I’m listening to my kids in the kitchen with their grandparents. They’re doing a chestnut experiment. We collected loads, while out on walks. I can hear such varied vocabulary: peel, shell, sharp, brains. And they’re using a timer, to see how long they boil the chestnuts for, 2 mins – “poke,” 4 mins – “still too hard,” 6 mins – “perfect!” My kids love experiments you can eat! And they’ve been learning new words at the same time.

We have also put chestnuts into dump trucks and trains, eaten them at tea parties, and thrown them. Very multipurpose.

I’m using this Halloween craft from Made by Joel, tomorrow with a 6 year old client. We’ll be practising giving each other instructions – “colour the pumpkin with the orange pen” and “cut the bat with the small scissors.” Then we’ll use the finger puppets to act out sentences: “the ghost is scaring the cat!”

Let me know if you have any favourite seasonal craft activities for young children, I’m always on the lookout.

We’ve been spending lots of time at the beach this summer, so here are some ideas for how to incorporate language learning into beach time.

First up, for me personally, this is textbook “follow the child’s lead” – because I am not a fan of sand, the beach is not my destination of choice, but both the kids love it. Take time to notice what your child enjoys doing at the beach, perhaps they want to make sandcastles but perhaps not. Collecting and arranging pebbles, digging holes, mark making with sticks, are also fun options. What inspires your child?

Next consider how much you talk when you play with your child. Experiment with leaving more silence, continue to follow your child’s lead and contribute when they ‘ask’ you to. They might use a direct question, give you an instruction, or simply look at you, to indicate they’re ready for your input. If more silence feels unnatural, try imagining someone chattering to you when you’re concentrating on writing a tricky email. The person comments on what you’re doing, asks you questions and makes suggestions you didn’t ask for – distracting and annoying, right?

Today my 3 year old and I talked about “sprinkling” the sand, and how wet and dry sand is different colours, as he buried his hands and feet. The 1 year old found out there is a limit to my ability to follow his lead, and we worked on his comprehension of ‘no’ – I must have said: “no eating” (sand) about a hundred times!

What does your child like to do at the beach? Any tips for stopping sand eating?!

Here’s the first post in a new series, Real Life Language Ideas. Therapy targets need to be worked on frequently between therapy sessions, this is easiest for the family and most functional for the child, if it can be incorporated into activities they do anyway. In this series, each post will explain how a child can practise various language and speech skills during a particular activity. First up: blackberry picking!

My 3 year old inspired this post, he loves picking blackberries. It’s an activity we can do as a family (the baby is more of an eater, than a picker) and fits with my intentions for the year of moving more and getting outside. Locals in our new home town have been keen to direct us to the best bushes, I encourage you to go forth and get picking!

Here’s some ideas for how you can support your child’s speech or language development at the same time as having fun as a family.

Waiting for face watching

This is more a practise area for the adult! As part of parent child interaction therapy I often work with adults on waiting for their child to indicate he or she is ready to hear language, by waiting for the child to watch the adult’s face. So get down to your child’s level at the blackberry bushes and wait for them to look at you, no picking, tasting or talking until your child watches your face.

Vocabulary

Working on verbs in therapy? You could model, emphasise, and then repeat, repeat, repeat: picking, eating, tasting, squashing, pulling, throwing.

If your child is practising concepts, you can incorporate those too. Use different size pots, to practise size concepts, or talk about:

• empty and full
• high and low
• tasty and disgusting
• healthy and ill (my 3 yr old and I discuss this a lot, in relation to how many we eat whilst picking!)

Questions

Model relevant questions for your child and give them plenty of time to practise asking you back.

• “Who should pick this blackberry?”
• “Where shall we look for more blackberries?”
• “How many shall I pick?”
• “Can I taste one?”

Sequencing and Narratives

Today we came home and my son helped his dad make a pie with our blackberries. Cooking is a great opportunity for practising: first, next, and last.

Speech sounds

If your child is working at single sound level, you could ask them to say the target sound 3 times each time they pick a berry, eat a berry, put one in the pot, or spot a juicy one. Do the same with vowel consonant, or consonant vowel combinations. If your child is working at word level, try and find a word or two that work for blackberry picking, for example: for /k/ in word final position: you could work on ‘pick’ or ‘sick’.

Let me know if you go out picking, or think of other targets that lend themselves to blackberry picking! And now for more pie pictures.

Hanen have recently released a revised (5th) edition of their It Takes Two To Talk handbook. I got my first copy 9 years ago, when I trained to lead the program, and I’ve been referring to it regularly ever since.

Parents who are worried about their child’s communication skills want to know what they can do to help, and this book is filled with practical suggestions. It guides parents. The authors state clearly, and multiple times, that they recommend parents consult with a speech and language therapist: this book is not designed to replace having speech and language therapy. However, it provides strategies and techniques that can be used in the meantime, or alongside attending therapy.

I’ve happily recommended this book to friends, whose children have delayed language skills. It is clearly written, with delightful illustrations that add clarity to the text. The tone is supportive, and not at all judgemental.

Changes in this new edition include:

• An updated Stages of Communication Development checklist,
• A section on supporting children who are learning more that one language,
• More ideas about how to integrate communication goals in play.

In the bilingualism section, the authors explain different types of bilingualism and state:

The important thing about choosing home languages is that you should be able to communicate effortlessly with your child. That means being able to talk, sing, read and express love to your child in the language you are most comfortable with.

What a lovely way to say it!

This book shows parents how to use the strategies as they go about their daily lives. During daily routines, such as mealtimes, while playing, reading and singing. Parents aren’t being told that to support their child they need to find more time, instead they are shown how to make the most of what they already do.

It’s an inspiring book; after nearly a decade of using this approach, I know the strategies well. And yet when I flick through the book, a picture always jumps out at me, and I’m inspired to try the game or activity with my own kids.

Thanks to the Hanen Centre for sending me a complimentary copy of the new edition, so I could write about it here. These views are my own.

In February, I wrote about wanting to spend more time outside in nature, two weeks later my family and I went on holiday to Wales, and 2 months after that we moved here! We’re now based in beautiful Llanelli, and feeling grateful, particularly for our daily walks along the coast.

I’m still seeing a small number of clients in London, on a fortnightly basis. I’m in the process of finding a therapy room in West Wales and excited about seeing clients here, too.

It’s all a big change. I frequently remind myself of the quote: “the only thing constant is change” and try to embrace all the newness. I’ve been reflecting on transitions and how long change takes to feel ‘normal.’

Our baby is now 10 months old and has been completely chilled throughout the whole move, he is a great conversation starter, making friends wherever we go. Obviously it’s been more challenging for our 3 year old.

I reminded myself how supportive visuals can be for little people (and big ones!) We showed him photos of the new house, the removals van, and the train he’d be taking to Wales. He loves the beach and all the new parks. And during the difficult times I’m trying to implement the advice from a book I’m still reading: How To Talk So Little Kids Will Listen: A Survival Guide to Life with Children Ages 2-7 I don’t want to use power over my son, the book has ideas for finding courses of action that work for everyone in the family.

People ask if we’re settling in. Yes, I think so. We’re happy to be here, although it still feels a bit like being on holiday. I wonder how long it will take to develop friendships, grow my first vegetable garden and feel comfortable saying: “ta ra.” Who knows?!

When parents ask about how long the therapy process might take, “who knows?” is not what they want to hear! I try to reassure them by showing them all the changes their child is making, support them to keep practising, and encourage them to believe in the process, their child and their own skills.

I’m hoping a benefit of life in Wales will be more time to write, watch this space. And if you’re a Speech Therapist anywhere nearby, and fancy getting together, please send me an email, I’d love to hear from you.

My partner has taken the kids out for a walk, so I have time to sit down and write this blog post. I’m reflecting on time. What do I want to use my time for? How can I use my time in a way that serves my purpose?

I haven’t written anything here on the blog for 4 months. I enjoy using writing as a tool for reflection, and ‘blog regularly’ features on my Goals for 2017 list. I meant to write earlier in the year about my intentions for my practice in 2017, but I didn’t make the time. I have two children, the youngest just 6 months old: quiet time to concentrate is rare. But I don’t want to think about time with a scarcity mindset, and I don’t want to live my life that way, rushing from one thing to another, frantically trying to do everything. That’s not connecting with my power.

I’m gradually returning to work, soon I’ll be working one day a week. I choose to schedule my day so that I have a long lunch break, which gives me time to go home and feed the baby. I can fit in 6 children for therapy. Writing this, I realise even my language implies scarcity: ‘fit in’ – squeeze. I want to try flipping this into a positive. How about: I get to help make a positive change in the life of 6 children and their families, what a privilege.

I read an interesting book over the holidays, which fed directly into my intentions for my work this year. Movement Matters by Katy Bowman really intrigued me. I feel like I need to read it through several times, as there is so much in there to think about. After reading it twice, I’m determined to stop asking the children (my clients and my own!) to sit down. I work with pre-schoolers, they have a whole lifetime ahead of them sitting down. All those hours, days, weeks – doing something their bodies didn’t evolve doing. And something some of my little clients find so tricky! So from now on in my sessions we’ll squat, and crawl and jump while we do therapy. And if we’re concentrating while lying on the floor, well that’s okay.

Secondly, I need to get out more. Humans are nature, yet today we perceive ourselves as separate from it. I’ve been reading about Forest School (lots of lovely child-led principles) and thinking about how to incorporate the ideas into my work. There is a huge, beautiful garden where I work, and I’m going to use it more. I bought this book about things to make or do with sticks and this one with ideas for outside activities, and I’m going to have a go. Spending time outside, being part of nature while I work and support children – now that’s serves my purpose.

Speechmark asked me if I’d like to have a look at the new Word Aware vocabulary resource, by Stephen Parsons and Anna Branagan. I was keen to check it out and said I’d write about it here, on the blog, if it was something I thought I’d use, and it is. So thanks Speechmark, for the complimentary copy.

The blurb on the back of the book says it’s: “a practical comprehensive resource designed to support…effective vocabulary development in pre-school children of all abilities.” The core audience is Early Years practioners, but it would also be useful for SLTs and parents. The approach is described clearly, with multiple examples and suggestions for how to implement it in the classroom. If a practioner was able to set aside the time needed to read the book, I think they’d be able to get started. However, if you wanted more support and ideas, Stephen and Anna regularly run workshops on how to set up and run the program.

This resource comes with access to a website, where you can print out supporting materials, which I much prefer to CD-ROMs.

An inclusive, whole class approach

The book starts with a detailed, interesting and clearly referenced introduction, which would be very useful for teaching staff and is a great refresher for SLTs. I like the fact that the approach is designed for the whole class, so it’s inclusive and that there is a strong emphasis on the importance of Adult Child Interaction. The reader is directed to Keena Cummins’ work for more information about this.  While reading the intro, I noted down the phrase: “enthralled rather than overwhelmed” (by new words) what a lovely reminder.

The book describes four strands to the teaching approach:

• Make words count
• Teach vocabulary
• Fun with words
• Word detective

Practioners are encouraged to provide an enriched word learning environment, teach vocabulary using the STAR method (see below), enjoy, celebrate and reinforce vocabulary, and finally teach children how to learn new words.

The STAR process teaches words in a structured and specific way, it is adapted from Blachowicz and Fisher, 2010. STAR stands for:

• Select – the most useful vocabulary
• Teach – the selected vocabulary in a meaningful way
• Activate – the meaning by using the words in context
• Review – the taught words to ensure they are retained.

The resource contains detailed directions with comprehensive examples for how to select vocabulary. In terms of how many words to teach, the authors suggest one topic word, one text based word (from a book), and one concept, per week. And just one word, per teaching session.

How do I teach a new word?

The book describes a teaching sequence, so adults can teach new words in the same (effective) way each time. The 6 step sequence includes selecting a picture or symbol to represent the word, and singing the Word Aware song!

To activate the word the child needs to hear it used in different ways, by different people, over a period of time. The book provides lots of suggestions for this stage, for example, treasure hunts are a great way to “activate” adjectives. Finally, we need to review words. This can be done with word bags, and there are several word bag activities described in the book.

Extra resources included in the book

The teaching concepts chapter includes plans for introducing and teaching over 80 concepts. These describe specific activities for each concept, and are a great time saver when planning.

The book also includes chapters about supporting children with higher needs, developing word learning strategies and involving families.

Ways of using the book

I plan to use the STAR process in my individual therapy sessions with children who are working on their vocabulary. I found the guidance about how to select target words, and the ideas for activating and reviewing them useful. I will share the practical activities with parents and teaching staff. I’ll definitely use the concept plans, I don’t think they’d need much adapting to use in a one to one session with a child. And I’ll also recommend this resource, and way of working, to Nursery and Reception class teachers.

This is quite a hefty book, there are 250 pages, and I think to get the most out of it, and the approach, people would need to set aside the time to read it through. Although you could skip over some of the concept plans, you’d still need 2 or 3 hours, if you’re new to the approach, as I was.

I’m excited to try these concrete ideas for teaching vocabulary, in my therapy sessions. Perhaps I can write a follow up blog post when I’ve had a go!

I took my first Hanen eSeminar a couple of months ago, and I’ve been able to apply what I learnt, straight away. I think this is the first eSeminar or online training, that I’ve paid for. It was easy to log in and I could watch the 2 hour video whenever I wanted with 30 days of unlimited access. There was also a handout to download. It was recorded live, so there were some parts when the presenter asked the people watching live to answer questions or vote. It looked like fun! I used this time to make notes and jot down questions.

Definitions of Late Talkers

The eSeminar was titled: Choosing Initial Vocabulary Targets for Children Who Are Late Talkers. I was interested in the topic because I’ve been seeing more and more children under 2 years old, a good proportion of whom are Late Talkers. Some of the information presented was from Hanen’s Target Word program. Cindy Earle who presented the eSeminar began by describing Hanen’s clinical definition of Late Talkers (as opposed to the research definition.) She said that children with less than 24 words at between 18 and 20 months, 40 words at between 21 and 24 months, and 100 words, with no or limited word combinations at between 24 and 30 months, (and no other major concerns in other areas), require therapy.

Communication Goals and Vocabulary Targets

The eSeminar covered risk factors and predictors of change, and then we started thinking about communication goals. I had previously worked on imitation as a goal, but never being noisy! Cindy talked about the importance of learning to vocalise with every communicative turn or “being noisy” and it’s something I’ve incorporated into my work. Cindy moved on to discussing vocabulary targets, providing a useful checklist, including: target words should be motivating for the child to say and starts with a sound in the child’s repertoire. There was also some interesting information about gestures and a discussion about having the word ‘more’ as a target. I hadn’t really considered before that ‘more’ isn’t useful for initiation. I’ve been focussing on verbs and motivating items since watching the eSeminar.

The eSeminar concluded with some video case studies so we could apply what we’d learnt. I really enjoyed the format, the information presented was relevant to my work, and Cindy easily kept my attention for the 2 hours.

Discount on Hanen’s eSeminars about Autism

April is Autism Awareness Month. Or as the folks over at Thinking Person’s Guide to Autism prefer: Autism Acceptance Month. And Hanen are offering 40% off their Autism eSeminars with the code: AAMSEM16. Check out the eSeminars available and remember the offer expires on 30th April.

Win a free eSeminar

The team at Hanen have kindly offered me a free Autism eSeminar to give away! Leave a comment on this post telling me the vocabulary targets you’ve had most success with (“Thomas?” “Up?” “Cake?”) and I’ll randomly select a winner in a weeks time.

I was delighted to hear how well a little client of mine had done with a new activity (a large container of jelly!) at nursery this week, although I was disappointed that his teacher had predicted he wouldn’t be able to access it.

I then read this journal article: The effect of using ‘full’ language when working with a child with autism: Adopting the ‘least dangerous assumption’ by Anne Emerson and Jackie Dearden, Child Language Teaching and Therapy, 29 (2), 2013. This research paper resonated with me because it discussed the implications of underestimating a child’s ability.

The researchers report that the Minimal Speech Approach (MSA) is recommended  in the UK Government guidance on teaching pupils with autism (Department for Education and Skills, 2002: 18) This approach involves using single words or two word phrases alongside gestures and visual supports.

This single case study describes work with Jack, who had been exposed to the MSA approach at his special school. The researchers investigated the effectiveness of a different way of working, they suggest: “it is ‘less dangerous’ to start by assuming understanding and adjusting language when comprehension difficulties become apparent.”

An Alternative to the Minimal Speech Approach

The researchers describe the specific characteristics of the intervention as follows, (I quote from their paper):

• speaking in complete phrases and using a range of vocabulary;
• speaking slowly and quietly, and waiting longer than might typically be expected for the pupil to respond;
• materials and resources to promote interest, interaction and fine motor skills (including pointing);
• initial focus on activities where there was no ‘correct’ answer so that the student could not fail;
an attitude of expectation that the pupil would be able to respond;
• close observation and commenting on pupil responses;
• a willingness to take risks by introducing complex tasks and discovering the extent to which individuals could manage them whilst ensuring success through scaffolding the learning task;
• literacy activities including reading and spelling accuracy tasks such as matching words and pictures and spelling activities;
• reading comprehension tasks.

What a wonderfully encouraging set of principles.

Results of the Intervention

The intervention was carried out during 32 sessions, that lasted between 20 and 30 minutes, over 20 months. Before the intervention teaching staff were using instructions with one information carrying word, after the intervention they reported that Jack was able to understand instructions with three information carrying words. The researchers reported that Jack became more motivated to initiate communication, finding creative ways of getting his message across. The intervention revealed that Jack enjoyed books, was able to match words and pictures, spell words, and sequence words into sentences.

In the discussion Emerson and Dearden state:

Following increased adult expectations, exposure to full language and literacy tasks, Jack demonstrated his ability to respond to more complex questions. Therefore by increasing his opportunities and reasons to communicate, the under-estimation of his cognitive abilities and literacy skill became evident. We contest that he had the means (ability to point) and cognitive ability to follow instructions prior to our intervention but was not being given the opportunity to demonstrate these as he was dependent on adult choice of activity.

The authors describe the teaching staff at Jack’s school as: “initially very sceptical about the approach.” However, over time teaching staff were able to identify that Jack could read, and observe other benefits to using more complicated language.

Reading this paper reminded me that by oversimplifying our language we are underestimating our clients, and limiting their progress. We must incorporate the principles outlined above and expose our clients to a range of interesting experiences.  This is especially important when the children aren’t able to provide such clear evidence as Jack was, of their abilities.

Photo of jelly by Gordon McLean.

A discussion with a therapist friend prompted me to think about how we measure the success of our independent therapy practices. There seems to be a tacit assumption, here in the UK, that as independent therapists we’re aiming to grow our practices, hire a team of therapists, and that more (employees and clients) is best.

My five year (and ten year!) plan doesn’t involve employing other therapists, working lots more hours or making lots more money. So what other metrics do we have for measuring progress with our businesses?

When I try and visualise a successful outcome for my business, I’m interested to notice that my mind is drawn first to how I will be feeling, when I’ve reached my business goals. I will be calm, not frazzled, I will enjoy my client work which will be challenging and rewarding, not frustrating and overwelming. I will be supported by, and support, a group of like minded colleagues.

So if someone were to record a documentary film, a day in the life of my therapy business when I’d reached my goals, what would the camera show? Me smiling and relaxed – my shoulders would be low. I’d have breakfast, and coffee, with my family, before I left for work. High energy sessions with happy children, and me feeding back to parents the progress their child was making. On my computer screen my caseload would show throughput, there would be no waiting list, as soon as I finished up with one child, a new family (who I was excited to work with) would enquire. I’d eat a healthy lunch, while reading a relevant research paper, and get home with energy to spare to play with my son before bed time.

Not quite what you tend to see written in a business plan! (Although I also have financial targets that I need to meet.) I’m interested in other ways (besides money) that we measure success, and other goals that we strive for.

Let me know how you measure your own success, what does it look like for you?