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.

To finish this series on Becoming Independent I’m going to write about two challenges I have: resisting doing things the way I always did them in the NHS and scheduling clients.

When I started working independently I kept asking myself: am I doing this because it meets my client’s needs or because this is the way I’ve always done it? One of the things I appreciate most about working independently is the freedom and flexibility I have to offer clients what they need.

Length of therapy blocks

Here’s an example. I started out booking clients in for 6 weeks blocks of therapy, like we used to in the NHS. Then I realised I didn’t need to be constrained by this timeframe if it wasn’t working for me. Although when I reflected on it, I realised it was working. 6 weeks is long enough to make measurable progress towards goals and allows me and the family to continuously review how we’re getting on. Parents can commit to blocks of 6 weeks; it doesn’t seem like speech therapy is something they’ll be doing forever.

In most cases, I have dropped the “consolidation period” between blocks of therapy, which we used in the NHS. Although I still use it for Parent Child Interaction Therapy because I see families benefitting from it. With direct therapy I see clients on a weekly basis for as long as they’re making progress towards their goals.

I’ve cut down on paperwork. I see parents each week and we discuss targets and progress, I don’t tend to write review reports or formal programmes, they’re not normally necessary.

Scheduling

I don’t have much advice to offer about how to arrange your therapy schedule, I wanted to flag this as one of my challenges. Parents enquiring about private therapy assume they can request an appointment time that works for them, which of course they can! However, as I only work two days a week it feels like more often than not our diaries don’t match up. Some parents are able to juggle things around; move the swimming lessons or switch the day of the week they work from home. Others aren’t, and ask me to recommend a different therapist.

I’ve learnt a few things that might be useful:

• The 8.30am slot is popular, but doesn’t suit families who have other school aged children to drop off.
• The 3.30pm and 4.30pm slots are also popular but don’t tend to be productive with nursery or reception aged children who’ve spent the day at school.
• Many parents are surprised when I suggest they could drop their child to nursery/school later or pick them up earlier to accommodate therapy sessions. Nurseries/schools respond to this in different ways, some are happy to release the child for therapy and others are not. It seems to be worth a try.
• When I had more free appointments, I tried to be strategic, e.g. offering mid morning (and sometimes hard to fill) appointments to children who did the afternoon session at nursery.

In some ways things are more straightforward now I’m close to capacity: either parents can make it work, or they can’t, and that’s okay with me. I bring up my availability early in the conversation, because if Tuesday at 2.30pm is impossible for a family, I don’t want them to feel they’ve wasted their time giving me a lot of background information.

That’s it for the Becoming Independent series! Did I miss something you’ve been wondering about? Let me know.

Photo by Cygnoir.

People have asked me how I advertise my practice. When I ask clients how they found me about half say someone they know recommended me. Some tell me they found me via the ASLTIP directory, and the rest searched google and found my website.

Encourage Personal Recommendations

Happy clients tell their friends! I’ve worked with a former client’s next door neighbour, been contacted by a woman who said her sister’s friend suggested me, and had parents recommended me to their child’s classmates.

I told people in the NHS and education department where I used to work, that I was leaving to work independently, and I’ve had enquiries and recommendations from them. I also tell people I meet that I’m a paediatric SLT – I once worked with my yoga teacher’s son! So carrying business cards is useful, I have these mini ones from moo.

I receive personal recommendations from other independent SLTs in the local area. Several friends work on a part-time basis, or specialise in particular areas of therapy. When these therapists receive an enquiry from a family they don’t want to take on (for various reasons) they recommend the family contact me. And I signpost families to particular colleagues if I think they’ll be a better fit for the child.

Use the Directory of Independent Speech and Language Therapists

I am a member of the Association of Speech and Language Therapists in Independent Practice so have an entry in their directory. Parents who find me here often haven’t seen my website, so they aren’t always aware of how I work and my prices.

Finding My Site by Searching on Google

I haven’t tried paying for google ads. I attempted to make my site findable by thinking about what parents might search for and including relevant content. I write blog posts about things I hope parents will be interested in, and I added myself to google maps. You can use a free or low cost service, like Squarespace, to make a website without having to hire a designer.

What didn’t work?

I haven’t had much success with adverts. In 18 months I’ve had two enquires from a (free) advert on netmums. I spent £20 on an advert on a local parenting website (I think they also included me in their newsletter) which didn’t generate any interest. I’ve written articles about communication development that were included in local parenting magazines, but again these didn’t lead to any enquiries.

I emailed around 25 local nurseries to introduce myself and explain what I could offer, attaching a pdf of a flyer I’d made. This led to me meeting one nursery manager, and then assessing one child and running a staff training session. So, it wasn’t a complete waste of time, but didn’t keep me very busy.

This post is part of a series about Becoming Independent. Next up, choosing where to work.

A few weeks back I found myself listening to inspiring speakers at The House of Commons. These speakers weren’t politicians or the academics who’d invited me, they were children, young people and adults with language impairments. The event was celebrating 2 years of the RALLI campaign, which aims to raise public awareness of what language learning impairments are, how to identify them and how to support people who have them.

The team behind RALLI are trying to make this information accessible by publishing it on a YouTube channel. The short videos are accompanied by slide presentations with references to relevant research and the evidence base.

Looking into the future

I work with pre-school children, so I find it valuable to hear from older children, and adults who have the same conditions as my clients. It’s like being able to fast forward 5, 10, or 15 years and see what the future might hold. The people with language impairments talked about what helped them and what they found difficult. A teenager spoke about how his life at school changed when people started giving him one instruction at a time, as well as extra time to process what they’d said. A woman spoke about the frustration of having to explain what a language learning impairment is, when you have a language impairment!

Watch a video

Thanks for inviting me RALLI team, it was a wonderful evening! If you’re not familiar with the RALLI videos take a look at Dorothy Bishop explaining why they launched the campaign or here’s me and two colleagues talking about SLI and Bilingualism. 

The folks at The Hanen Centre kindly sent me a copy of I’m Ready – How to Prepare Your Child for Reading Success and asked me what I thought. Here in the UK advice about how to support literacy skills seems to change frequently, so I was interested to see what Janice Greenberg and Elaine Weitzman suggest.

The book has 6 chapters: Early Literacy, Conversation, Vocabulary, Story Comprehension, Print Knowledge and Sound Awareness. It’s visually appealing; the text is broken up by photographs and drawings. I read it over several days and found it easy to pick up where I’d left off. There’s a comprehensive list of recommended children’s books, coded in terms of how they can be used to support literacy. I think the ‘Try it out!’ checklists and reflection questions look useful.

The book is full of practical examples from real families, so it’s both straight forward to apply and realistic, in terms of what parents can fit into their lives. There are plenty of Hanen’s trademark memory aids, some familiar like OWLing (observe, wait, and listen) and some new (to me) like POP – point out print.

My favourite thing about the book is how clear the authors are about the importance of making reading fun by following the child’s lead. I often worry that parents go in too heavy with the flashcards approach, which can put kids off, so I was relieved that the book stresses reading needs to be fun.

The blurb on the back of the book states that the authors have taken the most current research and broken it down into fun strategies for promoting early literacy. The only thing that frustrated me is that although they’ve provided references for each chapter, these aren’t clearly identified in the text. It simply says: “studies have found….” – so it’s not clear which study they are referring to. I think some parents (and professionals) would like to read more detail from the original research paper, and the format of the book doesn’t support this.

If you’re looking for ideas about how to use books (and conversation!) to prepare a child for reading and writing I’m Ready is packed full of them. It’s easy to read, practical and fun.

If you’re in the UK, the book is currently only available directly from Hanen. Hanen hope their UK distributor will be stocking it soon.

This is the first time I’ve blogged since I had a baby 8 weeks ago. I’m delighted to be sharing my life with this tiny person, although he sure does change the landscape of my days. Spare moments are scarce, when I find them, I hop into bed for a nap!

I’ve been told by parents I’ve worked with that I didn’t understand particular things because I didn’t have children. In my foggy mental state I’ve reflected on a few things I’ve learnt as a new parent.

I’ve realised how dedicated some parents are. I’ve known families come to therapy sessions with their older child when their new baby was just days old. In those first few weeks I called it a successful day if I could shower and comb my hair. These families had a legitimate reason for cancelling sessions but they didn’t: they came along, took part, and supported their older child. Wow. 

I also now understand how difficult it can be to get to appointments on time. I hate being late, but it’s hard getting me and the tiny person out of the house at a set time. I’ve sacrificed the shower and hair combing to make sure we made it. As a therapist, I can’t organise my day so that families can come to their appointments 20 minutes late although I can try and schedule the appointment for a convenient time. 

As a new mother, I’ve been the “patient” or “client” which takes some getting used to. I hadn’t spent a night in hospital since I was born! I’ve struggled with breastfeeding, when I tried to access support I realised: I didn’t know what normal was, and I needed to listen to my gut.

When I started telling the midwives and then the health visitors that feeding was incredibly painful they all said a variation of: “it is at the beginning,” and suggested I give it time. My gut told me something was up, but I’d never done it before and I didn’t know what to expect, I had no idea what “normal” was. It took lots of tears (mine – not the baby’s!) blood, an infection, and me doing my own research before I insisted on a referral to the tongue tie clinic. After 4 weeks I’d found the reason for all the pain and we could begin to move on. 

As a therapist I want to remember that parents may not know what type of communication to expect at their child’s age and although, of course, there is a huge range of “normal” I can provide them with this information. I also want to give parents time to explain to me what their gut is telling them, and really listen to them. I felt frustrated, overwhelmed, and angry when my need to be understood wasn’t met. I knew the professionals I saw didn’t have a magic wand, and couldn’t make the pain disappear, I needed to be understood.

Finally, although I knew no one I spoke to would have that magic wand, I really wanted them to. I know this is how some of the parents I work with feel. My partner gently reminded me we were looking for small improvements, aiming to move in the direction of painless feeding. He encouraged me to record the progress we were making in a notebook, suggested I review it often, and broke out the bubbly when we made it! I want to be this supporter in the therapy process, and bubbly on discharge is an idea I could get behind! 

I came across LessonPix, it’s an online product, there’s no software to install or CD to lose, and I can use it on any computer that has an internet connection. The cost is $36 (USD) per year for an individual subscription, which converted to £22.62 when I paid online with my credit card. It’s less than £2 a month, and as there’s no CD to receive by post you can get started straight away.

I’ve used this resource every week since I bought it, and I recently renewed my subscription for a second year. I’ve made all the usual things, such as symbols for visual timetables using the picture cards template. I’ve also tried out new materials, my clients have enjoyed the games like dominos and board games. I even made a bingo game with s cluster words for a client’s birthday!

To make a resource you simply search for the pictures you want to use and drag each one into your “tray.” You then choose what materials (picture cards, now and next board etc) you want to make, and the site produces a PDF. You can save your trays to easily make different resources with the same pictures later on. As the finished resource is a PDF you can print it from any computer, you don’t need to be signed into the site. I store all my resources in Dropbox, so if I forget to print them, I can always pull them up during sessions on my iPad.

It is so quick to use that it’s easy to personalise the resources for each child, simply putting their name in the title is a detail they appreciate. You can upload your own pictures and photos to the site and then use them to make resources in the same way. If you’re using words with the pictures, you can replace any of the existing labels with your own words – which means the USA / UK English differences aren’t a problem; just search for ‘faucet,’ choose which picture of a ‘tap’ you want, and change the label!

The only thing I’d advise you to watch out for is getting signed out of the site. If I sign in and start filling my tray to build a resource, then get distracted and come back later, the site sometimes automatically signs me out. If I don’t notice I’ve been signed out and finish making the resource, and produce the PDF (when I’m not signed in) the PDF has large watermarks on it and I have to re-do it.

The service was designed and built by Lori and Bill Binko, a husband and wife team in Florida. Bill is an active Twitter user, where he responds to therapists’ queries and lets people know about special offers. It appeals to me that they promote their service by providing useful information and responding to feedback. The gorgeous pictures of Florida sunshine (on Twitter) can be hard to take during winter here in London though! The site has a friendly feel, for example, if you can’t find the picture you need, simply click ‘request an image’ and let them know what you think is missing.

I wasn’t asked to write about LessonPix, (I paid for both of my annual subscriptions) I’m choosing to spread the word about a product I find useful. My subscription to LessonPix has met my needs; I can produce engaging, personalised, visual materials quickly and easily. It’s so affordable and easy to use that I feel happy recommending it to parents. Check it out!