Caoimhe Bradley Speech & Language Therapist
Emily GooseSpecialist Speech & Language Therapist
Teaching and therapy staff at Delamere School use a wide range of methods to support the needs of children with speech, language and communication difficulties and also swallowing difficulties. Some training has been provided by the speech and language therapists who work within school and some training has been via external courses.
The speech and language therapist’s role is to assess each child’s communication. This is done through communicating and playing directly with each child. We also observe the child interacting with other key people such as the teacher and TAs. When we do home visits we see your child with you and your family. At school we see the children in a group, with perhaps one other child sharing a game or we play with them on our own. We discuss our observations with the class teacher and plan an individual learning goal together for each child. We share our specialist knowledge of communication and language development with the teachers who use the national curriculum e.g. P levels. Our additional knowledge helps to break down learning into smaller, more achievable steps. Together with the teacher, we try out methods and share what works. The teaching team see the children each school day and work on the strategies and goals. We monitor the progress and alter the methods to suit each child. Parents are involved via the IEP process and annual reviews. We would welcome your input to discuss what your child is learning to communicate at home. Together we can help your child make even more progress.
Intensive Interaction is a method developed by Dave Hewitt and Phoebe Caldwell amongst others. Our practitioners provide training courses and have done so at Delamere school. As is usual, the training was shared by the full team. Resources such as DVDs and books are available. The Speech and Language team have written a short handout about Intensive Interaction. It is a method used widely with people who cannot speak. Some children struggle to send a message that others can understand. Other children can send quite clear messages through gesture and sounds. The person with the communication difficulty leads and the partner tries to recognise their mood and feelings. The partner watches the child’s movements and listens to the sounds that are made. The partner starts with simple copying so that they take turns. With more experience and knowledge of the child, the partner can echo back the rhythm and important sounds that are made so that it is a conversation. The conversation is not of words but of the child’s language. This can be sounds or movements. This is very powerful and rewarding for the child and the partner. Over time this helps the child’s development and their connection with others.
Some useful links:
The Hanen communication programmes are developed in Canada and are used across the world, translated into other languages. There are several programmes. The ones that underpin a lot of the methods that we use at Delamere are “It takes two to talk” and “More than Words”. There are parent handbooks written for these methods which are available from a firm called Winslow.
If you are interested to know more, please read our Speech and Language Therapists short advice sheets based on Hanen and other early communication methods. Ask your child’s Speech and Language Therapist which advice sheet to read e.g. discoverer, communicator, first words/signs, combiner, early sentence user, later sentence user. The stages for children who are autistic are: own agenda, requester, early communicator, partner. The methods used to help are described in detail in the “More than Words” book.
The Derbyshire language scheme was developed in Derbyshire. It is based on normal progression of language from first words to the stage of complex grammatical sentences. The scheme describes the stages of language in more detail than the Hanen stages and the national curriculum. This makes it easier for us to select an achievable goal for the children to work on. The scheme concentrates on certain aspects of language. It covers the understanding and use of a core vocabulary of nouns (objects) verbs (actions) and social words. Later on in the scheme other vocabulary is targeted for teaching e.g. prepositions such as on/in/under and adjectives. The top of the scheme covers long sentences joined together by connectors e.g. “and”, “but”. At this stage the child will also learn the past and future tenses and how to ask clear questions. Some children make unusual errors such as putting the words in the wrong order. Some children make common mistakes that most children make as they learn English e.g. “It falled down”, “Her going out”.
The main ways of helping children to talk are 1) to say back the important word to them clearly so the child can learn how to say it 2) to describe what is happening 3) to add an extra word or idea to what the child has said in order to extend the phrase. Find out more strategies in the Speech and Language Therapist handouts on language stages.
The main measure of understanding used in the DLS is information carrying words. These are the words in the sentence that the child had to remember. The keywords / information carrying words are words that cannot be guessed because the child is aware of a contrasting word. Can they retain these words and find the correct picture or follow the instruction? Children with language difficulties rely on guessing words from the situation and what is happening. They also rely on you repeating what you have said because they can’t remember the instruction if it is just said once. As their comprehension of language improves they no longer need so much support from visual clues such as noticing what you are looking at, holding or what someone else has done. If we speak to a child with the correct amount of support they will be more likely to learn and join in. They will be less confused which helps their behaviour.
Read more about the stage your child is at in language development. The SLTs have written leaflets which will explain each stage and ways to help. The leaflets are linked to the Hanen stages as both methods can be used together. Signalong can also be used with these methods. In fact many other methods you may have read about link to other methods. E.g. colourful semantics is based on the Derbyshire language scheme. Your child’s SLT can also explain these ideas to you and show you how to use the ideas in the handouts. Please contact us.
Signalong is a sign language system where we sign alongside speech. The signs are based on BSL but are the signs from one region in England. BSL has different signs in different areas of Britain. It has dialect just like our spoken accents vary. Makaton is also based on BSL and it has some different signs to Signalong. “Mr Tumble” uses Makaton on the TV so you will need to be aware that some of the signs are different to the ones that we use in Trafford. British sign language is a language in its own right and it has different word order from English. When we use Signalong we speak in short phrases and sign just key words alongside the spoken words. Please learn and use Signalong rather than BSL or Makaton.
Delamere has bought the license to use 50 signs on our website. There is a description of how to sign too. This refers to the hand shape eg flat, bunched and the orientation. This is the direction that we hold our hands and how we move them. Choose your dominant hand to be your “working hand” Catriona is wearing her watch on her dominant hand in the film clips that accompany the signs. The non dominant hand is called the “supporting hand”. This helps us to write how to sign for both right and left handed people. Catriona is a Signalong tutor, which means she can run training courses. We have run several for parents and staff over the years. Other staff who have been on the foundation course can share how to sign with you on a one to one basis. All of the SLTs and some of the teaching team have passed the foundation course. Trafford is a Signalong district and it is used in many schools and nurseries. Signalong is a charity so please do not photocopy resources.
PECS stands for Picture Exchange Communication System. It is often introduced with children who have not developed a way of initiating interaction with others. Usually, this means they cannot tell us what they want. PECS allows a child to approach an adult and start a simple conversation. By handing over/exchanging a picture of what they want e.g. biscuit or trampoline, the child is learning the basics of communication, ie “if I go up to someone and do/’say’ something I can get what I want”. This is known as meaningful or intentional communication. Some children will use this method of communication as their main way of expressing their wants and needs. Other children will start by using PECS and then move on to develop speech. The goal of PECS is to achieve successful communication, rather than to develop speech, but because each time a picture is exchanged the adult will say the relevant word, this can actually help speech to develop. Children might also benefit from having the visual support of the pictures to help them work out what to say.
At Delamere school we use many visual ways to support communication. One of the new methods we have started to use is PODD. This stands for Pragmatic Organisational Dynamic Display. It involves using symbols in a book in a two way communicational conversation. The adult will speak and point to the symbols to say what they are doing, what is happening or to ask a question. The adult will enable to child to reply or to start a conversation. Some children are able to use their PODD book more independently. It allows more interaction than PECS but is linked to this method as the same symbols are used. PODD is particularly good for children who have little or no speech but who can recognise and follow language through symbols. It has the flexibility of Signalong but is helpful for those children who do not have the fine motor control for clear signing.
Oral Placement Therapy is a way of adding a sensory layer to help children learn the correct motor patterns needed for eating, drinking and clear speech.
Our Speech and Lanuage Therapists are trained in this therapy and has experience of using it to support children with severe speech difficulties, including verbal dyspraxia. Many children who have unclear speech respond to therapy methods that teach sounds using auditory (listening) and visual (showing) methods, e.g. ‘listen and watch, they are then able to copy both what they hear and what they can see. For some children, these methods are not enough. So we add a tactile method to this. To help a child know what to do with their bottom lip against top teeth for the ‘f’ sound, we might do this by placing a small piece of food on the bottom lip and encouraging them to ‘’bite it off’’. We might need to increase general awareness first by using massage, then adding a talk tool. We use a range of tools, including chewy tubes, ark grabbers, facial massagers, horns, straws, bubbles and cheerios!
There is a clear progression with the ability to control and move the parts of the mouth for eating and speech. E.g. the tongue needs to be able to be held inside the mouth easily before the tongue tip can move to the side of the mouth for chewing. The next step would be lifting the tongue tip up behind the top teeth (for sounds d, t, n).
Speech and Language therapists who are dysphagia trained focus on the motor and sensory skills of eating, drinking and swallowing. We have a team of dysphagia trained therapists in Trafford. The Speech and language Therapists are part of this team. our Speech and Language Therapists are trained to advise on the oral stage (mouth movements) for eating as part of her talk tools training and they have trained in sensory difficulties which affect eating. If staff or parents have concerns regarding swallowing, a referral can be made to the dysphagia team.
The role of the speech and language therapist is to assess feeding and swallowing ability. This often includes referral for further investigations via the Consultant. E.g. a moving X Ray of the swallow called a videofluoroscopy. SLTs suggest and try out methods which help children to learn to use their lips, tongue and jaw more effectively to eat and drink. These are the motor skills of feeding. An improvement in mouth skills can also help the swallowing stage of feeding.
Some children have sensory difficulties which affect feeding . These difficulties can be helped by either a speech and language therapist or an occupational therapist. Dietitians focus on the child’s weight and nutrition. They suggest supplements and they advise on specialist milk feeds.
Please contact the school if you feel your child needs help with the motor side of eating and drinking.
If your child hasn’t been referred to her already, we can tell you how to ask your GP or Consultant to make the referral. We have an opt-in questionnaire for parents to complete too. If your child is already seen, please ask for a home visit or come into school to discuss your child.
