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.

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.

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?

One of my goals for 2016 is to make as many therapy resources as possible. I’m trying to spend more time rummaging through the recycling box and less time browsing on Amazon. I want to keep my clients interested, so I need a variety of materials. However, I don’t want to send the message to parents that the way to keep things interesting is by buying more and more toys. I hope to do some of the crafts as part of the therapy sessions, but this one I made myself, at home.

Toilet roll Octopuses

There are lots of “tutorials” online for this project, it’s really simple. I choose it because I’d collected LOTS of toilet rolls and because one of my clients is interested in facial expressions and another, sea creatures.

Here are my finished octopuses!

I enjoyed getting out my paints and making these. I put a paperclip on each one and we caught them with a magnetic fishing rod. The kids loved them. I’m not sure how sturdy they are, but they all currently still have 8 legs attached, so fingers crossed.

In the conclusion to their book, Jane Stokes and Marian McCormick wrote that they hope it makes you think “Hmmm…” – it certainly does.

As Jane and Marion designed the curriculum for a new postgraduate course in speech and language therapy they collected stories, and then wrote this book to add to the conversation about issues that underlie the SLT profession. The book has 10 chapters, 5 written by Jane and Marian, and 5 contributed by other people. It raises challenging questions and explicitly invites the reader to examine their professional beliefs.

There are a number of chapters I’m looking forward to re-reading and think I’ll review regularly. Marian’s chapter about reflective practice inspired me, and reminded me that one outcome of reflection needs to be a goal for the future. Aoife Gallagher’s chapter “To intervene or not to intervene” had me nodding with agreement. I’ve been considering the role of parental expectations, fear and anxieties in my own clinical work so was interested to read Aoife’s ideas about how to make services transparent and responsive.

In her chapter about supervision Jane introduces models from related fields, that we in speech and language therapy can learn from. Keena Cummins’ chapter on using video clarified issues I’d been struggling with in my therapy sessions. Her analysis of the value of face watching and mirroring between adults made me reflect on some recent interactions with parents. I hadn’t considered the link between spirituality and speech and language therapy. I enjoyed Sophie MacKenzie’s chapter on this topic, which discussed the narratives clients use at different points in the therapeutic journey and person-centred care.

I was scribbling down thoughts and questions as I read this book and enjoyed how it encouraged me to consider why I do what I do. If you’re a therapist who enjoys asking why and getting stuck in to some interesting discussions, I think you’ll enjoy this book. 

The book includes quote from students of Jane and Marian’s course, I was stunned by how insightful they were. If you’re looking to hire a new grad keep your eye out for therapists from the University of Greenwich!

I recently attended a workshop at The Music House for Children on introducing musical learning to children with Autism. I was energised and inspired by the session and left with several practical ideas I’m keen to try out. The workshop was led by Kirsty Keogh, it was refreshing to hear from a professional outside of speech therapy. Kirsty is experienced at working with children and young people with Autism, I could see from the videos examples how well the children responded to her.

She shared lots of practical ideas about how to use music with groups of children and during individual sessions. I’m going to try the “Island approach” – different instruments are laid out on around 6 mats on the floor. The instruments on the mats stay the same each week, except for those on one mat which change to introduce new instruments. The child chooses which instrument to explore, and then the adult joins them. It looked similar to Intensive Interaction, following the child’s lead and gently extending.

Kirsty suggested that when the child chooses an instrument or is given one, we give them time and space to explore it, by initially not doing anything ourselves. This made so much sense to me, but I realised I tend to jump in and start modelling how things work. I’m going to try waiting! I’m also going to try the way Kirsty suggested to get children to stop playing. A big, loud, dramatic buildup encourages stopping more than quietly trailing off. Starting slowly and softly can help some children with Autism access music, and low pitched instruments are easier for some children to tolerate.

Kirsty suggested we think beyond nursery rhymes, to songs with different rhythms, in different keys. She showed us how a song like Ipi N’tombi can be used as a call and response to encourage vocalisation. It’s impossible to sit still during this song!

Kirsty also shared some resources. Some of my clients would love this vibration speaker, which makes the sound vibrate from any hard surface you place it on! And Kirsty said it’s pretty robust. Drums for Schools have good value percussion instruments. And A Little Birdsong, has songs and ideas for pre-school children.

I played a lot of music as a child and teenager, and I’d love to play more now. I’m going to learn some simple tunes on the piano, and perhaps try and take some Ukulele lessons! They’re inexpensive, portable and sturdy – a winner!

Photo by Tam Tam

Last week I had what I thought was a winning therapy idea, when it didn’t pan out I had to improvise.

Two of my kiddies are working on verbs and we’d been practising “cutting.” I’m targeting /sn/ clusters (“snip!”) with another child. I was inspired by some recycled packing materials to try a hair cutting activity.

I drew faces on paper and taped wavy, strings of cardboard packing stuff on for hair, it looked great. I handed a pair of children’s scissors to the girl working on “snip” and she gave it a good go. But the scissors were too small and not sharp enough to cut the “hair” – oh dear. We started snipping other bits of paper, and then rapidly moved on to sticking things on to a picture of a “snail.” For the two boys working on “cutting” it was Toca Hair Salon to the rescue – phew.

Therapy is all about improvising: therapy sessions rarely go exactly to plan. We can’t follow a recipe, instead we spontaneously make communication opportunities from whatever is available, and teach parents to do the same.