Transcript Stephanie Ropic – Speech therapy

Speech & Language
BACKGROUND, IDEAS AND INFORMATION.
Aims of the session
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To discuss the role of the speech and language therapist.
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A background into different types of speech and language problems.
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General ideas to help a child who is slow to talk.
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More specific advise for children who have severe learning needs.
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Questions and answers time.
Speech and Language Therapy
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My name is Stephanie Ropic, a independent Speech and Language
Therapist.
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Children and young adults 0-25.
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Work with mainstream children and children with learning difficulties.
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Identify those children in need of help with their communication skills.
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Deliver therapy for children needing help.
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Train others to deliver therapy for children needing help.
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Work in parents’ homes to deliver therapy and upskill parents.
Speech and Language Therapy
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My name is Sophia Mitchell.
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Mixture of NHS and private speech and language therapy.
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Children and young people 0-19.
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Mainstream and special school children.
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Direct intervention.
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Training parents to deliver programmes.
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Training school staff to deliver programmes.
Why bother?
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10% of all children will have a speech and language problem.
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This means 2-3 children per classroom in the UK.
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In some areas of the city in Birmingham, 50% of 4-5 years olds are behind
with their talking.
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With the right help from a speech and language therapist, these children
can reach their full potential.
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Language affects how well a child can access the curriculum in school.
The effects of poor speech and
language.
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Can affect a child’s ability to reach their full potential at school.
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Can cause behaviour problems.
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Can affect the chances of getting a job.
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Can affect the child’s confidence and self-esteem.
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Can affect the child’s ability to read and write.
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Affects how they can cope with subject content for subjects like Maths
and Science.
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Affects the child’s ability to express wishes and desires.
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Affects the child’s ability to express their emotions and feelings.
Types of speech and language
problems.
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Poor attention and listening.
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Poor social interaction and social skills.
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Limited understanding of what people say.
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Limited expressive language, may not be able to speak in sentences.
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Limited vocabulary.
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Unclear speech sounds and articulation.
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Stuttering/ stammering.
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Eating, drinking and swallowing difficulties.
How can I help at home?
Ideas for home.
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Make lots of comments rather than asking questions. ‘that’s a red dress’, ‘you
are dancing’, ‘lets walk!’. Commenting all the time feeds in language to the
child so they start to attach meaning to words. The child will never learn that a
‘plant’ is that green growing thing, if you don’t tell them over and over again.
Sometimes a child needs to hear a word 50 times, in 50 different situations in
order to learn it.
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Reduce the amount of time spent watching the TV.
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Too much time spent in front of smart phones and iPads has been shown to be
damaging to a child’s development. Limit it!!
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Spend 10 minutes everyday ‘special time’. You sit and play with the child and
feed language into the play so the child can hear words and associate
meaning. Play is very important in the development of language for any child.
Ideas for home.
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Sit down on the floor and join in their play. Role play – pretend to be at the
doctors, pretend to be at school, pretend to have a picnic. Imaginative play
plays an important part in language development.
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Giving your child this extra attention will improve their attention and
concentration skills.
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Model (NOT correct) the right words – if they say ‘I swimmed today’ – you say
‘you swam today, well done!’. If they say ‘shoes’ for their boots you model
back, ‘yes, boots!’
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Absolutely no dummies should be used after 1 year of age.
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Extend their sentences. If they say ‘elephant’ you say back, ‘big elephant’. if
they say ‘give’, you say back, ‘give crisp’. They need the language modelled
to them in context at the right time.
Ideas for home.
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Increase opportunities for talking. So meal times, snack times, bath time
can all be times for talking.
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Give choices whilst showing the objects, ‘do you want apple or orange?’
rather than ‘what do you want?’ or ‘do you want milk or juice?’
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‘Sabotage’ is a technique we use where you do something differently so
the child needs to communicate. For example, give a yoghurt without a
spoon. Even a ‘ah ah’ noise and waving of hand is communication. Just
interpret the ‘ah ah’ into a word and feed it back to them. ‘oh SPOON!’.
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Avoid constant questions. ‘what this?’ ‘what colour is this?’ too much
pressure will make a child withdraw and remain silent.
Reading to my child.
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Read a bedtime story to your child every night. But why?
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You are giving them an opportunity to hear more vocabulary than they
could ever hear in real life – words like castle, prince, giant, fairy, wizard.
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They enjoy the affection and closeness. It makes them feel loved.
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They appreciate the one to one attention and therefore this improves their
attention span.
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You are giving them an opportunity to hear narrative language – once
upon a time, the next day, after that, in the end.
Alternative forms of communication.
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What happens when a child can’t use words to communicate?
“In this country we are justly proud of the freedom of
speech, that we can say what we want. But I think there
is even more basic freedom than the freedom of
speech and that is the freedom to speak”
(Professor Stephen Hawking)
What is AAC?
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Augmentative and Alternative Communication (AAC) is the term used to
describe various methods of communication which can be used by
people that find communication difficult because they have little or no
clear speech.
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It adds to (augments) or replaces (is an alternative for) spoken
communication). AAC can also help the users understanding as well as
provide a means of expression.
‘Aided’ and ‘Unaided’
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There are two main types of AAC: unaided or aided. Most people who
use AAC combine both methods.
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Unaided communication does not require additional equipment. People
use many unaided methods to communicate: e.g. body language,
pointing, eye pointing, facial expressions, gestures, Makaton signs.
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Aided communication requires additional equipment ranging from simple
picture materials (e.g. symbols and aided language displays) to a
computer or special communication device
Makaton
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Makaton uses signs alongside the normal speech, so the word order for the
signing is the same as spoken English. Many of the signs are the same as
those used in British Sign Language.
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Being in a Makaton signing environment can help a child to understand
verbal language.
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Being in a Makaton signing environment can encourage a child to use the
signs as a form of expression. This can be when the child has little or no
speech, or when a child’s speech is difficult to understand (usually
because of some other difficulties).
Makaton.
Objects of reference.
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Uses real objects to help the child understand and communicate.
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The adult begins by linking real or toy objects to situations throughout the
day. Needs consistency and repetition for it to be effective.
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A towel for ‘bath’.
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A plate for ‘dinner’.
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A shoe for ‘outside’.
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A blanket for ‘bedtime’.
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Just as with Makaton, the word needs to be said alongside the object in
order for the child to learn the word.
Picture Exchange Communication System
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PECS is a structured symbol exchange system of communication.
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PECS relies on interaction between and communicator and a communication
partner.
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When introducing PECS the emphasis is on creating motivating opportunities
for communication.
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The aim of PECS is not for the pupil to become verbal but to have a functional
communication system
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It teaches the pupil how to communicate for something they want and how to
initiate communication with others
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Your SLT can offer advice and support in implementing and delivering PECS for
your pupils as appropriate to their needs.
Communication books.
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Can use photographs or symbols depending on the level of the child.
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Needs an adult to teach the child how to use it. They wont know on their
own!
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Very effective at giving children a means to communicate who can’t do
so verbally.
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Reduces frustration for a child who can’t verbally communicate.
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Can go between home and school.
Communication books.
Communication books.
Switches
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Many ways to access switches
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Speech and language therapists work closely with Occupational therapists
and Physiotherapists
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Single message switch, switch to activate computer programmes, switches
to activate toys, switches to change the environment, switches to scan
and select to create sentences
Aided Switches
Look2Talk
Eye Gaze
Voice output devices
How to make AAC successful
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Ask for training Family members, caregivers, and school staff should
be trained on how best to support your child’s use of AAC. Training
should be one by a person who is knowledgeable in AAC.
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Model the use of AAC. If your child is expected to use AAC to
communicate, then it is important that you and other adults model
using the AAC system.
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Take time to listen and communicate. Communicating with a child
using AAC may be a slow process. It may take time for your child to
formulate and express his ideas. It is very important for you wait
patiently for your child to think about what he has to say and to
communicate his ideas to you.
How to make AAC successful
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Encourage your child to use multiple ways of communicating. A
child will naturally want to use the quickest way to communicate.
For example, a child would rather shake his head yes or no then go
to his communication board to say “yes” or “no”. Frustration can
set in if adults tell children to use their device when gestures or
other simple strategies can be used. Encourage your child to use
multi-modal communication.
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Teach your child to initiate conversations. Often times children who
use AAC respond to adult questions but do not begin
conversations with other children or adults. You can help your child
by teaching her to use language effectively such as saying “hello”
or “goodbye,” requesting attention or objects, or communicating
“more”, “no” or “finished.”
Useful sources.
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Refer to your local NHS service. Usually open referral system.
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Find an independent therapist – www.helpwithtalking.com
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Expect to pay £60-£100 per hour.
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Can you use your EHCP funding? – ask your local SEN officer.
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Makaton training courses – www.Makaton.org
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Create your own communication book – www.widgit.com
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Apps available on Apple and Android to create communication books on
a tablet.
Many thanks!
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Time for questions and answers.