Empowering non-speaking children: the power of AAC Core Boards

ByLondon Speech and Feeding September 25, 2023September 25, 2023

Autism Therapy | Speech and Language Therapy

Communication is the essence of human interaction, allowing us to express thoughts, feelings, wants and needs. For non-speaking children and their families finding an avenue to communicate effectively can be a really challenging journey.

Augmentative and Alternative Communication (AAC) offers a solution: with AAC Core Boards as a powerful ally and tool to empower and express more than requests: ideas, comments, surprise and delight, as well as saying no to something! Very important!

“AAC is a set of tools and strategies that an individual uses to solve every day communicative challenges. Communication can take many forms such as: speech, a shared glance, text, gestures, facial expressions, touch, sign language, symbols, pictures, and speech-generating devices” (RCSLT, 2023) to name just some.

AAC Core Boards are a powerful tool to empower non-speakers to express ideas. In this blog, we’ll explore the significance of AAC Core Boards and how they can unlock the world of communication for non-speaking children.

Let’s discover and understand AAC Core Boards

Firstly, let’s look at what a Core Board looks like…

Why not have a go and download your own copy (and other boards) for free on the Saltillo Word Power website.

AAC Core Boards are a specific type of AAC system that employs a grid-style board. This grid contains a set of core vocabulary words or symbols, which serve as a foundation for all communicative functions (e.g., initiating, greeting, requesting, negating, commenting, asking a question, and expressing surprise).

These boards incorporate high-frequency (most used) and versatile words. They enable us to construct sentences, express emotions, and take part in conversations, fostering a sense of independence and autonomy. By enabling communication, we also remove some of the frustration (from not being able to communicate) which contributes/or often leads to behavioural difficulties.

Building literacy skills

AAC Core Boards are not only tools for immediate communication. They also play a pivotal role in language and literacy development. By using these boards, non-verbal children engage with words and symbols. It reinforces their understanding of language structure and grammar.

As they consistently play with and then use their boards, they naturally absorb language patterns, laying the foundation for improved literacy skills. This immersive learning experience paves the way for future language acquisition and communication growth.

Customisation for individual needs

Every child is unique, and their communication needs can vary significantly. AAC Core Boards are designed with this diversity in mind, allowing for customisation to suit individual preferences and abilities. The boards can be adapted to include specific vocabulary relevant to a child’s daily life, interests, and activities. This personalisation ensures that the AAC Core Board is a true reflection of your child’s personality and needs, making communication more motivating, engaging and effective.

Collaboration between AAC Core Boards and Speech Therapy

AAC Core Boards are an excellent tool but we need to know one important aspect: they only work well when used regularly by the child’s family and key people in the first place.

The board needs to be used and modelled by adults consistently and regularly across environments. This is so our children know what to expect, take an interest and begin to use the boards themselves. Modelling the use of AAC Core boards is vital. Think how long it typically takes for a child to learn their first word. Around a year! During that time the adults talk constantly to their child without hesitation or expectation! The same goes for introducing this new way of communicating.

Collaborating with your child’s Speech and Language Therapist (SLT) ensures that your child receives the right guidance in using the AAC system. SLTs can assess your child’s communication abilities, recommend appropriate boards and provide guidance on how to best put them in place, so that your child can reach their communicative potential.

For non-speaking children, AAC Core Boards are more than just tools. They are bridges to a world of communication, connection, and empowerment. These boards harness the power of visual communication, foster language development, social interaction, and personal expression. They can be tailored to individual needs with the support of skilled professionals. AAC Core Boards offer a beacon of hope, helping to break through communication barriers and thrive in a world that is waiting to hear your child’s voice.

For answers to your questions and to explore the most effective support for your child, feel free to contact us.

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 woman on the left is pointing to her open mouth. A girl on the right is looking at her and copying the mouth shape.

Speech and Language Therapy

My child is very hard to understand! How can Speech Therapy help?

ByLondon Speech and Feeding August 2, 2021January 31, 2023

There are many reasons for speech sound delay or disorders and the first step is a thorough assessment.

What does a Speech Assessment look like?

With younger children, around 2 – 2.5 years we often start by collecting a good speech sample during play or general chatting. Sometimes we do this with an audiotape so that we are able to listen to your child’s speech sounds repeatedly in order to determine any speech error patterns. A good way to get a speech sample is looking at a favourite book together and trying to get your child to name as many items, animals or characters as possible in the book. For older children, 4.5 years plus we do more formal speech sound assessments where we show your child a series of pictures which focus on varying sounds or sound patterns, for example:

Are the end sounds present or left off, does your child say BE_ instead of BED for example?
Are the back sounds produced at the front of the mouth, is a digger a DIDDER or a pig a PID?
Are sound blends reduced, for instances a snake becomes a NAKE ?
Or do many phonemes (single speech sounds) collapse all into one error sound? Like all F , R or L become a B?

Once we have discovered the error pattern we can then unravel the problem and work on solutions. We make a plan and prioritise which of the patterns we can target first, second and next. There are several approaches that can be used to tackle speech sound errors and most therapist have two or three favourite approaches as their go-to. I will fill you in on my favourite ones in future blogs.

What does a Speech Therapy session look like?

These days we have two options: on-line via zoom and face to face in the clinic setting.

Both are great options!

For all clients who live far away a zoom session will be the option to go for. But zoom sessions also work really well for the older child as, let’s face it, are there any kids out there who do not like a bit of screen time?

I find that children around 5 years old really love the on-line games and sessions are fun and very effective. We usually start off with a quick game to warm up and then we go into the speech sound patterns we need to improve and work on. There are 100s of tried and tested on-line games and game decks which can be hugely entertaining and really nice to work with.

In clinic, we also often start with a short game to settle in and then we target the various sound patterns we are working on within table top games, or arts and crafts activities. We aim to get up to 100 speech sound trials per session, using a variety of motivating games to keep our little ones going and focused.

Both, face to face and on-line sessions are between 40-45 minutes long – time usually flies by! – and then parents get to practise home exercises to make sure that the new speech sounds are being practised every day.

Over the coming weeks I shall do blogs on great games and home exercises that I give the parents and I will talk about games we do in the session that are fun and can be copied for home use. Watch this space!

Autism Therapy · Neurodiversity · Speech and Language Therapy

Unveiling the hidden spectrum: Why girls and autism often go unseen

ByLondon Speech and Feeding March 13, 2024March 1, 2024

Autism is a complex neurodevelopmental condition characterised by social-communication challenges, restricted and repetitive behaviours, and sensory processing difficulties. While the prevalence of autism is estimated at 1 in 54 children, research suggests a significant disparity in diagnoses between genders. Boys are diagnosed with autism roughly four times more often than girls, leading us to question: Why are girls so much harder to diagnose with autism?

The answer lies in a complex interplay of factors, including:

1. Different presentations of autistic traits:

Socialisation: The stereotypical image of autism often portrays boys with aloofness and a lack of interest in social interaction. However, autistic girls may exhibit more subtle social difficulties. They may appear interested in socialising but struggle with understanding social cues, maintaining eye contact, or navigating complex social dynamics. This ability to ‘camouflage’ their challenges can lead to misinterpretations of their intentions and abilities.
Restricted interests: While autistic boys may have intense interests in stereotypically ‘masculine’ topics like dinosaurs or trains, girls might gravitate towards interests traditionally associated with girls, like specific characters or activities. These interests, often deemed ‘typical’ might be overlooked as potential indicators of autism.
Repetitive behaviours: Repetitive behaviours are another core diagnostic feature of autism. However, autistic girls may exhibit these behaviours in more subtle ways, such as intense focus on specific routines, scripting conversations, or engaging in repetitive social interactions. These subtle expressions can easily go unnoticed.

2. The ‘camouflage’ effect:

Autistic girls, particularly those with higher cognitive abilities, may develop coping mechanisms to mask their challenges in social situations. This ‘camouflaging’ can involve mimicking social behaviours they observe in others, leading to significant internal distress and exhaustion. This effort to appear ‘normal/typical’ can further hinder accurate diagnosis.

3. Societal biases and diagnostic tools:

Gender bias: The current diagnostic criteria for autism were largely developed based on studies of boys, leading to a potential bias towards male presentations of the condition. This can result in girls who don’t exhibit the ‘typical’ symptoms being missed altogether.
Lack of awareness: Healthcare professionals and educators may have limited awareness of how autism manifests differently in girls. This lack of understanding can lead to misinterpretations of their behaviours and missed opportunities for diagnosis and support. I must say that this is really common in my working day. I see a child—girls or boys in this case to be fair, but mainly girls—where parents tell me: the doctor/health visitor/paediatrician has said it was ‘just a little delay’ and I am thinking ‘Really!??? What did they look at? How did they not see X Y Z’… It really is still very common.

4. Co-occurring conditions:

Autistic girls are more likely to experience co-occurring conditions like anxiety and depression, which can overshadow the core features of autism. This makes it even more challenging to identify the underlying autism diagnosis.

The consequences of missed diagnoses and this goes of course for both, autistic girls AND boys!:

The consequences of undiagnosed autism can be significant. Children may experience:

Lack of access to appropriate support: Without a diagnosis, children may miss out on crucial interventions and therapies that can help them manage their challenges and thrive.
Increased vulnerability to mental health issues: The stress of masking and navigating social complexities can lead to anxiety, depression, and other mental health challenges.
Difficulty forming meaningful relationships: Social difficulties and communication challenges can hinder their ability to build and maintain healthy relationships.

Moving forward: Towards a more inclusive diagnosis:

To ensure all individuals on the spectrum receive the support they need, it’s crucial to:

Increase awareness and education: Healthcare professionals, educators, and the general public need to be educated about the diverse presentations of autism in girls and of course also in boys. Let’s not forget that we are still seeing older autistic boys with diagnoses given aged 12 years and older who have slipped through the net.

Develop gender-neutral diagnostic tools: Diagnostic criteria and assessments should be revised to encompass the broader spectrum of autistic traits, regardless of gender.
Encourage open communication: Parents, caregivers, and individuals themselves should be encouraged to voice their concerns and seek evaluations, even if their experiences don’t perfectly align with stereotypical presentations of autism.

By acknowledging the complexities of diagnosing autism, particularly in girls, and working towards a more inclusive approach, we can pave the way for earlier diagnoses, appropriate support, and a brighter future for all individuals on the autism spectrum.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

Autism Therapy · Speech and Language Therapy

Discover more about Verbal Dyspraxia

ByLondon Speech and Feeding September 4, 2023August 28, 2023

What is Verbal Dyspraxia?

Apraxia or dyspraxia is a difficulty in motor planning, which sometimes can be seen in both gross and fine motor skills, as well as speech. Gross motor refers to difficulties in coordinating the whole body (e.g., bumping into things frequently, often falling over hurting themselves or others through being “clumsy” or unsteady). Fine motor movements refer to smaller, more precise movements (e.g., difficulties doing anything with their hands such as holding a spoon or pen).

In Dyspraxia of Speech, instead of seeing a coordinated smooth way of talking, we see the articulators (tongue, lips, cheeks) and voice coordinating very smoothly. The voice can be very quiet or very loud. Muscle tone can be weaker at times. Speech sounds are very unintelligible, with a flat voice that can sound forced. It may be that the timings of verbalisation appear random and that children can say a certain word once and never again. This is often what we hear from parents.

It is interesting to note that many of our autistic clients are either non-speaking or are reluctant speakers. Sometimes they say a word once and then never again. Others say lots of words but the words are very hard to make out. Did you know that about 40% of autistic people have verbal dyspraxia? (Richard, 1997). Because the problem is one of motor planning, not of automatic motor execution, once a plan has become automatic, it is easier to get back to it and this is why we often see repetitive patterns that can be called ‘stims’ (Marge Blanc, 2004).

How can Speech and Language Therapy help?

Children with verbal dyspraxia can make great progress!

We provide frequent and appropriate speech movement opportunities and with time and the right support, children will move forward and begin to speak more fluently and with greater intelligibility. It is important to know this can take time.

We provide Oral Motor Therapy using a variety of approaches to practise breathing, vocalising on the outbreath, and sequencing our speech movements.

We design carefully tailored programmes focusing on words that have a lot of power (e.g., NO, GO, UP, IN, OUT, LET’S GO, STOP).

We offer shared enjoyment, and laughter. This helps a child find their voice. Other ways of finding our voices include singing or humming, or even yelling/shouting!

The most difficult phase of verbal dyspraxia is initiation, that is to start talking, to start producing a word. Frequent “automatic” repetition supports children with initiation because it removes the element of “thinking to start”. I often ask a child to repeat a word 5-10 times (with rewards at the end. A little game works well). You can see that with repetition the act of initiating is taken out of the equation as you are “on a roll “as it were.

Once a child starts to find their voice, we will be able to hear them talk lot… And if we give them credit and presume that what they are saying has meaning, we will find in time that their words become clearer and more intelligible. If we listen carefully, we can detect real words and phrases.

For more tips and support, please get in touch!

Speech and Language Therapy

Tele-Therapy – What Is That And How Does It Work With Speech And Language Therapy?

ByLondon Speech and Feeding October 16, 2021February 10, 2023

How can I help you assess and support your child when you live outside London or just can’t come to see me for any reason? The short answer is: YES I CAN and we can do it virtually! There are separate areas I can target using Teletherapy.

Here is one of them:

Parent – Child Interaction / Attunement

Through the pandemic and lock-down I have had opportunity to re-think how I can help people virtually and what I can do to ensure that parents continue to feel empowered and help their children make good progress even when I cannot personally come to their home or they cannot visit me.

My training with the HANEN METHOD came in so handy as of course in the US and Canada therapists and families traditionally cover huge areas and often are too far away from each other. They have been practising on-line/virtual or now known TELE-THERAPY for decades and are very advanced with research, materials and support in this area. I skilled up at the beginning of the pandemic early 2020 and by around April I was up and running! Nobody was able to see anyone in lockdown and of course parents were still desperate for help with their children.

The basic premise when supporting young children under the age of 5 years is that a NATURALISTIC approach is the best and very well researched to be highly effective. This means that the parents or caregivers are the most important and consistent key people in every child’s life and they are the best therapists and AGENTS FOR CHANGE.

Parents spent the most time with their child, even when they are working parents! – they are still most likely to spend many hours in the evenings and weekends with their child. When we are looking at how Social Communication develops we know that it emerges from birth through daily interaction and daily activities: playing, snuggling, running, eating, getting dressed, shopping with mum, sitting in the car with dad, playground, dinner around the table, bath time, story time, teeth brushing, bed time. These are the consistent areas where interaction takes place and where social communication can develop/be supported/ be enhanced. – do check out my other blog as well on this topic “What is Speech and Language Therapy”.

Parents Are The Agents Of Change

What do I mean by that? Parent-Child Interaction work focuses on helping the parent to tune in with their child and therefore enabling the child to tune in with the parent, in turn. Its about TUNING IN. This is often missing when children have social communication difficulties: they do not tune in. And parents end up tuning less into their children as time goes on, because the interaction is always so one-sided. Parents tell me again and again how hard it is to engage with their child as there seems to be so little “come-back”.

I teach your really powerful strategies that you can implement quite easily during your normal daily activities! You will not need to do any “home work”, i.e anything extra on top of what you normally do with your child anyway! How good is that!?

Each week I will teach you one or two new strategies to try out and together we will workshop exactly how you could do this. So you will walk away knowing what activities to target and how. Over a short period of time you will see positive changes, because you , the parent, have changed! PARENTS ARE THE AGENTS OF CHANGE. This is incredibly empowering for the parent as in the end you won’t need a therapist because you have become the ideal, consistent, expert therapist for your own child. The strategies will stay with you for life and over time you will be using them without even thinking about it. And your child will learn – over time – to tune in with you. TADAAAH! You’re welcome!

So give Tele-Therapy a try! I would really recommend it:

Convenient as you do not need to travel, and therefore cost and time saving.
It takes just one hour out of your busy day, not 3 hours with travel in London etc.
You will be fully supported with on-line video clips, slides, my write-ups and other materials I often make for you to support your journey.
You will feel empowered to help your child develop the very day you start the therapy.
You can have weekly support, fortnightly or monthly. You can contact me for brief hand-holds in between and most importantly your child will make progress.

If you would like to discuss this a bit more, get in touch with me! I would love to help. Check out my google reviews of clients who have done Tele-therapy with me, some of them live abroad, as far away as Australia and Tanzania or Germany. You will see it can work so very well.

Neurodiversity · Speech and Language Therapy · Top tips

Creating your calm: containment strategies for Sensory Processing Difficulties

ByLondon Speech and Feeding March 4, 2024March 1, 2024

The world can be a beautiful and stimulating place, but for individuals with Sensory Processing difficulties (SPD), it can also be overwhelming and even painful. Everyday sights, sounds, smells, touches, and tastes can be amplified to uncomfortable or even unbearable levels. This can lead to anxiety, meltdowns, and a constant feeling of being on edge.

One important coping mechanism for SPD is containment. Containment strategies are techniques that help individuals manage their sensory experiences and create a sense of calm and safety.

Understanding containment needs:

Containment needs vary greatly from person to person. Some individuals might find comfort in deep pressure, while others might crave quiet and solitude.

Common containment strategies:

Here are some examples of containment strategies that can be helpful for individuals with SPD:

Deep pressure: This can involve activities like wearing weighted vests, using weighted blankets, getting firm hugs, or applying deep pressure massage.
Movement: Engaging in rhythmic movements like rocking, swinging, or jumping can be calming for some individuals.
Proprioceptive input: Activities that involve proprioception, the sense of body awareness, can be grounding. Examples include yoga, stretching, and proprioceptive toys like chewy necklaces or fidget spinners.
Visual calming: Utilising calming visuals like nature scenes, dimmed lights, or fidget toys with visual patterns can provide a sense of peace.
Auditory modifications: Noise-blocking headphones, earplugs, or white noise machines can help block out distracting or overwhelming sounds.
Oral motor activities: Chewing gum, crunchy snacks, or chewy toys can provide sensory input and help regulate emotions.
Sensory bottles: Watching calming visuals move within a liquid-filled bottle can be visually stimulating and promote focus.
Creating a safe space: Having a designated quiet area at home or school where individuals can retreat to self-regulate can be invaluable. This space should be free from clutter and overwhelming stimuli and can include calming sensory items.

Additional tips:

Be patient and understanding: It takes time and practice to find what works best for each individual. Be patient with yourself or your child as you explore different strategies.
Consistency is key: Once you find effective strategies, use them consistently in different settings to create a sense of predictability and comfort.
Communicate openly: Talk to teachers, caregivers, and others about individual needs and how they can support containment strategies.
Celebrate progress: No matter how small, acknowledge and celebrate successes in managing sensory experiences.

Remember:

Containment is not about suppressing sensory experiences altogether. It’s about creating a sense of control and reducing overwhelming sensations to a manageable level. By exploring different strategies and working with a qualified professional, individuals with SPD can develop the tools they need to navigate the world and experience life to the fullest.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

A man and a woman hug a young girl at a table

Speech and Language Therapy · Top tips

Four struggles parents face when out and about with children with speech, language, and communication difficulties

ByLondon Speech and Feeding January 27, 2023February 10, 2023

You (as parents) often describe yourselves as being under constant pressure and stress when looking after your children and young people with Special Educational Needs and Disabilities (SEND). You may find going out to do the simplest of tasks a challenge. And you will try to avoid social situations out of fear and anxiety. One of the most important factors to you is having like-minded people who understand your position as a parent with a young person with additional needs. Let’s look at some of the challenges you face and how I can support you and your family.

1. Challenging behaviour and going out to the shops

When your child displays challenging behaviour and won’t go into a shop without buying a toy that they insist on having, it can be tough on your family. You see people around you staring as you try to manage the situation. They do not understand the pressures you face, or that the simplest of tasks are a huge challenge.

I can support you by giving strategies to use when out and about. I know that using visuals is important for your child. They may not understand or take in language when they are in a heightened state of anxiety or feeling overwhelmed. You could print pictures of the places you’re going to and put them on an easily accessible chain. Then you could use that chain when out and about at the shops. You may want to introduce a visual timetable at home. That way your child or young person understands where they are going. This may lessen their anxiety and subsequent behaviour.

2. Your child is not able to communicate their needs to an unfamiliar communication partner

When your child has difficulty communicating to an unfamiliar person it can be hard to manage. You feel yourself explaining your situation repeatedly. I can provide your child with individualised strategies or communication aids which support your child to communicate with both familiar and unfamiliar communication partners. We’ll work together to find which communication methods work in different situations and how your child will use these to help their independence.

3. Being overwhelmed

Your child or young person may easily be overwhelmed which may contribute to behaviour changes. I’ll work with your family to understand what the behaviour means, looking at what happened before and what happened afterwards. We’ll not only look at the behaviour but at the environment as well. This can inform how you can support your child or young person in the future, to reduce sensory stimuli (if needed) and for them to feel emotionally regulated.

4. People avoid engaging with you

One of the hardest things as a parent is for others to avoid you. You see them crossing the street because they don’t know what to say to you. All you want is them to accept you, to maintain your identity as a person and not as a SEND parent. I can support you emotionally. I can give you advice on local support networks where you can find other parents in a similar situation.

We know the stresses that being a parent with a child with SEND comes with. Please know I am always here to support you, to find solutions so that when you’re next out and about. Your experience will be a little easier and you’ll feel less isolated.

Improve your child’s communication, confidence, reduce overwhelm and feel supported here.