Wednesday, 20 September 2017

Assessing the SLCN of a child with PDA


When I did the PDA webinar for the PDA Society recently (to listen click here), a SLT asked me for tips for assessing a  child with PDA. I said that they usually weren't too bad for initial assessment as children with PDA often enjoy being centre of attention and novel situations. It is often much  worse when trying to engage with  therapy. I usually use a dog in the sessions so he makes life easier.

However, I was reminded at the weekend, that this is not always the case and that we need tips and strategies to get us though these potentially trickier situations.


Just remind ourselves of the main features of PDA:

·         obsessively resisting ordinary demands
·         appearing sociable on the surface but lacking depth in their understanding (often recognised by parents early on)
·         excessive mood swings, often switching suddenly
·         comfortable (sometimes to an extreme extent) in role play and pretending
·         language delay, seemingly as a result of passivity, but often with a good degree of 'catch-up'
·         obsessive behaviour, often focused on people rather than things.



We need to assess them to get an accurate picture of strengths, be able to give strategies for family and staff and to be able to devise a programme of work to address their issues and  to maximise their potential. Obviously,  the 2 areas we are concerned with are language processing and social communication.

We need to be aware that they do not like people to know they are struggling so they may
pretend/hide/disguise, distract or get angry..... or all 3.

1. Pretend, hide, disguise:
This is  a key factor in PDA. A parent may ask them to do something very simple such as turn off the TV but they will have a wide range of reasons why they can't e.g. my legs don't work, I can't find the remote, I can't reach the remote, I'm too tired etc. This can escalate if pushed. You may find similar issues when trying to assess. They might say, 'I'm not doing your stupid tests and you cant make me' or 'you're only being nice to me so I'll work with you and I'm not falling for it.' That is true, so we need things in our tool box to ensure we can get a full picture of SLCN.
2. Distract verbally or physically:
Many of the children with PDA I have worked with, have either tried to shock or frighten me. I have lost count of the times I've been asked 'the worse thing they can think of' (Boringly similar with tween/teenage boys) and even had one boy who said 'you can't go yet because you haven't had sex with my dad.' The key is to be very nonchalant and either ignore or pretend you hear that everyday: 'Ah, No thanks, I'm a bit busy'.
One poor 10 year old lad who had been in a secure unit for 3 months, enjoyed scaring visitors by poking their eyes. This was also because he had a deep sensory-seeking need which wasn't being addressed and he got what he needed from firstly the fear of the visitor but then the 2 burly male nurses bundling him to the floor as he manically laughed in their faces. Of course they thought he was some possessed devil child and didn't see him as the frighted,very anxious boy he really is.
3. Get angry with themselves or others:
The anger may come out of the blue and may not be seen coming. They may look perfectly happy, even relaxed but remember they have cultivated hiding their difficulties. The anger may take the form of them hurting themselves such as banging their heads on the table or may be at you or your things.
So what can we do:
1. Realise that it is anxiety based and keep calm. Never take it personally, never be offended. Ignore wherever possible. I have 3 rules: no hurting themselves, no hurting me and no damaging property. Other then that, I go with the flow.
2. Use all the strategies you would for making language simple that we preach to others. 
2. Give choices e.g. of which room to use, which order for the activities, which assessments even. This will help them feel in control. You may find a schedule of the session useful; picture photos or the written words.
3. Scale back demands by some of these strategies based on the 'Positive PDA' booklet:


Using indirect language

e.g instead of saying we're going to say “I wonder if we can...”

 “Shall we see if we can beat the clock...” ,“Maybe we could investigate…”
This means avoiding direct language such as“It’s time for you to...” ,“You’ve  got to...”, “You  need to...”
Allow take up time 

Plant the seed of what you would like to happen at the start of the session, but don’t expect it to happen straight away. 

Use the child’s interests
                                        
Using characters of interest can help de-personalise demands, as you are not personally asking them to do something. For example, if the child loves Peppa pig, get Mummy Pig to make the requests. Older ones may like a Starwars character or even the queen who  makes the  rules, so it isn't your rules. 
              
Use humour. 

If you feel the tension rising, humour is a fantastic distraction. You could try making jokes, using physical humour (exaggerated facial expressions, or silly walks), being silly or feigning ignorance.
   
Use distraction

Distraction can be a handy way to temporarily press ‘pause’ and ease the child’s anxiety.

Add other activities into the mix 

e.g. bubbles, popping balloons or blowing up and letting go, a feelie bag of sensory materials. 'If we just finish this, we will be able to do .....'.


The main thing to remember, especially as you feel exhausted at the end, is that this is for  a short time. Their parents live with this all the time! 

So good luck! Let me know how you get on.

Tuesday, 12 September 2017

We don't want you to teach colour, shape and size yet!

As you know we have just launched our new parent hub so we can  offer our advice and support to more parents.  We've done that because I believe all parents want the best for their child but if they don't know what that is, how can they?

As school has just started, I've heard so many conversations about what child can do. The clear favourites are counting, colours and shapes because that's what parents think they need to be teaching their little ones. However, teachers can do that when they're ready. They need to child to be at the right level to do that but there's important things that are needed first, language and  communication wise.

What teachers need little Johnie to be able to know, is the right vocabulary for his everyday needs, to be able to answer simple what, where questions and to be able to listen.

We use the Blank levels to explain the right order. We need to be able to answer blank level 1 questions before blank level 2

Blank level 1

  ·         Matching  e.g. Find one like this

·         Identifying a Source of noise e.g. what can you hear? 

·         Naming objects e.g. what is it?

·         Naming people e.g. who is that?

·         Naming actions e.g. what are you doing? 

·         Imitation e.g. Say this 

Blank  Level 2 

  ·         Describe scene e.g. what’s happened? (still in view)

·         Remembering information e.g. Who/what/where?

·         Finishing sentence e.g. Finish this ….

·         Identify and describe characteristics of objects e.g. what size is it? What shape? What colour? How many? How does it taste/smell/feel? Where is it?

·         Identifying object functions e.g. Show me the one we use for …

·         Identifying differences e.g. how are these different?

·         Naming object from category  e.g. Tell me something that's a type of

It makes the teacher's life a little easier if they can answer these questions. Oh yes, plus be able to go to the toilet by themselves and certainly be out of nappies!! Let me know what you think.

Consultant Speech and Language Therapist


Friday, 8 September 2017

Help for parents: join the club

The Communication Trust estimates that over 1 million children in the UK have speech, language and communication in the UK difficulties yet the number of speech and language therapists is falling. More and more parents are being left to fend for themselves but where do they look? Where can they go for help?

We been moved to action due to serious concerns that parents of children with speech are not getting sufficient access to good quality evidence based advice. We have become increasingly worried when we see parents who are on NHS waiting lists asking for advice and then being told they should be doing X Y or Z from other parents. Others are using ‘Dr Google’ which we all know can be very alarming and point us in a completely wrong direction, in many instances’. At Small Talk Speech and Language therapy, we know that language and communication targets should be integrated into everyday routines as much as possible. Children learn language in the situations where they need to know the words so no amount of flashcards or worksheets can do that. Other children have problems generalising what they learn so again, it must be in the real situation.

Activities which are done everyday that both motivate and interest the child are always going to work better than things that the child isn’t interested in. Snack time, meal-times and bathtime or even getting onto the car. Parents are busy so it can’t be extra work for them.

We have created a membership club for parents so that they can have access to real live speech and language therapists so they can ask the questions and have good, evidence based advice. They have webinars and short ‘how-to’ clips plus lots of other tips and tricks to help. There will also be a forum so other parents can talk about what they found useful.

They will have a monthly podcast show, the Smart Talkers Super Saturday Show, to look in depth at  current topics and interview relevant expert in the field. They will also have parents who have been in similar situations  talk about their family’s journey.

My blood pressure rises every-time I see bad advice being given. It’s well meant but wrong and is not in the best interests of the parent or the child. Self esteem in the child and parent confidence are so important.

We have launched the Parent Hub and hope to be able to support many more parents. www.smalltalkparenthub.com

Consultant Speech and Language Therapist
Small Talk Speech & Language Therapy
www.private-speech-therapy.co.uk


Tuesday, 22 August 2017

Developing a parent hub



We aim to support the parents we see through the process of speech and language therapy. While we aim to do this the best way we know how, there are many who do not have access to a speech and language therapist at all.

We are setting up a membership club to aim to do this for people we don't see. To make sure it is exactly right, we would really appreciate your help.

Please see the survey for the parent hub by clicking here

Thank you very much!


Tuesday, 8 August 2017

Short-term gain vs quality outcomes

The Royal College of speech and language therapists commissioned a cost-saving matrix to help services demonstrate the value of SLTs to national and local decision makers, while at the same time showing evidence of efficiency and value for money. All public services, and the professionals who deliver them, are under increased financial scrutiny and the pressure which ensues. As you no doubt know, there is more pressure than ever before to show how taxpayer funded services are cost-effective and how they meet local and national priorities.

The language unit at Flash Ley in Stafford has been a great example of specialist provision for children who are bright but have disordered speech and/or language skills. Specialist teachers and speech and language therapists have worked together to maximise the child's potential and they then return to mainstream school to be with their peers when they are more able to cope. I know several who have been. I met them when they were in nursery and knew they'd find it hard to cope in mainstream schools but they had normal learning ability so a generic special school would not be the answer.


Flash Ley had teachers who were more qualified and experienced in SLCN plus enhanced input from specialist SLTs. Working together gives the best way forwards.

Having worked for 30 years, I witnessed the first language units and the fights to have more. We knew then, as we know now, they are the answer for many children with disordered speech and language.

When I first worked, my NHS head of department was a lady whose views were never questioned. Partly because counsellors or managers daren't but also because she was the professional so she knew best. That's a long-gone scenario and, I for one, would never have managed a typical Judith Waterman peer over her glasses, half as well as she did. It said 'stupid man' without need for words!

There are 2 reasons why closing language units are not a good idea:

1. It's not good for the long term outcome of the children. These children have great potential.

2. The savings are only short term. For every £1 invested in enhanced speech and language therapy for children with SLI generates £6.43 through increased lifetime earnings.

This is in comparison to routine speech and language therapy, where enhanced therapy results in an additional 5,500 students achieving five or more GCSEs A* - C (or equivalent).

The resulting benefit of providing enhanced therapy for all children aged six to 10 who currently have SLI exceeds the cost of the speech and language therapy by £741.8 million.

Further analysis shows the estimated annual net benefit is £623.4m in England, £58m in Scotland, £36.1m in Wales and £24.2m in Northern Ireland.

 PLUS: parents will fight to take up specialist school places out of county (it's one of the few clinical areas where there is an evidence base to say they need enhanced!) so the LEA will have to pay thousands in legal fees to fight this. If and when parents win, these are the figures they might need the LEA to cough up:

Alderwasley  From £57,689.00  
Bladen House £82,223
Dawn House 25k (2013 figures)
 (figures from google so may not be up to date)

What will the provision look like for the children who should go to a language unit? It maybe a half-termly visit from  a SLT to school with extra TA support. This is not what the evidence say works best: the children who require the most specialist teaching are in the charge of the least qualified members of staff (absolutely no disrespect to the TAs but that's the fact).

As an independent SLT, whose team can offer weekly or more regularly, I'm not complaining as we can offer what they need BUT it's short sighted. Let's hope the other language unit in Staffs is more successful at fighting it.


Wednesday, 2 August 2017

Second common scenario

Last time, I talked about a common scenario for secondary school, this time I will share a common primary school one.

Picture the scene: playtime in small primary school:

Boy, L, aged 9 is knocked over by another boy who was playing football, 'Sorry!' he shouts as he runs off. L is very angry as he had bumped into someone last week and had been told off and had to stand by the teacher. He had been messing about and had been 'an accident waiting to happen' according to the teacher. So he duly reports the other boy to the teacher on duty. 'I saw L, it was an accident, don't worry about it,' she responds.

L has quite a black and white view of life and doesn't really see the difference. His vocabulary isn't great so the term 'accident' had been used last week and again today so what is different?

He's irritated so argues with the teacher, 'But he did it, it wasn't an accident'. The teacher is calm for a short while but then equally irritated (she's probably got so much to do, she'd rather not be doing a duty anyway).

He's angry now so shouts at the teacher as he would his mum (he doesn't know those pragmatic rules where he should be modifying his language to his teacher). The teacher is now furious and sends him to the headteacher.

L still doesn't see that he should not argue/be respectful so yells at the headteacher. He is now so upset by the sheer injustice of the situation and can't hear any reason whatsoever,

L is excluded for the rest of the week!

If they could understand that he has:

  • poor auditory memory
  • difficulty remembering and learning new vocabulary
  • rigid thinking
  • lack of pragmatic awareness
They might handle him differently.

If the school set up was communication friendly and staff knew about these difficulties it would make their life and poor L's life so much easier.

Speech and language therapists have a valuable role to play in assessing child with behaviour difficulties. All behavior is communication, it's telling us something. There's no point in working on the symptoms i.e. rudeness, shouting at teacher etc, we need to understand the cause because then we can address it.

Unfortunately, there are may Ls out there but it upsets me every time!



Monday, 17 July 2017

Secondary schools don't need speech and language therapists.... or do they?

I have a few common scenarios which show how speech, language and communication issues can be the predominant cause of behaviour problems. These scenarios are very common so could be about anyone of 6 or 7 clients currently known to me. This is the first one:

Teenage girl, second year of secondary school. No issues noted in primary apart from maybe a few 'fallings out' with other girls. No previous behaviour issues at home or at school. Perhaps she's even been a model student. 

Since starting secondary school, however  everything has started to fall apart: at home she's sulky, rude even abusive to parents, shuts herself away, won't go anywhere, friendships may have broken down, parents describe 'melt-downs' when she comes in. At school they didn't notice anything in particular and were quite surprised to hear of the behaviour at home in year 7 but this year, she is falling behind and they are constantly reporting her behaviour which is usually similar to this scenario with E aged 13 years:

Teacher presenting a  power-point which needs to be copied down
E. hasn't finished when teacher moves it on
E 'Excuse me sir can you just leave that a bit longer as I haven't finished?'
Teacher 'No E you'll have to stay at the end as everyone else has finished' E looks round and sees that 3 others haven't either
E 'No sir that's not true x, y and z haven't either'
Teacher 'E you're trying my patience, we've discussed your behaviour!'
E 'But Sir I'm not being naughty, I'm trying to do my work, I just need 2 more minutes please?'
Teacher 'That's it, you have a detention'
E 'For god's sake how stupid? I just want 2 minutes'
Teacher: That's 2 detentions young lady'
E 'I cant believe you're doing this I just want to do my work and you're treating me like this'

Sometimes it escalates further and sometimes EVEN further.

Sometimes the child is excluded.

The child may have 14 detentions in a 2 week period as in one case or 101 since xmas in another. 

Why should a child behave this way?

In the cases I have been dealing with:

1. slower processing skills
2. poor auditory memory
3. both of the above lead to difficulty understanding longer and more complex questions
4. literal understanding of language
5. lack of social skills/pragmatic ability means they don't modify their language for teachers so yell as they would to their parents
6. Rigid thinking means they cant 'let it go' because their sense of justice is so well developed they aren't wrong so the teacher must be
7. Can't see another's point of view 
7. An awareness of their difficulties but a desire to mask them means their anxiety levels are already heightened so it doesn't take much to 'set them off'

It has become a dreadful, seemingly untenable situation. School will have tried all their usual strategies for behaviour problems but nothing works. Yet the answers are simple strategies and an understanding of the problems. It amazing how we can make a HUGE difference by explaining to teachers why the child is doing what they're doing, if we now see them as struggling rather than defiant, abusive etc, we can avoid getting into many of the situations which have previously been a nightmare.

Some of these children may have undetected ASD but some will have language and communication difficulties which are not part of the spectrum. Hormones and personalities play their part too!


  • A one page profile needs to explain what the child finds difficult. Just the process of completing one of these may make the child feel respected and understood which is an important start.
  • Making sure all the child's staff have read and acknowledged the profile
  • Everything as visual as possible including  a print out of the power-point, gestures, notes. These can all be used to make aspects of the day clearer including the timetable, what a pupil will be learning in that lesson, expected behaviour, key vocabulary and information, the sequence of steps within an activity, names of equipment and where it is stored, etc.
  • Make sure the child is happy where they are sitting. I like them at the front so they can see the teacher and the teacher can see them but the child may well be uncomfortable at the front and want to be at the back. Sitting with a friend can be really helpful
  • Encourage an ethos where all pupils are encouraged to ask questions and seek clarification.
  • Have a code so they can let you know when thy haven't understood that no-one else will notice e.g. bag on desk, pencil case moved 
  • Agree how you can check they have understood
  • Expected behaviour is clearly described e.g. School ‘rules’ and ‘charters’, etc are written in simple, symbol or visual photos form so that pupils can understand them.
  • Quiet space is available for time-out or individual study.
  • A reflections log or journal where the child can write about what went well as well as what went wrong. Even better have  a mentor who can meet with the child regularly to discuss this
SLCN is just as big a problem in secondary school as in primary. In the secondary classroom, language is the foundation for participation in, and access to, most aspects of the school curriculum. Many aspects of written language, such as narrative or understanding what you're reading, can be limited by delayed language skills; 'by secondary age there is an increasing amount of figurative language in text books. The same is also true of ‘teacher talk’: 37% of teacher instructions in secondary schools contain multiple meanings, 20% with at least one idiom. As learning becomes more reliant on independent study, language enables pupils to make contact with others; to organise, manage and evaluate experiences; to influence and inform' (ICAN)

Last week I visited 6 secondary schools and was delighted with their positive responses. We all want whats best for the young person but we need to understand what this is to be able to do that. You may think that they don't need a speech and language therapy assessment as they speak fluently but if the usual strategies don't work, we can probably help fill in the missing links. Behaviour IS communication, we just have to work out what it's telling us.



Saturday, 8 July 2017

Selective mutism training in Staffordshire

Time goes so fast so we're planning what we're going to do for October's selective mutism (SM) awareness month already.

We aim to blitz the local radio shows again with the lovely Natasha Dale who has become a brilliant ambassador for children and young people with SM, we'll have a local press campaign and a training day for parents and professionals.

If you know anyone who would benefit from the training, please let them know, places are limited.

The aims of the day are:
  • To recognise and diagnose SM
  • To fully understand the causes and maintaining factors
  • To relate the above to an appropriate prevention or management plan:

     - educating all key people involved with the child
     - creating the right environment at home and at school
     - talking to the children and their peers about SM
     - considering the need for a formal programme

     - formulating treatment targets

Friday 13th October 9.30am -3.00pm
Uttoxeter Fire Station, Cheadle Rd, Uttoxeter ST14 7BX

£85 to include lunch and refreshments



We'd love to see you!


Thursday, 6 July 2017

My friend Daniel doesn't talk: book review

Image result for my friend daniel doesnt talkMy Friend Daniel Doesn’t Talk is a helpful children’s book about selective mutism, written by Sharon L. Longo and illustrated by Jane Bottomley. This book is very easy to read and understand and the illustrations add more of an insight in to what it is like to have SM. Although this book is very short and simple, it really focuses on the key points of stereotypical selective mutism. We’re first faced with a paragraph about some of the behavioural characteristics and signs of SM and anxiety, “He played with his shirt collar while his mother talked to our teacher, and his face was frozen”. Immediately we are let into the world of a child with selective mutism and are encouraged to almost feel the difficulty these children must experience. 

The main aim and purpose of this book is explained to be, to help others who don’t have SM, but know someone who does, understand the condition. 

Having had selective mutism myself, throughout childhood and adolescence, I felt this book was somewhat relateable and insightful. I particularly liked that it focused on Daniel himself, his behaviour, his anxiety and how others perceive him, as well as Daniel’s friend. I was really warmed by reading how SM can affect the other children in the class. I think it’s important and useful to take the time to read this book, especially if you yourself have SM, and especially if you’re a child, because it allows you to see that people want to understand, they want to help and they will accept and befriend you. Talking is not a necessity in gaining and maintaining friendships and the people who matter, the people who care about you (your friends) will remain patient and understanding as long as needed.

Daniel’s friend was full of curiosity and asked his mother many questions about Daniel and his SM. When curiosity about Daniel was the topic of the school playground, Daniel’s friend explained, “My Mom said some kids are so scared to talk that their words can’t come out”. Daniel’s friend was incredibly interested in learning about how he could help and be a good friend to Daniel, as were other children in Daniel’s class.

The only concern I have with this book is that it is very much based and focused on stereotypes. Nonetheless, this book still allows us some degree of insight into the condition from a child’s perspective. However, there is one part of the story that I don’t feel too comfortable with, “I’m going to be extra nice to him so he’ll talk to me one day”, as much as this can be read in a completely positive light, and indeed there is much positivity behind it, it also holds some concerns as it is potentially suggesting that there is a pressure to talk if a person is being nice to you, as well as giving the impression that a child with SM is to be treated as special with added attention. Although, of course, these comments and acts of apparent kindness do happen in schools, so I think it does hold some importance in being included in the book. It is important to remember that most children with SM want to be included, they want to be treated fairly and given the support and understanding they need, however they do not want to be singled out. A little further into the book, this is pointed out and rightly so, “we shouldn’t make a big deal when Daniel speaks. That would just make him feel more upset” which I think is an incredibly important key point.

Most of all, I thought the guide for parents and teachers, at the back of the book, is extremely useful. This guide explains that this book carries the theme of acceptance, diversity and equality, which is reassuring. I would agree, this book definitely not only helps children who have SM themselves, but it could be very helpful to children who do not have SM themselves, but know someone who does. It answers many questions and solves the confusion felt by many children trying to understand someone who doesn’t speak. Just as importantly, this guide also gives very brief but very accurate points and information on how teachers and parents can help and support their pupil, or child, with SM.

Overall, I would say that this book’s main purpose includes, to reassure children with SM that they are not going to be forced to speak, people will be patient and understanding and true friends will be supportive. At the same time it helps children without SM to understand children with selective mutism, or perhaps even it encourages other children to embrace and accept difference more broadly. My Friend Daniel Doesn’t Talk is a beneficial read and I would recommend anyone affected by SM to read it, whether that be first or second hand; children with SM, children without SM, teachers and parents.


Natasha Dale

Monday, 3 July 2017

Research: Autism and the sisterly bond



As the youngest of three siblings, with two older brothers I have been fascinated with how siblings interact. Playing with dolls and making up stories was my rest from running around the garden covered in mud with my brothers. During these hours I often wondered what it would be like to have a sister. Would we argue over toys and clothes, or would we share everything and get along perfectly? If our personalities were fundamentally different, would that make things easier or add another difficulty to the relationship?
This is what I have been investigating in my current research. Previous research has stated that sisters- when one has autism- have a more positive bond than a brother-sister or brother-brother pairs.  In my project ‘Understanding the experiences of sisters when one has Autism Spectrum Disorder’ I aim to hear the stories of sisters who have been effected by autism in one way or another, to gain an understanding of what may influence their relationship. Ultimately, I hope that this will add to the understanding of autism and sibling relationships and perhaps one day be used to improve the bond between siblings when one has autism.

Much of the current research focuses on the parent-child bond or the parent’s experiences. But the sibling relationship is often the longest relationship we will have in our lifetime, and it is so often overlooked in research and life in general. Furthermore, I would like to understand this research question from the perspective of the autistic sister to learn both sides of this fascinating bond.
I have already interviewed a number of neurotypical women who have an autistic sister. And I am now looking for autistic females who have a sister! Participants must be female, over the age of 16, have a diagnosis of ASD and have at least one sister.  If you, or anyone you know, are eligible and interested in being a part of this novel research, please get in touch with me at fhd1g14@soton.ac.uk
Participation will include one interview which will last no more than an hour- this can be done over the phone, skype or in person. Interviews will be recorded, transcribed and anonymised. Although some quotes may be used in the write up of the report, there will be no way of linking them back to you.  

I am hoping to have this research published in an academic journal and I would greatly appreciate any help in achieving this. Whether it is taking part or passing this on to anyone who may be interested.

Thanks for reading!

Ffion Davies

University of Southampton


Friday, 16 June 2017

Would you like your child to be ready for school and attend a quality holiday activity?


We have some summer group sessions running at our clinic base on the Staffordshire/Derbyshire border to help children be ready to start school. The sessions will look at:
  • Confidence to communicate
  • Attention
  • Listening
  • Memory
  • Vocabulary
  • Verbal reasoning

via games, activities and stories. We'll have fun while we learn! These sessions will be run by a fully qualified and experienced speech and language therapist.

Monday 14th August  to Thursday 17th August 9.30-11.30am

Cost: £200 per child. Spaces are limited so please apply early.

To book https://v1.bookwhen.com/smalltalk

Thursday, 15 June 2017

Exciting new development: summer school for teenagers with social communication difficuties

We are delighted to announce that we will be running some intensive group sessions for young people with social communication difficulties at our lovely, peaceful clinic at Bartonfields.  We we also have evening classes available from september.

As teenagers move into their secondary school and young adult years, they experience increasingly complex social situations and academic curricula that require more nuanced social understanding, fine-tuned critical thinking, a higher level of executive functioning, etc. 

We use the work of Michelle Garcia Winner, the founder of Social Thinking, to provide valuable teaching tips and delve into the scope and sequence of using Social Thinking’s products with students ages 11-22 to improve self-regulation and social competencies.  The materials are helpful for students with social learning challenges (ranging from ASD levels 1 and 2, Asperger’s Syndrome, ADHD, etc.) or students who are un-diagnosed yet struggle with the rapidly increasing demands of social interpretation and related social skills. Some of the materials that will be using include Socially Curious and Curiously SocialSocial Fortune or Social Fate, and Social Thinking and Me, and more. 

Monday 7th to Friday 11th August 2017 
Ages 11-14 9.15 am-12.15 pm 
Ages 15-22  1.15- 4.15 pm

Cost: £350 per young person. Limited spaces available. To book https://v1.bookwhen.com/smalltalk

Image result for curiously social socially curious  Image result for social fate social fortune

Are you worried about your child's speech sounds, would an intensive course be just what they need?


We have some summer intensive group sessions running at our clinic base on the Staffordshire/Derbyshire border to help children with speech sound difficulties. The sessions will look at:

  • phonological awareness
  • auditory discrimination
  • making a difference
  • consolidating progress

via fun games, activities and stories. These sessions will be run by a fully qualified and experienced speech and language therapist.

Monday 14th August x to Thursday 17th August 1.00-3.00pm

Cost: £200 per child. Spaces are limited so please apply early.

Please email: office@smalltalk-ltd.co.uk  To book https://v1.bookwhen.com/smalltalk

Thursday, 18 May 2017

ASPERGER’S SYNDROME IN 13-16 YEAR OLDS – a review


Image result for ASPERGER’S SYNDROME IN 13-16 YEAR OLDS – review 


This easy to read informative book is written by Alis Rowe, the founder of The Girl With The Curly Hair.

There are many different books available on autism spectrum conditions, but not so many which are written by those who have an Autism Spectrum Condition themselves, so that makes this book all the more helpful. Unless you experience first-hand you can never fully understand, so the best resources and research you can find are those that are written and offered by those the condition themselves. Alis gives a real insight into Asperger’s syndrome and some of the hurdles teenagers with the condition may face.

With this book focusing on the early teen years, age 13-6 years, it gives a more direct look into Aspergers and what that can mean for this age group. Not only does this book offer information, reassurance and comfort to those with Asperger’s themselves, I also think this book could be a great help in allowing parents, siblings and family/ friends of the person with Asperger’s to grasp a better understanding.

Asperger’s Syndrome In 13-16 Year Olds, is written in such a straight forward way, it’s a very easy read but it still manages to focus on so much valuable information. It really gives you a clear idea of what living with Asperger’s can be like and it encourages you to learn about the similarities and differences between people who are neurotypical and those who have an ASC. Alis Rowe has given some useful advice and reminders, which will be really helpful to many. Alis has also encouraged the readers to see that difference is not wrong; it is something that a person should be aware of and there can be many positives with being different. She has included a very simple but effective illustration of an example of thinking in an alternative way, which shows that difference is something that can be embraced. This illustration also includes the caption “She sees the world differently”.

It’s almost as if this book has been stripped of unnecessary detail, which allows it to focus on key points and key messages, which is extremely beneficial. Alis talks about many aspects of having AS, including: sensory challenges, friendships, feeling lonely amongst others, the stresses of the school environment, the difficulties of the journey of adolescents, special interests and why those with AS might have some, or all, of these differences and challenges. I think this book is a must have for all teenagers with Asperger’s syndrome who are feeling confused and alone in being different.



Natasha Dale


Wednesday, 3 May 2017

Doing what it takes........ a holistic approach

I am a speech and language therapist who sees children with ASD and/or complex communication difficulties including selective mutism. If I was in the NHS I would be called highly specialist. I see children who have many challenges, some of which are speech, language and communication but many also have extreme anxiety. It's a chicken and egg situation because if they didn't have Speech, Language and Communication Needs, they wouldn't be so anxious, if anxious at all, while the anxiety blocks their abilities both to understand and to express themselves. Therefore, to do my job properly, I have to know about anxiety and be able to address some of the issues alongside. Consequently,  have studied and  I use animal assisted therapy (AAT), CBT and NLP as part of my approach with traditional approaches including Social Thinking by Garcia Winner.

I discussed this recently at a RCSLT clinical excellence network. The responses were very interesting: completely polarised. Almost half the audience wanted to know more, took the references and 'where to go from here' information readily, the other half raised their eyebrows and shook their heads. There is a wealth of clinical evidence about all the approaches for counselling but they were disturbed because there isn't in speech and language therapy.

I use the animal assisted therapy by having Ralph (a certified PAT dog) in on sessions where I need the child/teenager to be relaxed so I can get on with the 'other stuff'. It works like a dream as he sits by them while they answer my questions or complete assessments. They can stroke him or ruffle his neck as they think or cry into his neck if they feel like it....he doesn't mind a bit.

The CBT is really just looking at the problem and breaking it down into baby steps, which is actually what most speech therapy is, while the NLP helps to shift negative mind sets.

The Social Thinking is a brilliant way of introducing the idea that social cognition is a vital area for us to get along with our fellow man even if we never wish to have a conversation with him.

I believe that we need to be more creative: there is no one-size fits all approach to these children and young adults. They've usually tried everything else by the time they come to me.

I know this blog-post will receive a polarised response too but I make no apology because my goal is to make a difference and not be just another professional who says they can't help because they don't fit traditional methods. As the saying goes: if we always do what we've always done, we'll always get the same results. We're lucky because we are not bound by commissioners or bureaucracy which imposes limits on what we do.

As a team, we have a wealth of clinical based evidence and that's sufficient for me: we achieve good, if not great, results!


Thursday, 27 April 2017

Why I love baby signing!

Guest post by Hannah Lindahl – Little Signers Club Leader for North Nottingham




As a ‘Baby Signing’ teacher I see, and am truly honoured to be a part of, countless occasions when the little people realise that they can communicate with the big people. The smiles on those tiny faces as the grown ups exclaim praise and joy as the little one shows that he is enjoying the ‘BUBBLES’ or that she would like to sing the song one ‘MORE’ time.

We all know that being a parent is a wonderful job but we also all know that at times it can be really hard work! Unfortunately, after approximately 9 months of baking, these tiny little beings are thrust into our lives with no instruction manual and no ‘standard issue’ crystal ball.

So when the tears start it’s a case of trial and error – a guessing game until a suitable solution (milk, a clean nappy or maybe just a cuddle) can be found.
Having embarked upon the ‘signing journey’ with my own children, I know just how invaluable having a method of communication with your child can be at times like this.  Seemingly endless tears from a frustrated, red faced, angry baby can be simply replaced with a gesture, indicating easily and succinctly that ‘MILK’ is required.

Which in itself is fabulous, amazing, and less stressful for everybody involved - but what if it was more than just signing? …….

One morning, when my smallest bean was approximately 9 months old, we took her older sister to nursery. At this time, the sign of the moment was most definitely ‘DOG’ , frantically signed at every passing husky, every mutt in a book and even in response to the dog barking next door! So safe to say that small bean was delighted  to see that there was a dog outside the nursery building, secured to the fence waiting patiently for it’s owner to return. Cue a happy child and a lot of excited signing for ‘DOG’!

And then our day continued pretty much the same as any other day. With big sister at nursery we were able to enjoy some ‘mummy and baby’ time and we passed the next few hours quite happily.

And then it was time to pick up big sister. We got ready, I explained where we were going and we got into the car. And as we drove towards the nursery I noticed something absolutely extraordinary – she was signing ‘DOG’!  We were not even there yet but she remembered?! She’s ONLY 9 months old – surely babies are not that clever? Oh, but they are! 6 hours after the original event, this tiny little person was showing me that she remembered what we had seen and she was excited about the prospect of a repeat encounter!

And it didn’t stop there – on arrival there was sadly no dog to be seen, which instead of upsetting her just resulted in a confused face and some signing ‘WHERE’?

And this was it – this was my BOOM, light bulb, WOW moment.  I already knew signing was fantastic at allowing my child to tell me if she would rather have a cup of ‘WATER’ or a drink of  ‘MILK’ , but at that moment I realised that it was so much more - She was now able to actually show me what she was thinking!

And that’s the incredible thing – even at this young, delicate age, when people assume they just sit and play and cry and sleep, babies are so capable and clever and able. The synapses in their brain are developing at breakneck speed and giving them the ability to think and question and process what they are seeing and learning. And all of the learning and new experiences just work to encourage more synapse development and new connections.

It’s like a vicious circle – but not vicious at all! – in fact quite the exact opposite! – A wonderful circle of development and encouragement and learning and bonding. And by signing they allow you a sneak peak into this world, like peering through a little skylight into their minds and seeing what wonderful ideas and thoughts are zooming around in there!


Signing with little people – why wouldn’t you do it? 

Hannah