Signing as part of good practise

The 3 Horn End Nurseries at Stafford, Hixon and Rugeley enlisted our services again to devise a specialist signing programme. Suzie Bancroft Nursery Manager says “Our view is that communication is fundamental to early learning and confidence”.  This training has helped staff to assess and improve their own skills when developing children’s speech and language. The programme also ensures the staff introduce signing as necessary in a developmentally appropriate, functional way.

At Horn End, they promote the use of sign language with all children as part of providing a language and literacy rich environment, filled with words, and books, to develop children’s new ideas and growing minds. 

In the Baby Smalls group I helped the staff identify which signs were important to add to comments or instructions that the staff were giving to the babies which helps their understanding and ability to express themselves before they can talk, as well as singing and signing. The pre-school group Toby Talls have had a specially devised programme to encourage their vocabulary and general language skills as they learned important signs while the Tommy Thumbs enjoyed singing and stories with sign. It was fantastic fun but the staff and children learned so much.

One of the outcomes of this project is the development of the communication policy in the nurseries to include daily signing with the children as this promotes their understanding, expressive language and speech development from a very early age.

I'm producing a rhyme and sign CD with favourites from the Horn End nurseries including traditional songs and some devised specifically for the purpose.

If you would like to know more about this then please call Suzie on 01785 609699 www.hornend.co.uk   or Libby on 0844 704 5888 www.smalltalk-ltd.co.uk

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Prader-Willi Syndrome (PWS)

Prader-Willi? What's that, I hear some of you ask. In fact, I'll be surprised if many of you know what it is and even fewer will have met someone with this diagnosis. Prader-Willi Syndrome is quite rare, indeed estimates are usually around 1 in 125,000. However, Small Talk Speech and Language Therapy know 3 young boys who have the condition.  Each one of the three is very different but all have delayed receptive and expressive language and two have delayed phonological processes.

Prader-Willi Syndrome (PWS) affects both girls and boys and is present in all races. It is characterised by extreme floppiness at birth caused by low muscle tone. This weakness is usually so severe that tube-feeding is necessary at birth, and up to several weeks afterwards, in many cases. Poor sucking ability and a need to sleep more than typical babies mean they often show little interest in food, and there is a subsequent failure to thrive in the early months of life, which can sometimes continue to the toddler stage and beyond.  This must be very stressful for the parents, it's bad enough for first time mums and dads anyway without the added pressures of trying to get their baby to feed. 


After toddler hood they tend to enter a second phase with different characteristics. At this point their interest in food and appetite increases, and over-eating may result. This, combined with the poor muscle tone, can cause severe and life-threatening obesity unless its carefully managed. This seems to be true for all children with PWS and I can't find any record of exceptions to this. Individual needs vary from person to person with regard to energy intake, and calculations regarding daily calorie levels need to be made with a dietitian. 

If you think of all the opportunities and free availability of food these days, this must be a nightmare to manage. Parents often report that this is the worst problem because the child will do almost anything to get hold of food. To have to constantly refuse food to a child who is desperate to have it must be awful. One of the parents we know is excellent at looking for and identifying potentially difficult situations to avoid e.g. her son starts school in September and will have to walk past 50 lunch boxes on his way out of the classroom! I hadn't thought of that and neither had school. Another worrying feature is that they will then cram food into their mouths to get as much in as possible and any subsequent choking may be silent because of the poor muscle tone. Sometimes, especially if they have a learning disability, they will seek non-food items, like John I worked with in the 1990s who loved to find and eat soap (thank goodness for pump action dispensers now!).


There is a possibility of varying degrees of learning disability and immature emotional and social abilities which may become apparent.


I've written about it today because its yet another condition which affects spoken language ability and the parents have a huge additional demand to cope. At the end of week 3 of the summer holidays and we're fed up of our children? Think about how much harder it would be if they had PWS... bet you're counting your blessings now!!


I've found a lovely blog http://mylittleson.blogspot.com/ about a little boy with PWS from his parents point of view.

http://www.praderwillisyndrome.org.uk/

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RCSLT Giving Voice: Key message 4

Key Message Four

'Urgent changes are needed to support timely access to speech and language therapy for those who need it.'

Mainstream services must support the early identification of speech, language and communication difficulties, and ensure timely access to specialist services that are sustained in proportion to need.

With more coherent planning and sharing of resources across traditional boundaries like health, social care and education, speech and language therapists will be able to organise seamless programmes of care for people who need support with their communication and swallowing. Health and social care trusts, acute trusts, local authorities, schools and probation services must work more closely together to provide access to speech and language therapy, regardless of when and where people seek support.

Responsible agencies must maintain better data on the speech and language and communication needs of their populations. Services should be planned in line with these needs and structured in response to the emerging and established evidence and guidance on what works best.

A simple brain scan to detect ASD?

Have a look at http://autisminnb.blogspot.com/  who today report................:

Scientists funded by the Medical Research Council (MRC) have  developed  a pioneering new method of diagnosing autism in adults. For the first time, a quick brain scan that takes just 15 minutes can identify adults with autism with over 90% accuracy. The method could lead to the screening for autism spectrum disorders in children in the future.

In the MRC-funded study, scientists at the Institute of Psychiatry (IoP), King’s College London, used an MRI scanner to take pictures of the brain’s grey matter. A separate imaging technique was then used to reconstruct these scans into 3D images that a computer algorithm can assess for structure, shape and thickness – all intricate measurements that reveal Autism Spectrum Disorder (ASD) at its root. Having developed this process, the computer can quickly pinpoint biological markers, rather than personality traits, to assess whether or not a person has ASD.

ASD is a lifelong and disabling condition caused by abnormalities in brain development. It affects about 1% of the UK population (over half a million people), the majority of these being men (4:1 male to female). Until now, diagnosis has mainly relied on personal accounts from friends or relatives close to the patient – a long and drawn-out process hinged on the reliability of this account and requiring a team of experts to interpret the information.

Dr Christine Ecker, a Lecturer in the Department of Forensic and Neurodevelopmental Sciences from the IoP, who carried out the study said:

“The value of this rapid and accurate tool to diagnose ASD is immense. It could help to alleviate the need for the emotional, time consuming and expensive diagnosis process which ASD patients and families currently have to endure. We now look forward to testing if our methods can also help children.”

Professor Declan Murphy, Professor of Psychiatry and Brain Maturation at the IoP, who led the research said:

“We think that our new method will help people with ASD to be diagnosed more quickly and cost effectively. Most importantly their diagnosis will be based on an objective ‘biomarker’ and not simply on the opinion of a clinician which is formed after an interview. Simply being diagnosed means patients can take the next steps to get help and improve their quality of life. People with autism are affected in different ways; some can lead relatively independent lives while others need specialist support or are so severely affected they cannot communicate their feelings and frustrations at all. Clearly the ethical implications of scanning people who may not suspect they have autism needs to be handled carefully and sensitively as this technique becomes part of clinical practice.”

Professor Christopher Kennard, Chair of the MRC’s Neuroscience and Mental Health funding board said:

“Bringing together the knowledge gained from neuroscience in the laboratory and careful clinical and neuropsychological evaluation in the clinic has been key to the success of this new diagnostic tool. In fact, this approach to research is a crucial theme throughout the MRC’s strategy. We know that an investment like this can dramatically affect the quality of life for patients and their families. The more we understand about the biological basis of autism, the better equipped we will be to find new ways of treating those affected in the future.”

The research studied 20 healthy adults, 20 adults with ASD, and 19 adults with ADHD. All participants were males aged between 20 and 68 years. After first being diagnosed by traditional methods (an IQ test, psychiatric interview, physical examination and blood test), scientists used the newly-developed brain scanning technique as a comparison. The brain scan was highly effective in identifying individuals with autism and may therefore provide a rapid diagnostic instrument, using biological signposts, to detect autism in the future.

The research was undertaken using the A.I.M.S. Consortium (Autism Imaging Multicentre Study), which is funded by the MRC. Support funding was also provided by the Wellcome Trust and National Institute for Health Research.

The paper, ‘Describing The Brain In Autism In Five Dimensions - MRI-Assisted Diagnosis Using A Multi-Parameter Classification Approach’ is published in the Journal of Neuroscience on Wednesday 11 August.

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Business development: simple principles

(My notes from busy mums networking meeting)

You have your good idea, you’re set to go or maybe you’ve been doing what you do a while.... identifying ‘business drivers’ is essential and we need to constantly keep them in mind. It is very easy to spend too much time working in a business, rather than spending time working on it.

What are Business drivers?

All businesses must consider the things which can grow the business, these are called the drivers. These remain the same whether it’s a florist shop, Internet clothing store, Security Company or a bar. These are: 

• How do we get customers/more customers?
• How do we get them to spend more?
• How can we get them to return/buy again?          

     

Getting Customers

Firstly, who is your typical customer? Which sector are you hoping to attract? Decide who you are appealing to, as your advertising and marketing will be different depending on the type of people you want to attract. For my franchises I want women who have decided they don’t want to go back to work in the industry or sector they were in previously. They are probably not looking for a franchise just an opportunity to get a work/life balance, keep their brain active, do something worthwhile and still be able to collect at 3.30pm. Therefore, doing the franchise shows probably isn’t wise but features in Parenting Magazines etc would be. Facebook is the best for us actually! For my speech therapy side, I spent hours sending fliers to GPs and Health Visitors as they’re the biggest referrers of children to speech therapy but I didn’t think it through properly.... my customers are the parents as they’re paying. An advert in the Primary Times which is aimed at parents did much more.

Attracting more customers:

Getting new customers is the most expensive way of increasing revenue because for every new customer you will have had to make calls, advertise, distribute fliers etc. It is obviously essential to the business but is only part of the plan.

Getting the existing customers to spend more is a great way of increasing income

The art of ‘up-selling’. Giving them reason to spend more. Think of the cinema.... how much do you spend on the ticket vs. the pop corn and although you might decide against spending an exorbitant amount on a drink in the foyer, one of the first adverts is the very cold gin perfectly designed to make you thirsty so you have to go back and get a drink. The warranties on electrical products are part of this too. What can you add that they just need to have? Sweets by the checkout were part of this until the healthy eating plans but I note that M&S have special offers at their checkouts that are very hard to resist and the staff are trained to ask if you’d like to add the temptingly delicious chocolate cookies to the basket! They ask so nicely, it would be almost rude not to.

We use promotional merchandise such as Smart Talkers t-shirts, mugs, pencils, bags. Once one child has a t-shirt the others then follow. We have regular campaigns such as design a mug, design a T-shirt slogan etc. so that they feel they’re having a say in new ones. We are doing our own CD’s so that they can be sold to customers.

How can we get them to return/keep buying?

The experts in this field are the supermarkets, think how they make you go back there e.g. loyalty cards, BOGOF offers, vouchers, points, customer databases which can be used for marketing or contacting later. Studies have shown that the biggest reason for not going back is a lack of feeling important or ‘perceived indifference’. This is the biggest factor to get right but also one of the hardest. If people feel their custom is important to you, they are more likely to return. It’s got to look genuine though, I hate the tag on call-waiting messages, ‘Your call is important to us’. If it was, they’d have answered it!! One of the biggest problems is the first point if contact. It won’t matter how good your product, follow-up service or how you are with the customer if the receptionist answers in manner that might suggest she can’t be bothered or the girl on the till doesn’t make eye-contact or speak.

Staff training is essential. Everyone needs to be aware of what is expected and why. When we had a bar, I showed the staff how they could increase tips by making eye-contact and smiling, also if it was really crowded some people might not want to wait but if the bar maid has made eye-contact and smiled they are unlikely to leave. They didn’t believe me initially but the practise proved it.

Use this knowledge about the customer’s attitude to your advantage e.g. we make a note of birthdays so you can send out birthday cards or let them know about special offers they might find useful.

Customer feedback is a good idea so that they feel valued; add a prize draw and you’re building a great database too!

 Plus your USP: Unique selling point(s)

What makes you unique? That’s such an important concept. What are you doing that’s different or so much better than anyone else? Smart Talkers Pre-school groups are different because we’re concentrating on communication, whatever the group from Baby Talkers to Smart Signing, Tiny Talkers to Small Talkers. However, we need to make sure that we’re maintaining this USP at all times. Think what you could do to make your idea unique to your area.  

These are just a start but are important to bear in mind as you progress and refine. Good luck!

Children's voices need to be listened to in more ways than one!

Few people are aware about the speech and language therapist's role in voice, both for children and adults. We have a role in prevention and treatment of voice problems. There is an excellent article on children's voice care at the Speech Therapy Information Services website http://www.speech-therapy-information-and-resources.com.  'We are aiming to do THREE THINGS:
keep the voice box healthy
reduce the strain on the voice
help the child to monitor his/her own voice

The vocal cords are covered with mucus – a gluey, slippery substance that protects and lubricates them. If it becomes too dry or too thick this reduces its ability to protect the cords. The following suggestions can help to stop this happening.

Drink water regularly
Depending on the age and size of the child, they should drink 6-8 glasses (1.5 - 2 litres) each day. This should be spread out across the whole day. Encourage the child to take frequent drinks rather than, for example, having three glasses at lunch time and then not drinking again until they get home from school. There is no need to buy expensive bottled water: for most purposes tap water is fine. Teenage boys aged 14 years and over, will generally require about 11 glasses (2.6 litres) of water each day. Just be careful that children do not drink so much that they then feel too bloated to eat proper meals.
Avoid caffeine
Tea, coffee and many fizzy drinks contain caffeine. This can be drying and it is also a diuretic – this means that it increases the discharge of urine and, therefore, the loss of more water.
Reduce fizzy drinks
As well as the possibility of containing caffeine, these often have high levels of sugar or sweeteners. These may also lead to dryness in the mouth and throat and can actually leave the child feeling thirstier.
Take care with fruit drinks
Fruit juices, smoothies and the like can be beneficial. However, some have high levels of acidity, which is not good for the voice (or teeth). Read labels carefully before buying.
Eat fruit and veg
For a healthy body, now and in the future, the recommended daily intake is five portions of fruit and vegetables. Fruit and vegetables are high in essential vitamins and minerals. They are low fat, low calorie foods that also help maintain a healthy weight. In summary, a healthy diet will keep the whole body, including the voice, healthy. Children and young people often enjoy novelty foods, of course. So, rather than cutting these out all together, why not reduce them or, better still, keep them as an occasional treat?
Drink with spicy foods
Hot and spicy foods may cause dryness in the throat. Always drink plenty of water with foods like this.
Keep air moist
Keep the air in rooms humid. In centrally heated rooms, keep a bowl of water on a table or on the windowsill above the radiator, or throw a wet towel on the radiator, so that the air is not too dry. Open a window to allow air to circulate. [CAUTION: DO NOT BLOCK AIR VENTS ON HEATING EQUIPMENT.] You can also use buy humidifiers designed for this job'.  To read the rest of the article: 

http://www.speech-therapy-information-and-resources.com/voice-care-for-children.html

Voice technology 'could help detect autism'

The BBC report that young children with autism can be identified by listening to the noises they make.

'Research suggests the babbling of infants with autism differs from that of children without it. The differences were spotted with 86% accuracy using automated vocal analysis technology.

Vocal characteristics are not currently used for diagnosing autism, even though the link has been suggested before'.

The study is in the journal Proceedings of the National Academy of Sciences. Read more at: http://www.bbc.co.uk/news/health-10686912  

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