Apps for Online Speech Therapy

By Magic Words Speech and Language Therapist, Susan Woodley

At Magic Words Online our online speech therapy platform has a fantastic range of built in communication apps. Here’s a selection of the apps we use in our online speech therapy and a bit about how they can help with a variety of different communication difficulties.

Auditory Workout

This app looks at following instructions and is recommended for use with children aged 4-10. It helps develop children’s key word understanding of language and understanding of concepts such as prepositions (positional language), size and colour. There are over 1000 different instructions on the app, meaning it can be tailored specifically to a child’s needs.  It uses engaging colourful pictures and with every correct answer the child earns a basketball. Once the child has earned 5 basketballs, they can play a game!

Articulation Carnival

This is a great app for children with speech sound difficulties. It can support children at every stage of their speech sound therapy. From working at producing the sound in words, phrases and sentences. The therapist can go through flashcards relating to the target sound or can play a memory game with the client.

Social Skills with Billy

This app can be used to help develop social skills, so is useful for working with our clients that have ASC (autistic spectrum condition) or social communication difficulties. You can work through social situations with the main character Billy, working out what are the appropriate things to say and do. There are over 100 real life situations to work through: birthday parties, going to the doctors, family dinners and so many more. Using this on our online therapy platform give the therapist and the client the opportunity to discuss the situations and the responses too.

Comprehension Aphasia

We also have apps to use with our adult clients. Comprehension Aphasia is an app designed for use with clients with Aphasia, central auditory processing disorder and Autism. It looks at understanding of yes/no questions and following directions with increasing levels of difficulty. It also has the option to have background noise, helping create an environment that simulates the difficulties our clients face in real life.

Wh- Question Island

This app can be used to work on children’s Blank Level understanding. Blank Levels relate to understanding different types of questions. The app starts with ‘what’ questions and progresses all the way to ‘why’ questions. It can be adjusted to the child’s level of need; with either multiple choice questions or the child giving the answer to the therapist. Using the app online gives the child the opportunity to discuss their answer and improve their understanding of the questions even more.

Magical Concepts

This is a fantastic app which works on understanding of language concepts such as same/different, positional language and size. It also works on understanding of describing words and emotions. This app uses photos to help develop children’s understanding in a real life context.

Syntax Workout

This app works on children’s use of spoken language. It focusses on grammatical elements that children with language disorders or autism may commonly find difficult, such as pronouns (he/she, his/hers) and function words (is/are). This uses a mix of photos and pictures with sentences for the child to complete

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If you’d like to know more about online speech therapy and how it could work for you just get in contact and one of our expert speech therapists will give you a call to discuss your needs and what we can do to help you achieve your own personal communication goals.

We Love Stories: We’re Going on a Bear Hunt

By Speech and Language Therapist, Charlotte Twelvetree

Book Details:

“We’re going on a bear hunt. We’re going to catch a big one. What a beautiful day. We’re not scared… UH OH …”

Anyone who has read this book will be singing this line in their head the same way that I did whilst writing it! In fact, this catchy, rhythmic, sing-song pattern is one of my favourite elements of this story and is what makes it so brilliant for helping develop language and communication in children.

I also love the variety of ways this book can be read and how it can be used in different environments.

It has an element of nostalgia for me on a personal level. As a child I can remember so clearly the excitement of going to the local library with my Mum to borrow this book. It was even better when they had the supersize version available!

Here are a few of my favourite ways to use this wonderful book:

Creating opportunities for communication:

The repetitive nature of this story can be used to create opportunities for children to communicate in any way possible. You can use pauses in repetitive phrases to allow your child to ‘fill the gap’.

Your child will then have the opportunity to complete the phrase. This can be done verbally, using vocalisations, communication boards, communication books, switches, a range of high-tech AAC, and signing.

It can also be used to request for continuation of the story because of the predictable adventure which is going to follow.

Sensory Stories:

Sensory stories can be used to bring life to books and immerse children in a story. Sensory stories are great for supporting children with sensory differences, learning disabilities, attention and language difficulties. Children can experience a wide range of textures, smells, lights, movements, tastes and sounds related to the story.

I regularly read this book outside where the children can see, smell, feel, and experience the grass, mud and water. Using our senses can be very beneficial in developing a child’s understanding of language. I also use a sensory bag to create the effect of the obstacles you come across in the story. For example; we will throw foam balls in the air, turn on fans, and feel ice cubes to create the experience of the snowstorm.

Language exposure:

“You can’t go over it. You can’t go under it. You’ve got to go through it!”

There are always lots of smiles and laughs when you get children to move. We love acting out this story as if we are trying to get through the different obstacles. Especially at the end when we tip-toe ‘through the cave’ trying not to wake the angry bear. It is a fun and engaging way to teach positional language and concepts such as ‘loud’ and ‘quiet’.

Joint Attention and Social Communication Development:

I have used different elements of this story during Attention Autism activities at all 4 stages. You can tell this story in such an entertaining way that you become the most exciting person in the room, encouraging joint attention skills. My personal favourite is getting children to take it in turns to make their way through the grass, mud, forest, snowstorm and the cave.

Narrative and Story-telling Skills:

There is a clear, repetitive, and well-illustrated sequence of events throughout this story. This creates a great opportunities for story-telling. Encourage your child to tell you what is happening. Think about ‘who?’, ‘what doing?’, ‘what?’, and ‘where?’

For example; “The girl is walking through the river”

This book gives endless opportunities for you to get creative!

For more information about Attention Autism, please click on the link

http://ginadavies.co.uk/

We’re going on a bear hunt by Michael Rosen and illustrated by Helen Oxenbury

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We Love Stories: Penguin

By Speech and Language Therapist, Claire Blagden

Book Details

Ben gets a present. He opens it and inside is a penguin. Keen to have lots of fun with his new friend, Ben says, “Hello Penguin” but Penguin says nothing.

Author Polly Dunbar has entertainingly illustrated some of the very typical (and sometimes very strange) things we do as adults to try to help children talk. The story of Penguin highlights just how difficult speaking can be for some children and that we don’t always know the reasons why.

Ben tries everything he can think of to make his new friend speak, including;

Asking questions: “Can’t you talk?”

Being silly: blowing raspberries, tickling and even ignoring him.

Coaxing: “Will you talk to me if I stand on my head?”

Penguin does not say a word.

Ben’s frustration builds and builds…. Penguin can sense it. Until eventually, Penguin’s steadfast silence tips Ben over the edge. Ben loses all sense of rationality and has a full meltdown demanding that Penguin says something. There follows a twist in the tale, which sees Ben and Penguin have an extraordinary encounter with a big blue lion who eats Ben in the blink of an eye for being too noisy. Penguin (still silent) bravely rescues Ben from the lion’s belly and their very special friendship is cemented. This is the catalyst for a change in their relationship, from one of expectation and uncertainty to love and security and where (much to Ben’s relief) Penguin opens up and tells Ben EVERYTHING.

How does this relate to Speech and Language skills?

The entire process of talking; from first words to full sentences is very complex and most of the time we don’t think about it unless we encounter a problem. Picture this very familiar scenario; at home your child never stops talking. You go out to meet a friend, your child hides behind you and doesn’t say a word. You encourage them to look and prompt them kindly: “Say hello”. Your child turns away, grips your leg tighter and buries their face into your coat. At this point you might feel a little awkward, you don’t want people to think your child is being rude so you might say something like; “come on, don’t be silly, you can say hello can’t you?” Or maybe a grandparent or another family member has come to visit and you notice your child goes from being a chatterbox to being reluctant to answer all granny’s questions. Or maybe you are a teacher? You know Sally can talk because you’ve seen her talk to her friends at playtime but she won’t answer the register or speak to you in class. This kinds of scenario can result in a bit of a stalemate. It can feel very worrying to see such a change in a child’s behavior too.

When in a situation where we are not sure what to do, adults sometimes say or do things that they wouldn’t ordinarily if they’d had time to think about it a bit more. For example, Ben tries every trick in the book to get Penguin to speak which only makes Penguin more anxious about talking but Ben hasn’t considered this.

Some of the phrases below might sound familiar to you. Maybe you’ve said them or have heard someone else say a similar thing?

“Have you forgotten how to talk?”

“He’s just being a bit shy today”

“If you don’t say thank you, you won’t be able to come to play again”

“Grandma will think you are rude if you don’t say bye bye”

Can you spot what all these phrases have in common? Well, they all carry a weight of expectation for the child to speak on demand. Most of us can relate to feeling similar anxieties as young people. Remember that time in school when you were dreading being the one picked to answer a question in class?

So.. what can you say or do instead?

It’s a relatively simple formula. Try to ‘say what you would like your child to say’ (but please don’t ask them to say it).

Back to the earlier scenarios…

Instead of “Say hello” you could say “Oh look, there’s Lucy. Hi Lucy! Hi, we are glad to see you”. Instead of “Say thank you” you could say “I bet you had lots of fun, thank you for playing together”. Instead of “Say bye bye” you could say “Bye bye Grandma, see you soon, bye bye” (cue lots of enthusiastic waving).

You can also use comments instead of asking questions to create opportunities for children to speak if they want to. This removes some of the pressure or expectation for the child to respond straightaway.

Instead of “What did you do at school today?” you could say “I bet you had a busy day, I’d love to know what you did”.

In schools, instead of “Who can tell me..?” you could say “Who would like to show me..” and give children alternative ways of participating that don’t rely solely on speech.

Try not to ask questions, bribe, coax or even gently encourage ‘on demand speech’. It’s not useful as a strategy for encouraging children to use language, in fact it can have quite the opposite effect (and you avoid getting eaten by a lion so it’s a win-win).

Some children are naturally quieter than others, as are lots of adults. We live in a society that rewards extroverts but let’s remember that not all of us enjoy being center stage. The same goes for children too. As early as pre-school, children are rewarded for putting up their hands to speak, to be active participants in a busy language-rich environment, but not all children will want to get involved in these outward displays of confidence. It’s easy to forget this and focus on trying to develop children’s ‘confidence’ as something others can see rather than focusing on building confidence through acceptance and respect for a child’s very individual personality and character.

NB: If you notice a persistent pattern of differences in your child’s speaking habits in different places, or if you have a child in your setting who you feel is more than ‘just a bit quiet’ please contact a Speech and Language Therapist to discuss. We will be able to give you advice and recommend further help if needed.

Penguin, written and illustrated by Polly Dunbar

We Love Stories: Giraffes Can’t Dance

By Speech and Language Therapist, Bethany Potter

In this series ‘We Love Stories’ our Magic Words Speech Therapists are going to be letting you know their favourite story books to use with children to develop their speech, language and communication skills and give you tips on how to make the most out of these stories.

It’s Bethany’s turn first! She’s chosen ‘Giraffes Can’t Dance’.

Book details: Gerald the giraffe is very good at standing still and eating leaves off trees but when it comes to dancing, he is pretty bad. His bandy knees and thin legs make dancing very difficult so instead of joining his jungle friends on the dance floor, he gets laughed at which makes him very upset. With some help and inspiration from a friendly cricket, Gerald discovers that anyone can dance… if you just have the right music. Gerald wows the jungle animals with his dazzling dancing.

Speech and Language targets: Books are a fantastic resource for addressing speech and language targets. Here are my tried and tested ideas on how Giraffes Can’t Dance can be used with children to develop their skills in lots of different ways. The overall moral of the story and the use of rhyme makes this a very enjoyable story to share during your next story time as a parent or therapy session as a Speech Therapist!

Teaching the moral of the story: Giraffes Can’t Dance is an important story for teaching children about accepting that everyone is different, embracing their own differences, and building confidence and self-esteem.

Rhyme & sound awareness:

Rhyme – Rhyme is used throughout this book in words such as ‘floor and roar’, ‘trees and knees’.

Syllable counting – how many syllables are in… ‘giraffe, elephant, dance’

Initial sounds – recognising what sound the word starts with to develop phonological awareness.

Speech sounds:

‘j’ in ‘giraffe, Gerald, jungle, imagine’.

‘n’ in ‘neck, knees, animal’.

‘r’ in ‘run, really, rhinos, roar, rock, rolled’.

‘d’ in ‘dance, different, dancer, Gerald, bad, sad’.

‘r’ blends in ‘crooked, trees, grass, froze, dream, crept’.

Vocabulary:

- Adjectives – tall, long, slim, bad, thin, splendid, clumsy, little, beautiful.

- Nouns – animal names: giraffe, warthogs, rhinos, lions, chimps, cricket, baboons.

Giraffes Can’t Dance, Written by Giles Andreae and Illustrated by Guy Parker-Rees.

Getting Creative with Therapy

By Speech and Language Therapist, Kate Eden

I have always been a creative person. Arts and crafts are a great hobby of mine, so finding a job that allows me to work with children and be creative at the same time was super! Working at Magic Words I see lots of different children for therapy throughout the week. It’s really important that all the children I work with are motivated and interested in the activities we are doing in therapy, that’s why I always check with children what their interests are at the start of the therapeutic process.

Whether it’s Super Mario, Minecraft, dinosaurs or drawing, tailoring therapy to the interests of my children means that they are much more engaged in the therapy sessions meaning that we get more out of our sessions. It’s really useful for me to stay in touch with what the children are currently watching and playing with too, as this allows me to have conversations with them on their level about the topics they are interested in. Plus, it means that I can use my creativity to plan and prepare how to incorporate these themes into the therapy activities for each session.

I use Twinkl and Teachers Pay Teachers as a first stop in checking for resources and activities within different themes. I always have a selection of colouring pictures with me, everything from transport to themed pictures for the time of year (winter wildlife and Christmas trees in winter!). I love finding games with lots of short turns that allow you to incorporate lots of repetitions of children’s targets throughout. Some of my favourite board games for this include Jenga and the classic Pop Up Pirate. I always carry lots of pairs games as these are great to work on speech sounds or practice target words. It’s always fun to switch it up as well, no one likes playing or doing the same thing for too long!

Teletherapy: The top 3 benefits of Online Therapy

By Speech and Language Therapist, Catherine Clancy

Magic Words Therapy has recently collaborated with specialist, bespoke online speech therapy software, designed by tech experts and speech therapists to start offering the option of online therapy sessions with the aim of making our therapy services more accessible to more people.

Our use of Online Therapy has provided convenience and flexibility for families we already see for therapy. For example, some families who live further away from our clinic have now chosen to receive some or all of their therapy sessions via teletherapy, from the comfort of their own living rooms. Teletherapy completely cuts out the time they used to spend travelling and sitting in traffic, giving them more time in their week to spend together.

During online sessions, we can provide therapy in real-time to support communication targets via this motivating and versatile platform, so that clients can access our high-quality therapy in a way that works around busy lifestyles.  

We have found that the idea of Online Therapy can initially seem quite daunting for some clients, particularly to those who are a bit technology-phobic! However, having recently started delivering online therapy myself I’m excited to have branched out into this new and innovative field. Using teletherapy is actually pretty straight forward for both the therapist and the client. I was pleasantly surprised by how easy it was compared to my expectations.

I have been impressed by how teletherapy has supported children’s progress and positively influenced my delivery of therapy. Below are my top 3 benefits of using online speech and language therapy:

1.  Greater Flexibility: Teletherapy has allowed me to work flexibly around the busy lifestyles of the families I support. A parent decided to make the switch to teletherapy as it gave her family the ability to integrate regular sessions within a busy weekly routine, where commuting to clinic for therapy sessions would not have been realistic. 

2.     A Motivating and Versatile Platform: I have found that children love working with me via teletherapy sessions as they are really motivated to use technology they love like laptops and tablets. Online Therapy contains fun and engaging online resources that make it very enticing for children to join in with the activities. As a therapist I love that we can upload our own personalised resources onto the platform as well as being able to use apps from Virtual Speech Centre. Virtual Speech Centre is a well-renowned speech and language therapy app developer. https://www.virtualspeechcenter.com/

3.     Better Use of Home Resources: Teletherapy is an online service where families and clients link in from home whilst the therapist is usually in an office environment. Because clients don’t have access to clinic resources, the therapist has to work innovatively to use online therapy resources and toys within the child’s everyday environment. This often means therapy is more functional as families are supported to use activities, resources and toys that are easily accessible. This supports the carryover of therapy and overall progress with targets. 

In addition to my top 3 benefits of teletherapy, I think it’s really important to mention that the use of Teletherapy has also helped Magic Words Therapy and the families we support to reduce our collective impact on climate change. Online therapy sessions have resulted in less air-polluting car use for both therapists and families and a greater emphasis on online resources that don’t require printing which uses lots of paper and ink. 

Despite its undeniable benefits there are of course some limitations to Teletherapy. This way of accessing therapy can work well for most clients, but not all. For some clients, face-to-face sessions are essential in order to support their engagement in therapy and overall outcomes. If you would like to discuss teletherapy as an option for your child I would highly recommend speaking to one of our therapists about this. They will be able to get to know your child and identify whether teletherapy would work for them and their unique needs.

5 Reasons Why I Love Being a Speech and Language Therapist

By Speech and Language therapist Gianina Giangrande

In 2012, I left a career in marketing to become a Speech and Language Therapist. It was the best decision I could have made and here's why.

1. Work with a Diverse Population

As a Speech and Language Therapist from New York City working for Magic Words Therapy in London, I’ve had the pleasure of working with people from cultures very different from my own. I’ve helped a Jamaican child with feeding difficulties eat rice and beans, a CBS news anchor reclaim her voice through vocal hygiene techniques, and a nonverbal child request ‘Driedel’ using an AAC device. How cool, right?

2. Geek out on Data

Data collection is a vital part of making clinical decisions on the effectiveness of treatment. If you love numbers like I do, there’s no greater thrill than seeing scientific proof that your client is making progress over time.

3. Have Creative Freedom

Speech and Language Therapy is as much an art as it is a science. It takes out-of-the box thinking and personalization to motivate children to attend in therapy. Where else can you make sparkling sound shakers and rockets from toilet tissue rolls?!

4. Never Get Bored

I’ve worked with both children and adults with disorders in feeding and swallowing, voice, articulation, phonology, expressive language, receptive language, and respiration. I’ve provided services in a hospital, a private clinic and the school setting to clients with Autism, Downs Syndrome, Aphasia, TBI, Stroke, Post-Chemotherapy difficulties and many more. Needless to say, I am CONSTANTLY learning.

5. Change Someone’s Life

I am humbled to know that the work I do has the power to break down the barriers of communication for an individual. It has driven me to become the advocate that I am for service provision for those who would benefit from Speech and Language Therapy. Cue the Mic drop.

Meet Our Cambridge Clinic Team

By speech and language therapist Bethany Potter

My name’s Beth and I’m one of the Magic Words therapists based at our new Cambridge clinic within Chestnuts Nursery.  

My first experience of speech and language therapy was not as a therapist but as a child with speech sound difficulties. I was struggling to say sounds in words like ‘cat’…especially difficult when your favourite film is the Aristocats!

I remember not wanting to go to therapy sessions because I would have to just sit and say the sounds I found really difficult; it felt like failing and was no fun at all. Now when planning sessions as a therapist, this memory is what drives me to create fun, interactive sessions where children don’t even realise it’s therapy!

Before studying to become a speech and language therapist I studied English Language and Linguistics. I developed an in depth understanding of child language acquisition and phonetics; this increased my interest in the world of speech and language therapy. Following this, I worked as a teaching assistant supporting children with a range of needs such as deafness and hearing impairment, ADHD, and dyslexia. I had always had an interest in speech and language therapy, but it was my role as a teaching assistant that really sparked my passion and I decided to go back to studying and start my career.  

The field of speech and language is so diverse and broad. I love working with all types of speech, language and communication difficulties. I have a particular love for working with early years, speech sound difficulties, language delay and hearing impairment. I’m sure this will only continue to grow throughout my career!  

Outside of my working day as a speech therapist, I enjoy yoga, running and exploring the world! My most recent trip was to Peru including the Inca Trail to Machu Picchu, a home stay on Lake Titicaca and a visit to the Amazon!

Stammering is Universal – Part 2

By specialist Speech and Language therapist Frankie Paterson

Remember Beatrice and Ugandan speech therapist Duncan Musasizi? When Beatrice and her guardian came along for a second therapy session it was great to hear that Bea’s fluency had improved significantly in the week since the last session.

It’s a joy to watch Duncan in action as a therapist. He has such a warm and engaging therapeutic manner with children. His face, as you can see in the photo, is incredibly expressive and animated, this is a great quality to have as children are drawn to animated faces and they are most likely to join in play activities if they can see that the therapist is excited about the activity.

Duncan makes impressive use of a limited array of therapy resources. There are no big cupboards full of toys here, so this is essential. He has a set of colourful building blocks that he shows great ingenuity at using in lots of different ways. He used them in a fluency shaping technique aimed at helping Beatrice reduce the rate of her speech by saying a word each time she put a new block onto a tower.

At our last session Duncan had demonstrated a very simple activity aimed at slowing Beatrice down; her speech and everything else. Bea is inclined to want to get everything done in a rush, speaking and moving very quickly, always worrying about being late.

Duncan got Beatrice up and moving for this, a signature feature of his therapy style. They took steps along the tiled floor, stepping from tile to tile with a pause in between each step. As they’re taking steps they count from one to ten, saying a number per step. The first time Bea tried this she was characteristically rushing, taking much quicker steps than Duncan and seeming to be so intent on doing this perfectly she was hardly pausing to breathe. Over the session he managed to get her to slow right down to his slow pace of walking and counting and to copy his relaxed walking style.

Beatrice’s guardian reported that her fluency had improved significantly since our previous session. She had told the people at Beatrice’s Sunday school that they must let her talk and always let her finish what she is trying to say. She ordered the local children Bea plays with to be kind to her, to always let her talk at her own pace and never to laugh at her. I have a strong suspicion these people will do what she asks; I would certainly not mess with this woman! I was very struck by how fiercely protective of Beatrice this lady is. A real force of nature. I felt happy for Beatrice that after her difficult start in life she now has this kind and strong woman to look after her.

www.yellowhouseoutreach.org/

Stammering is universal

By specialist Speech and Language Therapist Frankie Paterson

It is my pleasure to introduce you to speech and language therapist Duncan Musasizi and his client Beatrice (to protect her identity I’m not using her real name). Duncan is an outstanding Ugandan speech and language therapist who I worked alongside at Yellow House Health and Outreach Services in Kenya earlier this month.

Beatrice was accompanied to the clinic by her new guardian, a friend of her Grandma who had died only a few weeks before. Beatrice’s Grandma had been her sole carer and she had entrusted this kind lady to be her new guardian once she passed.

Beatrice came across as a highly conscientious little girl with a propensity to want to do everything perfectly. She and her guardian arrived super early for the assessment as Beatrice had been insistent that they must not be late as she wanted to get back to school ASAP!
Her guardian described Beatrice a worrier and prone to always doing things at high speed. We have not used Beatrice’s real identity because, although her guardian was keen for Beatrice’s story to be told, she was wary of condemnation from people in their community who see having a stammer as being a curse from God. In parts of Kenyan society all forms of disability are seen as a huge weakness, the effect of curses or witchcraft. Parents of children with disabilities can have an incredibly hard time. They often feel they have no option, once their child’s disability becomes more obvious, but to keep them locked away indoors, away from potential judgement and rejection. These children often stop going to school and are socially isolated, exactly the opposite of what children with communication disabilities need.

Beatrice is lucky to have a guardian who is bravely ignoring the judgement of their community and doing her best to get them to accept her. Beatrice will be coming for weekly therapy with Duncan and I supported him to devise a treatment plan. Beatrice is aware of her stammer but is still so very little and has a lot of adjustment to make to her new life. Duncan is keeping it very simple, starting off with a few practical activities aimed at slowing Beatrice down. Not just her rate of speech but everything else as well. We gave her guardian advice on slowing down her own speech and holding herself back from giving Beatrice advice on how to talk, like that old chestnut ‘take a breath and start again’. We asked her just to focus on letting Beatrice talk and listening to the meaning of what she’s saying, instead of focusing on any moments of stammering.

Working with people who stammer in a very different culture has been hugely beneficial to my understanding of stammering as a universal human phenomenon. People who stammer across cultures may have daily struggles that differ somewhat but fundamentally the nature of the adversity they face is the same everywhere.

All over the world, what people who stammer need is for non-stammerers to have more awareness about what stammering really is. That having a stammer does not make someone weak, stupid or cursed or even that different to anyone else. That having a stammer is never a defining characteristic and that people who stammer need to be shown the same respect as any other person. People need to know what to do when talking to someone who stammers. Mainly: you don’t need to do anything special, just let them talk, in their own way and in their own time. People who stammer just want you to listen to them with the same respect that you would pay to any other person.

Eco Team at Magic Words Therapy

We'd like to introduce you to Susan Woodley, our new Eco Rep. Sue is one of our speech and language therapists and like the rest of us here at Magic Words Therapy she cares greatly about our planet and preserving our natural environment.

Sue is going to be spearheading Magic Words Therapy's campaign to make our organisation as eco-friendly as we can possibly be by making changes big and small. We want to reduce our waste, reduce our carbon emissions and possibly even plant a Magic Words Therapy garden. Watch this space!

Voice therapy for transgender individuals

By Speech and Language therapist Wai Seng Thong

Finding your authentic voice

While I was living and travelling around in East Asia, I met a variety of gender diverse people and I was astonished to hear that most of the Asian countries had no integrated care pathway in their health services for trans individuals. Trans people are a minority group in most societies who are facing severe discrimination. Their needs have been poorly understood, especially in East Asia.

Growing up, I had a couple of transgender friends and I saw them struggling, undergoing both physical and emotional stresses, making me constantly worried for them and wishing that I could help them through the crazy roller coaster ride of transitioning and struggling to find their authentic voice. I could not imagine how hard this must have been for them to confront this, while also having to face a lack of support from their families and prejudice from people in their communities. Becoming skilled at supporting trans people to find their true authentic voice became a goal in my career as a speech and language therapist.

Assessment

As a trans person, assessment of your voice, carried out by a speech and language therapist, will highlight which areas need to be focused on in voice therapy. You may already be aware of changes in your voice. The aim of therapy is to work towards a voice that is compatible with your chosen gender while bearing in mind the physical limitations of the vocal tract.

Therapy for Transmen (Female to Male)

One of the effects of testosterone is to deepen the voice. This deepening is a direct result of the vocal cords increasing in bulk. During the early stages of hormone treatment, the voice may be unpredictable and the muscles around the vocal cords will feel the strain. Voice therapy is therefore important to help achieve a smooth transition from the female to male pitch.

Therapy for Transwomen (Male to Female)

Oestrogen treatment has no significant impact on the voice as once a person who was born male has gone through puberty, the larynx will have lowered in the neck and increased in size, otherwise known as our voices ‘breaking’. Likewise, the testosterone that influences other bodily changes during male puberty also thickens the vocal cords which makes the voice sound deeper. This cannot be reversed with oestrogen treatment after a person has gone through puberty.

Although there are many challenges surrounding voice modification from male to female, with the right support and guidance from a speech and language therapist, any issues with the voice can be reduced and corrected.

I have found it to be very rewarding to work with transgender individuals in helping them to find a voice that matches the true them. Changes in voice can be achieved through specialist vocal exercises carried out under the guidance of your speech and language therapist. There are many aspects of the human voice that make listeners perceive it as either masculine or feminine.

These include:

• Articulation patterns: the way we say certain sounds.

• Intonation patterns: the ‘tune’ of our speech i.e. the ups and downs.

• Volume: loudness or quietness of our voice.

• Resonance: the sound quality of the voice and how it is filtered using our speech producing mechanisms in the face and other parts of the body.

• Pitch: how high or low the voice is.

• Communication aspects: timing and non-verbal skills e.g. eye contact, gesture etc.

A speech and language therapist will be able to support you by giving you a good understanding of how to look after your voice to achieve the most positive results and help you to understand how your voice works. Knowledge is power and these learnings should help you understand the rationales behind the vocal exercises and how they work. We aim to increase your knowledge, awareness and your expertise in your own voice and how to train it. As speech and language therapists one of our goals is to give you the autonomy, skills and knowledge needed so that you can make informed choices about how to proceed and progress effectively and healthily with your personal exploration of your own unique voice.

If you have been searching for your authentic voice, the voice that you feel most comfortable with, then speech and language therapy could be the right choice for you.

Find out more here https://www.magicwordstherapy.co.uk/transgendervoice

Stammering and the Iceberg Beast

By Specialist Speech and Language Therapist Frankie Paterson

I was interested to learn about a proposed new way of thinking about aspects of stammering as a ‘beast’ that can be strengthened or weakened. Dr Rick Arenas thinks of a stammer as an ‘Iceberg Beast’ that can be slain. Rick, associate professor at the University of New Mexico, researches developmental stammering and is himself a person who stammers.

The idea of the Iceberg Beast originates from the iceberg analogy that’s been used to describe stammers since 1970 (J Sheenan).

The top of the iceberg, that’s visible above the water’s surface, represents stammering behaviours such as repetitions of sounds, words or syllables. This is the part of a stammer that is visible for others to see. The part of the iceberg that is submerged under the water is vastly bigger than top part. This underwater part represents the underlying aspects of a person’s stammer that tend to be invisible to others. These include anxiety about speaking, avoidance of speaking or of situations, emotions about speaking and stammering and beliefs about yourself and your place in the world as a result of the stammer.

Although Dr Arenas thinks this iceberg analogy is effective in portraying what being a person who stammers is really like, he has built on this iceberg idea using his own experiences as someone with a stammer and experiences that other people with stammers have shared with him. Dr Arenas has observed that for a person who stammers, the unseen part of the iceberg can be like a living entity that has the power to hold them back from living their life as they’d like to, and that it can grow, shrink and change over time. He has come to identify these undelying parts of his stammer as the Iceberg Beast, that can feed on certain types of things that give it fuel to grow and get stronger. At the same time, there are things that he can do that he knows will weaken and shrink his Iceberg Beast.

Rick explains “the beast is a cohesive collection of beliefs about stuttering that we allow to negatively impact how we live our lives”. Rick believes that as a person who stammers there are specific choices you can make that will make your iceberg beast either grow or get smaller. These choices are not ones you are stuck with and are destined to make forever. You can decide to make different choices.

What types of things allow the beast to grow?

· Not talking about your stammer with others or being open about it.

· Avoidance. Of words, situations, thoughts or truths about yourself and your stammer.

· Not accepting that you have a stammer.

· Being in denial about the stammer as being something that affects you or how much it affects you.

Rick believes that negative thoughts and feelings about stammering that are harboured for a long time and not talked about openly can ultimately transform into core negative beliefs about yourself and your stammer that your iceberg beast loves to feed upon, helping it to grow. For example, believing that you will always be too slow to get your words out, that people will always get impatient and bored when you try to talk or that you are weak or faulty because of your stammer.

Weapons Against the Beast

Rick lists ‘weapons’ that people who stammer can use to weaken and shrink the iceberg beast and so reduce the control that the stammer has over them:

· Daring to be open and vulnerable about your stammer.

· Allowing yourself to stammer openly and freely.

· Being honest with yourself about the impact the stammer has had on the way you’ve chosen to live your life.

· Self-Acceptance. Accepting all parts of your identity, including that you are a person who stammers.

· Authenticity with yourself and others.

· Talking openly with others about your stammer and thoughts, feelings and beliefs surrounding it.

Dr Rick suggests that useful questions to ask yourself are:

· What would you ideally be doing in your life that you currently are not doing because of the stammer?

· What do you avoid because of the stammer?

· In what ways is this actually impacting on how you live your life?

Dr Arenas believes that real lasting change comes from an exploration of your attitudes and beliefs about the stammer as opposed to focusing on the stammering behaviours themselves. He emphasises the fact that it is your beliefs and reactions to your stutter rather than the stuttering behaviours themselves that negatively affect your life. This echoes an idea from the stoic philosopher Epictetus that I have personally found invaluable in my own quest to change negative thoughts and the beliefs that underlie them. Epictetus stated that “Men are disturbed not by things, but by the views which they take of them.” To bring this back to stammering, it could be said that the act of repeating words is not the cause of your pain as a person who stammers, the root cause of pain are the negative beliefs you hold , e.g. that stammering somehow makes you a lesser person or that other people seeing you stammer will make them dislike you or think you are weak.

Being brave enough to be vulnerable

The qualitative research professor Bréne Brown pioneered the idea of vulnerability being a powerful act that can be immensely healing and galvanising in her viral TED TALK . So what’s vulnerability all about for people who stammer?

· Daring to be truthful with yourself and others about your stammer.

· Being brave enough to show things to others you’d really rather hide from them because you are ashamed, namely openly stammering.

· Daring to really look inward at yourself and to share those observations with others.

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Unicorn or Beast?

I think this idea of imagining the internalised part of a stammer as a fluid entity that can increase or decrease in power depending on choices within your control could be incredibly liberating for many people who stammer. Giving limiting core beliefs an identity, so that you can put them under the microscope can be an empowering and healing exercise.

This is very much in the spirit of an exploratory assessment I often use where the client is asked to draw their stammer. The results are of course unique to each person and can be hugely valuable in understanding a client’s relationship with their stammer.

I think it’s important to recognise that each person’s core beliefs about their own stammering will be unique to them and so the identity they give them will be unique as well. For one person their internal stammer might well be visualised as a beast to be slain. But someone else might see theirs quite differently, for example as a majestic but troubled and misunderstood unicorn, to be tamed and calmed! Warlike imagery of using weapons to destroy a beast could be negative and unhelpful for some people who stammer. I wonder if for some people, attaching a more neutral image to their stammer could be somehow helpful in reducing the negative hold it might have over their lives.

If you want to hear more from Dr Arenas he is interviewed about his Iceberg Beast theory on the excellent podcast Stutter Talk.

What have Cleopatra and children with listening difficulties got in common?

by Wai Seng Thong (Speech and Language Therapist)

Attention and listening – the foundation of communication

When I think about communication, I always imagine the Egyptian pyramids which, like communication skills, need to be built on a solid foundation. Also, both the pyramids and communication are really amazing things! For communication skills to develop, the solid foundation you need is attention and listening skills and just like those builders of old, if you are not listening or paying attention things can go awry (Check out the pyramid of Sneferu, it went awry big style!)

What are attention and listening skills all about?

‘Attention and listening skills’, is a concept that we as speech and language therapists talk about regularly. So I decided for this blog, I will talk about this foundation of the communication pyramid (and no you don’t need to be Cleopatra to make sense of it!) 

Often I hear parents and teachers use commands such as ‘Sit down!’, ‘Stop!’, ‘No!’, ‘Don’t do that!’ when children are not listening and running around like headless chickens. This can be during meal times at home or even in the classroom during reading lessons. We all know how daunting it can be when children don’t listen. This can be so stressful for parents and teachers. It can even cause emotional tensions within families. Well let me tell you this, if you struggle with children who don’t listen; you are not alone.

Does my child have problems with attention and listening?

Have a think about these questions:

·         Can your child sit still?

·         Can they keep their hands still e.g. without fiddling?

·         Does your child look at the teacher or at you when you are talking?

·         Can they concentrate when there is a lot of background noise like TV or music?

·         Can they repeat an instruction back to you?

·         Can they sound out words?

·         Can they remember long words?

·         Do they seem not settle with one activity, but tend to flit from task to task or toy to toy?

·         Does it often look like they are tuning out?

If you have answered ‘yes’ to any of the questions above, your child may have difficulties with their attention and listening skills.

You may be wondering why are these skills so vital? Or do we really need this skill nowadays as humans? To answer these questions lets go back to the desert in Egypt. Imagine the builder wasn’t paying attention or listening and cut the first stone for the foundations of the pyramid to the wrong size. This would obviously be disastrous. Difficulties with attention and listening can have an impact on all areas of learning; if a child is not able to listen and pay attention, they will find it difficult to process and then utilise important information in lessons when it is given to them. And then success in their classroom learning will be very hard to achieve.

How to assess?

Based on Reynell’s research there are six levels of typical development of attention and listening, these levels may be used to assess and understand the child’s development of attention and listening skills in relation to the developmental norms. Remember; there is a huge variation on what is considered ‘normal’ and I would urge people to question whether the term ‘normal’ is really fair or useful anyway? Levels like these are useful for the most part as they help us to see a sequence of levels of attention and listening development. For example, if a child is at a particular level, these levels help us by telling us what that child needs to be able to do next, to push on forward with their skill development and to reach the next level. These levels are:

Level 1 (typically birth to 1 year): Child’s attention is fleeting, shifting from one object, person, or event to another. The child will get distracted immediately by any new event such as someone walking by.

Level 2 (typically 1 – 2 years): Single channelled attention and the child can concentrate on a concrete task of their own choosing, however, will not tolerate any verbal or visual intervention from an adult.

Level 3 (typically 2 – 3 years): Child’s attention is still single channelled, but the child is not able to shift their attention away from the current task and then go back to the original activity with adult support.

Level 4 (typically 3 – 4 years): The child can alternate his/her full attention (both visual and auditory) between the adult and the task and now does this spontaneously without adult support.

Level 5 (typically 4 – 5 years): Double channelled attention. The child understands verbal instructions related to the task without interrupting the activity to look at the adult. Concentration span can still be short; however, they can cope with group situations.

Level 6 (typically 5 – 6 years): The child’s attention is well established and sustained.

How to support?

Due to the huge importance of attention and listening skills, I am often asked by both parents and teachers about how they can support children to become better at paying attention or listening to them. So I tell them this true story:

One day a good friend of mine shared her super-secret mouth-watering ‘Honey Mustard Chicken’ recipe, something I had tried for years to get to her to share. She really quickly told me all the ingredients, how to cook and prepare the chicken. Once I got home and tried to cook it, I found I had completely forgotten some of the ingredients and was hazy on the method, leading to a somewhat disappointing chicken dinner. However, when I went back grovelling again for the recipe, she told me the recipe step by step with great instructions and even with pictures and videos of her making it (such a kind friend she is). Then I went home and made the dish, following her instructions and step by step guide and as you can imagine it was YUM.

What would you rather do? Attempt to remember a long stream of complex instructions or remember a simple step by step set of instructions, with pictures? You are probably like me and would opt for the second method. Well it’s the same for children following adult instructions as it is for us as adults who are given a recipe or a set of directions to get to a place; too much information and no structure or visual support and we can all fail.

Now I am not saying this is easy. I do realise it’s hard to find ways to keep children focused especially in this busy and fast-paced Netflix and iPad era we now live in. So below I have shared with you my nine easy tips to support your child’s attention and listening skills:

1.       Always call your child’s name to gain attention. Like in a football match a player will call their teammate’s name when they want to pass the ball and get their attention.  

2.       Make sure you get your child’s eye contact before pointing to something, giving an instruction or asking a question as this not only shows them the good behaviour of eye contact but also helps to keep them focused.

3.       We sometimes forget children are smaller than us, so crouch down and get down on your child’s eye level to make sure they can focus on you.

4.       No one can focus on anything for too long. We as adults have our limits as well. We all need breaks from having to concentrate. So break times are important! This needs to be negotiated breaks with the child, for example giving 5 minutes’ free time once they have achieved a certain amount or focused on reading a book with you.

5.       Praise! Everyone loves praise so give specific and positive feedback to the child about their listening skills with phrases such as ‘Thank you for looking at me’, ‘Well done for waiting your turn.’  Sticker rewards are an amazing and cheap incentive to help children to be motivated for good listening. I have been reliably told smiley face stickers are their favourite (so a group of my preschool children told me!).

6.       In this manic world of noise and distraction try and create a quiet environment by reducing background noise such as TV before trying to get your child to listen to you.

7.       If a child looks confused or you’re not sure they understood what you have said to them, encourage ‘active listening’ by asking if they have understood or listened. You can help children use this as a strategy to compensate for their difficulties with attention and listening.

8.       Most vitally, like with my friend telling me the recipe, break longer instructions into short steps and leave plenty of time for children to process the information. Giving visual support to what you are saying is also highly useful.

9.       As adults, talking about things we are interested in with our friends means that  conversations flow. So when you’re talking to a child try to follow the child’s lead by talking to them about what they’re interested in or focused on. They will be more focused on the conversation if it’s interesting to them than if it’s not.

If you only remember only two pieces of advice from this blog, let it be these. Firstly: be like Cleopatra and make sure your child’s communication pyramid has a solid foundation. Without this structural base skill of attention and listening, everything else we try to build on it can end up wonky like poor Pharaoh Sneferu who has gone down in history as the Pharaoh who couldn’t build his pyramid straight! Secondly take heart in the knowledge that the Great Pyramid of Giza was not built in a day. It took many years and great patience to build. In the same way, developing a child’s attention and listening skills can take great perseverance and time, so do not worry if you do not get overnight success.

Working memory in school aged children

By Sonali Dutta, Speech and Language Therapist

WORKING MEMORY IN SCHOOL AGED CHILDREN

As a speech and language therapist I come across younger and older children who struggle with classroom-oriented tasks in school. When assessed by specialists, a good proportion of these children are found to have working memory difficulties. Working memory is responsible for retention and manipulation of information. As children get older, the learning-based tasks in school become more structured and complex, demanding high cognitive skills. Therefore, working memory plays a crucial role in determining children’s ability to handle learning challenges effectively. At home or in other social situations outside school, the environment is more play-based and relaxed and so the demands on working memory are likely to be less.

 WHAT IS WORKING MEMORY?

Working memory is one of the key cognitive processes required for effective learning and is often confused with short term memory. Short term memory is related to short-term storage of information. Whereas, according to recent research, working memory is a component of fluid reasoning i.e. ability to effectively identify key information from the task/environment and apply that knowledge. We use our working memory to register, maintain and manipulate information we see (visual) and hear (auditory) making it an integral part in our decision-making ability and behavior. Therefore, we can see how working memory skills can be closely related to achievement and learning in school aged children.

The Wechsler Intelligence Scale for Children (WISC) measures working memory in one of its subtests for measuring intelligence. However, we should bear in mind that although working memory affects how a child learns and performs in tests, it is not a measure of a child’s overall intelligence and that the IQ (Intelligent Quotient) also has non-measurable components which do not correlate to working memory.

WHAT ARE THE SIGNS OF WORKING MEMORY DIFFICULTIES?

Working memory deficits have been linked to attention difficulties, learning difficulties (e.g. dyscalculia i.e. problems with arithmetic) and language difficulties (e.g. following complex instructions) in children. Children with working memory deficits have difficulty in tasks involving memory demands in retaining and processing specific or structured information. Therefore, subjects such as maths, reading and science may be particularly difficult for these children. Attention, auditory and visual perception and concentration are required for successful processing of information.

The article ‘Working memory in the classroom’ by psychology professor Susan E Garthercole highlights a study where the teachers described children with working memory problems as having attentional problems. This shows that the underlying working memory issues in children can be masked as attentional problems and are likely to remain unidentified and unaddressed. The article further mentions that ‘zoning out’ or ‘mind-wandering’ are common behaviours in children with low working memory capacity when performing a highly demanding cognitive task as they cannot cope with the information overload and fail to complete the task.

Children with working memory difficulties may show the following signs:

·         Struggles to follow complex verbal instructions in a classroom.

·         Has problems in the area of maths, reading (comprehension) and science.

·         Takes longer than peers to complete tasks or does not completing tasks.

·         Has attentional difficulties.

·         Gives delayed responses to complex questions/instructions.

·         Provides non-specific answers.

·         Comes across as being disorganized

·         Comes across as being forgetful.

WHAT YOU CAN DO TO HELP

Speech and language therapists or educational psychologists can assess children’s working memory using formal or informal assessments involving specific recall/repetition tasks e.g. digit span (backwards and forwards repetition), picture span, letter/number sequencing etc. It is important to share with the child that they will have to work harder than most children to attend and concentrate in classroom tasks.

In our practice as speech and language therapists we always find that using visuals in  learning helps children retain and process information better. Being a mum with the knowledge of a speech and language therapist I know that hands on practical input and visuals helps my kids learn better. Recently I have used the hot kettle in my kitchen, a metal plate with ice and hand drawn diagrams to demonstrate the evaporation-condensation-precipitation to my 9-year-old daughter who was struggling to understand the water-cycle taught in school. She then went on to make her own illustration of the water-cycle and could not wait to show it to her teacher.

The following are some of the strategies teachers and parents can use to help children with working memory difficulties:

·         Eliminate distractions as much as possible during tasks (e.g. remove background noise, e.g. music, TV)

·         Gain the attention of the child by establishing eye contact with them.

·         Prepare the child for the task beforehand (e.g. provide an outline of what is going to be taught in the lesson). This will help information to go from short-term memory to long-term memory.

·         Provide clear and simple instructions.

·         Break down tasks and instructions into small chunks (not more than two-part instructions at a time).

·         Give the child the opportunity to rehearse or record the instruction (e.g. writing down the instruction).

·         Ask them to repeat the instruction to check if they understood.

·         Encourage the child to ask for repetition if they have not understood.

·         Encourage your child to keep notes, make outlines and use other brief reminders.

·         Encourage good organizational skills by using folders and dividers to keep work easily accessible and in order.

·         In school, providing notes and handouts will be useful when a child struggles to copy due to visual memory difficulties.

·         Visuals will help them understand and retain information better (e.g. visual timetable, flowcharts, diagrams, pictures, illustrations, videos).

A sensory approach to learning involving practical input and visuals will consolidate retention and learning (e.g. visual timetable, flowcharts, diagrams, pictures, illustrations, videos, demonstrations, hands on practical tasks).

My final week in Kisumu with Yellow House

By Catherine Clancy, Speech and Language Therapist

Unfortunately, I fell ill at the beginning of this week and it took me some time to get back to my usual self. However, I was able to attend a Communication Camp that had been organised by Yellow House to support parents of children with Cerebral Palsy. This post will be focused on the content of the camp and how Yellow House are raising awareness of cerebral palsy and empowering parents to support their children.

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On the left is Florence and the right is Duncan (with Gregory translating), who explained what communication is and ways in which children with cerebral palsy can successfully express themselves when speech is unclear or not present. The communication house is a lovely way to understand the foundations that need to be put in place before you can expect a child to understand spoken language, and then begin to express themselves using gestures and speech.

There was a specialist talk from an Occupational Therapist who discussed ways parents can support their child’s fine and gross motor skills through daily exercises. Here, John is demonstrating how to support a child’s ability to stand with support.

Here are some of the toys that the parents made for their children using those materials that are easily accessible to them – a very creative way of recycling waste into something kids can enjoy!

Whilst the parents were busy attending the talks within the camp, the children were taken into a separate room where they had the opportunity to play, sing and dance – it was a lot of fun and it was lovely to see the supporting adults interacting so freely and easily with the children – the children were in their element!

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After the camp and on my final day, I said bye to a client and his mother who has been supported through the use of Alternative and Augmentative Communication (AAC). A symptom of cerebral palsy for this client is stiff muscles and exaggerated reflexes (spasticity). Unfortunately, this means spoken language is extremely difficult for this boy and direct access to a communication board (e.g. pointing to a picture) is not possible. For this reason, eye gaze (looking at the picture) has allowed this client to communicate a preference when given a choice. This has given the mother a new way to communicate with her son and the joy that this brings to the both of them is wonderful to see!

My time working with Yellow House has been eye-opening, rewarding and enjoyable. I have met a team of people who are raising awareness of speech, language and communication needs in Western Kenya and are working hard to support children and their families. The stigma around disabilities is still very much present and during the camp many mothers expressed their sadness around the fact that friendships and relationships had ended simply because they had a child with a communication disability. However, seeing these parents come together and pro-actively learn about their child’s condition and how to best support them was very inspirational, which is heightened by the fact that these families are doing their best to integrate their children in their communities to reduce social stigma and normalise their child’s differences.

Goodbye Kisimu!

It has been lovely to see parents and families so invested in supporting their children.

By Catherine Clancy, Speech and Language Therapist

Week 3.

29.07.19: On Monday I spent the day at Russia working with the team to complete a triage. This is to support the management of new referrals who are seeking support for their child. Here, I completed case history questionnaires to find out the child’s strengths and difficulties, and as a team we discussed how to prioritise the new referrals seen. There are many people seeking support from Yellow House which can unfortunately mean long waiting times for clients to be seen. However, the triage gave us the opportunity to meet face-to-face with families and offer advice.

01.08.19: It’s August already! On Thursday I continue to see clients for their weekly therapy sessions. Above are some of the resources I made with the team to help children express their wants/needs and interests if they are finding spoken language difficult. When lunch time came around I thought I would try something new and ordered the local vegetables with chapati and beans – YUM!

30.07.19: On this day I continued to see clients for their weekly therapy sessions. The picture above shows a mother supporting her child through parent-child interaction strategies that aim to promote language development. The mother was focusing on following her child’s lead and using 1-2 key words to comment on her play. Videoing was used as a therapeutic tool to empower the mother to continue using those strategies that she used positively to support her child.

31.07.19: How was it Wednesday already?! (the weeks fly by!). I travelled to the EARC centre and continued seeing clients for their weekly therapy sessions. The photographs above show parents interacting with their children and supporting the use of low-tech augmentative communication. For these children, they were unable to communicate successfully using only speech and therefore a total communication approach has been adopted where we are using speech, gestures, key signs and a communication board to help them express their wants/needs/interests etc. Parental education is fundamental to the success of therapy as parents have to feel invested and motivated to use the strategies advised by us in order for therapy to have positive outcomes. Fortunately, both parents are open to learning to ways to communicate with their children and they are now aware that the belief ‘signing/pictures with stop my child from talking’ is only a myth!!

This week has been empowering and also eye-opening. It has been lovely to see parents and families so invested in supporting their children as ultimately, they are the experts on their child and have the opportunity to make the biggest impact - I have found videoing a great way of supporting this! However, the policies and procedures within the care system are very different to those we experience in the U.K. and it has required me to adapt a very flexible way of working to continue supporting children with the limited access to resources and early interventions.

My second week working for Yellow House

By Catherine Clancy, Speech and Language Therapist

19.07.19: On Friday I said goodbye to Maggie, one of the volunteers who has spent 10-weeks working with Yellow House Health and Outreach Services as a Speech and Language Therapy student from Torono University. It is great when students complete their clinical placements with Yellow House as it is a fantastic opportunity for clinical development, not only for the students but for the team themselves.

23.07.19: David (one of the Senior Speech and Language Therapists employed by Yellow House) and I spent the day working in the Speech and Language Therapy clinics situated within Russia, a hospital in Kisumu which is government funded. Here, I was working with children and their parents with a focus on augmentative and alternative communication (AAC). This is about supporting children and their families to implement other forms of communication which is building on the child’s strength. An example might be using key word signing alongside speech as well as supporting the child to communicate through symbols on a communication board. Parent education plays a critical role here as it is vital for parents to be invested in the therapy for it to prove beneficial for the child!

The team work alongside other professionals in the hospital including occupational therapists who support patients in their own clinic (see picture above).

24.07.19: I travelled from Kisumu to the EARC (assessment and resource) centre on a matatu (local mini bus) which takes around 45 minutes. Here, I saw more clients for therapy, again focusing on the use of AAC. I incorporated the use of videoing with parents to support their interactions with the children and it was lovely to see parents getting down on the floor and supporting their child in the best way they knew how. After a busy morning, Duncan (one of the Speech and Language Therapists employed by Yellow House) and I enjoyed a local lunch of chapati, skumowiki (green vegetables) and green grams (lentils) – it was delicious!

26.07.19: After another busy day supporting clients from Russia, I went back to the office and caught up on paperwork and resource making. This is the office for Yellow House and where the team carryout all the administrative duties, including planning for communication camps – this is when they invite children and their families to a 2-day training camp where they learn all about different diagnoses, the impact on communication and how to support their child using a total communication approach.

My second week on working with Yellow House as a speech and language therapist has really allowed me to get ‘stuck in’ and see clients and their families for therapy. However, it has been essential for me to collaborate with the therapists working for Yellow House to support their clinical development and to ensure the interventions I am suggesting are realistic and functional for this setting. It has been great to learn from the team working here and I hope that I have supported them to feel more confident using AAC within their own practice!

My first week in Kisumu, Kenya

By Catherine Clancy, Speech & Language Therapist

14.07.19: Just before I flew out to Kisumu! 

23.07.19: My first day! I visited Russia, the hospital in Kisumu where Yellow House support clients with speech, language and communication difficulties. This is where I had a lunch of chapati and cooked greens during my lunch-break.  

24.07.19 The Educational Assessment & Resource Centre (EARC) in Vihiga, a 45-minute journey from Kisumu on a Matatu. Here, I supported assessment for new referrals to the service. 

I have had a busy but very eye-opening and rewarding first week with Yellow House! It was lovely to hear from families about how the use of Alternative and Augmentative Communication (AAC) has given them a new way to successfully communicate with their child. Recently, a client with cerebral palsy was taught to communicate using eye gaze with a symbol communication board and the mother has been overjoyed with how this has enabled her to talk with her son which for the past 8 years has not been possible. This mother is very proactive and supportive of her son and does her best to raise the awareness and acceptability of disability in her local community by ensuring her son is treated with respect, compassion and integrity. 

Attention Autism Bucket Time

By Wai Seng Thong (Speech and Language Therapist)

What is Attention Autism?

One of the things I love about visiting schools is the expressions of joy on the faces of the children I work with. When they know it is bucket time some children can barely stay sitting down. In case you have never heard about Attention Autism, it’s an intervention designed by Gina Davies, Specialist Speech and Language Therapist, aiming to develop natural and spontaneous communication through the use of visually based and highly motivating activities for children with Autism Spectrum Disorders (ASD).

Attention Autism is one of my favourite activities as it makes learning fun and memorable for children. Before I start, NO you don’t need to be an X Factor level singer, but you do need to be able to hold a tune as this helps the children sing along. You also need to prepared to collect strange and fun toys to make the activity differ from week to week. I tend to use eBay and pound shops to add regularly to my collection.

All you need to do is have fun, as it engages the kids with your activity. If you are engaged, they will be too. It’s all about engagement, fun, motivation and showing them something worth communicating about.

Benefits of Attention Autism

Attention Autism is a regular part of my week. In the school I work in the children are always desperate to know what is in the bucket and jump up and down trying to look inside (this makes me think of children trying to take a sneaky peak in Santa’s toy bag on Christmas Eve!).

What is fascinating about this programme is that it sparks their curiosity and therefore creates reasons for them to communicate by asking questions, commenting and guessing what might be coming out of that mysterious bucket. From my experience of using this programme, it does not merely work on the children’s attention and listening skills, but also on their language skills (both receptive and expressive language skills). These can be a challenge for children with ASD. The sessions can be tailored to build on their vocabulary knowledge, for example, they can be themed around dinosaurs or superheroes etc.

What a session looks like and example activities

A myriad of themed activities can be incorporated into an Attention Autism programme. For example, bucket time can be filled with dinosaur toys (from sensory to wind up dinosaur toys etc).

I start with the song, ‘I’ve got something in my bucket, in my bucket, in my bucket. I’ve got something in my bucket, and I wonder what it is. Let’s look and see!’. The children sing along transfixed on the bucket, wondering what might be inside. Just a warning this song will take over your mind and at times I can hear it when I am mopping the floor or shopping! You then demonstrate the toys one by one and the idea is the kids watch, pay attention and do not touch. Hard to imagine, but it is surprisingly easy to achieve when following the attention autism programme.

The activities ‘Sleeping dinosaurs’ and ‘Roll the dinosaurs’ involve the children pretending to be asleep and rolling each other along the floor and more song singing. There are also more hands-on activities where children make dinosaurs with Play-Doh or arts and craft materials with big googly eyes. My kids love it all!

Useful tips when running an Attention Autism group

Always remember these useful tips when you are running an Attention Autism group:

•       Say less.

•       Use lots of pauses.

•       Exaggerate gestures and facial expressions.

•       Give time for thinking and stay quiet!

•       Show first then add words.

•       Have a clear idea of your objective.

•       Make sure your activity is the most exciting thing in the room! Cover up or remove distractions.

•       Turn disasters into ‘part of the plan’. It doesn’t matter if it doesn’t work out, this is a great way to model ‘uh oh’ and ‘oops’ etc.

As Gina Davies says: ‘let’s create an irresistible invitation for learning’. Attention Autism principles can be generalised into curriculum activities, for example, literacy and numeracy to facilitate learning and skills development.

Let’s really think about the activities we plan for kids. Is the activity irresistible? Is our activity worth communicating about? Fun and engaging activities create good memories. Let’s create a shared experience that is memorable and share laughs with our kids to help them learn.

For further information and more ideas on Attention Autism, take a look at these:

Facebook page - Gina Davies Autism Centre

https://www.youtube.com/watch?v=nFYnc4xcZ6k

https://www.youtube.com/watch?v=NMEhkD0W5Z8