Through the eyes of a child: 6-12months

The Communication Trust has produced 4 excellent videos for parents. Take a look at this one for babies between 6 and 12 months

Using animals in speech therapy: Small Talk's latest team member

Small Talk Speech and Language therapy have a new team member: 10 week old Labrador puppy called Ralph. We are the first speech therapy team in the country to want to utilise the power of animal assisted therapy. It will be a while before Ralph can be let loose on the children with speech, language and communication issues, so in the meantime we are helped out by local counsellor Frances Weston and her therapy dog, Tilly. Frances was based in Uttoxeter but now operates out of Sunshine Barn in Ashbourne. She has successfully been using animal assisted therapy as part of her work for a number of years.

It's well-known (and scientifically proven) that interaction with a gentle, friendly pet has significant benefits including physical and mental health and even encouraging children’s reading*.

Many of the children with whom we work, have severe anxiety which gets in the way of being able to assess their needs properly.  The team specialise in working with children with autism and those with selective mutism.

We decided to get our own dog after successful collaboration with Frances and Tilly. One example was a child who had severe behaviour problems, which were characterised by anxiety and a need to feel in control. The first session had been in a children’s centre but had been very difficult as the little girl, aged 9, had literally trashed the place, kicked, screamed, yelled abuse and it had generally been very stressful for all concerned. It’s very sad to see a child in that sort of state and we need to see the behaviour as panic attacks rather than ’naughty behaviour’. I needed to both assess her communication skills and be able to do my part to contribute to a potential diagnosis of autism. I knew immediately that we needed to enlist Frances and Tilly’s help, so the next session was held at Sunshine Barn where there are lots of animals such as Bertie and Beatrice the sheep, Steve the cat, ducks, chickens and lambs.

Tilly is a mature, sensible dog with years of experience of working with children and adults. Just having Tilly in the session made an amazing difference so I was able to do what I needed, the little girl was happy and relaxed and her mother was delighted. It meant that we could identify her needs properly. We were able to diagnose her with pathological demand avoidance, which is a type of autism’.

Small Talk and Frances Weston have also worked together with children with Selective Mutism, which is a phobia of talking and can be seen as a social anxiety disorder which affects many children. It can be very debilitating and affects the whole family. Having a dog in the session can be a first step in encouraging the child to talk.

Ralph will need to be properly trained so he can be recognised as a therapy dog and I am on a training course too so we can work together.  

for more information: 

Libby Hill 0844 704 5888 or 07792 906741 www.private-speech-therapy.co.uk

Frances Weston 01335 300996 www.brighterfuturespersonalgrowth.co.uk/

        

 Extra info

Physical Health:

·         lowers blood pressure

·         improves cardiovascular health

·         releases endorphins (oxytocin) that have a calming effect

·         diminishes overall physical pain

·         the act of petting produces an automatic relaxation response, reducing the amount of medication some people need

Mental Health:

·         lifts spirits and lessens depression

·         decreases feelings of isolation and alienation

·         encourages communication

·         provides comfort

·         increases socialization

·         reduces boredom

·         lowers anxiety

·         helps children overcome speech and emotional disorders

·         creates motivation for the client to recover faster

·         reduces loneliness

 Reading:  

·         helps children focus better

·         improves literacy skills

·         provides non-stressful, non-judgmental environment

·         increases self-confidence, reduces self-consciousness

Toddler not talking?

When we're called in to see  toddler who isn't talking, many parents are surprised that we don't start to work on getting them to say words . We have talked before about there being a pyramid of priority, as below

However, for some children, about whom we may be concerned about social interaction, we will suggest a different approach. As Hanen licensed therapists we might have these 5 top goals:

1. For the child to enjoy social interaction
2. To understand and use non-verbal communication (especially gestures)
3. To pay attention to people’s faces and words
4. To help the child imitate
5. To respond to bids for Joint Attention (RJA)

These can all be done through play.

Tips for Toddler Talking

This is useful for all the parents who want to know what to do:




By Kimberly Scanlon

What to expect from your first speech therapy visit

The other day I was approached by a parent whose daughter had been referred by their Health Visitor to Speech and Language Therapy. This parent came across very anxious as she did not know what to expect, or exactly why her daughter had been referred. It then occurred to me that health professionals i.e.  a  SLT, Health Visitor, Audiologist, GP etc; need to bear in mind what it must be like for parents coming to our appointments.

With this in mind I would like to take the opportunity to let you know what to typically expect from your SLT appointment. However, it must be noted that SLT services vary across the UK, and between independent and NHS services. For instance, we at Small Talk SLT Ltd; prefer to see children in their homes as this is where they are most comfortable and relaxed.

A referral may have been made by your Health Visitor, GP or Teacher; or in some instances parents themselves may request a referral through their GP or Health Visitor due to concerns regarding their child’s speech, language and communication. You may have to wait some time for your initial appointment; however if seen by an Independent Therapist children are typically seen very quickly.

So what happens at this initial appointment?

Case History: typically a SLT will take a thorough case history of your child’s development e.g. when they first sat upright, crawled, walked etc; the ages they were when they first said their first word. They may enquire about any eating or swallowing difficulties, hearing tests or any difficulties encountered during pregnancy or birth etc. All of which provides an SLT with a holistic view of your child’s development.

Listen to parents concerns: a SLT will typically allow you time to explain any concerns you may have about your child. Or, explain why your child has received this referral e.g. his teacher is concerned about the production of his speech sounds; ‘k’ and ‘g’. Etc.

Assessment: the SLT will then carry out a range of assessments. Some of which may be informal, and can appear as though they are playing games with your child; or they may be more formal e.g. sitting at a table with a book and score sheet. The approach taken all depends on what your concerns are, what the child’s difficulty is, and their age and level of attention. Often, the SLT may need to further observe your child in another setting e.g. school, or home.

So for example, at Small Talk SLT Ltd, if we receive a referral for a child under the age of Five Years. We will make an appointment to see them at home, take a case history from the parents then spend time with your child to build a rapport and observe them in their home setting. We will then carry out any necessary assessments. The areas we are typically looking at are illustrated in the diagram; building blocks to language....

Attention & listening skills are the foundation blocks to your child’s language development. The ability to ‘listen’ and ‘look’ appropriately, and learn to focus their attention will form the basis of all learning. A child’s development of attention is sequential, a SLT will typically use a framework developed by Reynell (1977) to describe a child’s stage of development of attention control.

Play is a good indicator of a child’s general development e.g. physically, cognitively and sensory. It also provides an SLT with an indication of what symbolic level the child is at. Play is also an excellent way to assess and build a rapport with a child; then play can be used during therapy especially with under fives. How else would you motivate them?

Understanding (receptive language) is the ability to understand what someone communicates, either through sound (auditory), or visually (reading and interpretation of sign). A child’s receptive language skills can be affected by poor attention and listening skills. A child with difficulties in this area may have poor auditory memory, poor concept development, poor vocabulary, poor reasoning skills, difficulties with auditory discrimination, difficulty with interpreting complex grammar communicated by others, poor sequencing skills; and so on.

Talking (expressive language) is the ability to formulate a message into words and sentences; which can be spoken, written or signed. A child’s expressive language skills can be affected by their level of understanding e.g. poor vocabulary and concept development can affect how a child expresses what they did at school today. Speech production difficulties, a limited opportunity to communicate, lack of confidence, and motivation can also effect a child’s expressive language.

Speech Sounds, the physical production of sounds e.g. p, t k, d etc. are the ‘cherry on the cake’. The child’s ability to produce speech sounds are affected by the previous language levels; and, or physical difficulties e.g. cleft palate.

An assessment at each level will determine where a child’s therapy needs to target. For example, a child may be refereed due to poor intelligibility. However, assessment reveals that he has a very poor level of understanding. Therefore this area would be targeted first.

If you are worried about your child please see www.private-speech-therapy.co.uk

Georgina White

NHS and Independent Speech therapists: Working together

In a previous post I discussed the differences and similarities between NHS and Independent therapists, and the importance of collaboration. But what does collaboration mean?

Collaboration means to work jointly together. Therefore, any example of people working together could be described as collaboration. But what does that mean for Speech and Language Therapists (SLT’s) and their clients?

A SLT may collaborate with a colleague i.e. another SLT, or SLT Assistant; when planning a language group together. A SLT may collaborate with a Health Visitor or GP when concerns are shared about a particular child in their care. Or, a SLT may work with a teacher or Teaching Assistant to set goals for a child in the classroom. Often, these ‘relationships’ can be short-lived; or sometimes they can be long term i.e. when working within a residential school setting. However, the main outcome of these collaborative relationships is that the client remains the centre of professionals focus. Any outcomes set for these children or adults should be client centred. 

A client-centred approach was first thought of by Rogers in the 1940’s. With this approach the SLT and the client and their family/carers work together to achieve change; the SLT becoming a facilitator and working in partnership with the client and their family and carers.  This partnership then enables SLT’s to develop trust and empathy so that clients and their families, carers, teachers etc. feel empowered.

I would also like to highlight that SLT’s are there to promote a positive change, not necessarily a cure. As, ‘cure’ is determined by an individual’s standards and beliefs about what is normal! Therefore an SLT will aim to offer help and advice appropriate to their clients’ needs, to enable them to attain the best quality of life they can be expected to achieve. This is not only challenging for the SLT but for parents, carers, families etc.

At Small Talk SLT Ltd we always strive to ensure that goals are appropriate to our clients needs. We are also very lucky to have the time and resources available to collaborate effectively with our clients and their families; and other professionals where appropriate.

Georgina White

Been busy

We've not posted in a while as we've been so busy this month that we haven't had time to write about it! What have we been doing? Well........

• Weekly Targeted sessions in nurseries and children's centres in Stafford, South Staffs, Lichfield, Burntwood, East Staffs and Tamworth areas
• Universal sessions in Children's Centres in Lichfield, Burntwood, East Staffs and Tamworth including Chatter Tots, Stories and Songs and Baby Talkers
• Bookstart in Stafford for families of toddlers 12m to 3 years
• Early Words Together in South Staffs, Lichfield and Burntwood. This is a new project from the National Literacy Trust for families of children aged 2 -5 years
• The Transition project in Tamworth: a really exciting initiative to help children and families plus network with nurseries and schools
• Various specialist assessments and reports for second opinions and tribunals
• Assessing children for a new channel 4 programme by Maverick TV called 'Born this way?'
• Specialist assessment and therapy in a secure mental health unit
• Individual and group therapy sessions in schools, children's homes and nurseries
• Therapy sessions for the LEA
• Training including Elklan 'working with under 3s' ideal for think two staff. It's accredited at level 2 or 3. We've also been running signing workshops and practical sessions on developing language through play in local nurseries.
• Plus taken on 20 new referrals in March

Erm... I think that's all!

Thank you very much to the team for all their hard work and dedication

We'll update progress on each shortly!