Who do I turn to?

By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

I have been a practising Speech and Language Therapist for over 18 years and a parent of two lovely boys for 5 years... Wow! How much my practice has changed since becoming a parent and seeing “the other side”!

From the moment you see those two blue lines on a pregnancy test the worrying and excitement starts. It only grows when you have that bundle of joy in your arms and will continue to grow, even when they are an adult (so my mother says).

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As soon as you know that you are going to be a parent life totally changes. Initially there are classes from the NHS and NCT; how to go through labour, what you need to do to care for your child in the early days and months.

Advice floods in (either wanted or unwanted!) from the internet, from books, television, from friends and family. They tell you what you should and shouldn’t do, EVERYONE knows best. You need advice and support with breast feeding, sleep routines, weaning and toilet training...  As time goes on there is an array of fantastic classes for babies, toddlers and children to develop song, rhymes, baby sensory, baby music classes, swimming etc... 

BUT WHO REALLY TEACHES YOU to help your child’s communication to develop?

The same concerns often arise for parents:

“He’s not like his sister... when she was 2 years old she would not stop talking”.

“People do not think he’s clever as they do not understand him, and he is getting frustrated”. 

“I was told her uncle did not speak till 6 years old; he is 3 years old and not said his first word.. should I be worried?”

“My son has started stammering... nobody stammers in my family why me? I have been told he will grow out of it”.

“We speak Spanish at home many chid is 2 years old and has not used any words, people say it’s because he is bilingual and I am confusing him”.

“My son’s behaviour is terrible he just will not listen I am not sure he understands me, his hearing was tested and its fine?” 

“I know I should not compare, but I look at other children in his nursery and I know there is something wrong. He seems so different and does not play with the other children, he just seems in his own world”.

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Have you ever been worried? Are you concerned about your child’s speech and language development? Who do you turn to? Where do you go? What should you do?

DO NOT WORRY AND DO NOT PANIC...

Magic Words is an Independent Speech and Language Therapy Practice working with children of all ages to support and develop their speech, language and communication needs.

We have clinics in Newport Pagnell, St Albans, & Harrow.  We offer home visits, nursery visits and work in schools with Children with Speech Language and communication difficulties. This may include: stammering, voice problems, language delays and disorders, speech difficulties, autism and many more.

Our fantastic speech and language therapy team are specialised to assess your child; looking at the areas of the communication pyramid:

Attention & Listening

Social interaction

Play

Understanding

Use of language

Speech Sounds

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We offer suitable treatment options which are personalised to your child’s needs, and most of all fun and practical.

#Dyspraxia17: What it means for one mum and her son

By guest blogger Jodie Franklin

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Meet Stanley. 

Stanley was diagnosed at a young age with dyspraxia, he was a very clumsy toddler who was falling over all the time, had no spatial awareness, the list goes on. At the age of 3 I simply put these things down to his age, but his speech was just not developing.

As time went on and he joined nursery we could see he was miles behind his peers. He didn't have a friendship group because nobody could understand him. I was embarrassed to say I struggled at times and our conversations consisted of me of me randomly pointing at objects until I correctly guessed what he wanted.

Stanley starting speech therapy was the first big step towards a diagnosis of dyspraxia. His speech problems alongside his other problems began to make sense-- it all came together-- it was like one of those lightbulb moments. We could then start the process of a formal diagnosis.

We continued our weekly therapy sessions and slowly but surely he was improving with his speech.

As his mother I was so moved to see his confidence growing. He started to make friends and even bought a couple of friends home for tea.

I can honestly say being able to communicate with Stanley made such a difference to the both of us. It was not just his confidence that was growing. 

Stanley is 8 now and his speech is not such a hurdle anymore. Don't get me wrong there are many other challenges, like the time at sports day when he tripped over the hurdles and took out three of his classmates on the way down, but the important thing is he can get up smiling.

He knows he has 'praxia' as he calls it and he sees it as a strength. When told by his consultant that he would find something he is really good at one day, his response was: "I already have I'm really good at falling over!"

Then he laughed.

I can not express how proud I am of his amazing attitude to life.

Working with children and parents from diverse communities

By Natasha White

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Are you currently working with children and families from a diverse range of communities? Are you a teacher or teaching assistant who wants to cater for EAL and bilingual pupils alongside a classroom full of children with other needs? Are you a speech and language therapist who needs to brush up on your bilingual CPD?

If the answer is yes, then you should consider our upcoming bilingual training days. 

Taking place in Sarratt (Hertfordshire postcode WD3 6AS) in February and June 2018, Sunita Shah will ensure that you leave with insightful and practical ways of approaching bilingual clients, pupils and their families. She has nearly 20 years experience of working with bilingual children-- so any questions you might have will be welcome! 

The aims of the day:

To understand the requirements to adapt practice to meet the needs of different clients groups distinguished by cultural or language.  This will also be applied to working within a multi-cultural society (paediatrics). 

The objectives of the day: 

• Getting to know your patch, how to collate demographical information.

• To develop and understand a true definition of “Bilingualism”

• Bilingual language development.  Laying the foundations to the development and acquisition of one or more languages. 

• To demonstrate a progressively deeper understanding of underlying theoretical concept and typologies of bilingual language development.

• To able to identify what factors may affect second language acquisition.

• Why a child may mix two languages, and if this is a characteristic of disordered language.

• To identify tests suitable for bilingual clients

• To be able to adapt and develop informal assessment to gain a base line of all the languages the child is exposed to.

• To be able to identify though formal/informal assessment if a child presents with a specific language impairment or limited knowledge of the additional language used within their environment.

• To be able to take an additional case history gathering more information on language use.

• To be able to train and work with an interpreter identifying the skills required by both the therapist and the interpreter.

• How to decide which language to be used during intervention.

• To identify what the advantages of bilingual language development are.

• To identify components of delivering a “cultural competent” service”

• To have an opportunity to develop problem solving when working with a bilingual client using various case studies.

• To collate reading list and reference to further develop skills when working with children and families from diverse communities.  

Alternatively, if you are a parent seeking therapy for your bilingual child and are living in the Harrow area, please contact us. Sunita is taking bookings now!

Makaton: signing your way to successful communication

By Eleanor Harris - Director of Magic Words Therapy and Specialist Generalist Speech and Language Therapist

Want children to understand you better in the classroom? Increase your gesture and use key word sign!

As a Speech and Language Therapist working with children with Speech, Language and Communication Needs (SLCN), I use key word signing whenever I speak to my clients to help to support their understanding. I also use key word signing to scaffold their spoken sentences, cueing them in with sign for the next word or idea in their spoken sentence. 11 years of experience tells me that this works really well and benefits the children, but what is the evidence to support this?

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The answer is that there is a lot of research that confirms my clinical experiences – there is a neat summary of this evidence here. 

Why does it work?

Imagine you can’t hear at all, or you can hear but you can’t make sense of the sounds you are hearing, as though you are hearing an unknown foreign language. You can see your teacher is talking, but her hands are still, and her face is expressionless. You don’t understand one word of what she says. You feel a rising sense of panic, what are you supposed to do? Everyone is looking at you. Your body begins to go into fight or flight mode. You don’t know what is expected so you have an emotional reaction. Perhaps you freeze, absolutely terrified. Perhaps you hit the table and run from the room. Perhaps you internalise this feeling of panic and never want to communicate at school again.

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Now imagine you still can’t hear or process the sounds that you hear, but this time your teacher is pointing at the things she is talking about AT THE SAME TIME that she says the word, for some words she is doing a SIGN at the same time that she says the word and the sign looks like the object or action. She is gesturing where things start and finish and she has a really expressive face so I can tell when her words are a question rather than an instruction, and I can tell how she is feeling when she says them. As she signs each key word, her speech is slowed down, giving me a chance to process the sounds and words a bit better. I understand 2 or 3 pieces of information from each sentence, I am learning what some words mean because the sign is said at the same time as the word, I learned a new word because the rounded circular outline you just mimed with your hands when you said the word ‘balon’ gave me a clue to understand that it means ‘ball’. I can see you want me to put the ball in a particular place behind me, I can tell because you pointed there after you said ‘balon’. I feel comfortable, I know what to do, I’ve learned new words and I achieve success. I want to communicate again next time.

We know key word signing and increased gesture doesn’t just help SLCN children, but also helps an increasing number of English as an Additional Language children in our schools, as well as typically developing children – listening to a person that uses more gesture is much easier than listening to a person who stands still and expressionless.

For further information on MAKATON, take a look at their website

Brick by Brick

By Natasha

Those familiar little bricks are being put to extraordinary use.

Originally developed by Daniel B. LeGoff (a neuropsychologist), who saw the mighty potential of this humble brick, Lego® Therapy has grown into a motivational practice used by speech and language therapists, teaching staff and parents alike.

It is believed that the name Lego® was adapted from the Danish phrase for ‘play well’. Certainly for many children, the ability to play and interact within social settings seems perfectly natural: it is a skill we often take for granted.  Although, there are also children who find the strategies needed for peer interaction less accessible. Intimidating, even.

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How can a child learn to socialize in a safe and supportive environment?

Our method: Lego® Therapy!

At Magic Words, we use this play-based approach to facilitate children toward ''communicative competence'' (Ralph and Rochester, 2016), depending on their individualised targets. Whilst some might need to work on maintaining eye contact and attention, others might attend the group to aid understanding of prepositions, problem-solving or sequencing.  

The aim of the game is, of course, to build a Lego model. This can be a simplistic or as complicated as you need it to be, according to ability and attention span of the group. The roles that we use are:

• Builder: constructs the model, listens to the architect

• Supplier: selects the bricks at each stage, listens to the architect

• Architect: holds the instructions, describes the bricks to the supplier, instructs the builder where to put them

• Facilitator: identifies problems and supports the group with solution

If you have limited numbers you do not have to include every role. Pick them according to the child's targets. For example, if the child struggles with listening you may wish to encourage them by letting them be the builder; they have the motivational reward of receiving a brick and putting it in place. Alternatively, if you have a child who needs to practice describing and ordering key words, the architect role would be an option.

In addition to the jobs, we establish a set of lego-rules to encourage 'model' behaviour. Depending on the age of the group, this could be a clear-cut as good sitting, good looking, good listening, and good talking. Lego® points can be rewarded to acknowledge their participation.  

Once the adult has explained each rule and role, they must aim to 'gradually step back and allow the participants to work out social solutions more independently as the intervention progresses' (Ralph and Rochester, 2016). It is hoped that at some point each child will become their own facilitator and navigate social interactions with the same skill they require to build a collaborative model.

One parent, whose child attended Lego® Therapy sessions at Magic Words, explained how her child began to generalise his new awareness:

“He has understood what good listening is for the first time. He now understands why we need to listen and what we need to do to listen well. This has really helped him access small group activities and to concentrate. His eye contact which was a major problem area for him has also improved as a result of understanding that looking is important as it helps people know you are talking to them. He has thoroughly enjoyed the activities and it has also increased his interest in Lego which he is playing with much more outside the group. I think it has also improved his social skills generally...” 

With the motivation of Lego® and the naturalistic setting of a play-based task, this child was able to access a level of social interaction, that he had previously not understood the benefits of.

It has certainly become apparent that this therapy is versatile and accessible approach for those with social, communication and language difficulties. Carolyn Green and Elen Wales, two of our very own therapists, remarked in their article 'Building Lego, building language': 'Several parents expressed that Lego Therapy offered intervention where the alternative would have been to not access sessions at all' (Bulletin, November 2016). 

Consequently, what does Lego® mean to the therapists at Magic Words? 

Lego® Therapy is a impressively straightforward and structured approach that allows for a great variety of skills to be modelled, practiced and repeated. It allows a therapist, teacher, teaching assistant or parent to incorporate a diverse range of targets under the guise of play. It allows the children who participate to have fun, to collaborate, to build their skill set brick by brick.

To learn more about Lego® Therapy, please contact us.

Diagnosis: pulling through the grief process

By Eleanor Harris - Director of Magic Words Therapy and Specialist Generalist Speech and Language Therapist

Providing a child’s diagnosis to a parent can be like launching a grenade at them.  With one short sentence you can be shattering their hopes and dreams of the perfect child that breezes through school, makes friends easily and goes on to over achieve. It doesn’t matter if the diagnosis is something as mild and temporary as a simple speech sound delay, or as serious and long term as Autism. Some parents readily accept the diagnosis after a long battle to get their child’s difficulties recognised while others are battling through the grief process and are not yet able to accept what professionals are telling them, seeking second opinions or not seeking any opinions at all and holding up a shield to the grenade.

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There is little in a Speech and Language Therapist’s training that prepares them for giving a diagnosis to a parent. It wasn’t until I had been through the grief process with my own son and his diagnosis of permanent hearing loss at one month old that I fully understood how the words can sting. The brain reacts to protect itself through denial, you can feel angry at professionals and yourself for not doing enough, ‘if only’ thoughts plague you with guilt and sadness sets in for the perfect and easy child development that your child will not have and the uncertainty for the future. 

Our role as diagnosing professionals is to recognise the stage at which a parent is at in the grief process, to soften our tone and words to show empathy, to be honest and frank and to provide them with a blanket of support and encouragement. We should provide high quality information using easy to understand language, given at a time when the parents are ready to receive it. I remember being given boxes and boxes of information that remained unread for quite some time until I was ready to ‘deal with it’. Professionals need to remain on hand for weeks after the diagnosis to be available for the questions that will inevitably arise after the shock of that initial grenade.

As you move through the process, sometimes stuck in one stage, sometimes feeling all of them at once, you gradually move towards the stage of acceptance.  You are able to accept where your child is now, what you can do to make them happy and healthy at their current stage, and begin to look towards the future with hope, optimism and certainty. Although your child’s passage through the childhood years won’t be the same as everyone else’s, they will achieve their best, be happy and be who they are with loving support from their family.

Having moved through the grieving process some time ago now, I look at my little boy and I’m so proud of his achievements and genuinely don’t even see his disability as a disability any more, just a difference that makes him stand out from the crowd.

Speech Therapists – for further information about best practice when providing a diagnosis, read this informative article

Parents – for further information on understanding the grief process related to a child’s diagnosis read this informative article

Lego® Therapy: Teaching Teachers to Play

Over two very successful sessions, Magic Words provided training for Learning Support and Teaching Staff who were eager to understand how Lego® groups could be utilised in a way to support their pupils' needs. The group came together from various school settings based in Milton Keynes and the surrounding areas.

Amongst some enjoyable practicals and video examples of therapy sessions, we covered: 

• History and research on the development of Lego®-based practices

• The communication pyramid 

• Language and Social Skills

• Job-roles: Builder, Supplier, Architect, Facilitator, Examiner

• Who should do each role?

• Lego® rules

• Discussion of how to facilitate a group

• What a typical session looks like

• Visual timetable

• Evaluation of progress

• Question-time with a qualified speech and language therapist

We received some encouraging feedback from several of the staff to the effect that they would be running their own Lego® groups as soon as possible. It would appear that Lego®Therapy is not only extremely accessible for our children, but is an inviting scheme for the adults facilitating social growth and communicative needs.

This particular continuous professional development training was arranged in association with PEP:MK, Primary Enrichment Partnership. For further dates, please visit their website here.  

Alternatively, we can provide direct training adapted to your needs. Please contact us to learn more.