Summer in East Lothian!

I thought about writing this post yesterday when summer had indeed arrived in East Lothian, as you can see in this lovely photo of the poppies in a field between Pencaitland and Tranent:

Summer Poppies Pencaitland & TranentSadly it’s a bit cooler and cloudier today but I’m sure there will be more sunny days before the summer is out. Here in East Lothian we are blessed with many beautiful beaches including the especially popular Gullane Bents, Yellowcraigs, North Berwick and Dunbar’s Belhaven Bay.

Panorama of Belhaven By, Dunbar looking North towards North Berwick

Blue skies and clear water at Belhaven Bay, Dunbar

The warm sunny weather brings many families to the beaches and the obvious place to cool off is in that lovely, blue water. However, to the unwary, the water can contain hidden dangers and the conditions are constantly changing with the tide and weather. With that in mind, I would like to point you all in the direction of some helpful advice that should help you stay safe while you’re having a break from your speech and language therapy sessions.

Please click here to go to the RNLI’s Respect the Water page where you will find lots of helpful advice that will help you and your family to enjoy a safe trip to the beach. At the very least:

  • Try to go to a lifeguarded beach if possible. The red and yellow flags you will see there show the safest area to swim in and that part of the shore will be being patrolled by the lifeguards.
  • Remember that swimming in the sea is very different from a pool. The seabed is very uneven and sometimes there are sharp changes in depth.
  • The sea around the UK is very cold, even at the height of summer. Take time to get used to the temperature as you go in and if you have a wetsuit, wear it. The Respect the Water website has some great advice about what to do if you fall into very cold water suddenly.
  • Make sure someone on the beach is keeping an eye open for you and can call for help if necessary.
  • Understand what a rip current is and what to do if you find yourself in one. Click here to watch Gwithian Academy of Surfing’s excellent video explaining rip currents. Basically a rip is a current that forms where the water coming into the beach in the waves flows back out to sea. They pull out to sea and may stay in one place like when they form around rocks or they can move around the beach as the tide changes. If you find yourself in a rip, swim at right angles to it (usually parallel to the beach) until you are free from its pull then either try to get attention and/or swim back into the beach. NEVER try to swim directly against a rip current, you will exhaust yourself and then you will be in a lot of trouble.

If you see someone in trouble in the water, your first action should always be to dial 999 and ask for the Coastguard. The Coastguard will then come to your assistance and will alert the RNLI lifeboat teams if necessary. If you can, avoid going into the water yourself as many people drown trying to save others.

Stay safe on the beach this summer and have fun!

Isla enjoying a sunny, windy day at Longniddry

Isla enjoying a sunny, windy day at Longniddry


Donate your Voice!

Donating your voice to help Motor Neurone Disease sufferers

Did you know that you can ‘donate’ your voice for the benefit of adults who suffer from Motor Neurone Disease? The Voicebank Project has been set up by the University of Edinburgh in conjunction with the Euan MacDonald Centre for Motor Neurone Disease Research. This research project aims to create a library of voices that can be used to ‘reconstruct’ patients’ natural speaking voices, including accent, for voice output communication aids.

Why is the Voicebank Project necessary?

Perhaps the most famous voice output communication aid (or ‘VOCA’) user and MND sufferer alive today is Professor Stephen Hawking. I think most of the modern world is familiar with the very synthetic and unnatural voice that his VOCA, The Machine, produces. Whilst professor Hawking’s device has been upgraded over the years, it seems that he has come to see the synthetic voice it produces as his own and has refused an upgrade to more natural sounding speech. In fact, I believe he has even copyrighted his synthetic voice, that means if you hear his voice on anything from The Simpsons to Big Bang Theory, yes, it really is him! You can find out more about Professor Hawking’s voice and The Machine on Professor Hawking’s website if you are interested.

Although Professor Hawking has come to accept his synthetic voice, the vast majority of people are devastated by the prospect of losing their natural speaking voice and having to replace it with something so robotic. Being diagnosed with MND or another neuro-degenerative disease is devastating enough without the indignity of having to ‘speak’ with a voice that you don’t feel belongs to you. After all, as I have described in a previous post right here on this website, Your Voice is your Auditory Face.

This is where the Voicebank Project comes in. The aim is to create a database of natural male & female voices with a variety of regional accents which can be used in conjunction with recordings of the patient’s own voice and those of their close relatives so that  VOCA users can choose a voice for their communication aid that they are comfortable with and that they feel reflects their own identity. You may wonder why the patient’s own voice can’t simply be recorded and used in the VOCA. Well, the fact is that for many people, one of the first noticeable symptoms of a neurological condition is in fact changes to their speech. By the time they are diagnosed, the patient’s speech is often significantly affected which is why a degree is of voice reconstruction is usually necessary. Do be aware though that at this stage, Voicebank is a research project only and not a fully-fledged and widely available service. Hopefully it will become part of the standard service for all VOCA users before too long!

I’m interested! What do I do now?

If you are interested and are over 16, have no reading or speaking difficulties and are a first language speaker of English, email to find out how to donate your voice. In particular, the project is needing male speakers from all over Scotland and from the areas shown on the leaflet here:

Leaflet from Voicebank giving details of accents requiredRecordings take about one hour and are done either at the New Royal Infirmary in Edinburgh or via the mobile recording team (Scotland only). You will need to wear a set of headphones and a little microphone and you will be asked to read a selection of sentences from a computer screen. Don’t worry, the text is big and easy to read! I recommend bringing a bottle of water as you’ll get a dry throat from all that talking. Go! Donate your voice!

If you would like to find out more about Motor Neurone Disease, visit the UK’s MND Association.

Free Online Autism Training!

I am always looking to update my knowledge of autism and any evolving support strategies. As I was looking for online training modules and ‘webinars’ (much as I don’t like the word!) last week, I came across an excellent resource that I feel the need to share. It is called Autism Internet Modules (AIM) and it’s a free – yes FREE! – library of training modules on a variety of topics relating to autism. The site has been developed by Ashland University in the US. A very big thank you from Blethers to Ashland for this amazing resource!

Whether you are a professional working with people on the spectrum, a parent/carer or indeed a person who has a diagnosis of autism, you will find some high quality information on the AIM website. All you need to do is register with your email and a password and you’re off! You can access certificates and academic credits if you want to but you do have to pay for these. However, all of the information is free. So far, I have used the Pivotal Response Training module which took me about an hour and three quarters to read through. The information was presented as a combination of text and video clips. At the start and end of each module, there is a short (5 or 6 question) assessment quiz so that you can compare your knowledge before and after.

I know that I’ll certainly be accessing more of the modules as part of my ongoing commitment to continuing professional development and evidence based practice. What a great resource!

Music for Children in Edinburgh & Lothian!

In previous articles (Music & Communication Development and A Further Note to Music & Communication Development) I have talked about the many benefits of exposing your child to music from a very early age. Singing and being sung to helps to develop the following fundamentals of communication:

  • Maintaining concentration – singing is very engaging and therefore easy to pay attention to for a long time.
  • Anticipating what’s coming next – music and songs lead the brain to expect or look for the next notes in the melody. Songs, especially nursery rhymes and the like, often have a predictable, repeating pattern of words and/or actions which makes it easy for a child to learn to anticipate what’s coming next as well as supporting maintenance of concentration.
  • Taking turns in communication by learning to listen and then respond within the song.
  • Using non verbal communication and eye contact – many children’s songs have accompanying actions which encourages the development of watching another person, copying them and co-ordinating gestures with spoken language.
  • Vocabulary development through repetition of words and use of rhyme.
  • Sentence development – hearing the same sentence structure over and over again is essential for learning to say new and longer sentences.
  • Phonological awareness – awareness of alliteration, rhyme, syllables and rhythms are essential skills for later learning to read and write as it supports the ability to break words down into sounds, work out what those sounds are and put them together again to make new words.
  • Sequencing – Like music, all language follows a sequence whether it’s the order of sounds in words, words in sentences or information in a story.

Experimenting with musical instruments and melodies is just as important as singing and adds extra sensory dimensions to the experience of music through the senses of touch, proprioception and vision. Like singing, playing instruments supports the development of many fundamental communication skills like:

  • Concentration – listening to music and sound is fun and children will often manage to maintain concentration for longer to an activity if music is involved.
  • Listening – to sing the right words at the right pitch or to copy a tune or rhythm with an instrument, you need to listen carefully and discriminate between the sounds you hear.
  • Self expression and creativity – music is inherently creative and making up songs and melodies is a fun way to express yourself without necessarily using spoken words.
  • Memory – remembering tunes and rhythms exercises auditory memory which is essential for learning new vocabulary and language structures. When we hear new language, we need to hold what we hear in our auditory memories so that we can analyse it and commit it to long term memory.
  • Pitch awareness – intonation in spoken communication is made up of variations in pitch and different ‘tunes’ have different meanings. For example, a rising ‘tune’ in a sentence usually means that it is a question. Music helps to develop awareness of pitch variations.
  • Rhythm – like music, all spoken language has a rhythm to it. Within words, we have rhythms in the form of syllables and stress patterns. Sentences also have rhythm in their stress patterns. Being able to recognise and repeat rhythms is essential for natural communication. Being able to break sounds into smaller chunks using rhythm as we do with syllables, is essential for learning to read and spell. Music helps us to learn these skills.

Above all, music is FUN! It’s easy to engage in a bit of music at home even if, like me, you are not the most talented singer. If you feel you’d like to add a more social dimension to your child’s musical experience, there are a variety of excellent children’s music classes available in Edinburgh and Lothian from organisations like Monkey Music and Caterpillar Music.


The Smarties Tube Test of Theory of Mind

Just the other day, I did the Smarties Tube Test for the first time in ages. Understandably, the parent of my client was somewhat surprised when I duped her child with my Smarties tube full of buttons! As I was explaining the reason for the test afterwards (best to do it afterwards to avoid any bias), I thought it would make for an interesting web post about theory of mind. Before I go on, please don’t worry, the client in question got a tube of real Smarties afterwards!

What is The Smarties Tube Test?

The Smarties Tube Test is a really simple but effective way to test Theory of Mind. Please understand that it is not a ‘quick and easy test for autism’ although it is helpful in combination with A LOT of other information in the process of diagnosing autism and other developmental conditions. First I’ll explain what Theory of Mind is then I’ll tell you how you do the test and what it tells you.

What is Theory of Mind?

Theory of mind is basically ‘putting yourself in someone else’s shoes’. It’s the skill we human beings use to ‘mind read’ other people so that we can figure out how others are feeling, what their intentions are, what they believe and what they are likely to know or not know. Theory of mind is what tells you how much background information to give another person when you are telling them about something that has happened to you. It is what makes us wince when someone we care about hurts him/herself. It is what helps us figure out when someone else is being sarcastic and it is what helps us to deceive others. Typically, theory of mind starts to develop about 3 and a half to 4 years old.

Who has trouble with Theory of Mind?

As theory of mind usually develops around 4 years old, you can expect that any child younger than 4 will not do well at mind reading! In addition, theory of mind is typically a core area of weakness for people who have a diagnosis on the autistic spectrum, so much so that it is widely regarded as an essential characteristic of autism.

How do you do the Smarties Tube Test?

First and out of sight of the child, put some buttons (or some pencils) into an empty Smarties tube. When you see the child, show him/her the Smarties tube (you can shake it!) and ask ‘what do you think is in here?’. The child will most likely say ‘Smarties’. Next, you open the tube, show the child what is inside and ask him/her ‘On no! What is inside?’. Hopefully he/she won’t cry and will say ‘Buttons’. You put the buttons back into the tube and ask the child ‘Can you remember what is inside?’, most likely they will say ‘Buttons’. Now for the clever bit. Tell the child you’re going to play a trick on someone who isn’t with you, it could be a brother, sister, mum, dad, teacher, whoever. Ask ‘If we give this to your brother (or whoever!) later, what will he think is inside?’ If the child has theory of mind and understands that his/her brother won’t know the tube is full of buttons, he/she will say ‘Heh heh! Smarties’. If the child does not have theory of mind, he/she will not be able to put aside his/her knowledge that the tube has buttons in it and will say that the brother thinks there are buttons inside.

I hope that all makes sense but, by way of further explanation, this video gives a nice summary of theory of mind and how you do the Smarties Tube Test. It also explains the more widely known ‘Sally Ann Test’:

Theory of Mind Testing

I find that the Smarties Tube Test is a quick, unambiguous and easy way to establish whether a child has developed theory of mind or not.


New Study Suggests that Music Training Supports Self Organisation!

I came across an interesting new piece of research into the benefits of musical training the other day on a music teacher Isla's Guitarfriend’s website – click here to see the article. This functional MRI study suggests that there is a link between early music training and improved executive functioning in both adults and children. So what does that really mean?! Read on to find out…

What is Executive Function?

Basically, Executive Function is the brain’s system for planning stuff, controlling inhibitions, thinking flexibly and generating new ideas. I like to think about it as a wee ‘executive’ guy in a pin stripe suit who sits in the front of your brain organising things. Executive function allows you to do 4 key things:

  • Plan stuff – for example, planning ahead for a PE lesson and organising all the things you need to pack into your bag the night before, planning a shopping list or planning an essay.
  • Transfer your attention between tasks – so that you can finish one task then switch your attention on to the next task which might be totally different from the first.
  • Inhibit inappropriate impulses – Executive function is what stops you from reading a text that makes your phone vibrate in the middle of a conversation with your mother in law. It also stops you doing things like pointing out the massive spot on the end of your friend’s nose or telling your teacher that her new haircut looks like someone put a bowl on her head and cut round it with their eyes closed!
  • Be creative - for example coming up with a new recipe idea, thinking of a fun day out for your friends or writing a song.

Who has difficulty with Executive Function?

Probably the biggest groups of people who typically have issues with weak executive function throughout their lives are those who have a diagnosis of Autism (ASD), Asperger’s Syndrome and/or ADHD. Other groups are also affected though,for example, those with head injuries or degenerative brain conditions. Even without a specific diagnosis, you can still have weak executive function.

What Does the Boston study say about Music Training and Executive Functioning?

First and foremost, no-one is saying that if you get your autistic child into music training they will be cured of all problems relating to executive function! Do not misunderstand this as yet another ‘miracle cure’! What the researchers found is that adult musicians and musically trained children got better scores on tests of executive function than a non-musically trained control group. The researchers carried out functional MRI scans (also called fMRI – click here to learn more) on musically trained children & controls while they completed a test of executive function skills. The scans showed more activity in the brain areas associated with executive function in the group of musically trained children than in the brains of the non-musically trained control group.

While this study does show evidence of better executive function in musically trained people, it does not establish whether the improved skills are definitely due to the musical training OR whether people with better executive functioning are simply drawn to learning music. More investigation is required to clear this up! Whatever the outcome of this line of research, the benefits of music training for a whole range of cognitive skills, including language development, are well documented. So expose your child to music when you can. If they are interested in learning to play something, let them have a go. erhaps pay a visit to my friends at Morningside School of Music for some lessons. Apart from anything else, MUSIC IS FUN!

A Further Note to Music & Communication Development!

Back in May 2013, I posted an article called Music & Communication Development which talked about the many benefits of learning with music. I was therefore very interested to read on the BBC website about some recent research which found a link between strong rhythmical ability and better language learning & literacy skills in teenagers. Click here to go to the article. Whilst I couldn’t necessarily see a causal link in the information presented on the BBC website, there certainly seems to be a strong correlation between performance on a rhythm tapping task and reading skills. Children who were better at the rhythm task were the best readers and those who struggled were the weaker readers.

As a speech & language therapist, this doesn’t really surprise but it is nice to see some concrete evidence of a hunch. Spoken language is just a continuous stream of sounds – imagine the last time you listened to someone speaking a language you don’t know. I’ll bet you couldn’t tell where one word ended and the next began. To be able to read and write our language down successfully, we need to break that continuous stream of sounds into words, syllable and individual sounds. How do we do that? Largely by using the rhythms generated by the stress and intonation patters of our first language to help us guess where the word & syllable boundaries are. It’s therefore no great surprise that enhanced rhythm awareness is helpful!

The Tiger Who Came to Tea

I use stories all the time in my work as a speech & language therapist and I have to confess that one of my favourites is The Tiger Who Came to Tea. I was therefore most interested to see an article on the BBC website about the story and it’s author, Judith Kerr (click here to open the article). I had no idea that the book was first published in 1968 and has never been out of print since. I guess I’m not the only one who likes it!

We see these books around all the time in shops, schools, libraries, at home and rarely give a thought to the back stories of their authors. For instance, I had no idea that Judith Kerr grew up in a Jewish family in Berlin under the shadow of Nazi Germany and was forced to flee with her family to Zurich in order to escape persecution. The effect that had on her later work as a children’s author is up for discussion but some argue that the uninvited guest of the tiger in the story is a parallel with the uninvited and insidious knock on the door that many less fortunate families experienced during the Hitler years.

Still, dark undertones or not, The Tiger Who Came to Tea is still a profoundly engaging story and will remain a firm favourite with Blethers!

Autism Friendly Theatre Performance

Well, it can’t be denied that the nights are drawing in and the weather’s getting colder so everyone’s looking for fun and exciting indoor activities to entertain their children. If you have a child with autism, this can be more difficult as lots of indoor activities for kids are loud, frenetic and generally very over-stimulating! Unfortunately public knowledge of autism is still a bit sketchy and people aren’t always as accepting of the behaviours and quirks of children on the spectrum as they should be.

Having said that, the good news is that more and more places are cottoning on and providing activities that are specifically planned for children with autism and cater for their needs. More and more cinemas and theatres are starting to put on autism friendly performances with subdued lighting and lower volume. It also means you can take your child along safe in the knowledge that no-one’s going to mind if they need to run around, make a noise, take a break or even have a meltdown in the middle of the show!

In partnership with the National Autistic Society, the Playhouse in Edinburgh is putting on an autism friendly performance of The Lion King on 24th November at 1.30pm, if you are interested click here to go to the website for more information and bookings. Have fun!

Your Voice is Your Auditory Face

I have just read a fascinating article in New Scientist dated 13th July called Voice Almighty – you can access a snippet by clicking here. One quote in the article really stood out for me and that was ‘your voice is your auditory face’. How true this is. Pretty much all of us can identify which of our loved ones is speaking on the phone within a couple of words. I’m a huge music fan and when I’m listening to a new song on the radio, I can usually identify the band by identifying the voice. I think because most of us have one and use it every day, we very much take for granted and underestimate the importance of our voices as part of our self-image and self-identity.

Part of the expression of your voice is your accent, love it or hate it, we all have one! Some people, often those with a standard or ‘Received Pronunciation’ accent, will claim they have no accent. This is not true, if you speak, you have an accent! Accent is a surprisingly strong element of our cultural identity and people will strengthen or try to disguise their accent dependent on their feelings about their own background and the people they are trying to fit in with. I always remember a wee boy who arrived in my primary school on a Monday with a strong Geordie accent and by Friday, he sounded just as Scottish Borders as the rest of us!

I used to live near Liverpool, and while I never lost my Scottish accent (it’s part of my cultural identity!), I did have to soften it a bit to make myself understood. All of my Liverpool friends used to comment that when I spoke on the phone to one of my Scottish friends I sounded WAY more Scottish. I think for sure they’d all say that my accent is much stronger now that I have moved back to Scotland. For me, one of the really nice things about being back in Scotland is hearing people using some good Scottish vocabulary and that makes me feel a strong sense of belonging. I also enjoy the look on Tom’s (he’s a Cumbrian) face when I use words like:

  • Hoachin – busy with people or crawling with insects
  • Glaikit – daft or stupid
  • Sleekit – sleek or, alternatively, sly and underhanded
  • Howk – to rake about or rummage (see Ratch below!)

To be fair, Tom has also introduced me to some fantastic Cumbrian classics such as:

  • Scop it – put it in the bin
  • Wass or wassai – very large
  • Woll – hole
  • Ratch – to rake about or rummage

Interestingly, when Tom and his brothers get together, their first form of bonding is to switch into broad Cumbrian and, even though neither of us are Cumbrian, myself and my sister in law join in too! Indeed, whenever Tom meets another Cumbrian, the test of whether they are authentic is to speak to them in his best Cumbrian Farmer.

So really, if you sit and think about it for 5 minutes, it becomes very clear how important the sound of your voice (love or hate it!) is to your own identity and how you present yourself to other people. Interesting!

Here are some interesting bits of trivia about voices from the New Scientist article:

  • A study in the US has shown that CEOs with deeper voices (102Hz as opposed to 125Hz) work for bigger companies and earn more.
  • Deeper voices (male and female) are perceived by others as more assertive and authoritative.
  • Higher pitched female voices and lower pitched male ones are rated as more attractive.
  • The average pitch of female voices in Sweden, the US, Canada and Australia has deepened by 20Hz since the 1950s – we can’t say for sure but this could be related to increasing numbers of career-women in roles like CEO.
  • Regional accents colour our judgement of the speaker – for example one study showed that people were more likely to judge a suspect as guilty if they spoke with a strong Birmingham accent than if they had a more neutral English one.
  • A study has shown that imitating a regional accent makes people rate the attractiveness of that accent more highly.