I kept two principles in mind when deciding what I needed to buy or borrow to start my therapy business:

• Wait and see what I need and then buy it – with internet shopping lots of things are available on next day delivery.
• Buy things that can be stored easily and used for multiple purposes – as I’d need to store everything at home and then carry it to therapy sessions.

Assessment materials

I bought two standardised assessments, my most expensive purchase. I’m happy with the two I chose and how many times I’ve used them. The publishers have displays at industry conferences or events and offer discounts, so if you’re planning on going to an event and need to buy assessments check and see if the timing works out.

I also use informal measures like Language For Thinking and sequencing pictures from Black Sheep Press. Some observation schedules are available for free online, like the Modified Checklist for Autism in Toddlers – so I use these.

Toys and books

My colleagues in the NHS asked what I’d like as a leaving gift, so my toy collection started with a tea set, a train set and Mr Potato Head! I bought toy animals, food and a fishing game. My parents still have toys from when my sisters and I were little so I “borrowed” soft toys and books from them. (Check the content of books, I love There’s a Hippopotamus on Our Roof Eating Cake but in my original copy, the character gets a smack: I skip this page.)

I’ve found some great bargains at charity shops and bought things to motivate particular clients. Homemade toys often go down well too, I still have the sparkly tube I made back in 2008 and still get strange looks carrying it to work on the bus!

Technology

I use my iPad in therapy. I record and watch back videos in Parent Child Interaction therapy, with a small set of speakers to boost the audio. I also use it to play games such as my favourites from Toca Boca. When I made a snakes and ladders style game to work on speech sounds, I realised I didn’t have dice, so I downloaded a free app (I think it’s for poker!)

We already had a colour printer and scanner at home, and I use both regularly. I bought a laminator and I use it for making visual timetables and other resources. I’ve written before about Lessonpix – the online product I use to make my visuals (and bingo games!) Finally, I use Cliniko to manage my appointments, write my case notes and send invoices. I’ll write more about how I use it in the next post.

Other bits and pieces

I bought two folding child sized tables and four chairs which I used for every session in my original therapy rooms and currently don’t use at all.

And my secret weapon? A box of tissues. I’ve finally realised that if I bring the tissues, I’m much less likely to get sneezed on!

This blog post is part of a series, read the previous posts here.

The Wellcome Trust hosts a series of lunchtime discussions with local scientists. Last week Dr Mairéad MacSweeney was talking about her work in the Deafness, Cognition and Language Research Centre, at UCL. The Wellcome Trust recorded a podcast of the discussion, so check it out when it’s published.

Mairéad explained that she uses brain imaging techniques, with people born severely or profoundly deaf who use sign language, to investigate language processing. In deaf native signers (deaf children born to deaf, signing parents) children move through the same developmental milestones as children learning spoken language, and show similar brain activation. Mairéad explained that (in native speakers) the brain treats language as language.

I was interested to hear that in some parts of the country parents of deaf babies are being advised not to use sign language as this will stop babies learning to speak when they go on to get a cochlear implant. Mairéad suggested that research into the plasticity of the brain doesn’t support this idea. Instead, as with children exposed to more than one spoken language, children simply need good quality early language stimulation. They can then use this first language as a base to build another language on top of.

Mairéad told us that deaf children find it particularly hard to learn to read, she quoted a figure: at 16 years old the average reading age of a deaf teenager (with normal non-verbal IQ) is 11 years. Researchers have found that lip reading skills predict reading ability, so Mairéad’s team is developing a computer game to teach young children lip reading, and investigating the impact on reading. If teaching lip reading supports reading, it could be used with other children who struggle to learn to read, such as those with dyslexia.

I asked Mairéad why lip reading predicts reading skills. She explained that lip reading supports identifying phonemes and developing phonological representations. I wondered about children with autism, some who learn to read early. These children aren’t known to face watch, and therefore probably aren’t lip reading. Interesting!

It was a lovely way to spend a lunchtime, keep an eye out for any other relevant talks and go along. 

Photo by Image Editor

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.

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. 

I spent last week hiking 50 miles along the Pembrokeshire coast path. It was beautiful, stinking hot and a trip I’ll remember for years. The hours of walking gave me time to think, and I realised a long distance walk is a good metaphor for the therapy process.

A long journey

50 miles over five days sounded straightforward when I was planning the route. Factor in a heavy backpack, rough terrain and a freak heatwave and those miles were long. The therapy process can be long too. Children may need to develop skills in several areas, they may learn quickly and then take time to generalise, or it may take time to find a therapy approach that works.

It’s challenging and there’ll be tough parts

The walk seemed hardest when it was steep and hot, then suddenly easier when the path flattened off and the sea breeze began to blow. Therapy has easier and tougher parts too. At times something clicks and children suddenly get it, at other times no one is in the mood. There may be frustrations and times when we want to give up. We need to keep going and wait for the sea breeze.

Repetition makes it easier

We bought a new tent for this trip: the first time we put it up, it took about 40 minutes! The second time was faster and by the sixth night we had it down to an art. Therapy get easier too. Families get used to practising at home and find creative ways of integrating activities into each day. Children get used to how therapy sessions work, they get to know the therapist and what to expect.

Celebrate all progress

When we got to the top of a steep climb, we’d take our backpacks off and celebrate with snacks and water! It’s important to notice and celebrate progress in therapy too, however small. Remember how far we’ve come.

People may not understand

Some people we passed on the trail looked at us like we were crazy, one man even suggested we take the bus! When I was struggling, the strange looks people gave me made me feel lonely and the walking seem harder. I ignored people’s judgements and kept going. Sometimes friends and family may not understand why a child needs therapy or how the process works. Families tell me this lack of support can seem hurtful, and is one more thing to worry about. Tell friends and family how they can help you, and then keep doing what you need to do.

If you commit it’s worthwhile

I was determined to finish the walk. I had to be flexible and adapt my plan. Due to the extreme heat we took a shortcut one day, but we made it! When families can commit to therapy, and work with a therapist they trust, children make progress. All the hard work pays off when a child is able to express themselves, make relationships and blossom!