Neurodiversity affirming Speech and Language Therapy

ByLondon Speech and Feeding
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Introduction

I am a neurodiversity affirming therapist and I love and endorse play-based therapy. I use it alongside a strengths-focused approach in all my sessions. Find out why we should use these transformative therapy methodologies in all our work and play with our children.

I always have a range of different toys and activities up my sleeve so that when one toy is no longer interesting, that’s fine. ‘Look here’s a new one, how about we try this one?’ When therapy feels like play, children are more likely to be engaged and attentive, which leads to better outcomes.

By using play as a context for Speech and Language Therapy we can create opportunities for children to use and practise their communication skills in a natural, real-life setting. This helps bridge the gap between the therapy room and everyday life.

Goals and targets

What about goals and targets I hear you say? Of course, as Speech and Language Therapists we always have our goals for any particular child. They can be speech goals (we want Bobbi to produce a ‘k’ sound at the end of words) or communication goals (we want Fatima to ask for something by pointing to it rather than grabbing it). And these goals can be achieved where there is a reciprocation and a positive, playful relationship between the adult and the child. That relationship comes through play and fun.

Play and fun

Play is how a child interacts and learns. If it’s fun, interesting, exciting or pleasurable then that is where the magic happens. And that is what we need to return to repeatedly and then see if we can fold our targets into the activity as we go.

As soon as we expect our child to do something and we try and shape their behaviours towards a certain outcome we no longer ‘play’. We are now in teaching mode, where we direct and where we are ‘in charge’. As a neurodiversity affirming therapist, I believe that all play is valid. We must not get into the trap of thinking that only functional play is valid, that there is only one way to play with that car ramp/puzzle/potato head. Our autistic children often need to play in a particular way to navigate their world and we must not try and stop that.

When we affirm and validate our child’s play and copy their play with enthusiasm and respect then, in my experience, all children regardless where they are on the neurodiversity spectrum will begin to engage with us, copy us, and learn how to communicate effectively about things that matter to them.

Play-based therapy allows therapists to tailor interventions to each child’s unique interests and abilities. This individualised approach increases the likelihood of success and progress.

Strengths-Focused Speech Therapy

Strengths-focused therapy emphasizes a child’s strengths and abilities rather than their deficits. It recognises that every person has unique strengths that can be harnessed to overcome challenges.

Focusing on strengths helps us build a positive self-image. This is especially important for children with communication disorders, as it can boost their confidence and self-esteem.

When we encourage children to play in ways that they enjoy and are good at they feel empowered and more in control of their lives and play. This can lead to increased motivation and a sense of ownership over their progress.

Now, imagine the powerful impact that can be achieved by combining play-based therapy and strengths-focused therapy in speech therapy sessions. This dynamic combination brings out the best of both worlds. It creates a therapeutic environment that is not only effective but also enjoyable for children and their families.

As Speech Therapists we can use the child’s strengths and interests as a foundation for play-based activities. This personalisation not only makes therapy more engaging but also more effective.

An example

Charlie, a 3-year-old with social communication challenges, had a deep interest in anything that spins. We used this strength and interest to create a variety of spinning activities. As he is allowed to engage in his spinners, we can practise lots of speech and language and provide great phrases alongside his interest and activities: Ready steady go! Stop! ‘another one’ ‘the red one’ ‘again again’ ‘I love it’ ‘it’s a spinner’ ‘Charlie loves this toy’ ‘it’s going fast’ ‘it’s so fun’ etc..

Over time Charlie started to copy some of these word models and then used them to create his own little phrases, such as ‘the blue one again’. When this occurred, we felt like celebrating because it had come naturally and appropriately to the situation without any coercion or direction. That is what communication is about! Well done Charlie!

Conclusion

Play-based and strengths-focused speech therapy approaches are powerful tools and by combining these approaches, we create a therapeutic environment that is not only effective but also enjoyable and empowering for our clients.

Contact me if you would like your child to have neurodiversity affirming speech and language therapy.

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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    With this approach, we use two sounds that our student is struggling with. For example, in my video this student cannot produce /sh/ and /r/. Both sounds have different rules, so I decided to contrast them with each other.

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    Phonology Therapy – what is it, why and how?

    Phonology is the study of the sound system of a language. It’s distinct from articulation therapy which focuses on the physical production of sounds.

    Phonology therapy focuses on rules. For example, sounds that are produced at the front of the mouth, in contrast to sounds that are produced at the back of the mouth, or sounds that are produced with a long air stream: /s/ or /f/ versus short sounds like /p/ or /t/; sounds are produced with voice or without voice.

    Many children, and sometimes adults, are unaware of some of the speech rules and confuse and replace individual sounds. They might say TAT instead of CAT or SIP instead of SHIP.

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    This approach is good for single sound substitutions. We offer word pairs that differ by only one sound, like ‘ship’ and ‘sip.’ One of our first goal in therapy is to highlight the difference between the target sound (e.g., /sh/) and the sound the child uses (e.g., /s/). This helps discriminate and eventually produce the correct sound.

    Multiple Oppositions:

    A child might replace lots of sounds with a single sound like a /d/. So instead of ‘four’, ‘chore’ and ‘store’ our child says ‘door’, making speech very unintelligible.

    The approach is typically geared towards shaking up the phonological system. Our goal is to choose two to four targets that are different from each other, and different from the substituted sound. If our child’s favourite sound is /d/ they can use their voice and make a short sound by stopping their airflow. So I will choose a different target sound to change up the speech system. For example I might choose an /f/, a /m/ and a /k/ sound. So I would contrast: ‘door’ with ‘four’, ‘more’ and ‘core’.

    Maximal Oppositions:

    In the Maximal Oppositions approach the treatment sets consists of words that are minimally contrasted and that have maximal or near maximal feature differences between each word pair. One word in a pair represents a sound the child ‘knows’ (can say at word level) and the other represents a sound the child does not know (cannot say).

    For example, a child may ‘know’ /m/ and be able to say words like ‘man’, ‘mat’ and ‘mine’. However, the same child may be unable to say /f/ as in ‘fan’, ‘fat’ and ‘fine’. The consonants /f/ and /m/ are maximally opposed as follows.

    I am always delighted to work on speech sound disorders, I love the challenge and the successes we can celebrate together. Get in touch with me!

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    Contact me via my contact form if you would like me to work with your child.

    Sonja McGeachie

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    Reference

    Pontecorvo, Elana & Higgins, Michael & Mora, Joshua & Lieberman, Amy & Pyers, Jennie & Caselli, Naomi. (2023). Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language. Journal of Speech, Language, and Hearing Research. 66. 1291-1308. DOI 10.1044/2022_JSLHR-22-00505.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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    Makaton for "finished"
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    The Hanen Program® – The beauty of the ‘4 S’

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    Image by freepik

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    3. The third one is GO SLOW

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    4. The last one is SHOW

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    At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

    For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

    5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

    The fifth is REPEAT.

    Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

    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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  • · ·

    LAMP Words for Life: A revolutionary AAC system

    ByLondon Speech and Feeding

    Introduction

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    There is a whole host of AAC apps and systems out there and each has their own advantages and benefits for sure. I have tried a good number of other systems. I do also like certain features of other AAC systems for sure. For example GRID: I love the versatility of GRID and the ease of editing the system is fantastic.

    Why I think it works so well

    However, strangely I always return to LAMP when push comes to shove. I have thought very carefully about it and so here are my thoughts on why this is and why it works so well:

    1. Intuitive interface: LAMP Words for Life features are for me really user-friendly and it is easy to navigate and understand (this is very important for non-techy people). I think it makes sense and it is accessible to users of all ages and abilities. Yes the pictures are a little bit different to other symbol systems we use, especially here in the UK to be sure, and this is one of the reasons why it is good to have a variety of systems available, so that we can cater for students who are used to other symbols or do very well with specific symbol core boards. I have learned though that the pictures are not that important when using LAMP because the entire system is based on MOTOR PLANNING. And once one knows the motor plan to find a picture it is in our brain and we do not look at the picture any more. So, the motor plan to find a word is much more important when using LAMP than worrying about what the picture looks like.
    2. Comprehensive vocabulary: The system offers a vast vocabulary of words and phrases, covering a wide range of topics and contexts. This enables users to express themselves effectively on a variety of subjects. That said, almost every time I use LAMP there is a little word I need and it’s not on there. But that’s not a problem: for example, I was looking for ‘sunglasses’ the other day. Sure, there is ‘sun’ and ‘glasses’ but that would be two separate motor plans and for my student that would be too many for now, so it was very easy to quickly add the new word ‘sunglasses’ under ‘accessories’ or ‘beach wear’ — I added it within less than one minute. Likewise, there are a ton of words which cater for the US market, and I tend to change them to fit the UK vocabulary like ‘nappy’ for ‘diaper’. Or I delete them entirely if I feel my child will never need to use a certain word like ‘conference’ or ‘nun’. PS: should they get to a point of using the system as an adult independently then these words can surely be added again, or if my student ever moves to the US then the words can be changed back to US terms again without any problem.
    3. Grammar support: LAMP provides built-in grammar support, helping users construct grammatically correct sentences. This can be particularly beneficial for individuals with language processing difficulties. But what I love about the way LAMP is organised here is that, in contrast with other systems I have used, it does not PREDICT what you want to say, it lets the user decide and find the right grammatical structure. I appreciate this because, just like I hate my phone or email offering predictive text or offer corrections to my words, I really do not get the systems that offer automatically a grammar change which mostly I don’t want. Where that is the case, I am often confused and hindered in finding the correct wording. I love the simplicity of LAMP and at the same the complexity that can be achieved gradually with practice. LAMP is fully designed to enable a user to build up not only vocabulary but a full language system. On a course recently I was able to hear adult LAMP users speaking to the audience in full and quick grammatically well-rounded sentences on a host of topics.
    4. Customisation: LAMP can be customised to meet the individual needs of each user. This includes options for adjusting the vocabulary, layout, and accessibility features. It is not as easy to edit as GRID I will say and that can cause me a little bit of frustration at times, but on balance I still vastly prefer the system as a whole. It can also be customised quite well for Gestalt Language Processors. It takes a little bit of practice and thinking about how best to do this but I have found a way that works well which I demonstrate in the short video clip.
    5. Community support: LAMP Words for Life has a thriving community of users on Facebook and this is so valuable and inspiring. Therapists and families of LAMP users alike share experiences, provide resources, and offer encouragement. This can be a valuable source of support for both users and their families.
    6. Comprehensive support: LAMP Words for Life offers quick and thorough support services, including training, resources, and ongoing assistance. This is invaluable and reassuring for both users and caregivers.
    7. Research-based: The development of LAMP Words for Life is based on extensive research and evidence-based practices. This ensures that the system is grounded in sound scientific principles.

    Conclusion

    To conclude LAMP Words for Life is a powerful AAC which provides us with a means of effective communication, language development, and social interaction. Whether you are a parent of a non-speaking child or a speech therapist looking for innovative AAC solutions, LAMP Words for Life is worth exploring.

    Example on how to use AAC at story time

    Feel free to contact me if you need help with your child.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

    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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