Transcript Toys2Talk Presentation

ACE Centre
Rachel Moore Speech and Language Therapist
Jackie Ayre Occupational Therapist
Communication
“Communication is crucial. Communication is a
fundamental human right. Communication is a
key life skill. Communication is at the core of all
social interaction.”
• From "A Review of Services for Children and Young
People (0–19) with Speech, Language and
Communication Need" (Bercow July 2008).
The ACE Centre
• Assessment of children with complex
communication difficulties
• Multi-disciplinary team
• Training
• Information
• Research and Development
But we were not seeing children
early enough…
• “Communication starts with interaction and
the earliest behaviours of children – there
are no prerequisites.” Cress 2000
• “What are we waiting for” Kangas & Lloyd
1988
The political picture
“Early identification and intervention are essential”.
From: "A Review of Services for Children and Young People (0–19) with
Speech, Language and Communication Need" (Bercow July 2008).
During this time we cannot afford to get things wrong.
The early years are critical in children’s development. Children
develop rapidly during this time
– physically, intellectually, emotionally and socially.
From "Curriculum Guidance for the Foundation Stage" (Foreword by
Margaret Hodge, Parliamentary Under Secretary of State for Employment
and Equal Opportunities, 2000)
So much happening…
• It is well documented that from conception to first day of
school development proceeds at a pace exceeding that
of any other stage of life.
• “Children are active participants in their own
development, reflecting the intrinsic human drive to
explore and master the environment” Shnokoff & Philips
• “Human Development is shaped by a dynamic and
continuous interaction between biology and experience”
Shnokoff & Philips
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Play is a motivational tool
Play!
• “Through play children learn about the world
around them. They learn to communicate,
interact with others, develop their own identity
and build on their social skills…”
– From ‘Play Talks’, SCOPE
“Children find out about the world around them through
a process of observing, exploring, speculating and
making discoveries.” Mary D Sheridan (1999). Play in
Early Childhood. From birth to 6 years.
Play is !!
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Having fun
Communicating
Developing skills
Taking control
• Physical difficulties can reduce opportunities for
exploration and play
• A child with complex disabilities needs tools at every
stage.
• Tool needs to be pitched at the right level.
Toys2Talk Project
• Early Intervention (The youngest child we
saw was 11 months)
• Children with a wide range of diagnosis
and difficulties
• Support for both families and professionals
– Information, strategies, equipment.
Support for both families and
professionals
• Parents are experts on their children.
• Experiences and expectations tend to be
based on the “normal” developing child /
no previous experience of a disabled child.
• Parents are looking for information, advice
and support
What did Toys2Talk involve?
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Referral
Information collection
Contact visit
Loan of equipment and information
provision
Information Collected about the
child
• Individual approach to all children referred
• Collect information from Parents and
professionals,
• For example:
– Communication
– Physical abilities and difficulties
– Level of play and interaction, sensory through to
imaginative play.
– Attention
– Likes and dislikes
Contact with the Child
• Sessions at ACE Centre
• Visits to children at home
• Visits to pre-school professionals
Following a visit with a child
• Loan Boxes
– adapted toys, access devices for early
computer play and communication resources
– whatever is necessary for the child to use the
equipment, including advice and guidelines
– CD of photos and video clips
Contents of a typical toy box
How did we go about it?
Picture/video of child
Identify appropriate tools for the individual.
Different types of play required different
tools
• Exploratory play
• Constructive play
• Pretend play
• Social interaction
(types of play Sheridan 1999)
• Developing control skills
• Motivation
• Exploratory Play (Edward)
• Constructive Play (Oscar)
Picture/video of child
Picture/video of child
Pretend Play (Tamsin)
Picture/video of child
Cooperative play (Poppy)
Picture/video of child
• Parents aware need for tools to enable
children to play.
• Were often unaware of what tools were
available.
Tools
Control devices
• Switches
• Touch screen
• Joystick
Switch Control
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Switches
Stick
Latching box
Activity- toy / Simple communication
device/ environmental control
Why Switches
Different reasons for introducing switches,
strategies and techniques.
Touch Screen
Different reasons for introducing touch
screens, strategies and techniques.
Joystick
• Different reasons for introducing joysticks,
strategies and techniques.
• “Communication starts with interaction and
earliest behaviours of children – there are
no pre-requisites”
Cress 2000
• Communication is integral within a child’s
development and learning from the earliest
stage …..
• An integral part of play.
Communication Issues
• Young age of children
– Communication difficulties may not have been
considered
– Some normally developing children may not
yet be speaking
• Within Toys2Talk project, limited potential
for long term support.
Communication issues
• Sometimes there was no SLT involved
• Always liaised with a SLT if one was involved
• Sometimes keen for any suggestions
• Sometimes they asked for specific input
• E.g. Equipment,
• Discussion / introduction of ideas
Parental approach
• Parents recognition of communication issues
varied widely
– Required flexible approach
• Some parents are keen to support
communication as early as possible
• Some parents concerned whether alternative
communication methods will delay speech
development?
• Where an SLT was not yet involved,
parents required advice and discussion
– Saarah. On a 6 month waiting list.
Discussed strategies
Picture/video of child
for encouraging sound
production, loaned a
signing dictionary and a
LITTLEmack
• Some parents required information and
support with specific situations:
– e.g. Morgan, had lost ability to communicate
and his mother wanted to investigate a small,
lightweight single message communication
device
Some parents were actively seeking support for their
child’s communication, open and interested in any ideas.
Sienna
Cameran
Discussed signing, loan of a
signing dictionary
Discussed eye pointing to
symbols. Provided core symbols
and an E Tran frame. Eye Gaze
Folder discussed. Loan of
Boardmaker software
Discussed how to use core
symbols, provided these
Picture/video of child
Picture/video of child
Poppy
Eye points to either side for Yes/No.
Communication book is under
development. Lent an E tran frame,
core Symbols,
Loaned Boardmaker. Already has a
LITTLEmack
Picture/video of child
Thomas
Talked about eye pointing to symbols,
lent E tran frame with core symbols to
support activities provided. Already
has a LITTLEmack
Picture/video of child
Case Study: Tiago
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Age 16 months
Cognitively bright
Cerebral palsy
Physically complex
Picture/video of child
– Attends the Bobath, moves through a variety
of positions through the day
Tiago was placed in a variety of
positions during our initial visit:
Picture/video of child
..and more positions at home…
Picture/video of child
Tiago was interested in everything!
He particularly loved the computer
Picture/video of child
Equipment loaned after initial visit
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2 Jelly Bean switches
Ruler with Velcro
Maxess Wedge
Mouser
Powerlink
Ablenet single switch latch and timer
Range of simple cause and effect software
Tape recorder
List of books with repeated lines
Guidelines on how to use equipment
E tran frame
Core Symbols
A CD of photos and video clips taken during the visit will be
included
Communication Resources Provided
• Tiago produces a range of sounds, 2 syllable
babble including some consonants, no words.
• Good eye pointing skills developing
• LITTLEmack already in place
• Toys2Talk provided E Tran frame, core symbols,
yes/no symbols
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Alison provided feedback soon
after initial contact
• Request for further visit
– lots more symbols: for meal times, nursery
rhymes etc
– Mounting switch so that Tiago could play with
the computer independently
– Trial of a joystick
– Further loan of toys
Developed a bank of symbols in a
short time, used throughout the day
Toys
Control
Picture/video of child
Choice
Picture/video of child
Fun!
Picture/video of child
Use of Computer
Picture/video of child
Bercow considers that failure to intervene
at an early age has far reaching effects
“If a child does not benefit from early intervention,
there are multiple risks, which may become apparent
over a number of years – of lower educational
attainment, of behavioural problems, of emotional and
psychological difficulties, of poorer employment
prospects, challenges to mental health ….”
From: "A Review of Services for Children and Young People (0–19)
with Speech, Language and Communication Need" (Bercow July
2008).
Rachel Moore - Speech and Language
Therapist
[email protected]
Jackie Ayre – Occupational Therapist
[email protected]