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


Understanding Language Comprehension

As a speech and language therapist, I often have children referred to me because their language is late to develop. Whilst those who know the child may feel that the main issue is lack of spoken words and may say he/she ‘understands everything’, it often becomes apparent during assessment that things are not what they seem. Children are great little detectives! In day to day life, they are constantly scanning their environment for clues that will help them understand. It is possible for a child to understand an instruction like ‘Go and put your coat and shoes on then wait by the front door’ without understanding a single, solitary word! But how? The answer is ‘Situational Understanding‘.

What is Situational Understanding?

From a very early age, we start to make links between things that happen around and to us, starting with cause and effect. Babies quickly learn that crying (cause) usually results in comfort of some kind (effect – often food or cuddles). As we grow and learn, we start to associate related things and we use this information to make sense of the world. Often, before children can speak much at all, they will do things like go to the table when you open the fridge or the cupboard where the snacks are. This is situational understanding – the child has learned that when you open the fridge or cupboard, the next thing that usually happens is that they get a snack at the table. The child does not need to understand any words to react appropriately, they are using the information from the situation to understand. Situational understanding is an essential skill that we all use throughout our lives. Ever been to a party which features folk dancing you’re not familiar with? Usually we watch what other people do and copy – we use what we see in the situation to understand what to do. That is what situational understanding means.

Let’s think now about our instruction ‘Go and put your coat and shoes on then wait by the door’. Your child will most likely have noticed that when you put your coat on and get the buggy ready, the things that follow are that you put their coat and shoes on then go out through the door. If you deliver the instruction while you are standing in the hall with your coat on and getting the buggy sorted out, your child doesn’t need to process any of the words you have said, they can follow it simply by using their knowledge of the situation they see.

To assess and work on true understanding of language, you need to consider how many words in the sentence the child HAS to understand in order to follow it, these are usually called either Information Carrying Words (ICWs) or Key Words. That means taking into account the environment, the situational information available and the choice of related objects on offer. It sounds mind-bending, but once you get into the swing of it, it’s fine!

What is an Information Carrying Word or ICW?

Quite simply, it’s a word (or short phrase) that gives you the information you need to follow an instruction without any situational clues. Let’s take the instruction ‘Go and put your coat and shoes on then wait by the front door’ and alter the situation to make some of the words carry essential information, i.e. turn them into Information Carrying Words.

First of all, the instruction needs to be given BEFORE you, yourself start getting ready and while you are away from the door. Secondly, words that have a grammar function don’t count when it comes to information carrying words! So we can get rid of a few words straight off: ‘Go and put your coat and shoes on then wait by the front door‘. Now we have 4 candidates to become ICWs! In the examples below, I’ve highlighted the ICWs in red and the things the adult does to support understanding of the additional words in blue.

1 ICW – ‘Go and put your coat (give the child the coat) and shoes on then wait by the front door (point to the door)‘. Here the child has to understand the phrase ‘shoes on‘ to follow the instruction. The situational prompt of being given the coat should be enough to prompt putting it on and pointing at the front door will prompt the child to go there. We’re going to assume that waiting is what the child usually does at the door, so there’s no new information in that word either.

2ICWs – ‘Go and put your coat and shoes on then wait by the front door (point to the door)‘. Here the child needs to understand both ‘coat‘ and ‘shoes on‘ but the point gives a clue as to where to go.

3 ICWs – ‘Go and put your coat and shoes on then wait by the front door‘. This time, you haven’t pointed to the front door so, not only does the child need to understand which items to get but also ‘front door‘ (as opposed to back door) so that they go to the right place.

I hope this isn’t too confusing! The easiest way I find of sorting out how many ICWs I’m giving a child is to think ‘is there a choice for each word in this instruction?’.

Here are some toys that I might use to work on developing understanding Information Carrying Words

Here are some toys that I might use to work on developing understanding Information Carrying Words

If I give the child the items in the picture plus the instruction ‘make Igglepiggle jump on the bed‘, I can be confident that it is a 3 ICW instruction because of the following choices:

  1. Igglepiggle or Upsydaisy
  2. Jump or any other action
  3. Bed, table or chair

Your speech and language therapist will help you to ascertain how many ICWs your child can understand at a time and will help you see if there are any patterns within each level of understanding. For example, a child may understand 2 ICW instructions made up of a person plus an object (eg ‘Give Igglepiggle the chair’) but not ones made up of a person plus an action (eg ‘Make Upsydaisy sleep‘). Usually speech and language therapists will work in 4 levels with ICWs – 1, 2, 3, and 4 ICWs in a single instruction. Beyond 4ICWs, things start to get more complex!

Bridging Between Levels

Once your child consistently understands a variety of instructions at the level you are working on, your SLT will advise you on how to ‘bridge’ to the next level. That usually involves using real objects, visual aids like pictures, sign language and/or pointing to give your child a clue about the extra ICW you have added. For example, if you are wanting to help your child get from 2ICWs to 3 using the materials in the picture, you might do the following to support understanding of ‘make Igglepiggle jump on the bed’:

  • Give the child Igglepiggle first
  • Sign ‘jump’ as you say it
  • Give the child the symbol for ‘jump’ as you say it
  • Point to the bed

The choice of materials is still there because you’d use all of the objects to maintain the choice for each ICW but you are making it a little easier by helping the child with one of the choices.

I hope that this article goes some way towards demystifying the concept of Information Carrying Words or ICWs ! Please leave me any comments or questions and I will do my best to answer them!

Pre-Literacy Skills for School Starters

In a few short weeks, thousands of 5 year olds will be starting in P1 at school. Central to success at school and in later life is learning to read and write. Did you know that the key skills for successful literacy development are built on our speech processing skills?

Photo of popular childrens' books , Zog, Bear Hunt and Dinosaurs Love Underpants

Some popular children’s books used in schools across the UK

Most young pre-school children are aware of words as whole chunks and that words help them communicate with others, however, they are not typically aware that each word is made up of smaller bits like syllables and individual speech sounds. As they approach school age, they start to become more aware that there are divisions within words and might start to experiment with syllables and rhyming (word endings). These broad divisions are the beginnings of phonological awareness for literacy.

Our spelling system in English is ‘alphabetic’ which means that there is a letter or sometimes a group of 2 letters like ‘sh’ that corresponds to each spoken sound. To be able to match sounds to letters for literacy, children need to be able to divide words up into individual parts, a bit like taking apart a jigsaw to see how many pieces there are. Because the first sound in a word is emphasised by virtue of being the first one you hear, children typically learn the concept of ‘begins with’ as the first step in this process. They then go on to break the word down further and start to realise that there are sounds at the end and in the middle too. It is easier for children to pick sounds out of a word if it is said on its own rather than in a sentence. There is now a lot of research which shows that well developed phonological awareness is linked strongly to later success in learning to read and write.

So, what skills does phonological awareness involve? Well, for typically developing pre-schoolers about to go into P1 or reception class, the following are core skills:

  • Attention & listening – it may seem obvious, but before we can do any form of learning at all, we need to be able to pay attention to what we hear! Related to this is the ability to listen to spoken information and to discriminate between sounds that are the same or different from one another.
  • Auditory memory – before we can start to break what we hear into smaller chunks, we must have enough capacity in our short term memory to hold onto what we’ve heard while our brains process it. Most 4 year olds will be able to remember a spoken instruction with up to 4 key parts. If you would like to look at auditory memory/attention/listening averages in more details, click HERE to go to Ellen A. Rhodes’ Auditory Developmental Scale: 0-6 Years.
  • Segmentation – when we are talking about spoken language, segmentation means breaking long strings of spoken language into smaller parts. Unlike written language, spoken language does not typically have nice, clear spaces between words. The first thing we need to do as language learners is to be able to break the speech stream into separate words. Once we have established where the word boundaries are (most typically developing children can do this well before starting school), we can start to break words into smaller parts like syllables, onset/rime and individual speech sounds.
  • Speech sound discrimination – in order to match a sound to a letter, you need to be able to hear it and know which sound it is. Some of the speech sounds used in English are clearly acoustically distinct from one another, like ‘s’ and ‘m’ or ‘k’ and ‘b’. Others are much harder to distinguish between on the basis of sound alone like ‘m’ and ‘n’, ‘s’ and ‘f’ or ‘d’ and ‘g’. Obviously, you need to know which sound you are hearing to be able to match it to the appropriate letter and therefore read and spell correctly.
  • Sound Sequencing & Manipulation – In order to read and spell, we need to know what sound a word begins with as well as which sounds follow and in what order. Another essential skill is the ability to manipulate sounds and sections of words to do things like swap a sound to make a new word (eg swapping vowels to give foot, fat, fit, fight and so on) or swap the first sound or syllable to make a rhyme, for example, if we take ‘f’ away from ‘fight’ to leave ‘ight’, we can add ‘l’, ‘n’, and ‘r’ to make rhyming words ‘light’, ‘night’ and ‘right’. Knowing ‘tricks’ like swapping initial sounds like this helps us to be more efficient in our reading and spelling.

This is by no means a definitive list of phonological awareness skills, however these are the core skills that children rely on when learning to read and write. If you are concerned that your child is not developing these skills and their speech is still difficult to understand at 4-5, then I would recommend requesting an assessment by a speech and language therapist so that any problem areas can be identified and addressed.

If you are happy that your child’s speech is developing well but you’d like to give him/her and extra boost with those pre-literacy skills, check out Top Tips for Early Phonological Awareness & Pre-literacy Skills on my website for some simple and practical ideas.

Making Speech & Language Activities Easier or Harder

I was asked recently about how to make activities easier or harder for clients. When you’re training to be an SLT or indeed working as a newly qualified SLT, this can be one of the hardest parts of the job as you often have to make adjustments on the spot. With experience this gets easier but even the most seasoned SLT will have moments where they realise a re-think is required. The bottom line is, there is no magic list of incremental steps, knowing how to step therapy activities up and down is the very essence of the specialist skills that we learn when we become SLTs. That’s what all that theory is for and one of the reasons why “Speech & Language Therapist” is a protected professional title! Having said that, understanding a few key points is helpful when doing your planning especially while you are training or in your probationary year.

Before we continue…

First and foremost, 2 important things to remember are:

  1. If a task is clearly way too hard for a child, you can just stop doing it! Better to stop and do something easier than to continue with something that sends a message of failure. If you have no easier therapy task, there is nothing wrong with just playing a game together to regain the child’s trust and build rapport.
  2. There is absolutely nothing wrong with throwing an easy task into a therapy session. It gives the child experience of success and helps them feel comfortable. So if you do find yourself with too easy a task and no way to step it up, don’t panic!

The importance of thorough and ongoing assessment

To my mind, the most important part of being able to step activities up or down for a client is to have a very clear understanding of what their individual strengths and weaknesses are. That is why doing a detailed and comprehensive assessment is always my first port of call with any client. If that takes 2 or 3 or even 4 sessions, then so be it! Therapy will always be more effective when it is based on a clear set of assessment findings.

Of course, no assessment is foolproof and an assessment only gives you a snapshot of the child’s skills on a particular day. With that in mind, constant observation of the child during therapy sessions is also essential. Their strengths and weaknesses may vary depending on external factors like the amount of sleep they had last night, the time of day, whether they’re coming down with something, perhaps they’re excited about an upcoming event and so forth. You may find that they may learn the new skill you are teaching either more quickly or slowly than you anticipated and you need to account for this too.

Planning Therapy

Obviously it best practice to plan your therapy ahead but I would advise against over-planning. By ‘over-planning’, I mean doing something like sitting down and writing a detailed plan of exactly what you are going to do in each session of a 6 week block. By all means, have an overall outline plan for the 6 weeks based on your assessment and therapy aims but I’d advise adding specifics into your individual session plans no more than one or maybe 2 sessions ahead. That means that you have your overall ‘map’ of what you are doing in the block to keep your therapy focused but you have the flexibility to alter your weekly plans session to session based on the child’s performance each time. Here’s an example of a plan that I have actually used from the start of a 6-week block.

Example Speech & Language Therapy Plan

One of my pre-block plans. As you can see, I have only done specific plans for sessions 1 & 2 of the block at this point.

Something I have not shown here is how to step up or down these activities. That’s because I know this child really well and have various tricks up my sleeve based on my previous experience as an SLT and with this child in particular. And here’s the rub! As I said at the start, I cannot give a definitive list of what to do to make things easier or harder for clients because that list will be different and individual for each child. However, I can share the key things I take into consideration when planning and working out how to step activities up or down. These are:

  1. What CAN the child do? Are there stronger areas of their language/speech processing that we can use to support weaker areas?
  2. What is the child likely to find more difficult but still achievable?
  3. What scaffolds can I use to support learning of more difficult skills? (Modelling, visual supports, signing and so on) How will I fade out the use of these scaffolds?
  4. What things are going to be outside of the child’s current skill set developmentally?
  5. What things are going to be outside of the child’s skill set based on their disorder?
  6. Given each activity I have planned for the next session, how can I make each activity one step easier or harder based on what I know of the child and the answers to questions 1-5?

Obviously keeping accurate notes of your sessions comes into its own here because you can then use the information you recorded to see how the child did, which supports worked and which supports you can try fading out next session.

I hope that this is helpful for those of you having trouble with stepping up and down. You are not alone! If you have questions about specific clients, do feel free to email me at I will get back to you as soon as I can but do bear in mind it can take a couple of weeks!


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!

New Resources!

As I have recently started working with more clients who need support with thinking & reasoning skills, I decided it was time to splash out on some new resources. In previous jobs, I have used Super Duper Learning Fun Decks from the US a lot, so I decided to get a selection from the lovely people at Taskmaster (the UK distributor).

A selection of Fun Decks to develop reasoning and social skills.After a good road test with some discerning clients, I can say that all of the packs have been a great success but particularly ‘That’s Silly’, ‘What’s Wacky’ and ‘What Are They Asking?’. Children love the bright, funny cartoon drawings and there are a variety of simple card games that can be played with each deck. Instructions are included with each set and the cards come in a hard-wearing tin for safe storage. The cards are very versatile in that they can easily be used with a group or an individual. The only slightly negative thing I’d say is that some of the language and pictures are very American (eg Pictures of Thanksgiving or use of words like ‘daiper’ or ‘sidewalk’). However it is easy either to translate, teach your child some new vocabulary or simply take the USA-specific cards out of the pack when you play.

Take a look at the Taskmaster website to see the full range of Fun Decks!

Top Tips for Pre-Literacy Skills & Phonological Awareness

What is Phonological Awareness?

‘Phonological Awareness’ basically means the awareness of how words can be broken down into parts and how sounds can be put together to make words. Phonological awareness is essential for literacy. Most young pre-school children are aware of words as whole chunks that help them communicate with others. They are not typically aware that each word is made up of smaller bits. As they approach school age, they start to become more aware that there are divisions within words and might start to experiment with syllables and rhyming (word endings). These broad divisions are the beginnings of phonological awareness for literacy.

Why do we need Phonological Awareness for Literacy?

Our spelling system is ‘alphabetic’ which means that there is a letter or sometimes a group of letters (like ‘sh’) that correspond to each spoken sound. To be able to match sounds to letters to read & spell, children need to be able to divide words up into individual parts, a bit like taking apart a jigsaw to see how many pieces there are. Because the first and last sounds in words are emphasised by virtue of being the first & last sounds you hear, children typically learn to pick these out first. They then go on to break the word down further and start to realise that there are more individual sounds in the middle too. There is now a lot of research which shows that well developed phonological awareness is linked strongly to later success in learning to read and write.

This sheet gives you some suggestions for some simple phonological awareness activities that should fit easily into everyday activities and routines. You will not need to find a ‘special time’ to do them.

Top Tips for Pre-Literacy & Phonological Awareness

The Small Business Marketing Minefield!

This article is aimed at anyone wanting to set up as an Independent SLT or, for that matter, any small business. When you set up a small business you instantly get bombarded by people offering all kinds of ideas about how to market and advertise your business. From friends & family to cold-callers, it seems everyone has an idea about how you should advertise your services! In my experience, and I don’t think I’m alone here, it is pretty overwhelming and at least one of the following things will happen to you:

  • People will endlessly suggest that you should pay to put an advert in a publication of some sort.
  • People will repeatedly ring you up offering (sometimes quite aggressively) to get you to the top of the first page of Google for ‘only’ £90-100.
  • People will ring you up asking if you would like to write a short article for their publication. In the next breath, they will tell you that they will charge you anywhere between £200 and £3000 to print it.
  • People will ring you up asking if you want to be one of only 10 (or other random but small number) of people of your profession listed in their industry-specific directory. Again, there will be a significant cost associated with this.

Chances are, if you are starting a small business, you will have a VERY small or non-existent marketing budget, so what do you do? Well, my first piece of advice to you is to talk to one of the business advisors at your local council (free!) and to book onto some of the Business Gateway (called Business Link south of the border) training courses (also free!) that cover marketing. The first one I did was called ‘Marketing on a Shoestring’ and it was a brilliant intro into all of the free or very cheap things you can do to market your business. Business Gateway also run more specific courses on building websites, using social media for marketing and optimising your website so that it’s found by Google & the other search engines. These courses are useful once you’ve got your marketing plan of attack together.

My second piece of advice is do not pay for anything unless there’s a REALLY good reason to do so! While there will be a few carefully considered things you will want to pay for at the start, like a web domain name and a well designed brand identity, there are literally hundreds of things you can do for free to get you started. One of the things I learned from Marketing on a Shoestring is that, by and large, adverts in newspapers and magazines are expensive and they really don’t work very well. If you really do want to try it, make sure you have a way to count up the business it brings in and do the sums! Did you gain enough new business to make back more than the cost of the advert? If not, it wasn’t worth it!

My third piece of advice is to ENGAGE WITH SOCIAL MEDIA! Facebook or Twitter might not be your bag but, like it or not, social media is MASSIVE and it’s free to use! Click here to check out a pretty mind-blowing YouTube video citing the 2013 statistics relating to social media. Seriously, if you want to market your business, you can’t afford to ignore the social media explosion. Having said that, it can be tough not get overwhelmed by all the different options and it’s easy to get sucked in to spending half your life on Facebook/Twitter/Google+ etc, etc. Therefore it is really important to consider which social media channels you are going to use and to have a clear plan of how you intend to use them and how much time you’re going to devote to it each week. Doing one or more of the Business Gateway/Business Link social media training sessions will give you some really good guidance and support to help you get the best out of using social media for business without losing days of your life to it!

My fourth pearl of wisdom is that you really need to build yourself a website. Like it or not, most people nowadays go straight to Google if they’re looking for a service or product, I know it’s always my first port of call. There are many different free platforms & templates out there that you can use to build yourself a website, from something really simple to a pretty complex affair depending on how confident you feel about doing it yourself. Of course, you can pay someone to do this for you and, depending on your skill and confidence levels, this may prove more cost effective than doing it yourself. Just be aware that it’s not actually that hard to get something simple up and running yourself for free if you do have a limited budget. I’m very lucky to have a dedicated and talented husband who has helped me to set this one up. We found that there are loads of YouTube videos and forums to help you understand how to use the various web platforms, so you needn’t be stuck. Once again, I’d strongly advise a Business Gateway course or two to learn about the basics of building a website and optimising it so that it gets found by the various search engines. While you can pay the £90 to be put in the advertised links at the top of the search page if you like, you can also do many FREE things to optimise your website so that it appears on that first page anyway. And, I have to say, as a regular Googler, I tend to ignore the paid for links anyway as they’re often less relevant than the organically generated list below. I’m sure I’m not alone there. Do be aware, however, that the things you do to help your site appear on the first page of search results can take a few months to kick in so don’t lose heart! You’ll get there!

As a fifth suggestion, I’d say it’s a good idea to get yourself listed on any relevant free listings websites that you can. Apart from giving you extra hits in searches, it also helps optimise your website to be found by the search engines. The likes of Yell and Thomson Local are a good place to start. You may also find that organisations relevant to your industry have directories that you can get a listing in for free, for example, I have a listing in the National Autistic Society’s services directory. Again, if you feel the need, there’s nothing to stop you paying to be included in one of the published directories if you want to, I’m just saying to think carefully about it’s coverage and to be aware that there are lots of listings you can get for free first!

Finally, the cold calling that probably irritates me more than all the rest is when someone calls me saying that they have a ‘feature’ on something relevant to my business in their publication and would I like to write a little editorial to go in. In the next breath they tell me it’ll cost me £300 (or more!) for the privilege. Not being bad, if I’m going to spend my time writing such an article to do someone else a favour by filling their editorial space, I think it’s more appropriate that it’s either free to publish or THEY need to be offering to pay ME! To be fair, articles telling people about what you do can be a good way to raise awareness of your business though, so it is worth looking around to see if there is a relevant publication that will be happy to publish a little editorial for you for free. As a starting point, your local council business development team will probably have a free magazine promoting local businesses which tend to have a wide circulation to small businesses local to you. Often they’re more than happy for you to send in a little profile of your business which they’ll publish for free.

So there’s my 2-penneth starters for 10 about marketing your business for not much money, I hope it helps you. Definitely get yourself along to your local council business advisor as soon as you can and see what free training is available in your area before you even start! Good luck!

Looking After Your Back

Like many other speech & language therapists, teachers, classroom assistants and anyone who works with little people, I have had my fair share of back problems. Shortly before I started Blethers, I had my worst ever attack of back pain in the form of a bulging disc and the accompanying sciatica. As anyone who has had the same will tell you, the pain is excruciating, relentless and utterly debilitating. The good news is that it does usually get better. I’m back to normal now, but it takes months and, for some people,  years to feel normal again. I have written this post because I want to help you avoid the nightmare that is a bulging disc if I can!

We often spend our days working at low tables, sitting on chairs that are designed for children, working on the floor and humpfing heavy bags of files/resources around. This will hurt you eventually! The good news is, there are a couple of really simple things you can do to help yourself avoid destroying your back!

If you work for an organisation, you will have mandatory manual handling training. Yes, no-one likes having to make space in their diary to do this but it is important. Get along to it and make sure you get information about your back, how it works and how to avoid hurting it. What you’ll learn applies to all of your life, not just work. You will also have an occupational health department and it’s worth getting their advice on setting up your computer and desk space in the best possible way. If you don’t work for an organisation, do a bit of research or speak to a consultant to find out about these things.

A photo of Isla's kneeling stool in the Blethers mobile therapy roomThink out of the box about low seating options. When I was furnishing the mobile therapy room, I wanted some options that would help me maintain a good posture at a low table or when working on the floor. I have ended up with a Bhuddist prayer stool! It’s basically a little kneeling stool which puts you in a really good posture and takes the stress of kneeling off your knees. These sorts of stool are available from all sorts of places but mine came from Blue Banyan – it was inexpensive and it’s very well made.

I’d also recommend investing in wheelie case or a good backpack to carry your stuff around in if you’re out and about a lot. You’ll still have to be careful lifting it in and out of your car and carrying it up stairs but it will take a lot of strain of your poor, abused back. Also, don’t be afraid to do 2 trips to your car if you need to. I know we’re all busy and don’t want to waste time but if you hurt your back you could end up in extreme pain and off work for months. It’s worth taking those extra 5 or 10 minutes!

Make a pre-emptive strike and strengthen your back and core by getting along to a pilates, yoga or Swiss Ball class. If your back & core are strong, you’re less likely to get injured in the first place and, if you do, you’ll recover more quickly. As an added bonus, you’ll meet new people at your classes and have a bit of fun while you keep your back in good shape!

Finally, if you do get twinges in your back, don’t delay and make excuses, GO AND SEE A PHYSIOTHERAPIST STRAIGHT AWAY! There are many physios out there and do bear in mind that you may need to see 2 or 3 before you find one that can help you. Personally, I can recommend the services of Taylor Physiotherapy for proactive and effective treatment.

Look after your back and it will look after you!

Communication Games 6 – Slinky

A slinky is is a really engaging sensory toy which works well with a wide range of children. There are many different sorts of slinky on the market nowadays, from rainbow coloured plastic ones to traditional metal ones to miniature ones. Keep your eyes peeled in toy shops and gift shops!

Various rainbow and metal slinkies

Most often, I use my slinkies for:

  1. Reinforcement – I find lots of children who are learning to use PECS (Picture Exchange Communication System) enjoy a slinky and it motivates them to exchange their picture for a go with it.
  2. Eye contact – As well as waiting for eye contact as a request for a turn with the slinky, you can have some fun looking down it at the child you are working with. It looks pretty inside, especially if it’s a rainbow slinky, and you get eye to eye contact. if you would like to learn more about basic, fundamental communication skills like eye contact, please have a look at my post titled The Fundamentals of Communication.
  3. Parallel Play - This is the stage in play development where a young person is happy to play alongside but not actually with someone else. Slinkies are good for developing this stage as it is easy to have one each and for the adult to begin engaging with the child by copying what they do with their slinky.
  4. Concepts – because you can stretch the slinky out to make it long & let it spring back to make it short, it is very useful for working on these concepts. I do this a lot if I am teaching the concepts of long & short in preparation for phonology work with children who ‘stop’ fricative sounds like ‘s’ or ‘f’ and say plosives like ‘d’ or ‘b’ instead.
  5. Verbs – Finally, slinkies are great for developing understanding and use of action words like ‘stretch’, ‘bounce’, ‘see’, ‘pull’, ‘wobble’, ‘wiggle’.