Practise routines for Speech & Language Therapy

When I’m working with clients, lots of people ask me ‘how much should we practise?’. The answer to this questions varies depending on the individual but there are some general principles that always apply.

When you are learning a new sport, craft or, like me, you are learning to play a musical instrument, you will make better progress if you are focused about your practise time. You need to practise slowly, often and repeatedly. You should also have a goal in mind for your practise session. The same is true for communication skills. Let’s look at each element of practise in turn:

  • Set a goal – lots of us forget about this one or think it’s not important! Having a specific goal in mind when you practise is REALLY important. If you set a goal, you know what you are trying to achieve. Most importantly, working to a goal will give you (and your child) a sense of achievement which maintains motivation. If you are working with young children, the goal you give them may be different from your own and it doesn’t need to be complicated! For example, your goal may be for the child to produce ‘s’ at the start of 10 different words by the end of your session but you might tell the child that they have to tell you about 15 pictures before you finish. Goal setting is a big topic so I’ll be doing a post next week about how to set goals in more detail…
  • Practise often – A little bit of practise every day is much more effective than saving it all up and doing it in a one-er once a week. This is why SLTs are always telling people that weekly sessions are not a magic cure! Your SLT session is the starting point, the most important stuff is what happens between SLT sessions. As a general rule, try to do 10 minutes at least once but preferably twice or 3 times every day. This will vary depending on what you are working on but your speech & language therapist will give you some guidance on how often and when to practise.
  • Repetition is good – when working with children, it’s easy as an adult to get bored with the same activity. Repeating the same activity is actually helpful when practising your communication skills. It means that you don’t need to waste lots of energy learning a new game then learn the new communication skill on top of that. Also, make sure that you don’t move on to the next stage until your child can do what you were working on correctly 80-90% of the time.
  • Start slowly – Working on speech is essentially learning a new motor skill just like any other. You wouldn’t pick up a guitar for the first time and immediately expect to be able to play like Eric Clapton! You have to start slowly, making sure that you get each movement of your fingers (or mouth!) exactly right. As you practise, you will find that the movements get easier and you can then get faster and faster. It’s much better to slow speech down and achieve the correct pronunciation than it is to speak quickly and have no-one understand you.

Finally, and above all, MAKE IT FUN!! If you get stuck, your speech & language therapist should be able to give you some ideas of fun activities to use to help you practise…

Intensive Interaction Video

If you work with people who are at a pre-verbal stage of communication development or you have a family member whose skills are at this level, I strongly recommend that you check out an approach called Intensive Interaction. I’ve been using this approach for 10 years and in 2007 completed Dave Hewett’s Intensive Interaction Co-ordinator training (in my maiden name!). Isla's Intensive Interaction Co-ordinator certificate

Intensive Interaction was developed in the 1980′s by Melanie Nind and Dave Hewett in Harperbury Hospital School, an establishment for young adults with severe learning difficulties. It is a way of communicating with someone who is at an early, often pre-verbal, stage of their communication development and of developing their communication skills further. Often this is someone who may be considered ‘difficult to reach’ or communicate with. Intensive Interaction is based on principles of natural parent/baby interaction and is very well supported by a wealth of academic research.

Between being born and the age of about 5 years, humans typically go from being unable to communicate intentionally (on purpose) to becoming highly complex and versatile communicators using and understanding not just speech but a massive range of non-verbal and social communication skills. The most amazing thing about this is that we typically ‘just pick it up’ without ever being explicitly taught. Between birth and our first words at 18-24months we learn a huge amount about what are called ‘The Fundamentals of Communication‘, skills which include:

  • Enjoying being with another person
  • Using and understanding eye contact
  • Using and understanding facial expression, gesture and personal space
  • Joint attention or sharing an activity with someone else
  • Taking turns
  • Using and understanding physical contact
  • Playing with vocalisations and realising that vocalisations have meaning

These skills are essential for learning to use more complex communication and spoken language later on. All of this learning takes place during natural face to face interaction with other people, primarily our parents. Interactive games like peek-a-boo, tickling games like ‘Round & Round the Garden’ and just babbling and copying your child’s sounds are all part of this complex learning and teaching process. Intensive Interaction is a way of continuing this sort of stimulation for people whose communication remains within this pre-verbal or early verbal stage of development.

The core principles of Intensive Interaction are:

  • Let the learner lead the interaction which means that you as the teacher need to be prepared to join in with your learner’s activity. By doing this, you ensure that the interactive activity is familiar and comfortable for the learner which means that they do not have to expend concentration on learning a new game before they can focus on the communication learning. It also helps to build trust between you as the learner develops an understanding that you are not going to overwhelm them and that you are prepared to do the early communication equivalent of listening to them!
  • Respond to what the learner does – you can do this in a variety of ways. You may like to copy what the learner is doing or reply with a ‘celebration’ like an exaggerated facial expression, sound or comment. If you respond using some spoken language, keep it simple, short and clear so that it is easily understandable to your learner.
  • PAUSE! – This is so important! You must pause after a burst of activity to allow your learner to process your response and to give them an opportunity to reply to you in some way. Slowing the process of communication down in this way has many benefits. It allows you a chance to observe carefully and it allows the learner to demonstrate skills that may already be there but that they usually do not get to show because the pace of communication is usually too fast.

 

For more detail about Intensive Interaction, latest news from practitioners and upcoming training courses, visit the Intensive Interaction website. And finally, because the most effective way to see the impact of Intensive Interaction is to watch someone do it, click here to watch a You Tube video of some Intensive Interaction practitioners working with children in Romania. Suzanne Zeedyk, a well respected researcher in the field of early communication, provides a commentary. Sadly the picture quality is not as good as it could be but it should give you a flavour of the approach in action. You can also find this and other useful videos on the Blethers You Tube Channel. I hope you enjoy!