How to survive and flourish in your first year as a speech and language therapist

By Faye Nugent - Magic Words Level 1 Speech & Language Therapist

Your NQP year is a big learning curve, both clinically and emotionally.  I have come to the end of my NQP year and it’s been a journey!  I have a varied caseload across mainstream schools, general clinic and complex needs clients which I am thoroughly enjoying.

Here are some of the things that have helped me in my NQP year.

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You’re not expected to know everything

I remember finishing university feeling the following: I can assess a child very well but what next? What therapy do I do? I had some experience from placement about different types of therapy but there is only so much you can fit in at university.

When I started my NQP role here at Magic Words Therapy I thought I was supposed to know all the assessments, therapy approaches and resources I should be using with all my clients.  Speech and language therapy covers such a wide range of client groups; from dysfluency to ASD to speech sound difficulties and developmental language disorder – the list goes on!  It would be impossible to be an expert in everything.

I have learnt lots different therapy techniques and strategies either from CPD training days, speaking to my colleagues and supervisor and reading up on the different therapy approaches out there.  Working alongside more experienced therapists has also really helped me take the pressure off myself and to realise that speech and language therapists are always learning in their careers and that no therapist knows everything; there is always something to learn!

My confidence has definitely grown through experience.I might not always know the answers, but I am learning the places to look for them and the people to speak to.I am always open with parents and teachers; if I don’t know the answer I will tell them so and I will research it and get back to them about it.It is okay to not know everything.I’m always looking out for ideas and inspiration to make therapy more fun and interactive for the children too – Pinterest, Twinkl and the shop ‘Flying Tiger’ have been life savers for me!

No one knows you’re a Newly Qualified Therapist

Nope, no one knows unless you tell them.  That goes for teachers, parents, SENCOs and other speech and language therapists.  A parent won’t know that it is your first ever initial assessment, and the school SENCO won’t know it is your first MDT meeting, unless you tell them.

In my first few weeks as an NQP, I thought everyone would know this was my first job and that I was inexperienced.  It did feel strange not having a clinical placement tutor with me all the time and having to make clinical decisions on my own.  With time I have become more confident in my clinical knowledge and decision making and now feel like a ‘proper’ speech and language therapist, not a student anymore! 

Everyone has to start somewhere: trust the process.In fact, other speech and language therapists find having NQPs in the team helpful; it’s good having someone on the team with fresh eyes, and recently trained up in the profession.Be confident in what you know, and the skill set you have. Remember you are qualified!

‘A problem shared is a problem halved!’

Being a speech and language therapist is a very busy role and it can become very overwhelming, particularly in your first year.  I have found it so helpful to speak to colleagues and my supervisor. They’ve helped with advice regarding assessment, therapy and caseload management as well as listening to how I am feeling, both the positives and the challenges. 

Clinical supervision is an essential part of your professional practice, it gives you the chance to discuss your work with someone who is experienced and qualified.  Regular supervision meetings have helped me to develop my clinical knowledge and skill set.  My supervisor has guided me to the appropriate next steps to take with challenging cases or situations.  The meetings also provide the opportunity to reflect on how you are coping and feeling.  I have found that discussing any problems, big or small, has always been helpful.  Sometimes it is just good to get something off your chest!

Supervision sessions are also a chance go through and more importantly sign off your NQP competencies.  It is a big document, but I found it helpful at the beginning of my NQP year to read through each competency and think about how I was going to achieve it and the evidence required.  It meant I had an idea and plan of what I needed to do.

It has also been useful to speak to my NQP colleagues.Most of our questions and queries have been similar so it has been good to support each other on the journey!

‘Have a go!’

I am a kinesthetic learner so after doing some reading I always learn best by just having a go.  I particularly remember feeling very nervous about running my first dysfluency group session; What do I do?  What is this ‘Tortoise Talking’? Will the children know this is my first dysfluency group? 

After I did my first session I felt so much more confident; the children responded well, they had no idea it was my first session.I was able to reflect on what went well and what I could improve ready for the following week.

Be flexible

Things change all the time: fire drills halfway through therapy sessions; ‘Viking day’ at school and the whole school is off timetable, parents not turning up for meetings.  Initially, I found it difficult when plans changed, especially when I was nervous about the session or had taken a long time to plan and prepare resources.  Now, I try to plan ahead and I ask parents their preferred method of communication (face-to-face meetings, emails, phone calls) and find out about events going on at school (sports day, whole school assemblies) etc. 

However, you can’t plan for everything and sometimes you just have to roll with it.For example, doing observations of the client instead of a therapy session on ‘Viking Day’ or using the therapy time to complete client-related work.

Breathe!

It's important to take time and ensure you are getting a good work-life balance.  We are very busy day-to-day in our roles as speech and language therapists and it can be easy for this to spill over into our spare time: thinking “I’ll just finish the notes at home” or finishing a report in the evening.  I try to keep work in the work environment and once I get home to take the time to relax and do things I enjoy.  I feel I am able to do a better job because I have kept a clear distinction between work and home and not running myself into the ground. 

My confidence and clinical expertise have grown with time and experience.I like that in our profession we are always learning and developing.Coming towards the end of my NQP year it has been great to look back and reflect on how far I have come.

What's the effect of screen use on the development of children’s speech, language and communication skills?

By Frankie Paterson - Specialist Magic Words Speech and Language Therapist

As speech and language therapists we are concerned with anything that could be affecting how children's speech, language and communication skills develop. We have been wondering about how lots of screen time is affecting children. We are keen to look into this issue as, with millions of children now using tablets for several hours a day from as young as 18 months old, we worry that this could be having an affect on how many of their early cognitive skills are developing, including language development and the development of their attention and listening skills.

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I recently listened to a programme on Radio 4 called ‘Why Can’t Our Children Talk?’.

I was very interested to hear on this programme that many teachers across the UK are voicing concerns about screen time. This echoes the concerns that I am hearing from the teachers I work with in schools in Luton. Many of the teachers who are voicing concerns have been working with children of 4 or 5 years old for many years and they are struck by recent marked differences in how children of 4 or 5 are presenting in terms of their language and attention skills.  Here's what one teacher had to say on Radio 4 about her own experience with children and screens:

 “Our children.. over the past 3 or 4 years, if you’ve got the interactive whiteboard on in the classroom they find it impossible to do anything apart from look at the screen… If there’s you to look at as the teacher.. telling them a story or there’s a screen, even if there’s nothing on it, they’re naturally pulled to look at the screen…They.. struggle with making eye contact because often when they’ve been hearing nursery rhymes.. it’s obviously been on a tablet where it’s been a.. brightly coloured screen they’ve been looking at rather than looking at somebody’s face”- Lorraine Boothe, Reception class teacher and assistant head at Chaul Lane Infant School. 

The Radio 4 programme featured a study that has recently been carried out on 900 toddlers in Canada. A clear link was found between language development and screen time in children under 2. It was conducted by Professor Catherine Birkin, a paediatrician in Toronto. She said:

“Children who used mobile devices.. had a higher risk of an expressive language problem at 18 months of age”

Apart from this one study in Canada there is no other evidence as yet about whether screen time is adversely affecting children's development or not. Much more clinical research needs to be conducted into this question before firm conclusions can be arrived at. However I think this question is hugely important as it has implications that we need to take seriously as a society

The Benefits of a Fidget Toy

By Danielle Allen - Service Administrator

In today’s modern age, many of us with children do find ourselves letting them watch YouTube from time to time. The videos more often than not, consist of unboxing of toys, some of which are fidget spinners. I could never understand why my children found these entertaining which is why I took it upon myself to research these types of toys. The more research I did either online or speaking to my son’s nursery teacher, I came to the positive conclusion that there is a benefit to the use of these toys.

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My son has struggled with poor attention and listening which can cause disruption in his nursery activities. With him moving into reception this year, I decided to further my research into fidget sensory toys to see if they could be of use for my son and other children who struggle with similar behavioural issues. I found that not only do they help with attention and listening but also ASD, anxiety and many more. From fidget spinners to fidget cubes, putty to taggy blankets, sensory balls to squishies. The list is endless on the variety of sensory toys available which allow families the ability to do trial and error for which one works best for your child.

A recent purchase for my son was a sensory fidget bag with a variety of toys inside. I actually found this from a fantastic online store on Facebook called Once Upon A Time. I showed my colleagues who have now purchased these for their children they see in clinic and at school. There has been great feedback from both the children and parents.

So, what exactly is a fidget toy and how do they help? Fidget sensory toys are tools which can help boost attention through the use of the toy which could allow him or her to focus more at school or at home. As I had mentioned before, there are a variety of different toys available from the way they look, to the way they feel, and in the general use. The fidget spinner for example, has a central disc on ball bearings with extended wings allowing you to spin the device. Or there is the fidget cube which has sensory tools on each face of the cube such as, a roller ball or a spring action button.

Overall, there are numerous benefits using these toys to address certain struggles a child faces at school or at home. The biggest is increasing the concentration and focus of a child. Studies have shown that using the left and right hemispheres of the brain is required for learning and carrying out task. Fidget toys have been proven to help these as movement and sensory input are essential and allow this to happen. Case studies have assisted this research in confirming that increased focus in a learning setting was achieved in a student who was using a stress ball.

Another huge benefit is using these toys to reduce anxiety. Fidget toys, although not a cure, can have a calming effect of those who suffer with anxiety or sensory issues, such as ADHD and ASD. It can help relieve the symptoms the user gets notably in the hands and fingers, they keep their hands busy. Some parents and teachers have raised concerns of it becoming more of a distraction however with children with ADHD or ASD for example, a situation can become overwhelming causing more disruption and potential harm. Fidget toys allow the child to fidget which can be a minor disruption at first, but can have a vast amount of benefits such as a soothing or calming effect. This can then develop to increased concentration and focus which boosts the productivity and learning for the child and classmates.

From a personal perspective, I have found fidget sensory toys highly beneficial for my son and am hoping he will continue to improve when he starts reception. It is a working progress which I will take at his pace as after all, it is going to be beneficial for him growing and building up his skills with attention and listening. I am looking forward to trying the variety of fidget toys we have and testing which ones help him focus more.

Top 10 Language Apps

By Faye Nugent, - Magic Words Level 1 Speech & Language Therapist

There is a huge variety of apps available to support a child’s language development.  Here is a selection of 10 of the top apps:

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SPLINGO LANGUAGE UNIVERSE

Splingo Language Universe is an app that helps develop a child’s comprehension (understanding of language) by exploring the number of keywords a child can understand in a sentence.  It is an entertaining and motivating game that helps develop your child’s understanding of different aspects of language such as verbs, nouns, prepositions and adjectives. 

The app can be used with children at a developmental level of 18 months to a developmental level of 4 years and upwards.  It is customisable, so you can adapt the app to your child’s developmental level.  The app builds from single key word (e.g. ‘find the apple’) to more complex four key word instructions (e.g. ‘give the big red apple to the boy’). 

The app is available to download on Google Play (£2.39) and iTunes (£2.99).

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GRAMMAROPOLIS

Grammaropolis helps develop knowledge and understanding of parts of speech.  Each part of speech is explored using a map which includes a variety of games and activities to explain the item.  As the child explores each map their understanding is assessed by quizzes throughout.

The free download offers games and activities for nouns.  Within the app you can buy access to other resources such as; verbs, adjectives, adverbs, pronouns, conjunctions, prepositions, interjections.

The app is suitable for children aged 7-8 years onwards. 

The app is available to download on Google Play (free with option to buy extras) and iTunes (free with option to buy extras).  You can find out more information at: https://grammaropolis.com/

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VERBS NEWS - VIRTUAL SPEECH CENTRE

Verbs News helps support the development of a child’s understanding of different verb tenses (simple present, present continuous, simple past and simple future). 

The app introduces Andrew who is a news presenter, he explains the four verb tenses via an animated video.  There are a variety of options as you can select the words you would like to work on and the type of activity for example auditory bombardment (hearing the accurate model of the verb used in a sentence), fill in the blanks or make up sentences.  For each correct response, the child is awarded with an anchor microphone. At the end of the session, children can take the role of an anchor, record their own news, and watch it in the newsroom.

The app works best with an adult supporting the child as this gives the opportunity to discuss each verb and provide an accurate model if the child has any difficulties.

The app is available to download on iTunes (£9.99).  You can find out more information at: https://www.virtualspeechcenter.com/app/verbs_news

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PRONOUNS WITH SPLINGO

Pronouns with Splingo follows Splingo the speech and language alien helping to teach the understanding and expressive use of a variety of pronouns.  The app is engaging and motivating, after 5 correct responses the player gets to select three items to place in their virtual bedroom. 

The app is fully customisable giving you the option to choose the pronouns you work on, a UK or US voice for instruction and whether the verbal instructions are written down too.

The app is available for download on iTunes (£2.99)

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PREPOSITIONS JOURNEY - VIRTUAL SPEECH CENTRE

Prepositions Journey is a fun and interactive app. With adult support the app can be used to develop your child’s understanding of prepositions, as well as giving them the opportunity to use prepositions to expressively respond to ‘where?’ questions.  The app allows the player to record their responses, replay them and see if they are correct. 

The app can be adapted to the child’s needs as you can select the specific prepositions you would like to work on.  The app creates reports following completion of a game which collates the scores together for each player.

 The app can be downloaded on iTunes (£9.99). You can find out more information at: https://www.virtualspeechcenter.com/app/prepositions_journey_app

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MAGICAL CONCEPTS - VIRTUAL SPEECH CENTRE

The Magical Concepts app follows Mago the Magician as he guides the player through a variety of concepts.  The game is highly motivating and makes ‘drilling’ activities more engaging as the player earns a star for each correct answer.  With enough stars the child is rewarded with a magic show.

You can select from a wide variety of concepts making each game specific to your child and their needs.  The app focuses on the understanding of concepts, however with adult support can be adapted to work on the expressive use of concepts within the game.

The app is available for download on iTunes (£9.99).  You can find out more information at: https://www.virtualspeechcenter.com/app/magical_concepts_app

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SENTENCE WORKOUT - VIRTUAL SPEECH CENTRE

Sentence Workout is a useful app to help support the development of the written form and expressive use of a child’s sentence structures.  It focuses on a variety of sentence types including nouns, pronouns, adjectives and verbs in a variety of sentence types.

The app is flexible to your child’s needs.  You can adjust the target sentences, whether you work on them by saying or writing the sentence, and the number of correct answers required before the reward football game.

The app is suitable for children aged 6 years and older.  It is available for download on iTunes (£12.99).  You can find out more information at: https://www.virtualspeechcenter.com/app/sentence_workout_app

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WH QUESTIONS - SUPER DUPER PUBLICATIONS

The app works on a variety of ‘wh’ questions, it initially offers the ‘who?’ question pack, however within the app you can buy additional resources such as ‘what?’ or ‘why?’ questions etc.  In each question pack you can choose between 4 games to play as a single or multi-player game.  For example, in the multiple-choice game players can either answer the question or select the appropriate question for the answer given.

The app uses bright and fun images and sounds that are engaging.  This is a useful app that can be adapted dependent on your child’s needs.

The app is available to download on iTunes (free with option to buy extras).

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CATEGORIES - I CAN DO APPS

As the name suggests ‘Categories’ focuses on organising information into their appropriate category. A variety of skills can be developed including a child’s vocabulary, understanding, spoken language and problem solving and linking ideas and concepts.  The app offers 5 activities; identifying an image relating to a category with an option of 2 or 3 images to select from, finding another item in a category, finding two images that go together and identifying the ‘odd one out’.

The app uses images of real objects and is simple and easy to use.

It is available for download on iTunes (£4.99).  You can find out more information at: http://www.icandoapps.com/

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WH QUESTIONS WHY? PUZZLE GAME - SPEECH AND LANGUAGE DEVELOPMENT, ONUR TEKIN

This app focuses on understanding and answering ‘why?’ questions which develops a child’s receptive and expressive language skills and problem-solving abilities.  The player can complete a short jigsaw of an image and then answer a ‘why?’ question, for example ‘why is the child’s ice cream melting?’. You can record your answers using the iPad’s microphone and compare these to the answer given.   

This app can be used with children aged 4+ years.  It can also be adjusted to your child’s needs and levels.

It is available for download on iTunes for Free with some In-App Purchases.  You can find out more information at: https://learnwhquestions.com/en/why/

Glue ear. So, you have been told your child has this, now what?

By Carolyn Fox - Service Lead for Hearing Impairment & Specialist Speech and Language Therapist in Hearing Impairment

What is glue ear?

Glue ear is also known as Otitis Media. If you have heard of these terms before, it is likely that either your child or a child of someone you know has suffered with it.  But what exactly is it, how does it affect your child and how concerned do you need to be? Well in this blog, we will be looking at this sticky subject and providing you with some answers and advice. 

Your ear is a clever little listening device that is made up of three parts; the outer, middle and inner ear. For us to hear sounds, the sound must pass from the outer ear, into the middle and inner ear and it then sends the sound information to the brain for processing. However, in a child with glue ear, the sound has a bit of difficulty passing through. It enters the outer ear but when it gets to the middle ear it meets an obstacle; sticky fluid, hence the name ‘glue ear’. A child with glue ear is therefore unable to ear all the auditory information that they should due to this trespassing substance in the middle ear. 

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Glue ear is common in young children 

Glue ear is most common in children between ages 2 and 5, this is also an optimum sound and language learning period! Around 15-20 percent of this age group will suffer from it at some point (Peer, L, 2005). Older children can get it too, although this is less common.

Signs to look out for if you are worried that your child may have glue ear

Knowing what to look out for is very important as glue ear will come and go. This means that children with glue ear will at times have no problems hearing and at other times they will struggle.

Watch out for:

• Lots of yawning?? Does your child seem more tired these days?

• Complaints of ear pain. If glue ear is present it may be causing some discomfort. 

• Is your child waking you up in the night (more than they usually do?)

• Does your child seem like they always have a cold? Are they breathing through their mouth?

• Does your child seem to ignore you when you ask them to do something? (More than they usually do?!) Do they generally seem like they are finding it hard to hear?

• Is your child angrier? Frustrated?

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Will glue ear have an impact on my child’s ability to learn?

All children will respond and behave differently when they have glue ear. There are many ways it can impact upon their ability to stay focused. Look at the list below to get informed and if you notice any of these things, it may be worth getting your child’s ears checked. 

Your child may:

• Need more repetitions of words and instructions or generally be slow to learn new information.

• Get confused or mishear information. 

• Have trouble staying on task or focused at school.

• Have limited vocabulary knowledge or they may not be learning words at same rate as their peers.

• Find it hard to join in games or follow the rules of a game.

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What can I do to support my child’s hearing?

If you are concerned, the first thing you should do is get a hearing test for your child. From there, there are some things you can do to help your child focus and support their hearing potential.  

• Talk about what it means to listen. Raise your child’s awareness to this e.g. the importance of facing the person, looking at the speaker, telling an adult when you don’t understand.

• Obtain your child’s full attention when you are speaking to them

• Where possible, reduce background noise e.g. mobile phones, television.

• Talk to your child at their level so they can see your face and lips. This will give them invaluable extra information about the words and sounds that you are saying. 

• Give your child the time that they need to process what you are saying. If needed, break down your sentences in to chunks. 

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If in doubt, check it out

In some cases, the sticky fluid will go away without treatment, but it is best to get your child checked out just in case. 

Speak to your GP and tell them what you have noticed and what you are worried about. There are different ways forward in terms of treatment. Your child may be given antibiotics. If this fails to resolve the sticky issue, then grommets may be offered. These are placed into the ear and will drain out the fluid.

Early identification is always better. In the case of glue ear, the earlier the problem is identified, the sooner your child can be given treatment. Early treatment will decrease any adverse effects on language learning and general development.

For more information and support, contact one of our Magic Words therapists for a chat or take a look at the NCDS website:

NCDS Website

Mummy-hood and Speech and Language Therapy

By Hannah Heslam - Speech and Language Therapist

As a speech and language therapist and a Mum it can be handy to have all this knowledge about speech and language development. It’s been useful to be able to see where my children are in relation to the developmental milestones I have used so much in my role as a therapist. I felt absolute fascination when each of my little ones finally started talking which was a delight and a worry, as for any Mum. 

When I was 32 weeks pregnant with my second child I became concerned that my baby was not moving. I was encouraged by my other Mummy friends to seek advice, and by the evening I was in the hospital having an emergency C-section.  It was a scary time and I was presented with some challenging prospects for my baby, a beautiful boy.

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My Journey

Having had a relatively easy pregnancy with my first little boy I wasn't prepared for or expecting to have my second child born early. It was a difficult time being swept into the delivery room and told by doctors it was going to be a hard journey ahead. He was born weighing 3lbs 4oz and spent just under 4 weeks in intensive and special care.  However, he has just turned 5 years old and is surprising us all the time with how well he is doing, achieving in line with or above expected levels at school and with his happy, cheeky personality. I’m sure he couldn’t have done so well without all the support of our family and friends.

At around 2 ½ years old, despite being able to put words together, his speech was at times difficult to understand. Wanting the best for my son and for him to be able to communicate as effectively as possible with other children, I started to carry out some speech activities through play. This really improved his intelligibility.  At about 3 ½ years old he did still make some sounds by releasing air through his nose instead of his mouth and he received some excellent therapy from a specialist speech and language therapist which resolved this issue.

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"Being a speech and language therapist and a mum, I'm extremely passionate about how early intervention really does work. I've seen the results in children I work with and in my own little one of course"

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Some words of advice about speech and language

I feel that my speech and language knowledge has supported me with my own children and I know that not everyone will have this wealth of knowledge.  With Magic Words our goal is to support children with speech, language and communication needs. Below are a few key pieces of advice for you:

Repeat and Expand:

To help with your little one's language development, repeat and expand what they say. This helps to show them how they can build their sentences and to value what they are interested in communicating about e.g. Child: ‘I have car’. Parent: ‘Yes, you have a blue car’. 

Commenting is great:

As parents we naturally want to ask our child lots of questions to check how they are getting on. A great way to develop language is to reduce the pressure of questions and to model language to our children by asking 1 question to 4 comments. Think of a hand, 1 question (your thumb) to every 4 comments (your fingers). 

Use modelling:

If your child has unclear speech, when they say a word that isn't clear, instead of correcting them, model it back to them so that they can hear a good model of how it should be said. For example, Child: ‘I have a dat’. Parent: ‘Yes, you do have a cat’.  This allows your little one to hear how to say the tricky word but takes away the pressure of having to say it themselves.

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‘A’ is for ‘Autovocabiography’…

By Elen Wales - Service Lead for Milton Keynes and Specialist Generalist Speech and Language Therapist, Developing Specialist in Hearing Impairment

Your vocabulary is a product of who you are, where you’re from and what you’ve done. No-one else will have the same vocabulary as you and I think that’s kind of cool. If you imagine all the words you know were written down it would be like your autobiography, your ‘autovocabiography’.

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One of my favourite books, being an unashamed speech and language geek, is Dialects of England by Peter Trudgill. He talks about the different words used to mean ‘truce’ by children in games in different parts of the UK, and has a map labelled with which were used where:

‘Truce’: barley, keys, skinch, kings, crosses, exes, cruces, cree, scribs, fainties

Sure enough my Dad used ‘kings’ in Scunthorpe and my Mum ‘skinch/skinchies’ in Sunderland. 

Most children hear about 45 million words by the age of 3. To develop a typical-sized vocabulary, between the ages of 18 months - 6 years, they need to learn about 8 new words a day. And that’s learn. Not just hear, or be exposed to, or say once, but to fully understand and be able to use appropriately - crikey. 

Vocabulary development is affected by:

• experiences: things we see and do, either in our own lives, or with others

• memory: ability to remember and retain the word

• opportunities: to practise and hear the word repeatedly

• motivation: how important / interesting is learning the word to the child?

• cognitive abilities: any learning difficulties or cognitive impairments

Research shows a child’s vocabulary is one the best predictors of educational achievement and employment. It’s our job, as parents, teachers, therapists and adults working with these kids, to help them write their own autovocabiography.

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'No one else will have the same vocabulary as you and I think that’s kind of cool.'

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So how can we do it, how can we nurture them to be best-sellers? Well, there’s lots of ways and you don’t need a whole load of resources to do it. Firstly, we need to acknowledge that words are more than their spelling. If you want to sound clever you can call it ‘semantics’, but this just translates as ‘word meaning’. The overall goal is to develop a child’s semantic network, or web, of what the words mean and how they link to one another.

Consider the word ‘spoon’. We know that:

• it has 1 syllable and rhymes with ‘moon’

• it can be made of metal, plastic and sometimes wood and come in a range of different sizes

• it is in the same family as the words ‘knife’ and ‘fork’, and that word family is called ‘cutlery’

• we use a spoon for eating, stirring, measuring and serving

• it has a handle part and bowl part, and is normally hard and sometimes shiny

• spoons are often in drawers in kitchens and on tables or in hands in the dining room

• the word can also be used as a mild insult implying someone is stupid

 Imagine a word like a spider on a web in the brain. When the spider has a strong web, and is linked to lots of different information about the word, if the child forgets a few of these links the spider is safe and web can still hold the spider in the brain. If the spider has a weak web, and is only connected to a few bits of information about the word, then if these few bits are forgotten the web cannot hold the spider and he falls out of the brain:

To build strong webs we need to approach the word and learning process from lots of different ways, utilise the power of repetition and keep it fun. You can try the following:

• ‘Word of the Day/Week’: stick it on the fridge as reminder for them and you, see who can use the word the most, maybe keeping a tally on the fridge as you go

• Read: support the child to read, read to them, get them to track the words as you read them - it’s all good

• ‘I-spy’: play I-spy but instead of using clues about what letter the word begins with, use information clues, e.g. “I-spy something made from metal…found in the kitchen…we can use to eat with…”

• Word stickers: It is notoriously hard to get kids to do extra work outside of school, but a bit is better than nothing. I send kids home with stickers on which have a word we have been working on, and if parents only have time to ask the kids why they have a bizarrely large sticker with a random word on, on the way to the car, then it’s a good start.

• Make it multisensory: turn it into a cheerleading song, e.g. “give me an S…S!...give me a P…P!...” 

• Word associations: start with a word and the next person needs to name something related and continue around everyone, e.g. ‘spoon - soup - bread - butter - cow - black and white - newspaper - book - paper’. Because everyone’s word webs are linked in different ways, it’s always surprising when someone links something to a word you never would have!

• Don’t give all the information straight away: cajole them into a conversation with you, e.g. rather than saying “I went to a party at the weekend”, just offer a teaser such as “You’ll never guess where I went at the weekend…”

Lastly - don’t underestimate the capacity of these kids. I’ll never forget the time a 5-year-old boy, with a language delay I might add, used the word ‘googolplex’ in a session with me. It took me a good few seconds to pick myself up off the floor and dig around in my brain for a vague meaning of the word, which I recognised, but would never have remembered to use. I’ve now listed him as co-author of my autovocabiography - I’m hoping it’s going to be a best seller.

Trudgill, P. (2000) Dialects of England, 2nded. Wiley

Social Stories Help Reduce Anxiety in Children with Autism

By Sarah Kassam-Hirji - Speech and Language Therapist

Social stories are exactly what their name suggests; very short and simple stories that illustrate a particular social scenario, often in picture format. They aim to help increase a child’s understanding of how to behave and what is expected of them in a given social situation. 

Visual strategies are highly effective tools to support language skills, and social stories can provide support to help children who struggle in social situations. Examples may be using a social story to help a child line up, lose a game or stay in bed through the night.

It is important for a social story to be short and focused to keep the child’s attention. They are frequently used with children on the autistic spectrum to help them understand social cues and reduce anxiety, especially in unfamiliar settings.

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A social story should provide the basics of what will happen in that setting/situation, and how the child should ideally behave. The idea is to write out exactly what happens and why, how it makes the child feel and the expected response. Symbols are used to show these language concepts, but for some children it can be useful to have photos of themselves in the situation as well.  

As with all things in life, there will be unexpected variables that a parent/caregiver won’t be able to control for, but the story should provide a basic foundation of support and understanding.  

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Key points to remember when writing social stories:

• target one specific situation at a time

• keep language simple

• keep it positive

• remain consistent

• Children thrive on repetition and learning takes time

My experience has been that all children with language difficulties benefit and respond really well to the visual cues and prompts that are provided within each story. We all struggle at times with how to behave in social situations and social stories can help give a child the ability to maintain emotional wellbeing as stress and anxiety are reduced when understanding increases.

A story that I have used time and time again with my children is ‘When I’m Frustrated’. Please note that the word ‘frustrated’ can also be substituted for ‘cross’, ‘upset’ or ‘mad’ – whichever the child will relate to best. The story helps support understanding of the emotion of anger and has been useful across many social situations.  In general, emotions are difficult to understand and explain, and stories that help target emotions in relation to stressful scenarios can be very beneficial.

This story in particular illustrates the idea that sometimes situations will make us feel upset or angry, but there are different strategies that we can use, such as counting or breathing, that can help regulate our feelings once again. This then helps us return to the social situation and ask for what we need.  It also shows that these feelings pass and that we will feel better soon enough.

As a wellbeing expert and speech and language therapist, this is a vital story for me to use with children that struggle with maintaining and regulating emotions when social situations become highly stressful for them. I believe stories that help children understand emotions can really impact how much a child continues to be motivated for peer engagement. This can then help develop other key skills such as turn taking and problem solving.

*Edited blog post

The colour of language! Making language colourful

By Carolyn Fox - Service Lead for Hearing Impairment & Specialist Speech and Language Therapist in Hearing Impairment

What is colourful semantics?

Speech and Language therapists work with children who find communicating tricky. This may be because they can’t produce some speech sounds, understand social rules for interacting or perhaps they have trouble putting words together to form sentences. Your speech and language therapist will be able to give you information on how to support your child’s language using different strategies. In this blog however, we will look at one therapy approach used by many speech and language therapists, Colourful Semantics (CS), created by Alison Bryan. Have you heard of it? Perhaps you and your speech and language therapist are already using it or some of its principles.

CS uses a colour coding system to highlight words within sentences. Splashing words with a little bit of colour helps children identify them, increases the predictability of what is coming next and makes it more likely that they will, after enough practice, be able to independently make the sentences following the colour coding rules.

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Let’s paint the scene for you

Having visual information helps children tune in to what they see as well as what they hear. Using colour gives children an additional hook to pin the language on to while they learn, providing them with the language boost they need. 

Still a bit blurry? Let’s paint a sentence for you!

Carolyn is eating an apple at home.

There are different parts that make up this sentence:

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Why we love colourful semantics

• Giving your child a structure for supporting their word order can help them express themselves and it will also help when it comes to writing. We love CS because it offers an easy to use way to do this. One colour follows another, so your child can do this themselves once they have learnt the colour coding rule and then you can check together that the words are in the correct order.  Using a sentence strip like the one below can prompt your child to put the pictures in the right order:

• This approach to language learning can be used at almost any stage. Your little language learner might just be starting to understand the concept of ‘who’, perhaps they are putting two words together or they may even be constructing more complex sentences. CS provides a flexible approach and can help expand your child’s sentences regardless of where they are on their journey. 

• You can spend time focusing on the important concepts such as ‘who’, ‘where’ and ‘what’ before you begin putting sentences together. This can be lots of fun and ensures your child has a good grip of these concepts before moving forward. For example, if you are teaching your child ‘who’, take a blank orange (the who colour) sheet of paper and find lots of different pictures of people or animals. You can have fun cutting these out from magazines or looking through family photos. As you look through the pictures place them on the orange card. It is important to emphasize the words ‘who’ and ‘orange’ so your child makes the link between the two as this will help with sentence building later. You can say things like ‘Who is this?’, ‘It is grandma’, ‘That is who it is’, ‘Who is orange, I will put it on the orange card’

• You can follow the method described above for ‘who’ with all the different coloured parts of a sentence e.g. ‘doing’, ‘what’, ‘where’. Once your child is confident, you can mix up the pictures and see if you can sort them on to the right coloured cards. 

• CS not only helps children learn the sentence components and construct sentences, it also supports them in understanding questions and asking them. Whilst using this approach, as you emphasize the key words and colours, they will learn to pay attention to questions e.g. ‘Where did she go?’, ‘Can you find the blue word?’, ‘That is right’, ‘she went to the cinema’, ‘you found the blue word’, ‘where’.

• You can get as creative as you like! Once your child is confident, help them to expand their vocabulary by prompting for alternative orange, green and blue words. This will teach them that sentences change and are flexible. They can explore sentences and change words all within the safety of this neat colour system! Eventually this will support storytelling, making up alterative endings and beginnings and helping them order their story!

• Get a little silly! An important part of learning language is to make sure it is as fun as possible. We all learn the most when we can have a good giggle. Have words for each part of the sentence written on different coloured card that your child can chose randomly, then following the order of the colours, they can make their own silly sentences. 

Need more inspiration?

If you would like any more information on how to use colourful semantics or think it might be a useful approach for your child, then why not contact one of our therapists at Magic Words! 

Have fun!

My Love for AAC (Augmentative and Alternative Communication)

By Melissa Mcilhiney - Highly Specialist Speech and Language Therapist and Complex Needs Specialist

When training as a Speech and Language Therapist you learn about AAC (Augmentative and Alternative Communication) methods in lectures. I have always been a more visual and hands on learner than one that can sit in a lecture theatre and take in what it being said.   So my love for AAC did not begin straight away but has evolved over the pathway of my career. It has shaped the therapist I have become and the type of client group I specialise in. This may sound cheesy, but it gave me a purpose and a role doing something I love. 

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When I was at university I was adamant I would be working with adults on stroke wards or on the head and neck cancer wards in acute hospital settings. How wrong I was! Don’t get me wrong, I had placements on both of these types of ward and I did enjoy them and learnt lots, but this type of work just wasn’t me. To this day, I can’t really explain what was missing from either of these fields for me. I then went on a placement in a DSP (Designated Specialist Provision) attached to a mainstream school I knew this is where I belonged.  I was placed with an amazing Speech and Language Therapist called Sue. She showed me a completely different way of working. I learnt Makaton (signing), was introduced to visuals such as visual timetables and ‘now and next’ boards. I was encouraged to use all of these within my practice with the children I was working with. It was here that my love for AAC began and my career pathway totally changed.  This placement impacted so much on me that I walked away knowing that kind of setting was where I wanted to be. To this day I don’t regret that decision one bit. Seeing the way children can progress and communicate with others, become more independent with their communications and seeing things individualised to each child’s needs lead me to start applying for Specialist Provision posts.  

As a newly qualified therapist you don’t normally even start thinking about a specialism, but I had no doubt that I was taking the right route! It felt natural. So, I applied to a special school and got a job in an MLD (Moderate Learning Difficulties) school working in an Autism base. Here my love for AAC continued to grow. I was introduced to PECS (Picture Exchange System) and we used this daily to take a very functional approach to communication. We used regular visual aids and worked on sensory difficulties at the same time. Therapy there took a very holistic approach and to this day my therapy style is still very holistic. This holistic view of therapy is now supported by the Department of Health and research supports the premise that looking at the child as a whole results in the most progress in their development.   

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I’ve been involved in a few cases where we had to use PECs and visuals to support the communication of children who were going into hospital or in one case had to be interviewed by the police. I remember people saying, “they won’t be able to tell us what they have seen”. How wrong they were!

This role marked the beginning of my dedicated mission to ensure that all children have a “voice” whether via signing, PECS or another method. I was adamant that every child must have a way to communicate. We just need to find the method that works best for each individual child. We know that not everyone is the same and communication (and aids) need individualising around the child’s needs. For example, A child with Retts syndrome who can only eye gaze will need different aids to a non-verbal ASD child.   

After the special school placement I joined the NHS for 6 years and worked in mainstream, pre-school special needs and eventually ended up back in special schools, my most loved environment to work in. I continued to use all different types of no and low-tech AAC devices here and then saw another therapist introduce an electronic aid with a child. I wasn’t directly involved with the child but it sparked my interest and another branch to my love for AAC started to develop. 

I remember sitting in front of the TV one night and seeing an interview with the late Stephen Hawking. I listened intently to every word he said. Not because I understood a word of what he is was on about (quantum physics is just not my thing!) but because I was astonished by the hi-tech aid he was using. The way he was controlling it through eye movement and how quickly and intricately he could explain black holes!  I then got really into researching his story but also the other types of hi-tech aids like Stephen’s there were out there ranging from I-pads to eye gazing machines.  In looking into them I realised that I had children on my caseload these would benefit hugely. We started putting them into the therapy of two children on my caseload. They made amazing progress! I have continued to use these types of aids with suitable children on my caseloads ever since.  

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Children are a lot more tech-savvy nowadays. A child on my current caseload was introduced to his aid last term and within days was able to order exactly what he wanted in Pizza Express without having to rely on an adult interpreting his wants and needs as he always had in the past. Children do not normally catch on to their new aids this quickly, but seeing how well children can progress with the right equipment makes this job worthwhile and again highlights the importance of giving each child their “voice”. 

Can you imagine living in a word where someone else speaks for you? Interprets what you want, what you need? Where you literally have no voice? To me this would be the ultimate nightmare and for the children I work with it leads to extreme frustration and behavioural issues. AAC methods give individuals a lifeline, a way of being able to communicate with others without requiring another person to interpret for them. It decreases frustration and most importantly gives people their “voice”. Research supports the use of AAC devices and has shown that using them increases the use of spoken language. Some parents are scared that AAC devices will replace speech this and from my many years of experience this is not the case. But that’s a whole other can worms that I will certainly open in a future blog!  

"I can’t think of a more rewarding job than giving someone their “voice”. And that is why I love AAC and my job"

HAS THE WORLD OF SOCIAL MEDIA CREATED A WHOLE NEW GROUP OF HEALTH & EDUCATION PROFESSIONALS?

By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

Early Intervention is Key

Who Am I?... My Reflections...Reality

I have been a practicing Speech and Language Therapist for over 20 years; and an Author; a mother of two crazy boys aged 18 months and 5 years. Oh, how my practice changed overnight seeing the other side.  Before eyebrows would be raised if patients were late or if homework was not done but seeing the other side of the coin of what parents must do in their daily routine opened my eyes.  I simply ‘’’respected my parents for getting to the appointment to support their child. I remember the first day back at work I saw a child who had transferred to our Trust the child’s mother had left; the father had special needs and the child was severely Autistic and nonverbal at 4 years old.  The family were homeless; as soon as they left the clinic, the waterfall of emotions took hold.  Suddenly it was not about the hour in clinic supporting the child’s communication it’s the reality of what the parents experience 24-7.

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My degree was intense but fascinating. I am so blessed to have worked with such wonderful children and amazing parents.  I once read “A child with special needs does not come with a manual... it comes with a parent that does not give up”.  I studied for over 3 years too gain my qualification as Bachelor of Science in Clinical Language Studies (Speech and Language Therapy).  I studied so many modules within the course, Child development, child psychology, neurology, various therapy models etc. I was fortunate to work in the NHS system for over 20 years and gained so much knowledge, skills and experience which I feel so grateful for.  I left public sector in 2017, and now work independently.  This was an extremely hard decision to make but I have enjoyed life post NHS so much.  The flexibility to not follow unrealistic expectations, KPI’s, endless growing waiting lists for assessment and therapy.... to give the family the type and frequency of intervention they REALLY need, which makes a difference... and quicker.... Early intervention is key.

Has Social Media Made A New Breed of Health Care &Education Professionals?

 I have been following various national and local groups on social media for parents. It’s a humongous network that supports parents in so many ways, from advice on sleeping, toilet training, weaning, behaviour, chicken pox, and overall development etc. There is nothing like having support from another parent about what they have gone through.  For many parents this is the first point of call.  Within the network there are parents who are Health Care Professional too.  It’s that comfort factor, to put the anxious parenting mind at ease.

My Concerns... Because I Care

Recently I have started to get slightly alarmed with some responses especially regarding communication development. Over a year ago I saw a parent who came to me when their child was 3 years old, it was evident this child had severe communication needs. I asked the mother when she started noticing when things were different the mother replied from 10 months old.  I asked why she waited so long, she reported she followed advice from her NCT friends and other people to just let him develop and in time the child would talk. The mother missed 18 months of vital intervention which would have made such a difference. I’ve seen this on several social media posts recently when people are asking about communication advice, a child of 2 years SHOULD be talking, if there are not they need support. Please see the ages and stages section on my website: www.tlc-speechtherapy.co.uk. Using the wait and see approach can miss vital months of support. Also, children have come to me at 4 years old with severe stammers, they started stammering at 2 years old.... why refer now? The parents said they waited as they thought the child would “grow out of it” .... no… again Early intervention is key. If you are concerned particularly about your child’s communication consult your Children’s Centres, GP’s Health Visitors, Early Years consultants, they are all very experienced, and they will always support you in the steps to taken.  Always remember the walk-in clinics and 111.

I see so many pictures of children’s rashes and suddenly the world of social media can be quick to diagnose, but in a quick snapshot post there is no medical history taken how can advise be given on what to do, when the child’s rash may look the same as what your child had, but the child may have other health concerns or allergies to take into account.  A parent has the most unique gift called “Gut instinct” parents never under estimate this. You know your child more than anyone in the world, if you think there is something wrong.... see a professional.  Please do not wait.

Use Your GUT instinct... Don’t Always Wait and See....

I guess what I’m trying to put across is although there is a place for support on social media... and some useful articles and advice, please be vigilant... The people of social media are not all qualified Health Care Professionals, go with your gut instinct. Also remember Early Intervention is key.  Certain advice I have seen from members on groups goes against what we practice as clinicians and concerns me. Medical and development histories are very important in the treatment and diagnostic process.

Keep doing what you AWESOME parents are doing.... it’s the best gift in the world being a parent and it’s our job to make sure our children stay happy and healthy.

The wonderful world of Pablo!

By Danielle Allen - Service Administrator

Autism Spectrum Disorder (ASD) is still a disorder that is vastly looked over. It is a complex disorder that has a variety of levels from mild escalating up to severe. Luckily today, although overlooked, people are becoming more aware of it and that it isn’t just a child misbehaving in the supermarket. As a mother I have found it hard trying to explain to my children why other people may act or look a little different to them and have found it such a relief that Cbeebies cover a wide range of disabilities and disorders in their TV shows or with their presenters. From previously working in an NHS setting providing paediatric training and now working in a Speech and Language Therapy setting for paediatrics, I have had some exposure to ASD children, but it wasn’t an area I was particularly knowledgeable in until doing my own research and then discovering the Cbeebies show Pablo which was released late 2017.

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After work I often join my children on the sofa for a cuddle and to relax to the sound of the TV in the background whilst they tell me about their day at school. It has become routine now that once I get in we will put on Cbeebies for the 5.45pm show of Pablo. This is incredibly child friendly and explains in a simplistic way about the many troubles someone who has autism could be experiencing and why they react the way they do. Even with Pablo's autism being as mild as it is, the programme helps outline what autism is. Not only is it informative for the child watching but also for us as the parent or carer. In the show each character represents a different area of autism and although all those who have autism do not necessarily show all areas of it, it is a guide to and broad representation of autism.

• Noa the dinosaur is great at problem solving but finds it hard to read others facial expressions

• Llama loves to repeat things others say and has a keen eye for detail

• Draff the giraffe loves to learn facts and is often heard saying “in point of fact”

• Mouse doesn’t like loud noises or crowded places but is very organised and is also a perfectionist

• Tang the orangutan is hyperactive but also isn’t good at reading social cues or other people’s feelings

• Wren often is seen flapping her wings to calm down, she also lacks concentration and is easily distracted

Many parents and others who have ASD have praised Cbeebies on social media since the premiere of the show in October 2017, leaving comments on Twitter such as:

 'My son Jaime is Autistic and I firmly believe that exposing children early to Autism and Autistic behaviour helps children become more accepting of their Autistic peers. Can't wait to watch the show with the little ones.'

 'I'm so happy you've done this there is hope for awareness :)'

‘I never thought I'd reach that point in my life where I started watching CBeebies again without kids. But, being like him, I am just compelled to watch #pablo. And after a few months, I just feel I have to say, @CBeebiesHQ, you done good. #ActuallyAutistic’

‘Pablo is the most moving, un-politically correct & realistic show 4 #Autism makes me cry!’

Another parent simply posted 'This is just so good I could cry’ with a variety of crying emojis.

It is amazing that something as simple as a show can have such a positive impact on the ASD community and help spread awareness in such a creative way that is easy to understand and enjoyable to watch. What makes the show even more remarkable and relatable is that the young boy who plays Pablo is an ASD child himself! We have seen Cbeebies do this with many topics, Justin Fletcher’s shows for example, Something Special being a prime example for making children aware that everyone is different and special in their own way. Even though my children are still very young at the ages 3 and 5, I am glad they’re getting exposure to the disabilities and difficulties of others through the shows they see on Cbeebies, unlike my childhood growing up where there was very little exposure.

So as a mum of two, I applaud Cbeebies, they have a household of Pablo super fans! I’d also like to applaud them with their wide range of shows exposing children and families to the different cultures and disabilities that are in world around them, I’m sure I’m not alone with that thought!

Have we forgotten how to play?

By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

Looking back at my fond childhood memories of growing up in Macclesfield, Cheshire, us kids had a fantastic time playing with friends and family.  In those days it was safe to play on the streets in the neighbourhood; hide and seek, water fights, hand stands, chasing friends, chasing balls and annoying my older brother whilst he and his friends jumped over cans with their skateboards.  Those were the days... fun...carefree... days filled with happiness and laughter. We didn’t need mobile phones for our Mums to monitor our whereabouts, we would just run to the command “dinners ready!”.  When we were indoors we would eagerly wait for a knock on the door and a “is Suni allowed to come out and play?”.

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Reflecting on these treasured days of my childhood I feel very aware of how much things have changed since then. Now that we are so governed by social media, tablets and technology.  It is not just the influence of this technology but also how safe we feel our children are to have the freedoms we enjoyed. I know that bringing up my own children in Harrow I would never even let them out the front door without me by their side.   

The question I really feel we need to ask ourselves in our modern world of tablets and consoles is whether we as a society have forgotten how to play. We are bombarded with marketing for so many different types of toys and games, but as a parent wanting to choose toys that will enhance your child’s development; what do you choose?  As a mother myself being exposed to the world of children’s toys I find that there can be such a pressure to choose toys that help my children’s learning of letters, numbers, shapes, colours, handwriting... the list goes on! I find myself wondering whether 3 year olds really need to know the names of all the planets in the solar system or all the names of the bones in our bodies? There seems to have been such a shift towards play being a tool for developing our children’s academic abilities that we have forgotten what is really important.  We need to get back to letting our children just be children! Let them play, get messy, have fun and use their imaginations!

How often do you actually just sit on the floor and play with your child? Are you able to switch off your urges to encourage your child to be focusing on learning and instead to simply let go, follow your child’s lead and pretend to be a fairy in a grotto with them or a wizard battling through an enchanting forest? 

I am not saying tablets and watching TV should not play a part in children’s lives. I know myself as a full time working mum arriving home late that there is that moment of peace you get when they are watching a favourite movie or playing on their tablets so you can just get all the household tasks  done!! Also in today’s technology focused world our children do need to be able to use t technology adeptly in order to be able to compete in the job market when they grow up.

We need to consider what we are exposing our children to. How much opportunity are we giving them to develop their social interaction skills, imagination and ability to communicate using language? To best achieve this, tablets and the TV need to be switched off and we need to play with our children and interact with them in a fully conscious way.  There are some great board games available which develop vital skills such as turn taking and interaction and children just love to win! Most importantly these games are about having fun together, about children laughing when their parents are silly, fun and play their games... Even if you’re not following the ‘adult rules’ of how things should be done.  It’s all about letting go and sharing the play experience with our children.

Sometimes when I look at my boy’s playroom it looks like Toy-r-us has just thrown up in there!  The best thing I did last year was to put all my their toys in the garage in boxes and called this their ‘toy shop’. My elder boy aged 5 is allowed to go in there once a week with his little basket. First he returns last week’s allowance of toys and then he chooses a new selection of toys that he will play with for the week ahead.  This ‘toy library’ system has made him appreciate his toys more, encouraged good behaviour in return for treat days on weekends, and promoted much more  excitement about always having something new to play with.  Most importantly from my perspective this scheme has improved his concentration skills. He is far more engaged with the toys he’s playing with as he has fewer toys to flit between.

A helpful thing to remember to do is to take a step back and think carefully before spending money on expensive toys for your children. Instead use your imagination and think of activities you can do together to help develop your child’s imagination and interaction. Things like making dens, playing dress-up and magical tea parties with dinosaurs and fairies.  Take time out to bake cakes and cookies with them; it’s motivating, fun and can really bring on their language, confidence and life skills.

There is such an emphasis placed nowadays on parents needing to DO THINGS and SPEND MONEY with on children like taking them to various experiences and activity centres. It’s so important to find balance with this kind of thing.  You don’t want your child getting so used to always going out to be passively entertained that when they are at home you are unable to have fun as a family. Try having fun with music and books; using interactive story telling and acting out scenes using funny voices for the characters.

Research is showing that today’s children are developing their play and imaginations skills later than children in the past. Also children’s lung capacity is decreasing and there is a higher instance of asthma. No wonder really as we don’t go out as regularly in the fresh air. This winter let’s wrap the kids up warm and go and pay in the park or the woods.

Let’s spend time with our children. Let’s teach them and remind ourselves how to let go, have fun and use our imaginations. So that when they are adults they treasure the memories they had growing up with their friends and families, having fun and just playing... just being kids

5 signs your child might need speech therapy...

By Frankie Paterson - Director of Magic Words Therapy and Specialist Generalist Speech and Language Therapist, Developing Specialist in Stammering

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How to spot signs that your child might be struggling with speech sounds:

• Your child is non-intelligible to adults who do not know them well

• They miss sounds from the beginning or ends of their words

• The child has a limited range of speech sounds

• They get vowel sounds mixed up

• They have difficulty with multisyllabic words

Early intervention is key, so as soon as you notice any irregularities, get in touch with us!

Who do I turn to?

By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

I have been a practising Speech and Language Therapist for over 18 years and a parent of two lovely boys for 5 years... Wow! How much my practice has changed since becoming a parent and seeing “the other side”!

From the moment you see those two blue lines on a pregnancy test the worrying and excitement starts. It only grows when you have that bundle of joy in your arms and will continue to grow, even when they are an adult (so my mother says).

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As soon as you know that you are going to be a parent life totally changes. Initially there are classes from the NHS and NCT; how to go through labour, what you need to do to care for your child in the early days and months.

Advice floods in (either wanted or unwanted!) from the internet, from books, television, from friends and family. They tell you what you should and shouldn’t do, EVERYONE knows best. You need advice and support with breast feeding, sleep routines, weaning and toilet training...  As time goes on there is an array of fantastic classes for babies, toddlers and children to develop song, rhymes, baby sensory, baby music classes, swimming etc... 

BUT WHO REALLY TEACHES YOU to help your child’s communication to develop?

The same concerns often arise for parents:

“He’s not like his sister... when she was 2 years old she would not stop talking”.

“People do not think he’s clever as they do not understand him, and he is getting frustrated”. 

“I was told her uncle did not speak till 6 years old; he is 3 years old and not said his first word.. should I be worried?”

“My son has started stammering... nobody stammers in my family why me? I have been told he will grow out of it”.

“We speak Spanish at home many chid is 2 years old and has not used any words, people say it’s because he is bilingual and I am confusing him”.

“My son’s behaviour is terrible he just will not listen I am not sure he understands me, his hearing was tested and its fine?” 

“I know I should not compare, but I look at other children in his nursery and I know there is something wrong. He seems so different and does not play with the other children, he just seems in his own world”.

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Have you ever been worried? Are you concerned about your child’s speech and language development? Who do you turn to? Where do you go? What should you do?

DO NOT WORRY AND DO NOT PANIC...

Magic Words is an Independent Speech and Language Therapy Practice working with children of all ages to support and develop their speech, language and communication needs.

We have clinics in Newport Pagnell, St Albans, & Harrow.  We offer home visits, nursery visits and work in schools with Children with Speech Language and communication difficulties. This may include: stammering, voice problems, language delays and disorders, speech difficulties, autism and many more.

Our fantastic speech and language therapy team are specialised to assess your child; looking at the areas of the communication pyramid:

Attention & Listening

Social interaction

Play

Understanding

Use of language

Speech Sounds

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We offer suitable treatment options which are personalised to your child’s needs, and most of all fun and practical.

#Dyspraxia17: What it means for one mum and her son

By guest blogger Jodie Franklin

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Meet Stanley. 

Stanley was diagnosed at a young age with dyspraxia, he was a very clumsy toddler who was falling over all the time, had no spatial awareness, the list goes on. At the age of 3 I simply put these things down to his age, but his speech was just not developing.

As time went on and he joined nursery we could see he was miles behind his peers. He didn't have a friendship group because nobody could understand him. I was embarrassed to say I struggled at times and our conversations consisted of me of me randomly pointing at objects until I correctly guessed what he wanted.

Stanley starting speech therapy was the first big step towards a diagnosis of dyspraxia. His speech problems alongside his other problems began to make sense-- it all came together-- it was like one of those lightbulb moments. We could then start the process of a formal diagnosis.

We continued our weekly therapy sessions and slowly but surely he was improving with his speech.

As his mother I was so moved to see his confidence growing. He started to make friends and even bought a couple of friends home for tea.

I can honestly say being able to communicate with Stanley made such a difference to the both of us. It was not just his confidence that was growing. 

Stanley is 8 now and his speech is not such a hurdle anymore. Don't get me wrong there are many other challenges, like the time at sports day when he tripped over the hurdles and took out three of his classmates on the way down, but the important thing is he can get up smiling.

He knows he has 'praxia' as he calls it and he sees it as a strength. When told by his consultant that he would find something he is really good at one day, his response was: "I already have I'm really good at falling over!"

Then he laughed.

I can not express how proud I am of his amazing attitude to life.

Working with children and parents from diverse communities

By Natasha White

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Are you currently working with children and families from a diverse range of communities? Are you a teacher or teaching assistant who wants to cater for EAL and bilingual pupils alongside a classroom full of children with other needs? Are you a speech and language therapist who needs to brush up on your bilingual CPD?

If the answer is yes, then you should consider our upcoming bilingual training days. 

Taking place in Sarratt (Hertfordshire postcode WD3 6AS) in February and June 2018, Sunita Shah will ensure that you leave with insightful and practical ways of approaching bilingual clients, pupils and their families. She has nearly 20 years experience of working with bilingual children-- so any questions you might have will be welcome! 

The aims of the day:

To understand the requirements to adapt practice to meet the needs of different clients groups distinguished by cultural or language.  This will also be applied to working within a multi-cultural society (paediatrics). 

The objectives of the day: 

• Getting to know your patch, how to collate demographical information.

• To develop and understand a true definition of “Bilingualism”

• Bilingual language development.  Laying the foundations to the development and acquisition of one or more languages. 

• To demonstrate a progressively deeper understanding of underlying theoretical concept and typologies of bilingual language development.

• To able to identify what factors may affect second language acquisition.

• Why a child may mix two languages, and if this is a characteristic of disordered language.

• To identify tests suitable for bilingual clients

• To be able to adapt and develop informal assessment to gain a base line of all the languages the child is exposed to.

• To be able to identify though formal/informal assessment if a child presents with a specific language impairment or limited knowledge of the additional language used within their environment.

• To be able to take an additional case history gathering more information on language use.

• To be able to train and work with an interpreter identifying the skills required by both the therapist and the interpreter.

• How to decide which language to be used during intervention.

• To identify what the advantages of bilingual language development are.

• To identify components of delivering a “cultural competent” service”

• To have an opportunity to develop problem solving when working with a bilingual client using various case studies.

• To collate reading list and reference to further develop skills when working with children and families from diverse communities.  

Alternatively, if you are a parent seeking therapy for your bilingual child and are living in the Harrow area, please contact us. Sunita is taking bookings now!

Bilingualism: Children developing more than one language

By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

I grew up in a bilingual family and was exposed to Gujarati and English from birth, I learnt to speak Hindi watching films and trips to India. I have very basic knowledge of French, Spanish, Arabic, Urdu and Punjabi, which has been learnt through school, and families I have worked with.

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I have two boys…. English is the dominant language at home, although we always use a few Gujarati words. My children hear Gujarati spoken when I am interacting with friends and family. The oldest that is 5 years old understands a few phrases and is now beginning to speak a few phrases. This is to my total embarrassment as I have been a practicing Speech and Language Therapist for 18 years and 15 years of my practice I has specialised in working with bilingual children and families and developing Early Years Settings, Schools and Speech and Language Departments nationally to encourage children to develop more than one language. How services should support and identify bilingual children who have learning needs or underlying communication difficulties. I have been the Chair of the London Clinical Excellence network for a number of years and also the National Advisor for the Royal College of Speech and Language Therapist in Bilingualism.

BACKGROUND

Did you know 75% of the world is bilingual? And there are over 6,000 living languages in the world. In London Schools over 200 languages are spoken.

Do you speak another language? How did you learn the languages you speak? Was it from birth? Is it the school you went to? Or a country that you lived in? How fluent are you in the language/s you speak? Do you children speak and understand the language/s as you?- wow lots of questions….

BILINGUALISM – A simple word yet such a complex term. How would you define bilingualism?
Is it?
The level at which they understand language?
The proficiency of the language spoken?
Should this extend beyond oral language reading/writing?
Is it dependent on the frequency/context of language use?

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HOW DO CHILDREN LEARN AN ADDITIONAL LANGUAGE?

Many families disregard teaching their children an additional language, thinking it will confuse them…. THIS IS THE TOTAL OPPOSITE! Bilingualism has sooooooo many ADVANTAGES to the cognitive and language system which we will explore later.

So how do children develop another language? Well if you think about it an Elephant will ALWAYS be ‘big, grey with a tusk and trunk’ no matter what language you speak, you are not changing it into a tiger!, we have to always remember that children will bring their knowledge and experiences as a joint system when developing languages. An elephant will always be the same, so when a child is learning more than one language they are not learning two features just one… the only thing is in English we call it “Elephant” and in Gujarati for example it’s a “Hathi”. There is always a common underlying proficiency, (Work of Jim Cummins 1984:2001).

STAGE 1
Words
Initially the child develops an understanding of words e.g. 'chair' (= 'sit on it'). Then they develop a name 'label' (vocabulary), which might include names of objects from all the languages the child hears

STAGE 2
Sentences
When making sentences, children use rules to help them put the words together. The bilingual child initially only has one set of rules. Your child may mix rules from both languages or use the rules from the language he/she hears most. This stage makes the child's sentences sound incorrect or confused

STAGE 3
Competency
Develops when the child separates the vocabularies and rule systems for the two languages.
The child may also mix the two languages in one sentence, this mixing is a normal and acceptable feature in bilingual language development.

VOLTERRA/TAESCHNER 1978

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ADVANTAGES OF BILINGUALISM

There are many advantages to being bilingual… here are a few
• Bilingual children have found to have a higher IQ
• Increases academic potential
• Have increased self esteem
• Think more creatively
• Find it easier to learn other languages
• Bilingual children have better reading abilities
• Communicate with a range of people
• Job Opportunities
• More empathetic

I think one of the priceless and most precious things that being bilingual has given me is the ability to communicate with the elder generation… it’s been magical being able to communicate in the same language as my grandparents listening attentively and learning so much about their past, their experiences, and life teachings. Something I treasure immensely.

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TOP TIPS TO BILINGUALISM

• It is important that you continue to use all languages introduced to the child.

• Do not be concerned about mixing different languages in one sentence. This is natural for a bilingual speaker.

• The focus should be helping the child feel successful in giving and receiving a message. Continue speaking your chosen language/s to your child even if he or she speaks back to you in a different language. If the child responds the message has been understood.

• Use short phrases with lots of gesture and facial expression, as well as expression in your voice. This will help the child understand the meaning behind the words.

• Do not tell your child “answer in XXX Language”, this puts additional pressure on the child to communicate and the child may develop anxiety or refuse to communicate.

• Do not only use one language, its natural for bilinguals to switch between languages, be as natural as possible with your communications.

• Avoid one language one environment, one language one person scenarios. Communication should be free and natural for it to give the child consistent model in the home environment to learn.

• Remember it’s All about exposure to the language if you do not speak the languages in the household they child may have exposure from grandparents.

• Encourage your child’s attempts to communicate in either language, giving lots of praise.

• Use nursery rhymes and stories from any culture/language

Makaton: signing your way to successful communication

By Eleanor Harris - Director of Magic Words Therapy and Specialist Generalist Speech and Language Therapist

Want children to understand you better in the classroom? Increase your gesture and use key word sign!

As a Speech and Language Therapist working with children with Speech, Language and Communication Needs (SLCN), I use key word signing whenever I speak to my clients to help to support their understanding. I also use key word signing to scaffold their spoken sentences, cueing them in with sign for the next word or idea in their spoken sentence. 11 years of experience tells me that this works really well and benefits the children, but what is the evidence to support this?

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The answer is that there is a lot of research that confirms my clinical experiences – there is a neat summary of this evidence here. 

Why does it work?

Imagine you can’t hear at all, or you can hear but you can’t make sense of the sounds you are hearing, as though you are hearing an unknown foreign language. You can see your teacher is talking, but her hands are still, and her face is expressionless. You don’t understand one word of what she says. You feel a rising sense of panic, what are you supposed to do? Everyone is looking at you. Your body begins to go into fight or flight mode. You don’t know what is expected so you have an emotional reaction. Perhaps you freeze, absolutely terrified. Perhaps you hit the table and run from the room. Perhaps you internalise this feeling of panic and never want to communicate at school again.

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Now imagine you still can’t hear or process the sounds that you hear, but this time your teacher is pointing at the things she is talking about AT THE SAME TIME that she says the word, for some words she is doing a SIGN at the same time that she says the word and the sign looks like the object or action. She is gesturing where things start and finish and she has a really expressive face so I can tell when her words are a question rather than an instruction, and I can tell how she is feeling when she says them. As she signs each key word, her speech is slowed down, giving me a chance to process the sounds and words a bit better. I understand 2 or 3 pieces of information from each sentence, I am learning what some words mean because the sign is said at the same time as the word, I learned a new word because the rounded circular outline you just mimed with your hands when you said the word ‘balon’ gave me a clue to understand that it means ‘ball’. I can see you want me to put the ball in a particular place behind me, I can tell because you pointed there after you said ‘balon’. I feel comfortable, I know what to do, I’ve learned new words and I achieve success. I want to communicate again next time.

We know key word signing and increased gesture doesn’t just help SLCN children, but also helps an increasing number of English as an Additional Language children in our schools, as well as typically developing children – listening to a person that uses more gesture is much easier than listening to a person who stands still and expressionless.

For further information on MAKATON, take a look at their website

Brick by Brick

By Natasha

Those familiar little bricks are being put to extraordinary use.

Originally developed by Daniel B. LeGoff (a neuropsychologist), who saw the mighty potential of this humble brick, Lego® Therapy has grown into a motivational practice used by speech and language therapists, teaching staff and parents alike.

It is believed that the name Lego® was adapted from the Danish phrase for ‘play well’. Certainly for many children, the ability to play and interact within social settings seems perfectly natural: it is a skill we often take for granted.  Although, there are also children who find the strategies needed for peer interaction less accessible. Intimidating, even.

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How can a child learn to socialize in a safe and supportive environment?

Our method: Lego® Therapy!

At Magic Words, we use this play-based approach to facilitate children toward ''communicative competence'' (Ralph and Rochester, 2016), depending on their individualised targets. Whilst some might need to work on maintaining eye contact and attention, others might attend the group to aid understanding of prepositions, problem-solving or sequencing.  

The aim of the game is, of course, to build a Lego model. This can be a simplistic or as complicated as you need it to be, according to ability and attention span of the group. The roles that we use are:

• Builder: constructs the model, listens to the architect

• Supplier: selects the bricks at each stage, listens to the architect

• Architect: holds the instructions, describes the bricks to the supplier, instructs the builder where to put them

• Facilitator: identifies problems and supports the group with solution

If you have limited numbers you do not have to include every role. Pick them according to the child's targets. For example, if the child struggles with listening you may wish to encourage them by letting them be the builder; they have the motivational reward of receiving a brick and putting it in place. Alternatively, if you have a child who needs to practice describing and ordering key words, the architect role would be an option.

In addition to the jobs, we establish a set of lego-rules to encourage 'model' behaviour. Depending on the age of the group, this could be a clear-cut as good sitting, good looking, good listening, and good talking. Lego® points can be rewarded to acknowledge their participation.  

Once the adult has explained each rule and role, they must aim to 'gradually step back and allow the participants to work out social solutions more independently as the intervention progresses' (Ralph and Rochester, 2016). It is hoped that at some point each child will become their own facilitator and navigate social interactions with the same skill they require to build a collaborative model.

One parent, whose child attended Lego® Therapy sessions at Magic Words, explained how her child began to generalise his new awareness:

“He has understood what good listening is for the first time. He now understands why we need to listen and what we need to do to listen well. This has really helped him access small group activities and to concentrate. His eye contact which was a major problem area for him has also improved as a result of understanding that looking is important as it helps people know you are talking to them. He has thoroughly enjoyed the activities and it has also increased his interest in Lego which he is playing with much more outside the group. I think it has also improved his social skills generally...” 

With the motivation of Lego® and the naturalistic setting of a play-based task, this child was able to access a level of social interaction, that he had previously not understood the benefits of.

It has certainly become apparent that this therapy is versatile and accessible approach for those with social, communication and language difficulties. Carolyn Green and Elen Wales, two of our very own therapists, remarked in their article 'Building Lego, building language': 'Several parents expressed that Lego Therapy offered intervention where the alternative would have been to not access sessions at all' (Bulletin, November 2016). 

Consequently, what does Lego® mean to the therapists at Magic Words? 

Lego® Therapy is a impressively straightforward and structured approach that allows for a great variety of skills to be modelled, practiced and repeated. It allows a therapist, teacher, teaching assistant or parent to incorporate a diverse range of targets under the guise of play. It allows the children who participate to have fun, to collaborate, to build their skill set brick by brick.

To learn more about Lego® Therapy, please contact us.