If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.
Step by Step guide to Gestalt Learning
Let’s explore the following stages of Gestalt Processing:
Stage 1: communicative use of whole language gestalts
(e.g., “let’s get out of here”)
Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.
Stage 2: mitigated into chunks and re-combining these chunks
(e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)
This is when you take parts of gestalts or phrases and then combine it with other parts.
Stage 3: further mitigation (single words recombining words, formulating two-word phrases)
(e.g., “get…more”)
They are going beyond their gestalts. Furthermore, they may begin to label different objects.
Stage 4: formulating first sentences
(e.g., “let’s get more toys”)
You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.
Stages 5 & 6: formulating more complex sentences
(e.g., “how long do you want to play inside for?”)
You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.
My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.
Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.
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.
When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.
You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).
We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.
Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.
Want to learn more about gestalt language processing?
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’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.
Let’s start with understanding what each of these words “Gestalt Language Processors” mean.
Gestalt: “the way a thing has been placed or put together”
Language: “a system of human communication”
Processors: “responds to and processes basic instruction”
So, let’s put those meanings together. “Gestalt Language Processors are children who process early language in strings of sounds or chunks.” They tend not to process single words.
It is important to understand this way of processing communication because between 75-90% of children with Autistic Spectrum Conditions process language in this way (Blanc, 2012). We know that it’s important for young people to have their voice heard and to be able to express themselves. So, it’s vital that they move from echolalia to self-generated communication to be able to do this. This means that our children’s communication partners play a vital role in supporting their child’s language. We can support our children by modelling phrases until the child has learnt the process themselves.
Let’s explore an example together
X (who is a gestalt language processor) and his family love to feed the ducks in their spare time; this is an activity that takes place regularly. Let’s look at how you, as the adults, could support X in his communication. Look at the phrases that are used. They are meaningful to the activity with repetition used throughout.
Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.
Need a boost in confidence to support your child’s gestalt language processing?
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.
Below are two reviews I got from grateful clients over the past 4-6 weeks; this blog is more about how Feeding Therapy can help you than blowing my own trumpet…. though that said, it is always so nice and gratifying to hear when parents are happy and hopeful about their little one’s feeding journey. Feeding Therapy is a substantial part of my work as a Children’s Speech and Language Therapist. One of my specialist subjects is Autism and we find that many children on the Autism Spectrum are very specific about eating, and will often refuse a range of typical family foods in favour of a narrow range of foods/snacks.
Mostly, feeding difficulties are a combination and complex cocktail of factors that have contributed to the current status quo: sure, there may have been some physical problems to start off with, such as reflux causing the baby discomfort, constipation, a very tight tongue tie or a swallowing problem caused by neurological difficulties and of course sensory processing difficulties are also very physical experiences. We always begin with a very thorough case history taking and information gathering, followed by an oral assessment and observation of the actual swallow to establish what might have been – or still might be – the cause for the feeding difficulties.
In most of the cases I see in my practice, the original obvious cause is no longer present, especially with older children. So, if the swallowing is fine, the reflux is no longer present, the tongue was divided (twice!) why are they still not eating much, refusing to try new foods, only accept certain textures etc.
The answer is extremely complex and multi-faceted and this little blog is not covering any factors in detail (we would be here all night) -I mentioned sensory processing difficulties earlier on. These are mostly still present but often not acknowledged or recognised by parents. And it is certainly the case that one of the contributors is parental anxiety; this tends to run very high and has been for many months, sometimes years. This in turn often leads to very tense and unpleasant, endlessly long meal times and many times children are force-fed several times a day in order to “get something down there” as otherwise they would probably starve themselves.
Additionally, parents end up only offering a very narrow range of foods because that is all their child will eat. This ends up in a vicious cycle of children being fed porridge-style food for all meal times and of course they won’t progress to more mature foods if these mature foods are never on offer.
In order to help address and disentangle some of the issues I often introduce the “Division of Responsibility in Feeding” as researched and recommended by Ellyn Satter (The Satter Feeding Dynamics Model)
Here are the main points of her approach:
Children have a natural ability with eating, they eat as much as they need and they grow in the way that is right for them and they learn to eat what their parents eat. (E Satter). The parent is responsible for WHAT the child eats, WHERE and WHEN the child eats. The child is responsible for HOW MUCH they eat or WHETHER to eat. Satter proposes that parents should guide their child’s transition from nipple feeding through semi-solids, then thick and lumpy foods to finger foods and then on to normal family meals.
Please note: this model is only appropriate for children where the original physical cause is no longer present!
Of course it’s not easy! It requires a huge shift in thinking about feeding and it requires to trust our children to know what is best for them. This is very big for most parents, as it is not how we were brought up and it is not commonly known that babies and children know what is good for them!
However, it is certainly true that parents who follow this particular approach and make small, steady changes in the way the offer foods, and in the way they create family meal times differently, children make very nice, pleasing progress and over some months we often see remarkable positive changes.
I like to work in a team and especially for this type of problem it is essential to have a multi-disciplinary approach. A knowledgeable dietician is an enormous plus in any feeding team as is of course a
Paediatrician and/ or a Gastroenterologist and the most important people in the team are the parents!
Feeding Therapy is all about collaboration and a ‘team around the child” approach. When we have this in place and there is trust amongst the team members then we make fantastic progress.
I visited London Speech and Feeding a couple of days ago with my 8-month-old granddaughter and her mother. Sonja made us feel comfortable and at ease from our first introductions. She was able to pinpoint my granddaughter’s mum’s anxiety around weaning very quickly. She not only gave her the tools to do this successfully, but also really encouraged my granddaughter’s mum and instilled confidence that she had everything she needed to make this sometimes-difficult transition without further anxiety.
Sonja was very thorough in her initial assessment of my granddaughter’s physical milestones and her developing speech. My granddaughter felt very comfortable with Sonja and happily played along with her. Then came the big moment – trying out various foods! We were amazed to see just how easily my granddaughter, with Sonja’s expert encouragement, took to sampling the wonderful array of different delicious morsels Sonja had prepared for the session. My granddaughter even drank from a cup for the first time! Wonderful!
Sonja then emailed a summary of the session and an extensive array of resources with suggestions for my granddaughter’s mum which she has now put into action. My granddaughter’s mum couldn’t thank Sonja enough for her caring attitude, extensive knowledge, and warm professionalism. I have no hesitation in recommending Sonja, she’s a fantastic Feeding Therapist!
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Sonja (and her lovely colleague, Sandra) were stupendous. I had brought my one-year-old son to see them as I was concerned that he wasn’t eating enough. They looked at his history and we ate together to make sure they had all the information they needed to give an accurate diagnosis. Whilst our outcome was that Henry was in fact doing brilliantly (and I just needed to chill out a bit!), I would imagine if there was something more serious going on, Sonja would make you feel just as supported and empowered as she did with us. Excellent follow-ups too. Money well spent for a bit of reassurance for a stressed out mama. Thank you, Sonja!
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.
Here is a very commonquestion/request that I get from most parentsI see: ‘Help! My childhas lots of toys!In fact we have so many toys we couldopen a shop but , alas, he/shedoesn’t play with anything for longer than a minute, even less than that! What can I do?’
My short answer to this is always: consider tidying most of the toys away and ROTATE them! This is my top tip for helping your little one sustain interest, focus, curiosity and creativity. Let me explain…
First up, I am not suggesting you sell all his/her littlegems on E-Bay (although…. ☺ ok let’s not go
there for now). NO, I simply recommend that instead of having ALL the toys out in the living room and all across the home, you put them into categories and groups and you pack them into boxes or containers so that you can find whatever you are looking for easily. So, all the construction toys – Lego’s magnetix, blocks etc go together; all vehicles, all animals and animal related items, etc etc you get the idea. (I am not suggesting you need to do a whole KONMARIon everything, (thoughto be honest I do think personally there is merit to her approach but I digress).
It works a treat not having ALL toys available at all times. Let me quickly tell you a little story about my childhood which may sound draconian to most of you, but we are talking late 50’s now in post war Germany….. What happened in my and many families for Christmas was this: your dolls house or railway tracks – and I am talking industrial tracks with electricity and proper little trains, your little shop or dolls-kitchen, all of it came down from the attic and was put up over night by one’s dad or uncle in possession of a screwdriver and some DIY skills, in readiness for the big event, this being the 24th of December, the Holy Evening. We children knew this, of course, and started talking about seeing our beloved toys again for Christmas and the period thereafter until about the 6th of January. We couldn’t wait to play with our toys and it was total bliss and happiness for about 4 weeks where we literally played day and evening with those toys. (We did get some new ones as well to be fair, but I cannot remember any of the new ones.) All that I now remember, in great detail and fondness, was my shop, my kitchenette (Victorian, splendid!), my dolls house and my cousin’s most fabulous intricate railway track. All of our toys occupied the entire basement of our home and this was where we played and played and played. Until the 6th of January. Oh yes… that was always a sad day of course when everything was packed away until…..December!!!! yep…. I vaguely recall there being a ‘special day-out’ with little treats arranged for us all and whilst away, the toys were taken up into the attic.
Like I say, it may seem somewhat outdated as an idea…but I actually am so glad I had that experience because I believe it has helped me with my language learning, my imaginative play, my ability to share and play with others, attention focus and last but not least it helped me learn to value my toys and appreciate the things I have more deeply than would otherwise have been the case (no research there, just my opinion).
Now I am not suggesting you do this, and indeed I never did this with my own kids either (I don’t have a large basement for starters)…. But I did rotate their toys quite a bit, inspired by the basic notion of my childhood experience.
The benefits are obvious if you think about it: apart from greatly reducing clutter at home, there are so many benefits of toy rotation for children. Just like us, children often find too many things all lying about unsettling; and especially our children with sensory processing difficulties can lose their sense of ease and calm very easily when overwhelmed by too many toys on offer. This is when they become restless and start roaming from one toy to the next without any focus or functional play. Additionally, just like adults, kids get bored with having the same toys or playing the same games, of course!
Anything that we always have available is by definition no longer novel or interesting.
Children who struggle to attend and listen due to developmental delays perhaps, or neuro-diverse development, possibly Attention Deficit or other diagnoses, have an increased tendency to roam, pick up and discard items as they often get distracted so very easily.
I recommend selecting a small range of toys for one week to start with. Ease your way in! Nothing is written in stone, it is not an exact science, rather more an intuitive strategy of picking what feels right for your child. If you have bags or boxes of small toy categories, as described earlier, now it becomes quite easy to decide on what toy groups to bring out.
I will give you an example – you could think of it as a TOY DIET!… so, like a food diet, you think of your food groups that you need daily and you put a menu together that has one of each group; however most of us don’t have the exact same foods everyday, we vary it so it’s a nice, healthy and enjoyable balanced diet. The same with the toys, so for instance:
Toy Rotation ‘Diet’
Week 1
Construction Group: Legos/ Duplos (not a ton, but a nice amount so you can actually build something)
Puzzles: Animal Farm Puzzle Vehicles: Cars and the Car Run
Action figures: Mr and Mrs Potatoe head Musical Instruments: Cylophone
Mark-making: Bunch of crayons/paper plates
Books: I wrote to the Zoo/ Hungry Caterpillar
Week 2
Construction Group: Train tracks
Puzzles: Rainbow puzzle
Vehicles: Trains and Planes
Action figures: doll house figures
Musical Instruments: Drum set
Mark making: Bingo daubers and fun bingo sheets
Books: Bear Hunt/ Rainbow fish
Larger Toy Items
Don’t worry about rotating those: they can be a steady back-drop to the category items your child has available: today/this week it might be animals feeding in the kitchen. Next week it might be action figures or Mr and Mrs Potatoe Head. The following week, there might be playdough out so then that can be used in the kitchen together with some Paw Patrol figures, etc. Like I said: most of us do not have a handy and empty basement or attic to store away large amounts of stuff so we do need to be pragmatic.
Tidy Up
This is often simply too overwhelming for children and the best they can do, if you are very lucky, is to throw everything into one big box, which is not what you want!
However, if you have 4-5 clearly labelled boxes for each category, now Tidying up can become a nice little activity in and of itself. Example: let’s put all the cars into the red car box, let’s count how many cars we have! Let’s see if we can find all the cars that I have hidden and then put them into the red car box! Let’s see what colours our cars are as we tidy them away…..endless possibilities for a little language development as well as a tidy bedroom, you can see this is a WINNER! You’re welcome! ☺
How To Prepare
Should you ask your child for permission to rotate their toys?… Erm… no! I think that would be like asking your little sweet-toothed cherub if she minded having the 5th ice-cream taken away… we know the answer to that one! Just decide on it, get your boxes organised, perhaps a cabinet bought or made – Ikea do simple ones – and then one day when your child is out, or in bed, you can start collecting all the toys and sifting through them – you might even want to weed out a few as you realise they are broken, bits are missing, that one scratches the floorboards, that one makes too loud a noise…etc… and then hurrah ! You are left with a load of toys that are brilliant and good for rotating. Let the fun begin!
Electronics
A last little note on ELECTRONIC TOYS – they are, in my humble opinion, fiendishly attractive and all-consumingly fascinating for little ones…and they are mostly counterproductive to creative play. Children who are prone to repetitive behaviours, repetitive play and reduced attention span will often focus on these beeping, singing, pinging toys to the exclusion of everything and everyone else around them. This may not really be great for your child if he/she is struggling to jointly attend with other children or yourselves; or if your little one has sensory processing difficulties or lacks imaginative play.
I would highly recommend that you reduce those electronic books/toys to a minimum and only bring them out very occasionally, preferably when you yourself need a little break! The same goes for the television, laptop and tablet of course! Please consider REDUCING or entirely REMOVING all electronics from your toddler if you would like to help your child to play, to focus on a range of toys and to build their creativity and joint attention.
Summary
Rotating your child’s toys is a fantastically useful strategy that will help your child develop focus and play more independently, while also helping you reduce clutter in your home.
Simply make sure a good range of toy groups are available at any one time.
Carefully select only a few items of each group.
Don’t worry about rotating big toys. These toys providea great back-drop for your child’s creative play, almost as part of the furniture.
Keep the toys that are having a little breakout of reach and, if possible, out of sight. Out of sight is usually out of mind and therefore your child will be able to enjoy what is in front of them and not pester you all day for the thing they cannot have.
Think LESS IS MORE! There are no strict rules on how many items you can have out, but on average I would recommend one or two per category at the most.
Try to keep to a regular rotation and to make sure they have time to really explore their toys fully. Once a week is a good place to start.
Reduce/eliminate electronic toys – This is so important!
Trust and relax knowing that you are helping and facilitating your child to really enjoy their toys, and to deepen their creativity and focus.
Let me know, drop me a line and tell me how you are getting on with this. I would love to know!
🙂
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.
“Attention Autism” is an Early Years Intervention designed by Gina Davies, Specialist Speech and Language Therapist. Gina created this amazing therapy approach based on her many years of working with children on the autism spectrum. It aims to develop natural and spontaneous communication through the use of highly motivating activities. These activities offer your child an IRRESISTABLE INVITATION to engage and attend to.
I love using this approach and have trained in all of the stages including the Curiosity Stage which is for another blog. I use it frequently with all children who have trouble attending, listening, sitting or waiting regardless of whether they are neuro-diverse or neuro-typical, this activity and method is so great for all children!!
Why is it important for our children to attend and listen?
It is commonly assumed that, as our child has passed their hearing tests he/she will be able to listen and respond to being called, being questioned or asked to do something. However, all children I see in my practice have reduced joint attention skills, which means that whilst their hearing is often good, even brilliant to the point that they can often hear a faint noise somewhere outside the house like a distant train rushing by – but strangely they can’t seem to hear their name being called. Parents often ask me why this is the case, why can my child not turn round when I call him?
The reason lies in the difference between hearing and listening. Listening is a skill that needs to be learned and practiced. As a child develops, their hearing tunes into (listening) the sounds and noises they hear on a daily basis. This is how a child develops understanding of the speech sounds they hear every day (which then form the basis of their native language); they also get to know “their door bell, dog barking next door, daddy coming up the stairs” and so on. They tune into those common every day sounds and noises and gradually start to copy speech sounds to form words. So listening is tuning our ears to the sounds that surround us. In contrast, many of us have to work in large office spaces or noisy environment, perhaps even a café, etc, where we are able to tune out those environmental noises and sounds that surround us, for otherwise we will not get that report/piece of work done in time! Our focus means that we become single-minded and single-channelled concentrating on our work and so we do not hear people chat and clutter all around us.
Tuning in and out is a skill that we learn and some of us are better than it that others, it comes largely with practice but also with motivation – I go back to the report that needs doing by end of the day – my motivation is strong and I can now focus and blend out all around me so that I get the work done. Other times when I am not so motivated I might doodle and tune into what is being said at the table next to me, because my focus is not that strongly dedicated to my work.
Many children who are delayed in their development and especially children on the neuro-diverse continuum have difficulty with tuning in. By contrast, they are very good at being single-minded, single focused on what it is they are wanting/needing to do at any one point. And so they cannot listen to sounds, speech, noises around them very easily at all. They are fully absorbed in their activity and are not able to look and listen to mum/dad calling their name. Once we understand this we can start helping our children to practise tuning in a bit more bit by bit and day by day.
Enter the Attention Autism approach!
There are 4 stages to this method:
Stage 1: The Bucket to Focus Attention
The first stage involves filling a bucket with visually engaging toys that aim to help children learn how to focus their attention. Three toys will be presented to the child/group one at a time and the therapist will make simple comments about each toy to help introduce them to the children and expand their vocabulary.
Important to know: the Attention Autism approach does not require the child to look at the adult, or to sustain eye-gaze on the objects. Instead engagement may be indicated by non-verbal signals such as seeming alert and interested, and looking frequently at the object.
Stage 2: The Attention Builder
At this stage the child/group is introduced to visually stimulating activities. This stage aims to build and sustain attention for a longer period of time. Activities may include ideas such as:
Flour castles which can be built like sandcastles, using flour, a bowl and moulds
Erupting volcano activity
Wriggly worms foam – pile shaving foam onto an upside down plastic flower pot with the holes taped over; then slowly press down another plastic flower pot over the shaving foam and the foam will come through the top holes looking like wriggly worms, especially if you have dropped a bit of food colouring on top of the foam
Important: children are not required to make eye contact or sit still during these activities. The focus is on engagement, in whatever way the child demonstrates this.
Stage 3: The Interactive Game – Turn-Taking and Shifting Attention
The therapist demonstrates a simple engaging activity and invites children up to have a turn. This may be the same activity from stage 2 or something new. The aim is for children to learn to shift their attention from the group/sitting experience to doing something and then going back to sitting again.
Stage 4: Individual Activity
In the final stage of Attention Autism, the adult models an activity, and then each child is given the same equipment to use themselves. They do not have to copy exactly what the adult modelled. The aim is for the child watching to have a go independently with confidence, and then to take their materials back to the leading adult at the end. The activity should be engaging and enjoyable for the children. The Attention Autism approach aims to foster an interest in learning new things and to inspire communication in whatever form works for the child.
Ideally this should be practised 4-5 times a week aside from the therapy session. But I have seen it work with just 2-3 practice repeats per week. It can be tough in the beginning until your child gets used to the “no touch just look” rule but with a little bit of practice usually children do sit well for the first part of the Bucket activity within about 10 sessions and after that you are on a roll!
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.
This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /S/ sounds and good /SH/ sounds.
Initial consideration
There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:
The student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
The student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
The student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
The student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)
When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.
Most of my Lisp students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.
Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.
Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: /B/ /P/ /L/ /N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so ‘LELLOW’ instead of ‘yellow’.
Do not fear!
But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!
We work on breathing, holding our breath for a bit then pushing it out and then holding it again.
And when it comes to the actual /S/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.
We then work on producing the sound /S/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S–EE : the /EEE/ sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!
And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.
The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.
I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!
Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT LISP!
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.
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.
