Introducing the Poke-A-Dot Series of books by www.innovativekids.com and available on www.amazon.co.uk and many bookstores – I love this book and it is one of the most used books on my book shelf. Since I bought this one some years ago several others have been published including Two other Nursery rhymes: Wheel-on-the-bus and 10 little monkeys.
Different topics: Ocean animals, first words, a ‘good night animals bedtime story” and various others. They are ALL GREAT! I don’t have a preference but since I only own the Farm Animals below I thought I would talk you trough that one.
What it is about:
It centres on the nursery song of “Old Mac Donald has a farm” and goes through 10 farm animals (10 cows, 9 pigs, 8 chickens, 7 sheep, 6 ducks, 5 horses, 4 goats, 3 kittens, 2 dogs and 1 rooster). Each page has corresponding Poppers for every animal on the page which invite your child to practice pointing and popping with their index finger. They pop quite loudly which is the whole point after all and thus they provide a much better pop than, say, a bubble-wrap pop.
What I love about this book apart from the obvious pop-pop-popping are the very sturdy, thick hard board pages it is made up of. This book is pretty indestructible and believe me some have tried!! The down side is that it’s quite heavy and not one to have in your travelling toy bag – though if you are taking your little one on a long-haul flight you might just find it invaluable and worth the extra kilo it weighs (I did actually put it on my kitchen scales and it does weigh a hefty 1.1 kg! Something to consider).
But at home, on your book shelf, it’s a really good find and of course you might want to opt for any of the other editions depending on what your little one is into – or have them all! Why not!
What this book is great for:
Developmental Age
2-6 years. It says 3-6 yrs. on the cover but I have shown it to younger children with developmental and speech delays and it has never not been at least looked at with interest – the popping with child’s finger might come a little later, but until then an adult can pop and poke with good effect!
Words/sounds: animal noises and animal names plus farmer/mud/water/stable/hay
Cause and effect: point and pop
Places : farm/lake/meadow/stable/field/mud
Develop Speech Sounds, particularly good for:
/b/ – baa
/m/ -moo/ meow
/p/ – pig, pop/push/pull/peck
/sh/ – sheep
/k-c/ – cow/ quack/cluck/duck
Concepts:
colours
numbers
prepositions (in/into/on/ inside/outside)
Published By:
Innovative Kids
ISBN: 978-1-60169-024-1
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Echolalia is a term used when assessing or treating children with Autism. The term refers to the repetition or echoing of utterances, either our own or others’. It can also be echoing phrases heard on television, advertising jingles or catchy repeat phrases used in tv programmes or nursery rhymes and songs. Whilst we all use echolalia occasionally and it can be observed in typically developing children, we tend not to see/hear it beyond the age of 2.5 years old. Children with ASD, however, do use echolalia often into late childhood.
There are generally two types of Echolalia:
Immediate echolalia
Here the repeated phrases or words are produced immediately after someone has spoken the original words or within two conversational turns of the original utterance.
Delayed echolalia
The repeat echoing of the original utterance occurs sometime later, more than two conversational turns or with a much longer time delay. Due to the delay it can be hard to interpret the meaning of the echolalic utterance as it may refer to something that happened long ago and in a different context to the originally utterance.
(Stiegler, 2015, Fay 1967, Blanc 2014)
There are other unconventional speech behaviours which include:
Perseveration of Speech – persistent repetition of speech
Repetitive questioning – persisting even though answers were given
Vocalisations such as: humming, whistling, clicking, squealing etc.
Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:
Information sharing
Responding to answers
Labelling
Drawing attention to self
Protesting
Requesting
Giving instructions
Self-regulation, calming
(Stiegler 2015, Prizant 1983)
Echolalia does have a function and is part of the Gestalt Learning Process (where longer units of speech are memorised and then used as a whole without the individual words being meaningful).
As a Speech and Language Therapist I promote sound and proven Intervention based on the Hanen Programme which helps provide a highly facilitative Interaction Style and I will tell you a bit more in my next blog how the “More Than Words” approach can help children with echolalia move through their Gestalt Learning into more analytic processing of language, grammar and meaning.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
First up try and get down at eye level or Face-to-Face with your child
Try to sit so that your child can see you easily, i. e. your child does not have to look up to make eye contact with you. We call that Face to Face: try and sit opposite your child. This makes it easier for you to see facial expressions and therefore pick up nonverbal /pre-verbal communication. Now you can connect and share the moment with your child.
OWL (Observe, Wait and Listen)
Never skip this step as it prepares us for what happens next !
Observe
First, try and simply watch your child quietly and listen and observe what he/she says or does; you need to know what your little one is interested in. For example with this toy (pictured below) we could observe that your child loves the actual spinning of the marble, perhaps more than that noisy click-clacking down the run. Or perhaps he loves collecting the marble at the end and feeling it in his hand.
You could start off with showing once how the marble goes down and say:“ look it goes round and round !” Then hold back and observe, without speaking, so that your child has time to explore the toy.
Wait
Just sit and avoid telling or showing your child what he or she could do with the toy. This gives your child an opportunity to explore and experiment.
Listen
Listen to what your child says, or look at your child’s non-verbal communication without interrupting. Your child will now feel and know that you are really present and that what they have to say is important. It’s best to avoid questions like, “What are you doing or “What’s this?” as that might be a lot of pressure when they don’t know what to say about that yet.
Respond immediately by showing interest
Once you have all the information from OWLing you can respond in the right way, for example: if she catches the marble at the end of the run and looks up with a smile or a sound you could respond with: you’ve got it! One marble in your hand! Nice playing!
Now how to join in the play:
First you can copy what your child is doing
If your child puts the first marble at the top of the run you can take a turn and do exactly the same once his marble is done. Ideally you might have another marble run, perhaps a similar one, it does not have to be exactly the same! Once your child has put the first marble in you can do the exact same with your own marble on your run. Your child is likely to look at what you are doing and you might well see a smile on their face or perhaps she might say: look at mine!
Next you can build on that
You can respond with simple comments like: “Wow! Yes I am looking at yours now! It’s spinning on the red one lots! I love the noise!” Now wait once more to see what your child says or does.
To summarise
We are signalling to our child that we are really interested in what they are doing and saying so we can “collect” our child, i.e. bring him/her back into a joint interaction.
Important
We want to try and not direct our child but respond with interest and fun! This creates a lovely stage for interaction and joint play! And this leads in turn to practising conversation and ever more opportunities for great speech and language skills to emerge.
Great activities we use in Speech and Language Therapy:
Any cause and effect toys like this Marble Run
Creative activities, such as mark making with crayons
Train tracks (building and running the trains)
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
A Day In The Life Of An Independent Speech And Language Therapist
I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:
I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.
Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.
Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.
I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.
I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.
My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Why imitation is so important and how can speech and language therapy help children who struggle to imitate?
Imitation or copying starts in early infancy. When we observe a young baby and his parent or familiar adult we can see clearly and frequently that the baby will be intently looking at adult’s face and try to copy their facial expressions, smiles and all those funny baby sounds we often make with young babies.
These sounds are called “motherese” and are the beginnings of a little conversation between the parent and the baby. The “conversation can go back and forth for a long time and include sounds, as well as facial expressions.
A little later on, once the baby can crawl and sit up unaided the copying then goes on to include toys and objects. Mum or Dad will show their toddler how to use a drum or how to put a little train on the wooden tracks and the toddler will try and copy this. They may not succeed and be a little clumsy perhaps but the act of copying anything and everything their favourite adult does is typically seen throughout the day.
We all know and have laughed at mums or dads saying; ssshhh don’t say that in front of the baby he/she will copy you, watch your mouth! (as dad is swearing at the broken radiator….)
This imitation goes on for years and includes eventually of course little words, more words, putting words together and then creating sentences, all the while our toddler is listening to how their adults speak, not only what they say but how they say it. This is how dialects and accents can be transmitted easily from parent /family to child.
Copying in Children with Autism
We know that children with autism often struggle to imitate. We see children on the spectrum typically having great difficulty to copy adults or children; this can be seen in very reduced play with their peers in nursery for example.
Children with autism tend to have reduced joint attention and engagement with others and need to develop the ability and awareness to copy others in order to then engage more jointly with others.
Speech and Language Therapy can help with Parent Child Interaction work and Coaching, here is how:
During my coaching work with parents I teach step by step how to help a child who struggles to imitate:
We look at all the researched skills and actions that adults can take to help their little one to copy, starting with close observation of their child’s interests, then following and including their child’s play and copying/imitating their child in how they play. I teach steps in a graduated way so that it is easy to see the progress and joyful to have the results at the end.
The results are clear to see over time: our children on the spectrum learn to imitate actions, with objects and gestures, then sounds and words. Alongside this increased imitation skill the child can then develop more joint attention and engagement.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
AMAZINGLY EASY Activities that we can do at home and in the clinic to help our children practise those targets!
I bet you have wondered what amazing things are done by a therapist in the clinic that you could not possibly do at home…? Well, if so I am here to tell you that you will be absolutely fine with just a few select toys and games and you will be able to get those targets done in a jiffy!
What we clinicians do very well and what you probably can’t do yourself is formulate and design the targets that are important for your child to practice. Once we have assessed or reviewed your child’s progress and needs we can then design the perfect next step of targets for you.
So for example, we have decided your little one needs to be practicing their ‘r’ sounds at the beginning of short words. We decided that based on our clinical expertise and our assessment and we have already worked with your child and managed to get this tricky ‘r’ sound just about right on its own. Now we are ready for short word practice.
It has been researched that in order for the brain pathways to re-shape or reform we need to get about 100 words in per day of our target sound. That sounds like quite a lot, right? But actually….. it’s not that bad. After all you only need to say 5-7 words about 20 times and hey presto that’s about 80-100 words.
So here are some simple games I use in my clinic all the time and these games are easily available online or in your local toy shops and this is how to do them:
Pop the Pirate
Pop the Pirate, sooo good and popular:
Lay out your target words which you will have been given by your speech therapist and put a few swords on each word.
Each time your child picks up a sword they will need to say the target word 5 x, like:
rip rip rip rip rip or run run run run run just like that in a row, bish bash bosh.
Then they can stick the sword into the barrel. Onto the next sword which they can pick and then again
race race race race race and stick in another sword
So with this little lot I put out 5 target words and 3 swords on each.
You will therefore get…… 15 words per picture, and that makes….75 words , there that is nearly all you need to do.
If you then do another little game like this one:
Magnetic board game
This is a Magnetic Board game, and they are suddenly EVERYWHERE. But you could also just take a baking sheet and some fridge magnet you might have kicking about.
Same principle as before, but now since this is your SECOND game of the day and you have already got 75 targets under your belt you only need to do one more round of 5 target words each:
Each time your child picks up a magnet piece they will say the target word 5 more times:
Ray ray ray ray ray and DONE you will now at the end of this short round have 105!! target words done with just two little fun games.
How good is this? Your child won’t hardly notice that they are in fact doing their speech therapy homework.
You’re welcome 🙂
Get in touch if you would like me to help finding good targets for your child to work on. They can be speech and/or language targets with this game method.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Let me introduce you to another one of my favourite books I have been using A LOT of late:
Written in RHYME – extra BONUS if you ask me, as we can use it for our speech delayed children as well and/or with our children who struggle to create grammatical sentences, or even just any old sentences will sometimes do, let’s be honest.
What’s it about:
An array of animals, starting with the Elephant who wants to get on a bus of course then onto some Monkeys rioting about in a supermarket, next a Tiger reading the paper on a train, a crazy Seal driving a tax round Buckingham Palace, a Camel on a boat, a Giraffe on a plane and numerous other mad ideas involving unsuitable passengers on the wrong vehicle (or any vehicle come to think of it) until finally on the last page a solution (of sorts) is found for them all…. I leave you to find out what happens
What I love about this book is the mad rhyming that goes on and the super funny illustrations which have even my most inattentive and “ants in pants’ kind of children spellbound and actually looking and listening to the story. Many of my little learners absolutely delight in the mad ideas in this book and I have had some pretty crazy story telling which made us fall about laughing (I always have to laugh when my kids laugh in the session it’s too cute). It’s a great read for thinking about problem solving and WHY something is not a good idea, and what could possibly go wrong – well quite a lot actually!
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Many of my students have difficulties telling stories. When looking at a book together, even books they love and have seen many times, they often struggle to understand what they are reading and cannot therefore retell the story in any sequence. A great method I often use with those students is called Colourful Semantics.
What is Colourful Semantics?
Colourful Semantics is an approach aimed at helping children develop grammar and meaning of phrases and sentences. We help children identify WHO is the subject in a story, what is he/she/it DOING to WHAT and WHERE. There are lots of colour coded stages but we tend to start with the basic 4:
WHO = ORANGE
DOING = YELLOW
WHAT = GREEN
WHERE = BLUE
Once a student is accomplished at this level, we move on to different colour codes for describing words (adjectives), connecting words (with/together/and/therefore) feeling words (PINK), timing words (BROWN) eg. when, tomorrow, last week etc.
Colourful Semantics is a really useful method and helps children to organise their sentences. It also helps me knowing how to guide a student in thinking about the story.
The approach can be used with children with a range of Speech and Language Needs, such as:
Developmental Delay / Disorder
Autistic Spectrum Condition
Down Syndrome
Any other syndromes and related speech and language delays
General Literacy difficulties
There are a wide range of benefits to using this approach and I use it in my therapeutic work with children of around 3 years plus. Below is a little video which shows how I use it with this student who has general language difficulties associated with Autism. One of the main benefits with this student is that seeing the Cue Cards helps her to use a much wider range of vocabulary than she would ordinarily generate. Her sentences are getting longer and she is more able to answer questions. In general, I find it useful to help with storytelling and to guide us through the story in a sequence.
There are many on-line games these days that have incorporated the Colourful Semantics Approach. Once a child is familiar with the basic colour scheme then gradually the visual prompts can be reduced to using verbal prompts.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.
Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.
My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:
Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
When saying the same word again and again, different mistakes can be heard
Intonation difficulties: speech sounds monotonous
Vocabulary is very limited
Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”
When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.
I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?
Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.
How to find the perfect therapist for my child/client:
There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.
Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.
The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.
However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.
A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.
Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.
How I can help you:
I have 3 main areas of specialism:
Parent Child Interaction Coaching
This is an amazing way to help children with the following difficulties:
Social Communication Difficulties, Autistic Spectrum Disordersand
Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?
In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.
Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation
I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.
Feeding and Swallowing Difficulties
Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.
What does a speech therapy session look like?
All sessions differ slightly depending on the age of the child and the nature of the difficulties.
However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.
Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.
What does a Coaching session look like?
During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.
Research Papers on the Efficacy of Parent Child Interaction Coaching
The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Why is joint engagement important for communication development?
It has been well-documented that the development of joint attention is impaired in children who have social communication difficulties or autism. It is, in fact, this impairment which distinguishes children with ASD from children who have other developmental delays.
A lack of joint attention in very young children is an early sign of autism as it is a signal that there is a disruption in the motivation to connect socially with others. Since this is a crucial element, I thought I would outline what we mean by Joint Attention as supported by the research undertaken at Hanen.org.
In typically developing children, the ability to shift attention between a person and an object for the purposes of connecting socially or for requesting develops around the same time. However, for children with ASD, these components emerge one at a time and in a linear fashion. Children with ASD usually start with requesting something and later they may learn to share attention for social sharing. (see pattern below as a general guide).
As with typical development, there is variation in the order that these skills emerge but the following patterns of development is commonly seen:
Reaching, taking adult’s arm/hand or pointing to ask for something — but without looking at the adult
Gradually alternating looking between person and object of desire
Then learning to follow the point of another — which is responding to joint attention initiated by another
Directing attention to share interests — without looking at the adult: pointing to a truck on the road/ helicopter circling above
Then directing attention to share interest by alternating gaze shift between person and object — here the child is now initiating joint attention.
What is important to note is that in order to fulfil the criteria for true joint attention, the purpose of directing the attention of another person must be social in nature. In other words, it must not be exclusively to obtain a desirable object or event/action. True Joint Attention is seen verbally or non-verbally; we want to share a thought with another person and direct them to something we are interested or excited or spooked by.
For example: we can see an amazing firework display in the distance and we want to quickly direct our friend’s attention to this. In order to do this we might be tugging their sleeve/arm whilst pointing to the display in the distance, and perhaps we might add “wow look over there!” We are doing so simply to share an interest without obtaining anything, we are just being social with each other. So True Joint Attention is not just looking at what we want to have, then look at the person who can get this for us and then point to the item. We can say that this is the precursor to true joint attention, which is purely social in nature.
Because true joint attention is an essential precursor to typical language development, the absence of joint attention in children with ASD contributes to difficulties with language learning. Beuker, K., Rommelse, N., Donders, R. & Buitelaar, J. (2013).
The Hanen programme for Parent Child Interaction teaches parents of children with Social Communication Difficulties step by step how to enable their children to learn to pay attention to an object and the parent at the same time.
We learn how to enable a child to:
engage take turns
shift eye gaze between toy and adult
copy adult’s actions, gestures and then words
play with toys in different, new ways
interact and for longer periods of time
have fun whilst playing
If you would like to know more about the Hanen programme please get in touch. I look forward to exploring the topic with you and help guide you forward if this is something your child is struggling with.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Does your child say “Dough” instead of “Go”? Or “Tea” instead of “Key”? Do you hear a /Sh/ instead of an /S/ does “see” sound more like “she”?
We Speechies call this a Fronting Pattern which means that a sound that should be produced at the back of the throat with the back of the tongue, like K or G , is said at the front of the mouth with the tip of the tongue, like a T or a D or SH. When this happens speech can be really hard to make out because these sounds are literally everywhere in everyday sentences. Just think how many K’s and G’s we hear in a simple sentence?
For example, I heard my little student say earlier today: “I know what game we can play in your garden? It’s the one with cones and rings and cushions! I know where it is I can get it.”
But it sounded like:
“I know what DAME we DAN play in the DARDEN! It’s the one with TONES and rings and TUSHIONS! I know where it is I TAN DED it.”
If that sounds familiar to you, here is a little overview of what we can do about it:
First up it’s always good to start with general speech sounds awareness: does a child hear syllables and intonation? Do they know words that rhyme? Can they follow or copy a simple beat with a drum? Can they listen and hear quiet sounds and loud sounds and can they copy those? Can they follow mouth and tongue movements:, for example : stick out your tongue, lick your lips, click your tongue, blow raspberries?
Then it really helps to talk about BACK and FRONT of things and to draw attention to the back of the mouth and the back of the tongue and the front tip of the tongue and how sounds are made in the mouth. I often use a puppet to show this or a model of a mouth like this one here in the picture.
Next we try and listen to words starting with a BACK sounds like a K or a G , and I read out a list of words with those sounds: COW, CORE, CAT, CONE, KEY etc or ARK, EEK, OAK, ACHE…
Or GOO GUY GUM GONE
After that we try and see if a student can actually produce a single sound like a K or a G just by itself. If they can, that’s a really great start and if they can’t I help them to produce one – over a few sessions we usually get there. We call this Sound production in isolation.
Once a child can produce a sound correctly, on its own, we try and start working on very simple words that are really powerful like “GO”!!!!! in a motivating game or “CAR” for little ones who love a car racing track.
Now that we have established the back sounds and are using it in short words, we can gradually re-train brain pathways and oral- motor/movement pathways to use these new sounds in many words and then short phrases. That can take time!! This is called generalisation and it is not uncommon for it to take up a whole year for fluent speech to be error-free .
Why does it take so long? Being able to produce a correct and clear K or G sound does not mean it will be used easily. Our brain pathways are fixated or habituated to the error sound. It takes time for habits to change. A child might be able to hear the word TIGER with a G in the middle and she knows that it is not a TIDER but when saying it her tongue automatically moves forward rather than lifts up at the back. It’s a bit like a person who has a rounded back: the brain knows to stand upright and how not to slouch, but when we don’t focus on it, ooops we have slouched again because that is what we are comfortable doing and our body moves with our habit.
It takes effort and motivation to change our movement patterns and that includes our tongue and lip patterns! We usually get there through a huge variety of games and practice. Lots and lots of repetition is key as is motivation to change.
Parents and carers are crucial in the success of Speech Therapy!
We need your feedback at home, the regular short and sweet exercises, the constant positive encouragement and great modelling of speech sounds. We often find that parents are tuned into their child’s error sounds and can understand them much better than anyone else. This is great of course in many ways, however, it also means that the child has less motivation to change: if mummy understands me then my world is ok.
I will give you a short outline of what different speech therapy models I use in my practice, be it in clinic face to face or on-line in my future blogs soon.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
