Tag Archives: independent speech and language therapy

My favourite therapy prop: a 20 year old toy dog

dressing up dog

Last week was Speech Pathology Australia Week & talk on twitter turned to favourite toys for therapy. I love toys that can be used to work on several different targets. Meet Dog, he’s one of my favourites because he’s so versatile, and the children love him! Wikipedia tells me that Pound Puppies were sold in the 1980s, I think I was given mine for Chanukah when I was 8 or 9 years old. Who knew he’d be starring in therapy sessions more than 20 years later!

I’ve recently been dressing up Dog to work on the verb: wearing. Here’s what a therapy session might look like.

When I teach a new word, I begin by modelling it a lot in different contexts. The child and I take turns choosing items for Dog to wear, and I comment: “wow, Dog is wearing glasses. I’m wearing glasses and Dog is wearing glasses.”

Accessorising ourselves

DSC_9970

Then we start putting on funny accessories ourselves and I keep modelling the target word: “You’re wearing goggles, you’re ready for a swim.” “I’m wearing a monkey hat, it’s warm!” Children learn by doing; in this activity they’re wearing different things, while I model the word. It’s also fun to take photos of the child wearing different accessories, and talk about what they’re wearing in each photo.

Dressing paper dolls

DSC_9963

Next we try a paper based activity, like this doll game. We dress the dolls (while I keep modelling the target word) and then I’ll try to cue the child in to using the word himself. I’ll say something like: “My doll is wearing a yellow dress and boots, your doll is…?”

There’s an app for that

DSC_9972I found this free iPad app, which is good to end on. The child selects clothes and shoes for the doll – it’s another fun opportunity for more modelling and perhaps the child will be ready to use the word himself.

Tip: children want to keep trying different clothes on the doll. So when it’s time to talk about what she is wearing, I take a photo of the outfit and switch to the photo app. Then the child can’t change the clothes anymore and can focus on describing what she’s wearing!

Practise at home

I give the parents the paper dolls to take home, encourage them to practise the other activities as well, and remind them to talk about what they’re wearing throughout the day.

If your child is struggling to learn new words and you’d like an assessment or advice, get in touch.

Reflecting on 3 months of independence: trying to be myself

IMG_0893

Three months ago I left a job in the NHS and started working for myself, as an independent speech and language therapist. It’s been an adventure. First I found two lovely therapy rooms and got myself kitted out with kiddie sized furniture, toys, assessments and a laminator! Then families began getting in touch and my caseload started to grow.

I’ve been reflecting on how things are going. Two blog posts I read recently feel relevant to my situation.

You Are Not a Large Corporation A manifesto for the self-employed by Paul Jarvis, is a list of things that self-employed people can do with their new freedom. I love it! It includes:

You can let your personal values and ethics guide your work and who you work with.

You can be yourself, even if you think it’s not professional. Being authentic draws others in and can be quite contagious. Your personality is awesome enough to let shine in any and every situation.

He also talks about defining success for yourself, breaking the rules, learning from mistakes, and not having a plan.

The post made me think: I spent 7 years working in the NHS, I became accustomed to the NHS way. I’m constantly asking myself, am I doing it this way because it makes sense or because that’s the way I’ve always done it? I’m grateful that I can work in a way that reflects my values rather than having to follow rigid protocol. I’m thrilled by the progress my little clients are making, now I’m able to tailor therapy to their needs.

What about being myself, being genuine, letting my personality out? Nobody told me that I couldn’t do that in the NHS. Perhaps I didn’t have time, or keeping part of myself back was a coping strategy for an overwhelming job. But clients value seeing our personalities. I read this post (follow Dana’s blog, she talks a lot of sense.) It’s a lovely letter from a mother to her daughter’s therapists, she finishes by thanking the therapists for loving Maya:

The therapists loved Maya, despite the fact that they weren’t obligated to do so, and that expression of love gave me the hope and belief that others would see how amazing she is and love her, too.

I’m thrilled that my new role allows me to really get to know the children and their families. We see each other every week and are building relationships. I’m worrying less about being professional and instead I’m focussing on being genuine, because that’s how we connect with and learn from each other.

It’s not all roses and children magically putting two words together. When things go wrong I’m trying to practise mindfulness, remember not to dwell, and move on. Sometimes I find I’m questioning everything, including my skills and sanity! I’m new to this running a business malarkey, it can be tough.

 

Parents want a speech and language therapist who has time for them

Post it notes, themes

I’ve been thinking about how parents choose a therapist for their child (I’ve recently set up my private practice). What are they looking for? What do they want? I used feedback I’ve received from parents to make a list, then arranged my ideas into themes.

First there are ‘logistical’ factors. Parents want an SLT who:

  • is punctual,
  • is professional – doesn’t cancel appointments at the last minute,
  • is reliable – does what she says she’ll do,
  • gives appointments at a convenient time,
  • communicates in a convenient way, for example by email,
  • completes reports in a reasonable time frame,
  • has time to listen to them.

Next there are ‘therapist’ factors. Parents want someone who:

  • can build rapport with their child, so therapy is fun & their child likes going,
  • can facilitate progress, so their child develops new skills,
  • is flexible, if something isn’t working she’ll try a different approach,
  • is responsive to changes in the child or family,
  • is experienced,
  • is consistent (this is a big one) they want the same therapist, not a different person every block or visit.

Interpersonal factors are also important. Parents value therapists who:

  • listen to their views and respect them,
  • believe in their child’s ability to make progress and offer hope,
  • can give advice and support around wider issues such as school placements,
  • can work well with the other professionals their child sees,
  • can admit when they don’t know something and ask a colleague,
  • are transparent, with an open, honest, straightforward attitude.

A magic wand and the evidence base

I thought of two more things that don’t really fit in above: the magic wand and the evidence base. Some parents want to find an SLT with a magic wand, someone who can simply make their child’s difficulty disappear. If you find one, let me know, I’d love to interview him or her for my podcast!

Finally, there’s evidence based therapy. I’m not sure how much of factor the evidence base is for parents. Although I’ve never been asked to support my therapy plan with research papers, I have been asked: do you think this will work, how has this approach worked with other children, and which approach will have the quickest result? So some parents are evaluating different therapy options, it’s really encouraging.

When I look over this list, I’m struck by how many of these depend on a therapist having enough time. Perhaps that’s the key, parents want a therapist who they feel, has time for them.

What have I missed? SLTs, what do your families tell you they’re happy with and what do they complain about? Parents, what is most important to you when you’re looking for a therapist? I’d love to hear from you!

 

Organising life is hard for both therapists and parents

 

Rhiannan at sunrise (kind of)

 

London feels different at 6.15am. There’s a sense of opportunity: a new day stretching out ahead. The streets and trains are less crowded, the city feels calmer. Now I’m self employed I bounce out of bed each morning with the sunrise… just kidding! I am doing two early starts a week though, so I can offer therapy sessions before school. Surprisingly, I’ve enjoyed being up earlier than normal. I’m using the change to try out new ways of organising my day. Continue reading

Using “yes, and…” to facilitate change

Change diagram

I’m in a transition phase; I’ve left my NHS role and started work as an independent therapist. I find change tricky. I had an interesting conversation with Abi Roper and Tom Starr-Marshall that made me think — why is change in the NHS so difficult? And in a solution-focused kind of way, what makes particular projects successful?

Looking back, there was a pattern to my attempts at service development (try and follow along with the diagram!):
Continue reading

To connect with our clients we must model vulnerability

Keep_Calm_and_Carry_On_Poster

I believe that wonderful things happen when we step outside our comfort zone and do things that scare us, when we’re brave and allow ourselves to be vulnerable.

There was recently a discussion on twitter about SLTs presenting a calm exterior even when we’re panicking or out of control on the inside. We all know this feeling! It got me thinking, we need to present ourselves in a way that inspires confidence in the people we work with. We also need to bring our vulnerability to work – and not worry about people seeing our uncertainty. It’s hard and something I continue to struggle with.

Continue reading