Thursday, 15 March 2018

Don't rely on the test score alone

I read this interesting article today which mirrors my beliefs:

We cannot rely on standard testing alone, we need a measure of what the child or young person is doing in 'real-life' everyday, functional ways. As a great example, I've got an annual review this week where the 14yo has scored age-equivalently on everything on the CELF-4 BUT that does not mean he needs to be discharged.

I see him on a one-one basis where he sees me as an equal. There's no anxiety so I can push him to his absolute best, he wants to both please me and beat me at tasks. His memory has wikapaedic qualities! However, in everyday situations he cannot put his skills into place as he has auditory processing issues, anxiety, difficulty reading people's cues and clues and he acts as a much younger child (as a safety devise?). His anxiety affects his processing and his language and communication difficulties remain a huge barrier to accessing the curriculum, making friends and 'fitting in' with his peer group. Fortunately, he has a parent who knows all this and will fight to the nth degree to make sure he receives the support he needs.

I've also seen numerous children who score well on tests but in context cannot use these skills demonstrated in the one-to-one, quiet situation with the very nice lady/man who is skilled at getting the best out of children for the short time they're there. We only get a snap-shot of the child in that situation, at that time.

Instead of relying on just a score, we also make use of checklists and interviews with people who know the child best, so parents and teachers; we use tools such as the CCC2 and the Dewart and Summers Pragmatic profile. We also use a dynamic approach so we're looking at everything from the initial 'Hello' to the sight of the back of their head on the way out!

Formal assessments have a place, of course (I'm not stupid!) but we need to listen well to the important people in the child's life and be more confident in our skills as clinicians! What do you think?

Monday, 12 March 2018

How to get help for Selective Mutism

Smira has worked hard to produce an excellent flowchart about where/how to get help for SM:

Links given on page 1 above:

Search for Private Therapist
Check that the therapist has SM knowledge and is registered with

Links given on page 3 above:

Additional Reading
Details and purchase links for all of the books below are on the Recommended Reading page on the SMIRA website.
  • “Selective Mutism Resource Manual 2nd Edition” (Johnson & Wintgens). Most changes in 2nd Edition are for older people with SM and generalising outside school
  • “Tackling Selective Mutism” (Sluckin & Smith, ISBN-13: 978-1849053938, ISBN-10: 1849053936)
  • “Can I tell you about Selective Mutism?” (Johnson & Wintgens, ISBN-13: 978-1849052894, ISBN10: 1849052891)
  • “Can’t Talk? Want to Talk!” (Jo Levett, ISBN-10: 1909301310,ISBN-13: 978-1909301313)
Selective Mutism Information flowchart p4

Have a look at the SMIRA website

Friday, 9 March 2018

What’s inside Tasha’s Toolbox!

I’ve been so busy lately with all the new children on my caseload on and of course the launch of our Parent Hub Membership Club; that it got me thinking back to many years ago to when I was a student at Smalltalk. I remember Libby telling me on the very first day that as a Speech Therapist there will never be enough hours in the day and that I always had to be prepared for anything the job may decide to throw at me. And of course, she was right! On that day she assigned me one simple task! – to create an ‘Initial Assessment Kit’ that, when working with any child on the caseload, I would be able to use to carry out a complete assessment screen of their communication development. After a small moment of panic (that of course I didn’t admit to at the time) it occurred to me that, no matter what child comes through the door, regardless of the difficulty or diagnosis there are still underlying factors we need to target.

And so, my Mini Assessment Toolbox was created and nearly 8 years later I am still using the same kit, if not with a little wear and tear and a few new additions. Though one thing hasn’t changed; there are still not enough hours in the day and I still need to be prepared for anything. If like me, you are continually dashing between appointments, have little time to remember all the resources you need beforehand or get thrown into a new assessment at the last minute, it may be a good idea to have your own handy Toolbox that you can keep with you containing all the essentials!

Today I thought I’d write a helpful post showing you what’s inside my Assessment Toolbox.

 1.      ‘Now and Next’ Visual Timetable whiteboard
2.      Session Activity pictures
3.      Short story book (with accompanying Blank Level Question)
4.      Bubbles
5.      Balloons
6.      Balloon Airplane and (a fun and engaging turn-taking toy)
                                                              i.      Wind-up - Toy “Dancing Robot”
7.      Information Carrying Word (ICW) pictures
8.      Matching Rhyming Cards
9.      Everyday objects: (for Auditory Memory and Vocab)
                                                              i.      Cup
                                                             ii.      Ball
                                                           iii.      Spoon
                                                           iv.      Car
                                                             v.      Bear
                                                           vi.      Pencil
                                                         vii.      Glasses

10.  .and of course, Stickers
So next time you are rushing between appointments, just remember to keep you Toolbox close by, and you’ll be surprised by how many areas of speech and language you can work on with just a few everyday objects!

Wednesday, 7 March 2018

What is a lateral lisp?

A lateral lisp is a type of functional speech disorder, where a child or adult has difficulty producing specific sounds.


The term “lisp” is not typically used by speech and language therapists as it is not very specific - there are actually four different types of lisp as well as all the other speech sound errors. Instead we may say “lateralisation of s” or “s articulation difficulties” depending on what the error is.

What is a lateral lisp?

As mentioned, a lateral lisp is a type of functional speech disorder. Unlike some other lisps, Lateral lisps are not found in typical speech development. The tongue position for a lateral lisp allows the air to flow over the sides of the tongue instead of over the front. This is the reason this sort of lisp is sometimes referred to as a 'slushy lisp'.


There is no known cause of a lisp. However, some professionals suggest that excessive or long-term use of dummies could be a contributing factor. This is not the case for all, as some children who have never used a dummy still go on to develop a lisp.


There are many different ways to work on Lateralised sounds, depending on what the sounds are.  Typically it will include listening activities, production of the sound in isolation (the sound alone) progressing onto words and sentences.

Sophie Harding
Speech and Language Therapist

Sunday, 4 March 2018

But she looks fine when she's here!

How many times have I heard this yet the parents KNOW their child is anxious?! Maybe they've had to drag them kicking and screaming into school, maybe the child has tried to self harm or attacks their parents on a regular basis. I saw this on twitter and it sums up how anxiety is not one thing. We don't always see it. A child can mask: hide their issues at school but all the time building the pressure til they get to the save haven of home or maybe just the carpark in some cases. It's called the 'delayed effect'.

It's not right just to say, 'it's parenting,' We need to listen, we need a team approach not 'them' vs 'us'.

Please help spread this word as it's a HUGE problem and children's mental health depends on more people being aware that anxiety does not have just one 'look'.