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!

Language Building Apps for iPads and Tablets

Arguably slow on the uptake, I have just discovered the Splingo group of apps from the Speech & Language Store. I’m glad I found some time to look into Splingo as the apps have already been a big hit with several of my clients!

Designed by speech & language therapists, Splingo is a set of apps aimed at teaching children at developmental levels of around 18 months – 4 years the following core language skills:

Splingo’s Language Universe – Understanding instructions with 1, 2, 3 and 4 Information Carrying Words (post explaining ICWs coming soon…) plus listening and attention. This App also targets understanding and using different types of word – nouns, adjectives, prepositions and so on.

Actions with Splingo – Understanding and use of action words (verbs).

Pronouns with Splingo – Understanding and using pronouns like she, I, them, we and so on.

Categorisation with Splingo – Categorisation of vocabulary and building links between word meanings.

Screenshot from Categorisation With Splingo app by Speech & Language Store

Screenshot from Categorisation With Splingo

As the adult, you can set up the apps at the appropriate level of complexity for your child, you can even choose between an American or British voice. I love that last feature as so many language apps are very Americanised!

Each app sets up a series of instructions based on the areas you have specified (for example, using and understanding the pronoun ‘she’) and your child works through the activities in a game format with integrated rewards. The animations and characters are attractive, fun and motivating for children.

Screenshot from Pronouns With Splingo app by Speech & Language Store

Screenshot from Pronouns With Splingo

The learning apps are available for anyone to use, although it’s probably worth getting some advice from a speech & language therapist or teacher first, especially if your child has any sort of additional needs. If you are reading this as a speech and language therapist, I should point out that there is also a Splingo Receptive Language Assessment App which is available for use by SLTs. So far, I have found this extremely useful, particularly for clients who have limited attention for picture-based activities and especially those who are unable to accept enough direction in their play to be assessed with toys.

At the time of writing, all Splingo Apps are available from the iTunes App Store and you can find Splingo’s Language Universe and Pronouns with Splingo on Google Play. Of course, if you would like some advice on using any of the Splingo Apps with your child, feel free to contact Isla at Blethers, email is usually the best way to catch me: blethersslt@gmail.com

Remember, you can find out more about Splingo from the creators, Speech & Language Store!

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.

Special Needs Friendly Summer!

As the summer holidays are upon us, I thought I would make you aware of a couple of special needs friendly summer activities that are on offer in East Lothian and Edinburgh. Please feel free to send me a comment or a Facebook message if you know of anything else I should include! This is by no means a definitive list!

  • Odeon Cinemas offer monthly autism-friendly screenings for children, you can find the schedule on the Odeon website – CLICK HERE
  • If you have a family member who is a wheelchair user, did you know you can access the beautiful beach in North Berwick with a special beach wheelchair loaned free of charge from North Berwick Beach Wheelchairs? You will find them at the Beach Hut on North Berwick Harbour, just behind the Scottish Seabird Centre or CLICK HERE to visit the website.
  • Sticking with the beach theme, Coast 2 Coast Surf School welcome special needs groups to their surf school. What a great opportunity to get your kids accessing the sea safely! CLICK HERE to visit the website.
  • The Scottish Seabird Centre also welcomes children with special needs of all kinds and provides an interesting day out for children and adults alike. CLICK HERE to visit the website.
  • If animals are your child’s thing then a visit to East Links Farm Park is always good fun, CLICK HERE to visit the website for more information.

Have fun and stay safe!

Summer Sunset North Berwick, East Lothian

 

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 info@smart-mnd.org 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.

Blethers Meets the Tall Ship in Leith

I was quite amazed when I turned the corner at Ocean Terminal in Leith and was confronted with the sight of the majestic ARC Gloria tall ship staring back at me. I’m sure you will agree that she is an impressive ship and her Colombian flag is particularly huge! I believe she is owned by the Colombian military and is in town for the Tattoo. I recommend popping down to Leith for a look, she’s a pretty impressive beastie. The Scotsman have published a wee report if you want to find out more, click here.

Tall ship, ARC Gloria in Leith docks with a REALLY BIG Colombian flag

ARC Gloria in Leith docks with a REALLY BIG flag.

High Praise Indeed!

I really should be writing a report just now but I felt the need to share a positive review from a 3 year old customer of mine! As anyone who works with children will tell you, pre-schoolers are a tough audience to please so it’s always nice to know when you’ve got it right. The mum of the child in question emailed me toady to say that she had asked him what his favourite thing to do at nursery is and the answer was ‘play with Isla’.

Another happy customer then! 🙂

Sleep is Key to Learning

Here’s an interesting bit of research about the importance of sleep for learning. There is a growing body of research which shows that sleep is essential to human learning although no-one really knows specifically why this is the case. The University of Sheffield recently published the results of their latest study on the topic of sleep and learning which focused on babies of around 12months old. They found that the babies in the study were much more likely to learn a new skill if they had a nap soon after their first attempt at it. Clearly this has many implications for how we work with our children and teach them new things. For one, it really underlines the importance of doing things like reading (or indeed your child’s speech therapy homework!) just before bedtime.

Quite rightly, the researchers were keen to point out that their finding was that sleep soon after learning is constructive for learning new skills. No-one is saying that you should learn new things when you are tired, more that ‘sleeping on it’ may be more helpful than we might first assume.

You can find the full article on the BBC website by clicking on the following link: Regular naps are ‘key to learning’ and now I’m off to consolidate my learning….

Isla doing some on the job learning!

Isla takes time out to do some ‘on the job learning’!

World Autism Awareness Week 2015

March 27th – April 2nd will be 2015’s World Autism Awareness Week and various events will be taking place across the world in recognition of this. To my mind, autism is a state of being that you cannot recognise from the outside and brings with it disabilities that are not obvious simply from looking at the person. Our society is getting better at recognising and accommodating disability but I feel very strongly that ‘invisible’ disabilities like autism, Asperger’s and ADHD are still very poorly accommodated by society. This is our opportunity to change that!

Ready for Onesie Wednesday Autism Awareness WeekI shall proudly be wearing my onesie on Onsie Wednesday on 1st April (no, that’s not an April fool!) and I’ll be making an effort to make more people aware of autism spectrum disorders and what they are. Let’s start with some interesting facts!

  1. Autism comes in many forms so no two people who have a diagnosis are the same. Most now agree that autism is a spectrum rather than one distinct condition. The best description I have heard is that autism is a bit like a 100 piece jigsaw. To get a diagnosis on the spectrum, you would have 80-100 pieces of the puzzle but everyone has at least 15-20 pieces! People who have many of the pieces  but not enough for a diagnosis might be considered to have an ‘asperger’s personality’.
  2. According to current estimates, there are about 700 000 people in the UK who have one form of autism or another. That’s one in every hundred people! (Source – The National Autistic Society)
  3. While many people on the autism spectrum have special interests (anything from volcanoes to Thomas the Tank Engine!), only a very small proportion (about 10%) have what society calls a ‘special talent’. That means 90% of people with a diagnosis ARE NOT like Rainman!
  4. Unfortunately there is an unacceptably high risk of bullying for people on the autistic spectrum. The National Autistic Society quotes a figure of over 40% of children with autism being bullied at school but I have seen much higher statistics such as 70% of people with Asperger’s Syndrome (a form of high functioning autism) experiencing bullying.
  5. You can’t tell that someone has autism from looking at them. It is an invisible disability. The next time you meet someone who doesn’t look at you, stands to close or seems socially awkward, please don’t dismiss them as ‘weird’, ‘rude’ or ‘arrogant’ straight off. Take time to wonder “does this person have autism?”. Next time you see a child having a full scale tantrum in a shop, don’t judge and dismiss it as poor parenting, naughtiness or spoilt behaviour. Take time to wonder “does this child have autism?”.

You will find many, many more interesting facts and statistics on the National Autistic Society’s website. Go ahead, educate yourself!