Tuesday, 14 May 2019

It must be the parent: why unconscious incompetence is dangerous!

I feel so angry my head could explode! I'm supposed to be off today but I've written a report. A report on a boy who social workers, CAHMS and school feel is 'fine' but I know is not.

I had a call from the social worker who told me that they suspect the parent of making up their child's issues and that he's 'fine in school'. In fact even the head teacher says he's quite 'normal'. Yet the parent talked about her 7 year old wanting to die, having awful melt-downs, not understanding the world etc The boy himself confided in me that he doesn't want to be here in the world and it's just too scary. He has tried to run in front of a car, jump out of  an upstairs window and hold his head under the bath water...he's 7 for Gods sake!!!

The social worker feels that as I'm 'private' the parent has shopped around to find someone who will agree with her and as I'm 'private' I would, because I will have been paid.

I'm not angry that she has, in effect, called me unprofessional, I'm angry because the rest of the people involved don't know what they don't know. George and Miriam, two brilliant parents I know, discuss this as 'unconscious incompetence' which sums it nicely.

The boy has significant language issues which he doesn't want people to know about, he wants to please, to do his best and not be seen as different but the cost of keeping this up, is enormous; so he has to let it out when he's at home, where he can be himself. The toll on his mental health is rising.

This is a phenomenon known as masking which many parents of children with ASD know all to well. However, its not just confined to the autistic population, children with any type of issue may do it. This particular boy needs assessing for ASD but ones with developmental language disorder can also display this.

Please, please let's just listen; listen to the parents who are at their wits end, listen to the child who is struggling, listen to your instinct!


Saturday, 11 May 2019

Practical PDA training

Every week see children who have demand avoidance, some will be very anxious so need to control, others will have PDA (Pathological Demand Avoidance). We don't need to get into the debate of whether this exists or not but we do need to understand why children are demand-avoidant, so we can better help them.

We are running an informative and practical training day on Saturday June 15th at Cannock Fire Station 9.30-3.30 where I will go through what PDA is and is not, in the morning, and Rachel Tenacious will deliver a workshop on low-arousal approaches in the afternoon. These approaches work with all anxious children.

This is great CPD for any professional (we are registered UK training providers so you will receive a credible certificate for your CPD file):

Teachers: you will receive information to help you understand children in your school, what it means to have PDA and learn strategies which work for those children

Speech and language Therapists/Educational Psychologists: you will be able to understand sufficiently to be able to assess new clients and then understand how you need to tailor therapy in order for it to work.

Parents: When we understand our children, we can better help them, you will also learn strategies to help at home.

£90 including lunch.

So book today, as spaces are limited to allow for better participation.

www.bookwhen.com/smalltalk

Libby Hill is a multi-award winning speech and language therapist who appeared in Channel 4s Born Naughty. She sees children with PDA from all over the UK and occasionally abroad. She is part of the PDA professional's group and the PDA Research group. She supports PDA action and the PDA Society. She is co-writing a book about Parental Perspectives of PDA

Rachel  Tenacious is a late diagnosed autistic parent with three children aged between 30 and 16. H is her youngest child who was diagnosed with autism at age 9 and selective mutism at 15. She removed H from the education system in 2015 after she had what we now know as an autistic burn-out. The school system didn’t suit H at all but home ed was  amazing. She shares her experience at support groups.  

Friday, 1 February 2019

Doesn't listen, is rude, homophobic, racist and fights with other children!; why he's my kind of child

Rant alert!!!!

I find myself getting increasingly angry when I hear about the lack of understanding of the impact of speech language and communication difficulties.

Yesterday, I met a young man aged 11 years: He was charming, polite, eager to please the adult .

He:

  • has significant auditory processing difficulties, which means he finds listening and attending in the classroom situation very difficult  (previously identified by Ed Psychologist)
  • has a very poor auditory memory and poor verbal understanding which means following classroom instructions is extremely difficult for him (previously identified by NHS SLT)
  • has expressive language difficulties, of which he is very aware but he does not want people to know, so he masks this in a variety of ways, one of which is  by using words and phrases but he has heard other 'cool' children using. Occasionally, this is racist or homophobic but he is unaware of this as he has heard others using this language freely. As he does not know it is rude or wrong, he will use it in front of school staff. (vocabulary issue previously identified by NHS SLT)
  • has very, very literal understanding, so he will do a exactly as they say e.g.  'work quietly'  will mean he still talks (albeit quietly), 'stand here' means he finds the exact spot (identified previously by NHS SLT)
  • he cannot initiate communication as he has pragmatic difficulties and  asking for help is one of the hardest things to initiate. He may ask a person next to him what he supposed to do but he's unlikely to ask the teacher...... then he gets into trouble for not doing what is supposed to do or talking
  • he has impaired executive function so is impulsive, has difficulty initiating tasks and organising himself.  
  • he is desperate to have friends and to be liked, so will do things to impress people.Sometimes this is to be the class clown, sometimes looking very silly
  • he is not good at relationships with other children, he does not read their intentions so is very vulnerable to children whose intentions are not good. 
  • he cannot negotiate so is likely to fallout with children and need support for interactions


He also has increasing anxiety, poor confidence and  low self-esteem (not surprising!).

This young man with all these barriers to his learning and making friends has an education and healthcare plan so should be receiving lots of help.......... is he?

NO: he just been excluded for low level disruptive behaviour e.g. not listening, being rude, homophobic, racist and fighting with other children!

This is a prime example of a child with speech language and communication difficulties being totally, totally missed understood. If he had a label e.g. autism or ADHD or looked different e.g. down syndrome, cerebral palsy, people would make allowances and  would want to do their best but because he looks 'normal' and has no label, he is being totally totally let down by the system .

We desperately need the 'unique child' label to be more than just that; a label. How does the term, that is flippantly passed around in meetings, look? This child needed his strengths and his weaknesses identifying and accommodations made. His behaviour is communication!

Please let's look behind the behaviour, why is a child behaving badly? Those who need the most help ask for it in the least helpful ways! I've just been judging the communication Trust Shine a light awards and there's some great SLCN work going on in the justice system but let's not let it get that far, lets get it right early on before the damage is done. 

School staff need more training and more support! We need more speech and language therapy so school and SLT can work together for children, like the olden days when I worked in Dudley circa 1988; we have gone backward not forwards!

I did warn you it was a rant!


Tuesday, 29 January 2019

Moving forward with CoProduction, its time to #flipthenarrative. January 2019


Guest blog by Rachel Tenacious

I am writing this on the back of attending #CoPro19 this week, probably the best conference I have ever been to. The speakers were all amazing and singing from the same song sheet as me.

When you have been "That Parent", a "Persistent Complainer" and a "Vociferous Parent" for as long as I have it can start to feel like you are never going to get your voice heard, when you seem to be so opposed to the system and all that it stands for, it can start to feel that your voice is never going to be loud enough!

But guess what....... There are a whole lot more voices, like mine, they are getting louder and there are professionals on board too. I wanted to bottle some of them and bring them home.

After three and a half years of very successful home ed where we have been supported by a couple of professionals and have been on a learning journey with them, the time came for H to tentatively dip a toe back into "the system"

We were utterly determined not to put H back into a setting where they measure progress by attendance and test scores but ignore clear signs that the child/young person is falling apart. The course for home educated students seemed like a good starting point because it is a very short number of hours, it doesn’t start until 1.20pm and the staff have worked with young people like H who have been through traumatic times at school and those who had been outside the box for a long time [for ever in some cases].

The first true coproduction training I did was selective mutism training with Libby Hill when some of the professionals in the room said they had never been on a training course with parents. This was an eye opener for everyone in the room and we all came away feeling that this is most definitely the way forward.

I joined the Autism Working Group and Selective Mutism working groups in Walsall because I am passionate about sharing the message about coproduction, flipping the narrative and making sure that the families/child’s/young person’s voice stays at the centre of everything.

Flipping the narrative means we start to see the child as the centre of everything and use their ambitions and wishes as a starting point for developing their support.

We do not set targets such as;

"H will speak to 3 people by Wednesday"

In fact we have removed the need for H to speak at all pretty much. She has people around her who know what needs to be done and they don’t wait to be asked to do it they just do it. This frees H up to focus on just being herself and getting through her day. This removes a huge amount of stress from H and as a result of that she is quite often able to speak when she wants to.

The adults around H are not there to encourage, urge, cajole her into doing stuff, they are there to provide a cushion and a protective barrier to help her feel safe.

When the adults around H provide her with that protection she is safe to start to show us what she is capable of.

Recently H attended a meeting with us at college, after half an hour she was due to go to her support group. I reminded her of the time and her LSA offered to go with her but she said she didn’t need her to and that she would come back if she needed to for any reason because she knew where we were. One of the professionals in the room was utterly mind blown at her level of confidence to navigate a fairly busy area of the college independently.

I believe H has been empowered to do this because she knows that the support is there for her all the time and it doesn’t disappear as soon as she looks like she is "coping".

I took the opportunity to reinforce to everyone around the table that this has happened without setting one single target for H.

Trust is a very powerful thing. Our children and young people need to be able to trust that their supporting adults are just that and not just there to push them out of their comfort zone.

As I am gaining more confidence in my  role as " An expert team member" I have started to lead meetings, to invite who we need and almost railroad professionals round to our way of thinking.

Many have already worked in a team around the child type situation so suddenly finding themselves back in this situation is not too scary for them.

This is called Co-production and the aim is to put us as parents, children and young people on a level playing field with the professionals.  We know our children better than any of them, we spend every day finding out what helps and what doesn’t.

Now is the time to flip the narrative and start working from a point of what the child or young person can do and stop focussing on what they can’t. When we trust them and stand beside them they move forward at a pace that is right for them.



If you are interested in learning more follow these people on twitter for starters and get involved:

@gdmorewood   @elly_chapple, @StarlightMcKenzie ,  @AspieDeLaZouch,  @Andylowarousal,

@MsJoBillington





By Rachel Tenacious

  
                                      


 
A little bit about me, I am a late diagnosed autistic parent with three children aged between 30 and 16. H is my youngest child she was diagnosed with autism at age 9 and selective mutism at 15.
We removed H from the education system in 2015 after she had what we now know as an autistic burn-out.
The school system didn’t suit H at all but home ed has been amazing.
Since my diagnosis I have begun to share some of our experiences at support groups and am hoping to expand this out to schools, colleges and anywhere people want to hear me really.


Wednesday, 16 January 2019

What Teachers Need to Know About Teaching Children on the Autism Spectrum

When teachers view the behaviour of children on the autism spectrum through typical lenses, their view is often distorted. To teach children with autism you need to know autism inside and out to have the clarity that allows you to teach children the way they learn, to interpret what the child is communicating and to respond appropriately. Here are some helpful hints and tips to help school life be a more comfortable experience for the teachers, the child and the class.

1. The most important work thing is to build trust. Without that, they may be too anxious to do what is asked, Make every effort to win them over e.g. take notice of what they like or is important to them. Dinosaurs, space, Minecraft, learn about them so you have something to talk to them about and often use it to your advantage.

2. Many teachers have told me, they cannot give a child support because it would be unfair to the other children in the class. Explain to the class about autism and the extra help an autistic child needs to allow their other children to help support. This will teach the other children about autism, compassion and patience.

3. Never label a child’s behaviour “naughty,” “difficult,” “oppositional” or “rude.” You may not know the cause of the behaviour but if you understand autism and the child you can often work it out. If not observe, do an ABC chart this will provide you with vital information. There is always a reason behind the behaviour you just need to be patient and work it out.

4. Acknowledge the parents who have been raising their autistic child as knowing their child better than you do.

5. Find opportunities to raise the child’s stature in the classroom and the school. Is he great at magic? Let’s do a magic show! Is he an expert on dinosaurs? Let’s create an incredible dinosaur station and he can be the curator! He’s a great reader? Let him read stories out loud for the class

 6. The autism-related difficulties are not parenting issues. Autism is a pervasive development disorder, and that means autistic students may have some differences in every area of functioning across the curriculum. Executive functioning is often a weakness so try find other ways to help the child. E.G. visual representations.

7.Children with autism need patience and understanding. Give them that.

8. Teach children with autism the way they learn often this is visually.

9. If the child is having a difficult time, don’t insinuate or suggest there are problems in the home. Parents need my understanding and support, they have their child 24/7 and are often very stressed.

10.Celebrate the successes and the attempts and teach to the gaps in understanding and skill without directly pointing out mistakes. Demonstrate, model and practice until they get it.

11. I know that a lifetime of being corrected makes a child afraid to take a risk. Therefore, create safe and supportive environments where risk-taking is applauded. Let the children know that as an adult you get nervous taking chances, too!

12. If an autistic child tells you they are being bullied, believe them and act on their information. Sometimes they may feel they are being bullied when it is not bullying, explain it to the child with autism help them understand.

13. Many children with autism are tired — of course they are! A number of them have sleep disorders. They can’t settle down until late into the night. The diurnal rhythms of these children can be off by three to four hours, so they may be awake until well past midnight. If they are awake so late, it is no wonder they can be very groggy in the morning. Mornings can be tough on them, so watch what see what they are like first thing in the day. In the a.m., prepare lesson plans with preferred and alerting activities for those who need the extra time to be fully awake.

14.They often have slow processing speed. So, know that rushing a child who takes 20 seconds to process what you have said will literally slow him down and potentially make him anxious.

15. Autistic children may need help with organising, prioritising, managing their emotions, being flexible in their thinking, starting their work, coming up with ideas, remembering, and managing their time. These are brain-based differences. This is executive dysfunction. If you want a child to learn these things, you have to teach, not chastise and dictate what they need to do, but demonstrate the value of these skills so they master them.

16. I know stimming helps some of these children focus, regulate and/or manage anxiety. Never, shame or humiliate them by calling attention to their stim and insist they stop because they are bothering their classmates. Look for other ways they can do their stimming that is not disruptive. However, if this has been discussed with the class, I have found the children to be understanding and helpful towards the child.

17. If a child believes in themselves, they can do anything. Create opportunities for them to see their potential, and for peers to see it, too.

18. Consider the reality of anxiety. All roads can lead there: bullying, sensory overload, social alienation, slow processing speed, volumes of homework that seem impossible to keep up with. keep that in mind when creating lessons and homework for the children. Often homework is a bone of contention as they may consider school work to be done in school and home is different. As many do compartmentalise consider allowing them to do their homework at school. Maybe in a lunchtime homework club.

19. Don’t insist the need to look at you in order to pay attention to the lesson. In fact, looking away and doodling may be how they can pay attention. Often, they can look at you or they can listen to you, but not both. honour their sensory needs.

20. It’s hard for children to learn from teachers they do not like. If they like their teacher, they’ll have a good year. If they don’t, they won’t. How you treat the child determines if they like you or not.

21. Many children with autism have empathy — lots of it. Your cat died? He told you a joke to make you laugh because you look sad — not because he is cold and heartless. He may not know how to respond to what he sees or feels. That’s why it’s really important to create social/emotional development goals that can teach autistic children what to do in these situations. Don’t chastise or humiliate them for responding in ways that others feel are inappropriate. If there’s a clear gap in the child’s understanding, it means now we know what we need to teach it to them.

22. Being verbal doesn’t mean ASC children know how to communicate. Autism is a communication disorder, so try to find out what that means to each of your autistic students. Just because they are precociously verbal does not mean they can find the words to say what they need, express what they are feeling or understand all I am asking.

23. Many autistic children must be taught that 93 percent of communication that is nonverbal: facial expressions, tone of voice, body language, context. Work in activities that will help teach them that. These skills are so important in social success. E.g. My dog died the child with autism may laugh and this would cause upset. They are not laughing because they find it funny, they may not know how they should react appropriately. They may even find one of the words funny without understanding the context

24. check in for comprehension, not by asking, “Do you know what to do?” But by saying, “Tell me how you’re going to answer that question, Bobby.” And if Bobby is on the wrong track, don’t tell him he’s wrong, praise him for his effort and keep discussing until he understands.

25. Many people expect nothing of nonverbal autistic children (though many are bright) and too much of our highly verbal autistic children. Try working to understand the strengths and needs of them. I personally have worked with nonverbal children who are highly intelligent and understand exactly what you are saying to them.

26 let them know everyone makes mistakes. I will make mistakes. When I do, I will apologise to the individual children affected.

27. “No” can be a trigger for many children on the spectrum. Try and find a way to make them feel understood, and work hard to find a way to say, “Yes.” “Yes, Johnny. You want to play with the Lego. I will let you do that. First, let’s finish your math, then you’ll play Lego.” Finding another way to say no’ is not ‘giving in’ to bad behaviour. It is being mindful that this child feels less anxious when he or she has some semblance of control over the day, or when engaged in activities they feel comfortable and competent in doing. Use first/then visuals and schedules to help the child see when he can do his favourite things.

28. Be aware the ASC child who is a model student may have frightening meltdowns and express extreme anxiety at home related to the school experience. When social, sensory and academic demands become too much to cope with, the child will let it all out where it is safe to do so: with his family in his house. Give the child 15 minutes at the end of the day with something that relaxes them and helps them cope.

29. Behaviour issues are often a result of lack of training, lack of understanding, and lack of communication issues. Don’t tell parents their child was rocking in his seat, sitting at his desk not doing any work, or looking out the window while I was teaching the class. He has autism. He’ll rock to calm himself. He may not know how to start the work because he forgets the steps or didn’t understand the lesson, and he was looking out the window so he could pay attention to the lesson

30. Don’t wait for things to fall apart before you act being proactive is better than reactive for you, the child and the rest of the class.

31. Many autistic children do not like to be wrong, to be corrected, to be told they missed something, forgot something, or have to edit their work. Break work into small achievable chunks and check in for comprehension every step of the way. Teach the value of making mistakes and let them see you tolerate making a mistake.

MOST OF ALL ENJOY TEACHING THEM THEY HAVE LOVELY SIDES TO THEIR PERSONALITY AND CAN BE A LAUGH.

Collated by Karen Horner
Autism Consultant

Saturday, 8 December 2018

Can your child HEAR speech sounds?


When I see a child who is unable to make (articulate) accurately, the first thing I ask myself is - Can the child hear the speech sound? 
We use lots of different sounds in the English language and for these to be produced correctly children need hear the difference between them first. This is known as phoneme discrimination e.g. Did I say s or sh?
Some children cannot hear the difference between sounds for example:  I may say ‘take a sip’ and they hear it as ‘take a ship’. As you can see, this inability to hear the difference between ‘s’ and ‘sh’ changes the whole meaning of the word they hear!

Why can’t my child hear the sound?
This is a question I am asked a lot. Sometimes it may be due to a hearing problem such as glue ear (Otitis media) either in the past or presently – this is why we always recommend a hearing check. A hearing problem will mean that the child is perceiving the sound differently to us and therefore cannot make the distinction.
 However, there are many children who have perfect hearing but cannot make the distinction, unfortunately there is not a clear answer but it maybe that when they were developing their early speech skills they made an ‘error’ and stored the sound incorrectly.

Sound perception research
Newborn babies can perceive all the speech sounds of the entire world’s languages (about 600 consonants and 200 vowels!!). At about 6 months of age, they start to lose the ability distinguish between many sounds that are not used in their language. So, for example, a child who mainly hears English loses the ability to tell the difference between different types of ‘t’ sound (e.g., a dental /t/ and a retroflex /t/), whereas a child exposed to Urdu would retain this ability.
This phenomenon has been called perceptual narrowing or perceptual reorganisation (Werker et. Al. 2012).

Ideas to support the distinction of sounds
·         Can they tell you which sound you are saying from a choice of 2 or 3?  Younger children often enjoy relating speech sounds to pictures or actions rather than letters, e.g. Using the Jolly Phonics pictures and saying “s” when you see the snake. 
·         Ask the child to clap, bang a drum or press a buzzer when they hear a specific sound e.g. “we are going to listen for ssssss, hit the drum when you hear sssss” proceed to say a sequence of speech sounds including the target. E.g. ‘t, sh, s, m, k’.
o   If they don’t hear it repeat and say ‘I heard sss, we need to hit the drum!’
o   You can provide them with a picture card so the child can remember what sound they are listening for.
·         Expose the child to the sound as much as possible!

Remember!
In these games you are focusing on the sounds, not the letters e.g. kite and carrot begin with the same sound even though they are different letters.

Sophie Harding

Speech and Language Therapist 
BSc (Hons) MRCSLT MHCPC PROMPT-Trained

(Werker, J.F., Yeung, H.H., & Yoshida, K. (2012). How do infants become native speech perception experts? Current Directions in Psychological Science, 21(4), 221-226.)

Monday, 26 November 2018

How Reading to Cats Can Help Your Child Develop Confidence


Guest blog post by Emily Cline


You've got brains in your head
You've got feet in your shoes
You can steer yourself any
Direction you choose!

- Dr. Seuss, The Cat in the Hat

Do you remember what it was like learning to read? Your early experiences of learning how words are written and spoken may have been with a parent or a sibling. Later on, you may have participated in group activities in school. You may have found it easy or you may have found it hard and that you needed some support.

Do you also remember the bond you had with a family pet when you were a child? A family cat or dog is often, in a sense, a child’s first friend. They learn to how to interact with another living being. They also get their first taste of unconditional love, friendship, and companionship. You may have spent hours in each other’s company, happy to just “be”.

When you are learning to read, doing so by speaking out loud what you are seeing on the page helps with your learning. But it can also be a daunting and intimidating experience! How people respond to what they hear you say can make or break your confidence – big time! When you’re taking your first baby steps developing confidence is vital. The same goes for reading and speaking the written word, a non-judgmental response helps build confidence.

Enter the cat for confidence!
Cats and kids – Dr. Seuss got it. So did the creators of classics such as Slinky Malinki and Puss in Boots. Many children have a natural empathy and bond with cats. They will often both connect, curled up in the corner, in their own world together.

For kids learning to read, the act of reading to a cat can help with developing the much-needed confidence to continue. This is especially kids who are not strong readers. There’s just quiet acceptance of what’s being said and no judgment at all. Reading aloud to a cat (or dog) gives kids a safe environment to practice this skill in their own time and without interruption. Aside from the cat that wants to sleep on the book, of course!

How reading with a cat is clever!
Reading to a cat is a confidence booster. It is also a clever strategy to help kids with both literacy and life skills in many ways. How so?

Self-confidence
One of the ways we learn how to become self-reliant is by making our own choices and decisions. A child reading to a cat, who has been able to decide on the book they will read, has taken one step to learn to be self-reliant.

Another way to learn is to make mistakes. As a child read aloud to their feline company, they may stutter and stumble over words. With an unbiased feline audience, they can self-correct unselfconsciously in their own time.

Practice makes “perfect”
When you are learning to read repeated letters, words and phrases gradually build your skills. Learn anything through repetition, and after a while, the skill or behavior becomes second nature. Reading fluency is one of those areas that benefit from patience and practice.

Many kids have a favorite story that they like to hear over, and over again. If this sounds like your child, they may love to share their favorite story, read by themselves over, and over, to their cat!

Social skills
Given some cats can sleep for up to 16 hours a day, admittedly the time to socialize is limited! However, this means your child begins to understand they may need to consider when it is a good time for both them and their cat to sit down with a book. They are then learning the art of compromise.

The cat alley here goes two ways too. Most cats love the sound of a human voice and being talked to. If they are a cat with a timid nature being read to quietly is a good way for them to spend time and be socialized into the company of people. It’s a win-win.

Cats you can visit

You don’t necessarily need to have a cat in your own home for your child to read to either. There are many organizations that have reading programs for animals. Some are dedicated to the benefits the company of a cat can bring to developing reading skills.

Schools and libraries often run reading programs in conjunction with volunteers from assistance animal groups. These good people will bring in a super kid-friendly feline or two and find a quiet room for the kids and cats to read together.

Many rescue shelters have times when kids can come in to visit and spend time reading to their cats. This very worthwhile activity helps children with reading skills, and with socializing cats waiting for new homes.

Cats you can call your own
If you are considering bringing a cat into your home think about the ages of your kids and their readiness to handle an animal safely. You also need to take into consideration where you live and whether it’s pet-friendly. And don't forget the costs of looking after a cat including their food, vaccinations, and health checks.

Cats are relatively low-maintenance. However, they still need places where they feel safe and comfortable to sleep, eat, and toilet. You will make the day of most cats if they have somewhere where they can get up high, be in a room with a view, and/or have toys to play with!

Cats are not only a popular choice as a family pet; they are also a popular companion for people with emotional support animals. Emotional support animals (ESAs) can be of benefit to people with a range of emotional and psychological conditions as part of a treatment plan.

If you are wondering about ESAs for kids under 18, talk with your child’s own health professional in the first instance. Emotional support animals have been found beneficial for kids with anxiety and autism. But always work with your health provider to establish whether an emotional support animal is a good option for your child’s condition. It is important to know everything about
emotional support animal registration.


Emily Cline