How to help in the classroom by those who really know

See how pupils at Hetton School have provided their own training film and compiled a leaflet of how teachers, therapists and parents can help children with speech and language difficulties in the classroom

ADHD or just poor attention and listening skills?

I was concerned to hear a report in the news the other week regarding an increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) among children and adults resulting in the  steady rise in "attention drugs". According to the Care Quality Commission in the UK prescriptions have gone up by 56 per cent since 2007.

I question as to whether the diagnosis of ADHD is always accurate? Are drugs to treat ADHD given out to quickly before a thorough assessment is established?

Since working with children that attend our language groups within schools and children’s centres, I have found that the majority of children have very poor attention and listening skills. These skills are essential for all learning especially for speech, language and communication development. Furthermore, social communication can be greatly affected if a child or adult cannot attend to people by looking, smiling etc.

There are many factors that can affect a child’s attention i.e. neurological components, medication, environment, poor motivation etc. As accurately described by Libby Hill, ‘It is a known fact that today we live in a very visual, fast- paced world, and often the first time a child is required to do any formal listening is when they start school. Many children have to be taught to attend and listen before they can begin the demands of the national curriculum.’ All these possibilities and potential reasons for poor attention and listening need to be considered in our assessments as speech and language therapists; and those of other professionals; i.e. we need to remain holistic.

Some children are naturally more energetic, restless and excitable; with these more ‘lively children’ I try to take the following approach:

·         I always have a positive approach to all children, providing praise when necessary no matter how big or small others may observe their achievement to be.

·         I always remember that all children have their own strengths and weaknesses; and I will often reassure parents by highlighting these strengths.

·         I will include an activity I know they enjoy

·         I implement a routine so that they know what to expect

·         I will often include energetic activities; therefore putting their energy to a positive use, goals can still be met

·         Observe when their attention is better i.e. particular times of the day, particular activities, with particular people etc. All of which can inform your management of that child so that these opportunities can be repeated more often resulting in success.

·         Depending on the child/children I will include a reward; given at the end of the session i.e. stickers, or a particular activity etc.

·         Reduce my demands on that child i.e. reduce the level of information given at a time, ensure to reduce questions.

·         If needed repeat instructions/comments several times.

These are things that I find useful when working with children that ‘struggle’ with their attention and listening. I would love to hear about your experiences and suggestions.

 

Thank you,

Georgina White

 

You might think we’re ‘just’ having a snack....

But I’m actually..

·       Making a choice of snack and drink which is really important.

·       having a good reason to communicate

·       Increasing my confidence. 

·       Taking part in one of the best communication opportunities of the day. Notice how they only give me a little bit so I have to ask for more. The word ‘more’ is a good word to build from 1 to 2 words together.

·       Working in my expressive language skills: they expect me to request in the best way I can and they push me to do a little more when they know I am able

Working on language and communication skills is best done in real everyday situations. We need to make sure we are giving 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? Put the one you think he wants last to begin with so he can copy easily at first.  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.

Hanen have a great term called 'owling' and we all need to do  more of this:

• Observe
• Wait
• Listen

 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

You think we're just having a story... but we're doing lots more

Last week I covered some Chatter Tots sessions where I had to read a story to the group. It's always quite hard to engage a large group but doubly difficult when some parents just chat to each other at the same time. I tried the usual tricks to engage theses parents but I didn't want to pause the story as several were really engrossed. I waited until the end then  I casually mentioned to the parents that the story was actually a significant part of the group and it would be great if next time they could encourage the  toddlers to be a part of the session. They were apologetic but said they had no idea that  was a useful part and actually thought I was killing time!!!!!!

I've said it before and I will say again, this is why a story is important:

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 not 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.

4. School-Aged: Once children are used to being read to, they will never be bored if somebody will read, and since there are bound to be times when nobody will read and they are bored, they'll have the best possible reason to learn to read themselves.

All the research agrees that reading to themselves isn't a signal to stop reading to them though, even when the child starts to read stories to himself for pleasure. 

Specific
1. Bonding
Maybe the most important benefit a parent and child have from reading together is a bond which naturally develops as they spend time together. They are connecting with the baby while the baby is doing the things she likes best; being with you and hearing your voice speaking to her. ‘The book isn’t as important as the moment and........ it could even be a comic,’ Lesley Smith, Early Years Practitioner.

2. Attention/listening:
Attention skills are extremely important and need to be learnt to be successful in school. Attention and listening are the main skills in decline in the 21st century. A recent survey of 100 primary schools hi-lighted this (Libby Hill, 2010). By sharing a story book early on, it is helping to develop both attention span and listening.

3. Social interaction
Perhaps the most important benefit is the time the adult spends reading with the child. ‘The book is the vehicle for the interaction, which is the most important thing,’ Deborah Falshaw, Teacher & Early Years Practitioner.

4. Communication
Many of the components of communication are developed whilst sharing a book: turn-taking, listening, shared attention and speaker/listener roles are identified

5. Language
Hearing the adult use different intonation patterns and the full range of phonology of the language they’re speaking helps develop the child’s own speech and language.

a) Vocabulary: linking the names of words to the pictures helps vocabulary development. It’s often easier to find pictures than real objects to show the child. In any event, the pictures supplement the child’s semantic links to aid the acquisition of new vocabulary.

b) Reasoning: Following a character's actions in a story helps develop problem solving skills. Children are just learning about the world they live in. They are beginning to learn that their actions have consequences. Story book characters can help test these sometimes confusing issues without the pain of going through it themselves. The next time a child is confronted by a situation he has encountered in a story that has been read to him, he will know he has options.


6. Intelligence/Imagination
Getting children absorbed in books helps stimulate imagination which has been proved to advance their thinking power. They learn to pretend and put themselves in the story which often promotes a higher level of thinking. Children who are read to at an early age find it easier to express themselves and their feelings, making them more confident as they grow up (Professor James Law, City University, own conference notes 2009).

7. Emotional development
Children’s emotions can be validated through story reading. Sharing stories about characters who have the same emotions, especially negative ones, lets the child know that the feelings are normal. Children can learn from the reactions of the characters in the story (Susan Anderson, ‘The invaluable importance of reading to your child’).

8. Good habits
Children will pass on the love of reading to their children if they have been read to. Children live what they learn. They will be more likely to share reading with their own children.

9. Introducing difficult topics
Sharing stores about controversial topics is a good way to introduce discussion. Topics from sex education to drug issues can be difficult to discuss without a book as springboard.

10. Helping to handle stress
Life can be tough for a child in the 21st century. Books provide escapism as well as a source of comfort.

You think we're just singing but we're doing so much more

It was lovely to see so many families at the Songs and stories session last week at Stafford Children's Centre when I covered for Nikki. One family had even travelled from Cannock because they know the benefits of the class. Someone else commented they weren't coming because 'it was just singing and reading'.

Well, it's not 'JUST' singing  at all .........

We mostly use nursery rhymes  which 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 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")"

so its helping them with pre-reading skills!

Come along to any  of our Smart Talkers Pre-School Communication classes and join the fun

www.smarttalkers.org.uk

Are you an NQP thinking of independent practice?

So you have finished or, are near to finishing your Speech and Language therapy (SLT) degree! Finally, all that hard work on placement, and tears and sweat for your final year project is over. Then, if like me back in September, reality hits; it’s time to find a job. Which for many, not just SLT’s is a daunting prospect at this time.

Now, we have all been advised that ideally recently qualified practitioners shouldn’t work in independent practice or independent organisations, etc. However, although working in independent practice may not be ideal; especially as many positions may not offer the appropriate support we need. I think we need to be inventive, and proactive. For me that does not mean working on a long term voluntary basis or, as a Teaching Assistant. After all, that is not we have trained for. So I took the approach of ‘getting out there’, and approaching SLT’s in independent practice for voluntary/ paid work. I am so pleased I did, I am now working for a fantastic company doing the job I love. I am also very lucky as I work with a lovely team; and a fantastic supervisor.

I am aware that there are other newly qualified SLT’s out there that, like me have taken ‘the plunge’ into independent practice. This is not only daunting, but can also be quite a ‘lonely’ way of working; as you don’t always have regular opportunities to discuss ideas with others; or share recent publications and resources etc. With this in mind, I have set up a Facebook page for Newly Qualified SLT’s working in Independent Practice. This is only in its early stages with only a few members, it’s a informal group where you can discuss your concerns or ideas, or share any reading materials or resources. So if you are interested in joining us, please comment below. I am open to any ideas on how to take this group forward.

Thank you

Georgina White

You think it's just bubbles.....but it's actually a fantastic tool for developing a child's language

In our Smart Talkers Pre-School Communication groups we use bubbles for several reasons to:

• gain and sustain attention which  is important for all learning but especially learning language
• gain eye contact which might be a problem for some children
• copy words such as 'bubble', 'gone',' more', 'pretty', 'pop' or later 'that's a big one', 'I like the pretty bubbles'
• create a  communication opportunity, so we pause to allow the child to request more at their own level i.e. could be by looking, pointing, saying bubbles or actually requesting verbally
• teach concepts and vocabulary such as 'more', 'gone'
• encourage  2 words together e.g. 'more bubbles', 'bubbles gone'. These 2 words are great 'pivot' words to help develop 2 words together as they allow so many other word combinations e.g. more jumping, more biscuit, more cuddles
• cope with the end of an activity so they know where the bubbles activity fits in the class and that we will do them again next time
• allow them to run off a little steam so we can re-focus more easily afterwards