence on the development of a child's speech, language and communication?

Even if a child is in full-time day care, the parents still have the most influence on a child's communication development according to the latest research (Routledge et al 2012). This Hanen page shows parents why http://www.hanen.org/Special-Pages/BSHM.aspx?_cldee=bGliYnloaWxsMUBhb2wuY29t

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

Have you got a child in your class who seems a little 'odd'? It could be a language processing problem

I have just observed a boy in a class room I was visiting, (I was there for another child). He had, what to me, were obvious signs of a processing problem.

Due to these problems he had devised strategies to cope and there were  certain associated factors.

1. He follows other people's lead physically i.e. he sees the rest get up to carryout what the teacher has said and then does what they do

2. He verbally copies what others have said e.g. Madison before him said she went to the cinemas so when it's his turn, he'll copy that. 

3. He just picks a random sentence if asked a direct question and he has no lead to follow. He knows they want an answer and he wants to do that quickly

4. He has diversion tactics i.e.  he'll discus what he's interested in, in the hope that whoever has asked him something will be distracted down that road. These are usually verbal but sometimes physical i.e. kicking the table in the hope we'll be irritated and stop placing demands on him. He hasn't yet used aggression or other behaviours which would get him removed from the classroom. I fear that's only a  matter of time.

5. He is frustrated as he doesn't understand what's happening.

6. He is being teased about his problems

7. He is becoming anxious and as we know anxiety blocks understanding in children and adults

8. His self esteem is affected

The staff are kind, caring, capable and want to do their best. However, no-one has picked him up and no-one is worried. How many more children are there in our classrooms who are also struggling but the staff haven't got the knowledge, training or experience to identify them? It's very sad! The staff need so much more help as they just don't know what they need to be aware of.

If you are worried please give us a call 0844 704 5888 www.private-speech-therapy.co.uk

Too much pressure on our children? Yes, sometimes!

Any one who knows me, knows that I go on about children not having sufficient stimulation these days and I have even been heard to say that there is no such thing as 'too much'. I now wish to amend that somewhat following a meal out on Saturday night.

The next table had two parents and an obvious 'only child'. The poor girl aged about 4 years was constantly taught and tested throughout the meal. The parents said absolutely nothing to each other through out their prawn puree starters and chicken kormas, they just bombarded poor Victoria with question after question after question.

There was no encouragement and occasional undeserved criticism. 'Lets play Ispy Verity, you go first,' said Daddy. 'I spy something beginning with pink,' said the poor child. 'Clever', I thought for a pre-schooler but Daddy didn't think so. It was met with scorn and derision.

'What letters can you see on that sign,Victoria?'  asked Mummy. 'I can't see a sign', said the poor child hoping to avoid the lesson'.

'What does 'stunning' mean asked Daddy?'. 'It means really good', said the child. 'No!', scoffed Daddy ' it doesn't. If I called Mummy stunning would you agree?' At this point the poor child just wanted to escape and so did I!!!

When a man collapsed on the floor, they ignored her questions about it and re-directed her to her food. This could have been a really good discussion topic as the para-medics arrived and began to minister to him but they were too busy 'teaching'.

There were lots of lessons the child could have learned about social language and conversation at a meal table. The parents could have been good role models and demonstrated the etiquette of eating out and how she should behave. They could have enjoyed her company and each others but they obviously thought the tirade of questioning, is what they should be doing. They even kept giving us smug looks as if they were showing  us how it should be done (We were without our 6). How I kept my mouth shut, I don't know!!

My book, 'How to prepare your child for school' isn't ready yet but when it it is I'll keep a copy in my bag... to give to parents like them? NO, to smack them round the head with..... hard!!

What's your favourite children's book?

The parents of our Smart Talkers groups have voted for their favourite story. Here is their list:

• The hungry caterpiller
• What the lady bird heard
• Stick man
• Walking through the jungle
• Whatever next?
• Room on the broom
• Dear Zoo
• We're going on a bear hunt
• The tiger who came to tea
• The Grufello

What do you think, is yours on the list? We'd love to know....

What is your favourite nursery rhyme?

What is your favourite? Why do you like it? We would love to know!


Some that we sing:

• Old MacDonald. You can add to this by having pictures of animals so that younger ones can choose what to sing next
• If you're happy and you know it: get the child to choose, if they don't you could always sing about what they are doing e.g. Wriggle your legs, give a smile, 
• Incy wincy Spider, add the actions
• Twinkle Twinkle: by far the favourite of the Bony Hay Teeny Talker group!
• The Scarecrow song; they love the adult lying on the floor too
• Baa baa black sheep: some of the language is bit obscure e.g. dame, master etc but it doesn't matter
• Humpty Dumpty: sad but they like it
• Hickory Dickory: all four verses to make full use 
• Wind the bobbin up: simple but effective
• Wheels on the bus; have pictures of the options so the can choose what's next
• Sleeping bunnies: I'm always surprised how they love this given that it's so simple.
• 5 little monkeys: add sign or actions
• 6 fat sausages: add sign or actions
• Head, shoulders, knee and toes: do it really slowly so they can access it
• 5 Little ducks:  add sign or actions

I have a bag of props and a little book of pictures so that children can choose what they want to sing. You can make it into a spoken language activity too by hiding 1 prop in a bag, talking about it then asking what song you could sing about it.

www.smarttalkers.org.uk

Too busy to talk to our children... so what?

If you are asked the question: what makes humans different to animals? Many people would answer that it is our unique ability to communicate. However, in the 21st century this fantastic achievement is being eroded. Language learning just seemed to happen effortlessly and easily in the past. Without TV, computer games, DVDs etc it was much easier to 'just' interact. 


As well as the technological developments there are other pressures of modern living which are having a major impact on this interaction.This was conformed by a recent ICAN survey which reported on parents' busy lives.The survey of 2,000 parents by children’s communication charity I CAN found that parents often have to work longer hours and therefore spend less time with their children. Three-quarters of those surveyed are taking on extra work and 35 per cent admitted increased workloads meant they rarely have time to talk to their children. One in five parents said they are too tired to talk with their children when they get home from work and 55 per cent said they have less quality time with them due to work.

Among those surveyed, one in five has taken a second job and a similar proportion is taking work home. A third said work calls or responding to emails at home often hampers attempts to talk with their children. 

Yet the lack of parental interaction can cause a huge knock on effect. Parents have a major role to play in developing their children's speech, language and communication skills so paucity of their interaction means that spoken language skills will not be as good as they should be. This will then later affect schooling as they need an appropriate level of spoken language  before they are ready to learn written language.Too many children are starting school without these necessary levels.


It is very hard being a parent today, we have many, many pressures to cope with which weren't around in the 60s and 70s and so many other issues that make us feel guilty for not being the perfect parent. I should know, I am a single parent with my own business,  which is may be the worst combination for time demands. However, it's vital to make time for them as that's probably the most important thing you can do.

We've all made New Years resolutions about dieting, getting fit, earning more money but may be we should have a resolution of just spending more quality time with our children. I want mine to look back at their childhood and remember the time we had together, not that I was too busy for them. At the end of the day they are more important than anything else. 


I've just done a reality check and know I could be better, how about you?


Our Pre-School groups are ideal to focus on pre-school interaction. We are also Hanen licensed Speech and language therapists so qualified to encourage parent-child interaction   www.smarttalkers.org.uk www.private-speech-therapy.co.uk

Are nursery rhymes out dated?

A recent Small Talk survey showed that many people today are not really aware of nursery rhymes. People over 40 were more likely to recall one or two, whereas, an entire class of 17 year olds studying child care, could not think of even one.  May be nursery rhymes have had their day, are old fashioned, out dated, even boring? 

Does this matter if they are dying out and parents are not singing to their children?

YESSSSSSS!

Nursery rhymes are important for many reasons:

1. Most importantly (to me as a speech and language therapist) is that they help develop spoken language skills. They are a  powerful tool in the repertoire of language developers. They show the child the rhythm and flow of language, help connect words to actions and help a child to understand and remember words. They also help attention and listening. A room full of noisy babies will still and quieten when I start singing (No, that's not my awful voice!!) and to add action keeps their attention for longer.

2. Bonding: Singing together helps language development but also interaction between parent and child or carer and child.

3. A recent Swedish study published in the journal Integrative Physiological and Behavioural Science suggested that singing, not only increases oxygen levels in the blood but triggers the release of “happy” hormones such as oxytocin, which is thought to help lower stress levels and blood pressure. As other studies show the increased levels of  both parental and child stress levels in the 21st century, this must surely help.

4. They can be used in conjunction with other communication enhancers e.g. choice making. The ability to be able to make choices is fundamental to human communication. Choosing which song to sing from a variety of props or choosing the next behaviour for action rhymes such as  'if you are happy and you know it'. These are non-verbal behaviours so do not require a verbal response. 

5. Increases confidence. Even if they haven't got the necessary expressive skills to join in verbally, they can take part with the actions.

6. There is overwhelming evidence that early learning of nursery rhymes and rhythmic poems, songs, and chants significantly enhances early reading skills and phonemic awareness.  In fact research highlights phonemic awareness as a strong predictor of a child's reading success. It helps them:

• to hear rhymes or alliteration
• to blend sounds to make a word (e.g., /a/-/t/ = at)
• to count phonemes in words ( how many sounds do you hear in "is"?)
• to identify the beginning, middle, and final sounds in words
• to substitute one phoneme for another (e.g., change the /h/ in "hot" to /p/
• to delete phonemes from words (e.g., omit the /c/ from "cat")"

Does it matter if they are not the traditional nursery rhymes? I would say that singing anything with your baby and toddler  is better than not singing at all but the latest Adele or Beyonce track is not designed to assist phonological awareness skills which will give all the benefits above.

Does it matter if you can't sing? Definitely not. A parent's voice is the best in the world to a baby or a toddler. They are no X factor judge, likely to shoot you down in flames. They will just enjoy the interaction and see it as great fun.... and whats more it's free!

The next blog post will look at which nursery rhymes we use in the Smart Talkers Pre-School Communication groups www.smarttalkers.org.uk

How can I help my Toddler Talk?

Surprising research tells us that in some areas of the UK, over half of the children going into school don’t have the communication skills they need to learn, make friends and succeed. There are many theories why this is the case. One thing is for sure, toddlers need help to learn to talk. Much of this help comes from a close, trusted adult who responds to their attempts to communicate and who provides a stimulating environment for them to learn in. Our Smart Talkers Pre-School communication groups are designed to help by using games, puppets, stories and songs to work on the essential pre-requisites for healthy communication. We offer advice for activities to do at home and how the child's everyday activities can be excellent opportunities for language development. But what if there isn't a group near you? Check out this excellent publication from ICAN priced at £12.99

Revised and bolder than before, Toddler Talk is a beautifully illustrated activity pack to promote communication development of toddlers from 18 months to 3 years old that now comes in a paperback and hardback edition.

Toddler Talk includes 35 inspiring activities on durable cards for parents and other adults to play with the toddler to develop the toddler's communication skills. The activities have been developed by practitioners with specialist experience in developing communication with under threes. The activities are focused on the following five areas:

1. Attention and Listening
2. Understanding what is said
3. Learning and using new words
4. Building sentences
5. Talking socially

Toddlers need the space and time to process sounds and to learn what they mean. Eventually, words build into sentences, into mini-conversations and this means that children will be able to get the best of their new learning environments.ISBN: (978-1-908173-02-7)

Also available, Babbling Babies activity pack.

Will there be a book in your child's Christmas stocking?

My own children don't enjoy reading at all as they are not natural readers. They would choose almost anything over reading to occupy their time. However, there will be several books in each of their stockings as they are important for so many reasons. One of which is the special time we share as I read to them with my arms around them. I treasure this time as it's great for cementing the bond we have. We discuss the story, chat about our day and unwind ready for bed.

However, the proportion of children without books is increasing according to the National Literacy Trust. It is now one in three, compared with one in 10 in 2005. Children with their own books were more likely to be above-average readers and do better at school, the study of 18,000 children suggested. Poorer children and boys were less likely to have books, it added. The survey was carried out in September with school-aged children from 111 schools across the UK. It suggested that a third (33.2%) did not have books of their own. That translates to 3.8m children UK-wide.

Is this important? Yes!!!! books are important for so many reasons see http://www.smarttalkersblog.com/2010/06/reading-is-important-too.html for more details.

They are an important vehicle for parent-child interaction. A great tool for sharing!


Will there be any books in your child's Christmas stocking?

How to interact with pre-schoolers

I have seen some really good nursery worker-child interaction this week and some awful examples too. I won't  name and shame the bad ones but the good ones need mentioning. Jayne from Little people Nursery in Burntwood and Kelly, Lynne and Sara from Little Springs in Rugeley are all natural communicators. They have a skill for interacting with pre-schoolers which really brings out the best in the children. I mentioned it to one of them and she dismissed it by saying it was instinctive but in reality, nowadays it isn't. Our natural talents as communicators are diminishing. 

So what makes them so good, why are they able to bring out the best in the little ones? The Hanen course I went on last week was all about showing parents how small changes to their own behaviour can have a dramatic effect on their child's communication. According to Hanen, the following techniques help to engage a young child in conversation:

• Accept anything the child says as meaningful and try to interpret it for them. For example, a non-verbal child took a coat to Sara and lifted his arms, she said, 'Oh, you want your coat on? I'll put your coat on'. 'Coat on' is exactly what he would have said if he could talk. I also saw a TA just take a coat from a child who handed it to her and put it on while carrying on a conversation with another adult. This was a missed opportunity for interaction.
• When interacting with a child always have eye contact. Kelly was giving instructions to a child about a whole group activity so she crouched down to his level. Always be on their level with your face turned to the child's to face. The same TA mentioned above gave a very long and complex instruction 30 reception children while facing  away from them and trying to talk over her shoulder. Out of the 30, it looked as if just 2 little girls actually understood the task. Then to add insult to injury they were all told off for 'not listening'!
• Use lots of different tones of voice, facial expressions and gestures. These help children to interpret the meaning of what is being said. All the staff mentioned are very expressive which helps keep their attention too. Imagine if you were in a  foreign country where you didn't understand everything that was said to you,  it would be really helpful if people used facial expression and gesture to supplement what they said to you. A quiet, flat affect is also the easiest way to switch off a child. Life is exciting to a two and three year old, working with them gives an opportunity for adults to be excited about it too!
• Follow the child’s lead in playing even if the child plays with a toy in a different way than would be expected. It's only adults who stick to rigid rules while playing, who says the jigsaw pieces can't be spun or stacked or become chips?
• Keep the conversation going by using the right type of questions. Try to avoid closed questions like “What is this?” or questions that answer themselves like “You want a biscuit, don’t you?”. Rather, use choice questions like “Do you want juice or tea?” or open-ended questions like “What happened?”
• Wait for a child to say something, don't step in and anticipate. As with the coat example earlier, if a child who can talk, just hands the coat, wait for him to ask you to put it on. Hanen have what they call 'owling': observe, wait and listen. 
• Add onto what the child says, so if the child says blue car, say 'yes a big blue car'. Jayne is excellent at doing this in a really natural way.

If you want to read more these very simple but powerful tips there are two Hanen publications which are well worth the effort to read. They are clear, simplistic and very, very sensible.

  

Small Talk SLT are able to offer Hanen 'It takes Two to Talk' programme for parents and from July 'Learning language and loving it' for early years professionals. www.private-speech-therapy.co.uk