Babies do need more books and less TV!

Annette Karmiloff-Smith  said on Radio 4 yesterday that babies learn from  TV more than books. Now, may be this just a  lady who is looking for some attention, working on the old premise that any publicity is good publicity BUT this is such an important topic and one which will keep cropping up over and over.

Let's set the record straight: Babies can't learn to communicate from TV, they need the stimulation of their parents speech and to be held too for bonding and attachment. Sharing a book, therefore,  is an excellent opportunity for interaction. May be Ms Karmiloff-Smith thinks we're talking about actually reading the book. I'm talking about using the book in the interaction.

There have been many, many research studies on the influence that sharing a book has on their educational growth, and in almost all of the studies done, reading to children as early as four months of age has been ‘proven not only as a good parent-child bonding, but as giving the child a good educational start in life’ (Maria-Helen Goyetche, owner of Early Childhood Education, 2009).  :

General points:

1. Babies: There’s no such thing as too early. It’s good to start showing babies pictures and talking about them as soon as they focus her eyes on the pattern on a jumper or the change-mat. It’s part of parent –child interaction. Sue Gerhardt, discusses the major adverse implications on the developing brain if there is not this type of quality interaction, (‘Why love matters’, 2004) 

2. Toddlers: discovering new words, learning to "read" pictures to find the meanings of words or the answers to questions hiding behind those thrilling pull-tabs: where's the kitten gone?

3. Pre-schoolers: a realisation that pictures on the page are the introduction to print; being read to helps the child toward written language at this age just as it helps towards spoken language two years previously.

I've written more on this several times now (http://www.smarttalkersblog.com/2010/06/reading-is-important-too.html ) so I won't go on but please don't  let that ludicrous headline from yesterday put you off reading with your little one!

Please vote!

My Dad told me, at quite a young age, that the more staff you have, the more hassles you get. So I'm really lucky with the ladies I have on my team.  There are many reasons why I love working with each of them: Georgina, Helen, the 2 Deborahs, Franky, Kirsty, Alison, Dee, Tasha, Nikki and Nicky. I am grateful to each for helping me do what I do. 

Nicky and I have worked together for some years now and is everything I look for: consistently reliable, conscientious, great with children, professional with families and always makes sure the paperwork is in on time. She makes my job easy. I observed one of her sessions last week as she was concerned about a child. The group was well planned, well run and she showed a great rapport with the children.

I was delighted, therefore, this morning to see that her group at the Willows Children's Centre in Lichfield has been nominated as best local group for under 5s in the 'whats on 4 little ones' national competition.

Can I be cheeky and ask you to vote for Smart Talkers Pre-School Groups in Staffordshire please as I'd really like her efforts to be more widely appreciated 

http://www.whatson4littleones.co.uk/award-nominations-2013.asp

Nicky's contact email is info@smalltalk-ltd.co.uk and phone 0844 704 5888

I haven't told her yet so you know before her!

Thank you so much!

www.smarttalkers.org.uk

Communication break down in a big way!

I have just spent a fabulous week in Sharm el Sheikh, Egypt. The weather was hot, sunny and a major change from the cold, wet drizzle from which I had escaped. It was relaxing, refreshing and a world away from work.... except in a way it wasn't really, as there was communication break down to a major degree.

There are around 5,000 Russians who arrive weekly into the area. At present there are no Germans, Belgians or Scandinavians because they are advised against travel to Egypt given the current domestic difficulties. There are some Polish, some Italians and some British. The resort staff speak english, french, german, italian and spanish but hardly any know any Russian. They aren't really keen to go to to the trouble of learning as the Russians behave as if the staff are something scraped off the bottom of their shoes. The Russians, however don't ordinarily speak any English or any other language but their own.The result is similar to what I see on a daily basis: Communication breakdown leading to frustration, infuriation and temper tantrums. The difference is that the one throwing the tantrum is an 17 stone, twenty something not a pre-schooler.

It was almost funny to see how they tried to get around the problem. They tried raising their voices, then moved on to shouting then stamping fists on tables. The worst was in the Italian a  la carte restaurant where the menu was a mix of Italian and English. The poor waiter was flustered, upset and completely overwhelmed, the Russian couple angry, disappointed and so very frustrated. 

The same strategies we use with the children would have worked brilliantly: lots of gesture and visual clues. The 4 s's if there's limited vocabulary knowledge:

1. Go slow

2. Show

3. Say less

4. Stress (the important words)

Pictures and symbols would have solved the issue where no spoken vocabulary is known and if everyone could sign, well..... imagine how fantastic that would be!

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

The challenges of a speech and language therapy student

by Gemma Biles

Recently Libby contacted me and asked me if I would like a chance to write a guest blog for the Smart Talkers blog and without a second thought I jumped at the opportunity. Then I realised I had no idea what to blog about. When discussing this with friends they said “Gemma, isn’t your blog about the challenges you have as a SLT student? Why don’t you write about your experiences in a way that reassures other SLT Students that they aren’t alone in this”. So my experiences as a SLT student didn’t start the day I begin this degree, it all started with the day I wanted to become a SLT. 

Back in 2004 when I was 15, I went to a careers day intending to listen to a woman talk about her experiences as a teacher. The thought of working with 30 children everyday made me nervous and doubt this was the career for me. It was at this point of doubt that a lovely lady took to the stage and stated "I am a speech and language pathologist, I work 1:1 with children" - anything more she had to say was interesting yet irrelevant, she already had me at her opening line. So over the years doing my GCSEs and A Levels I worked with many children within the disability sector and shadowed many SLTs attempting to gain experience in order to apply for my place on a SLT degree programme. 2 years ago I had the opportunity to sit for an interview for a place on a degree programme, and I can safely say that was the last time I felt confident that I knew what it was to be a SLT. I was asked questions that I had no answer to and posed scenarios that I was unaware were SLT related. When I found out I had a place on the course I was gobsmacked. Now 15 months in to my course I realise that not having an answer to something does not mean you are any less of an SLT. The same feeling of lack of confidence and uncertainty in my answers has occurred over and over, both in lessons and on placement. These moments have however been more of a learning curve than the moments when I did feel confident and did know the answer, and these are what have defined me as a SLT student. 

I recently read a quote by Bruce et al. (2005) who stated that students should be "thrown in the deep end" in order to develop SLT skills and I can safely say that a degree in SLT does just this. On a recent placement I admitted that I had a lot of observation experience and little hands on experience, I was then given a “caseload” and asked to go away and informally assess, formally assess, write therapy programmes and discuss all this with other professionals. Well at the time I can safely say I was drowning - but now in hindsight, that was the best opportunity I have had throughout my 15 months as a SLT student. I was pushed and challenged beyond belief. But more importantly I realised I COULD be a SLT and that I was more likely to be able to survive when I wasn’t being “hand-held”. At the end of this placement I discussed how I had felt with a wonderful SLT that had supported me over the 5 weeks and asked her how it was she managed to be so competent in so many areas, having recently graduated herself. 

She gave me some knowledge that has been beyond reassuring and continuously useful – “always know your evidence base, always be critical in your decision making and more than anything, always be the swan – graceful on top, paddling like mad underneath, never let anyone see how fast your feet are paddling”. It is at this point that I am about to begin my first placement of my 2nd year – where I have no doubt that I will begin my first day saying “I would like a chance to get hands on” and I would encourage any SLT/SLP2B to tell their placement educators this, no matter how scary it may seem! I’m sure I shall be endlessly tweeting and blogging my swan like paddling throughout this placement in January 2013 – so follow me @GemSLT or view my blog at http://speechandlanguagethera-peers.blogspot.co.uk/ 

Reference Bruce, C. Parker, A. and Herbert, R. (2005) ‘The Development of a Self-Directed and Peer-based Clinical Training Programme’ International Journal of Language & Communication Disorders, 36(Suppl) 401-405.

Christmas - No Surprises Please: I have ASD!

by Geoff Evans, Head of Quality Improvement, Options Group

Introduction

If asked what we like about Christmas many of us would reply with "the surprise presents", "the many different foods", "not having to engage in normal daily living routines", "socialising" and "meeting different people".

These are the things that make Christmas so special. For the individual with autism these are the very factors that make Christmas so difficult and a time to get through as quickly as possible. I recently asked a friend with Asperger’s Syndrome what we could do to make Christmas a better experience for him. Without smiling, he replied "cancel the b****y thing".

1. The Countdown To Christmas

It seems that Christmas starts earlier and earlier each year. This year I saw decorations on sale in August. This can make it very difficult for the individual with autism who often struggles with the concept of time and deferment of gratification, to wait for presents and the actual day to arrive. Using a variation of the traditional advent calendar can be a good way of helping the individual understand that Christmas is coming.

Some parents have used their child’s special interest for example, Thomas’s journey towards Christmas. This consists of a cut out Thomas the Tank Engine that moves towards Christmas a station at a time (each station represents a day or a week). The calendar or method chosen needs to reflect an individual’s level of understanding.

Other parents try to play down the coming of Christmas and keep it a secret for as long as possible. Obviously this is easier said than done. They could try to set Christmas within a time frame, for example we start preparing for Christmas when we put the tree up or after some other significant event. It is equally important to have a set time when Christmas is over.

2. No Surprises Please

Whilst some individuals with autism love surprises, others find them difficult to cope with and prefer to know exactly what they are getting for Christmas. One young man I talked to recently said he found it difficult to understand why anyone would want to buy him presents that he didn’t want or need. Also he said he found it impossible to pretend to like something that he did not. It is important to involve this young man in the selection of the present and the wrapping of it. Doing this reassures him that he will not be getting any unwanted items on Christmas Day.

When choosing presents, parents often feel under pressure to buy items that they would buy for an individual without autism of a similar age, they also feel that they should spend significant amounts of money. For me, it is about buying presents that will bring the maximum amount of pleasure to the individual and will have meaning for them. If this means buying unusual objects or wrapping up different types of household bricks - it’s OK.

3. Maintaining Structures and Routines

A parent told me that one Christmas her son with autism came into the kitchen whilst she was putting the turkey into the oven. In an anxious and confused voice he asked her "mummy, why are we having turkey for breakfast? I want bacon".

It is easy to forget that even the little changes can cause misunderstanding and in some cases this will lead to difficult behaviour.

A parent from Lincoln told me that she has experienced many difficulties with her child due to the change in Christmas day routines. For her the solution was to cook the dinner a few weeks prior, freeze it and then on the big day all she had to do was defrost and cook it, enabling her to keep more closely to the normal routines. This strategy was successful in reducing the difficulties.

If the individual normally needs a supportive schedule, don’t forget that they will require it over the Christmas period and you will also need to ensure that you have the appropriate symbols or pictures available.

4. Giving The Opportunity To Opt Out At Social Gatherings

Christmas is often a time for family gatherings, meals out and other social events. All of these can be a source of stress and anxiety for the individual with autism. Levels of stress can often be managed by providing a safe place for them to retreat to when it all becomes too much. A favourite object can also be a life saver at such events.

Encouraging the individual to flick though an Argos catalogue can mean that they remain calm and you get to stay longer.

Final Comment

When I used to run a sibling support group, I asked them to talk about what was the best thing about having a brother or sister with autism. One seven year old boy said "Christmas is great! I get two lots of presents. First I have my own presents, and then I have my brother with autism’s because he only wants the wrapping". I hope that this inspires us to always look for the positives over the Christmas period. I hope you all have a wonderful Christmas.

To read Geoff's regular words of wisdom, it's definitely worth subscribing to the Options Group Newsletter.   Visit the website www.optionsgroup.co.uk, to find out more about this and their ASC services.

Happy Christmas

Happy Christmas to all our friends, clients and followers!

We don't send out Christmas cards, as for several years, we have done a monthly donation to Cancer Research UK instead. We hope you understand.

We are looking forwards to an exciting year with lots of new plans. Watch this space!

Love from Libby, Franky, Helen, Georgina, Nicky, Nikki, Dee, Deb, Alison, Kirsty and Tasha!