How to use Attention Autism to develop language and communication

ByLondon Speech and Feeding
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Now you’ve read Attention Autism (part one), you are familiar with the concept of ‘bucket time’ and the benefits it has to offer your child. It’s time to explore all the different stages. In sessions, it can be noisy and with so much to take in, you may want something to refer to. If you’re in need of a helping hand or memory jogger for stage two, read on…

Knowing what stage your child is working at is vital. Every stage has different aims to develop and enhance functional communication. So being familiar with your child’s goals ensures you can continue to practise at home. If you’re unsure of their goals, please ask your Speech and Language Therapist.

With all speech, language and communication goals, the aim is always to generalise skills from therapy settings to home and nursery or school life. This generalisation period will take time. Please try to stick with the plan. You will experience the benefits for your child, and it’ll make family life a little easier.

You may remember that Autistic children thrive on visuals. Let’s use their strengths to support their communication needs. It is a good idea at the start of the activity to have a visual for what’s happening now and what will happen next. If you’re anything like me, you’ll grab a pen and paper or a whiteboard and whiteboard pen, and will doodle away! You don’t need fancy photos.

On the left is a bag with Now written above it and Bag below. On the right are three children playing with Net written above and Play written below.

The attention builder

Stage two of the Attention Autism approach is called “the attention builder”. The clue is in the name, your child’s goal is to keep focused on the activity for a longer period. The duration will be different for every child, but it’s useful to time their attention, so you can report progress back to your therapist.

Parents are often worried about doing something wrong. If it all goes a bit pear-shaped or not as you expected, don’t panic! This is the time to ask yourself, did my child have fun? Did they engage in the activity? It’s very helpful to reflect on the experience. What could you do that would make the activity easier for your child to access? (For example, did you set up the activity before your child entered the room? This would allow for a smoother session, so that waiting time was minimal.)

Three ideas for stage two activities

There are so many ideas out there, which at times can feel overwhelming. I’m always looking for the easiest options to present to you to reduce overwhelm and allow it to feel manageable.

Remember this is about having fun. Your child’s communication will benefit from you relaxing and having this structured approach.

Here are our three top ideas for stage two attention Autism activities:

1. Flour castles

You’ll need:

  • Container, cup or glass
  • Flour
  • Sheet (for the table/floor) (optional)

This is a fun-filled activity to try. But it can get a little messy!

Fill a small glass, cup or container with flour and flip the cup over to build flour castles. It’s great to engage your child especially with the “Splat” at the end.

2. Paint balls

Another activity which is a little bit cleaner is ‘Paint balls’.

You’ll need:

  • Tray, container
  • Paint
  • Rubber balls or marbles
  • Paper (optional)

First dip the marbles into the paint, then drop into the container and roll it around to make a pattern. You could always make a pattern on some paper.

I love to use everyday objects in therapy, so when I came across this next idea, it was added to the list. It’s simple, effective, not to mention clean!

3. Skittles

You’ll need:

  • A packet of skittles
  • Warm water
  • Plate

You’ll need to create a circle of skittles around the edge of the plate. Then add small amounts of warm water to the plate and watch the rainbow of colours appear.

These activities offer a sequence to build and sustain your child’s attention. Remember the key is to have fun. Create meaningful interactions that your child cannot miss! If they can learn to hold their attention, they can learn to use functional skills.

Now you’ve got ideas for stage two activities. Go ahead and carry them out.

Have fun!

If you need speech, language or communication support or advice, I am always here to help.

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.

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Ten games to support communication in primary school aged children
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Ten games to support communication in primary school aged children

ByLondon Speech and Feeding

When parents visit me with their child, their stress is palpable. Often parents don’t relish or even expect to be asked to practise strategies at home with their child between sessions. Let alone to practise whilst on holiday. I understand that you don’t necessarily want anything extra added to your daily ‘to do’ lists. This is why we try our best to incorporate all speech and language therapy practice into children’s daily activities.

For example:

  1. during bath time;
  2. mealtimes;
  3. getting ready for bedtime;
  4. story time
  5. yes, playtime!

These are activities that all parents will engage with anyway, so it seems to make sense to incorporate both. This is to avoid adding extra pressure on parents’ already stressful and time-poor daily lives. I am hoping my blog will come in handy, especially for the summer holidays.

On holiday you are unlikely to have your usual games and toys with you – so here is a nice little list of things you can use instead of traditional games and toys:

If you can think of any other alternatives on holiday and would like to tell me about them, I would love to see your comments below. We can never have too many holiday games!!

If you are at home over the summer and you do have some games in the cupboard you might want to dust these ones down or buy one or two new ones (if you want to).

Most games have multiple uses, and it’s always best to adapt a game to match your child’s interests and what motivates them.

So let’s start…

  1. Pop up pirate: pop a sword into the barrel and watch the pirate pop up randomly. Practise social skills, speech sounds, expressive language (e.g., put a sword on a picture, say the word/sentence then pick up the sword and push it into the barrel).
  2. Word games such as ‘ISpy’, ‘I went to the shop and I bought…’, ‘describe a person and guess who they are’: perfect for when you’re on the move, whether travelling or walking. You can play this anywhere and still support speech, language and communication. You could play ISpy using your child’s special sound, or ‘I went to the shop and bought all things beginning with [insert special sound here]’.
  3. Shopping list: Orchard game is a game to practise categorising. We explain the analogy of the brain being like a filing cabinet. If information is all in the correct place, it’s easier to find, retrieve and use. You can also practise specific speech sounds in this activity. You could also put the words in a sentence to add more of an expressive language element.
  4. Wiggly worms: this Orchard game is all about phonological (awareness of sounds) awareness. Matching a letter with the word. You can also practise the sounds in the words (e.g, g-o-l-d = gold; m-a-ke = make). Talk about the elements, e.g., ‘g-o-l-d’ has 4 sounds, 1 syllable; ‘m-a-ke has 3 sounds, one syllable. You can talk about what words rhyme with the different words and what makes a rhyming word (i.e., the middle and end sounds remain the same).
  5. Sound detectives: this Orchard game allows children to identify sounds. It also has an app (if your child prefers a tech-way of learning). Children identify the sound then they can add the picture card to their path and become closer to being a successful detective. This game can also support memory skills.
  6. Conversation cubes: throw the dice and start building a story. You can also create and use ‘colourful semantics’ sentence strips to support expressive (spoken) language as support to build the narrative.
  7. Think words: ‘name it, press it, pass it’. A great game to expand word knowledge. You can talk about the words at the end of each round exploring semantic (meanings) and phonemic (sounds) links. Your child can also develop social skills (such as attention, listening and turn-taking).
  8. Poo bingo: this is perfectly disgusting but equally fun for kids of about 3.5 years plus – if your child’s target is to practise /p/ sound this is the one for you. You can also learn all about the different animal’s poo, which I am sure you have always wanted to do!! The more we know about a word, the easier it is to store, retrieve and use. Yes, even talking about poo can help!! Also, it’s great for our visual learners.
  9. Simon says: a game that can be played indoors or outdoors. Parents can take turns being “Simon” and give various commands that your child must follow. This means that your child can practise their receptive (understanding of) language as well as their expressive language, speech sounds and social skills (such as turn-taking and initiating).
  10. Ker-plunk: this is perfect for practising your child’s special sound. Repetition is very important, but also can be monotonous, so finding a game that they enjoy is vital. Take turns to pull out a stick. Next, your child can either say their special sound or word (depending on what stage they are at) or hear a good model from other players.

Do you still have questions? Contact Sonja for support.

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.

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

ByLondon Speech and Feeding
Unveiling the hidden spectrum: Why girls and autism often go unseen
Image by Freepik

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.

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.

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Five ways to use books to encourage speech, language and communication for reluctant readers
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Five ways to use books to encourage speech, language and communication for reluctant readers

ByLondon Speech and Feeding

Reading can be a tricky skill to master for young people with speech, language, and communication difficulties, which may lead to reluctance in picking up a book. But that doesn’t mean you can’t use books to inspire and encourage them. It’s important to think outside of the box and take an innovative approach.

But before you do that, you need to identify why your child is averse to reading. There are many possibilities: is it that they have difficulties remembering what they’ve read; or perhaps they may have difficulties decoding the words, which is the ability to apply your knowledge between letters and sounds; or it might be that they are unable to understand the language used. Whatever the reason, it’s helpful to know. It’s only then that we can support their needs which may lead to greater enjoyment in reading.

A boy behind a pile of books on a table with hands in fists

Explore five ways in which we can encourage reluctant readers using books:

  1. Firstly, we could narrate what’s happening from the images and relate it to experiences that your child has had, which will make it more relevant. For example, when looking at a book with a cat in it, you could say “do you remember the time when grandma had a black cat sipping out of her glass of water?”.
  2. You could talk about what they think will happen next and make predictions. You could even make this into a game. Write your predictions on paper and see who is right.
  3. Draw images to identify the key parts of the story. You might want to create a story board together.
  4. Make a sensory experience, where your child can have a hands-on approach. See what you have at home, you don’t have to go out and buy materials. E.g., If the book is talking about a gravel path, you may have rice crispies; if it mentions the weather, you could spray water or have a torch for sunlight. Let your imagination do the work! This is also a great way to learn new vocabulary. In addition, you can also use a colour coded structure to support their expressive language (e.g., who? (the man) doing what? (is eating) to what? (an apple) how? (quickly) where? (in the park) when? (on Monday). Write out the different parts of the sentence with a picture for each part. So, your young person has a visual to learn from.
  5. Why not act out the story with family or friends? This really brings the story to life and allows your child to practise vital skills for attention and listening and social interaction such as turn-taking.

Make sure you use a book that is appropriate for the age and stage of your child’s development and adapt your activities accordingly.

Check my blogs for speech, language, and communication support.

Contact me and see if I can help you.

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

A Day In The Life Of An Independent Speech And Language Therapist

ByLondon Speech and Feeding
A Day In The Life Of An Independent Speech And Language Therapist

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.

Explore seven activities to encourage speech development in school-aged children
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Explore seven activities to encourage speech development in school-aged children

ByLondon Speech and Feeding
Explore seven activities to encourage speech and language development in school-aged children
Encourage speech and language development in school-aged children

We hear too often parents ask, “what do I need to buy so I can support speech skills at home?” The advice I give is to use what you have at home; you don’t need specific toys or equipment. I’ll give you some ideas so you can adapt them for your child or young person’s interests.

Ensure you know which level your child is working at (e.g., sound level, consonant + vowel, consonant vowel, word, sentence, or generalisation level). If you’re unsure ask your child’s Speech and Language Therapist. The more practice your child has, the better, so practise little and often.

1. Bubbles

Explain to your child that you will play a game. You’ll take it in turns to say their tricky sound and practise at whichever level they are working at/towards.

2. Pop up pirate or similar

Explain the rules of the game to your child (as above). You could stick a picture to each of the swords for variety or stick photos on different characters beginning with their tricky sound. This would be particularly helpful if they are struggling for motivation.

3. ISpy

This is a great game where you can involve the whole family and you can even play it to and from school. Choose their tricky sound and everyone takes it in turns to say “ISpy with my little eye something beginning with [insert tricky sound]”.

4. Hide and seek with words

Explain to your child that you will hide pictures around the room. They will cover their eyes and will be told when they can look. Then they become a word detector and search for the pictures. After they’ve found each one, they are to say the sound (at whichever level they are working at).

5. Name 10!

Your child will name 10 words beginning with their tricky sound. Your Speech and Language Therapist will be able to give you the words at the level they are working at.

6. Sound focused game – silly sentences!

Your child will make silly sentences beginning with their tricky sound. E.g., if your child’s tricky sound is /s/ a silly sentence might be ‘Simon sat on sizzling sausages this Saturday’. Take turns to create them. Allowing your child to hear the correct sound is important for their production skills.

7. Throwing a beanbag on the correct sound

Have their tricky sound and the sound they make placed on the floor. They can use a beanbag or a ball to throw or place on the sound which you produce. Explain what you expecte them to do. Use specific praise (e.g., you listened well).

You can adapt all the above activities to meet your child’s needs. Please feel free to contact me should you need any further advice. I’m here to provide support, reduce your overwhelm and empower you to support your child’s speech and improve their communication. This will in turn reduce their frustration.

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.

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Six ways to prepare your child for the Christmas festivities

Six ways to prepare your child for the Christmas festivities

ByLondon Speech and Feeding

It feels like the Christmas festivities start earlier and earlier every year. This makes it harder for your child with communication difficulties to process what is happening. Whilst you can’t do anything about the events that happen around your child, you can start to put into practice strategies which may support them and allow them to regulate their emotions.

Speech Therpaist in London
Six ways to prepare your child for the Christmas festivities

Explore six ideas here:

1. Print off or buy a blank calendar to use at home

You can start to write in activities out of the usual routine and add a picture to allow your child to understand what it’s about. You can also use it as a countdown to Christmas Day to try to prevent ‘how long’ questions.

2. Make use of visual timetables

These are useful in everyday settings and activities but also when change occurs.

3. Be aware of any non-uniform days

Days like ‘Christmas Jumper Day’ can make your child feel uncomfortable and may affect their behaviour. By giving yourself time, you can have conversations with your child’s teacher to find a more suitable alternative. For example, they can wear a Christmas t-shirt that they find more comfortable.

4. Think about what will benefit your child

Do they like being surrounded by people or do they prefer a quiet space on a 1:1 basis? Christmas activities often involve lots of group work in school (e.g., rehearsing for carol concerts or plays). They might prefer to pre-record their part in the Christmas play or create pieces of art which can be used. At home, they may prefer one guest visiting at a time, rather than all at once.

5. Explore how your child is feeling

It’s important to find out how your young person is feeling and how these impact on the activities of that day. It might be that your child doesn’t like surprises and the intensity of opening gifts is too much for them. They may prefer gifts to be left unwrapped and given throughout the day, rather than all at once.

6. Consider sensory needs

Ensure your young person has everything they need to meet their sensory needs. This can be e.g. noise cancelling headphones, fidget toys, or comforting items. These will particularly be helpful with routines changing, often with little notice. If at home, you may wish to not put lights on the Christmas tree if visual stimuli become too much.

Remember clear communication between home, school and other family members is vital during this time. By having clear communication and expectations, your young person will feel more secure. And you can have a Christmas that is right for you and your family.

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.