My final week in Kisumu with Yellow House

By Catherine Clancy, Speech and Language Therapist


Unfortunately, I fell ill at the beginning of this week and it took me some time to get back to my usual self. However, I was able to attend a Communication Camp that had been organised by Yellow House to support parents of children with Cerebral Palsy. This post will be focused on the content of the camp and how Yellow House are raising awareness of cerebral palsy and empowering parents to support their children.

On the left is Florence and the right is Duncan (with Gregory translating), who explained what communication is and ways in which children with cerebral palsy can successfully express themselves when speech is unclear or not present. The communication house is a lovely way to understand the foundations that need to be put in place before you can expect a child to understand spoken language, and then begin to express themselves using gestures and speech.


There was a specialist talk from an Occupational Therapist who discussed ways parents can support their child’s fine and gross motor skills through daily exercises. Here, John is demonstrating how to support a child’s ability to stand with support.


Here are some of the toys that the parents made for their children using those materials that are easily accessible to them – a very creative way of recycling waste into something kids can enjoy!


Whilst the parents were busy attending the talks within the camp, the children were taken into a separate room where they had the opportunity to play, sing and dance – it was a lot of fun and it was lovely to see the supporting adults interacting so freely and easily with the children – the children were in their element!


After the camp and on my final day, I said bye to a client and his mother who has been supported through the use of Alternative and Augmentative Communication (AAC). A symptom of cerebral palsy for this client is stiff muscles and exaggerated reflexes (spasticity). Unfortunately, this means spoken language is extremely difficult for this boy and direct access to a communication board (e.g. pointing to a picture) is not possible. For this reason, eye gaze (looking at the picture) has allowed this client to communicate a preference when given a choice. This has given the mother a new way to communicate with her son and the joy that this brings to the both of them is wonderful to see!


My time working with Yellow House has been eye-opening, rewarding and enjoyable. I have met a team of people who are raising awareness of speech, language and communication needs in Western Kenya and are working hard to support children and their families. The stigma around disabilities is still very much present and during the camp many mothers expressed their sadness around the fact that friendships and relationships had ended simply because they had a child with a communication disability. However, seeing these parents come together and pro-actively learn about their child’s condition and how to best support them was very inspirational, which is heightened by the fact that these families are doing their best to integrate their children in their communities to reduce social stigma and normalise their child’s differences.

Goodbye Kisimu!

Goodbye Kisimu!

It has been lovely to see parents and families so invested in supporting their children.

By Catherine Clancy, Speech and Language Therapist


Week 3.

29.07.19: On Monday I spent the day at Russia working with the team to complete a triage. This is to support the management of new referrals who are seeking support for their child. Here, I completed case history questionnaires to find out the child’s strengths and difficulties, and as a team we discussed how to prioritise the new referrals seen. There are many people seeking support from Yellow House which can unfortunately mean long waiting times for clients to be seen. However, the triage gave us the opportunity to meet face-to-face with families and offer advice.


01.08.19: It’s August already! On Thursday I continue to see clients for their weekly therapy sessions. Above are some of the resources I made with the team to help children express their wants/needs and interests if they are finding spoken language difficult. When lunch time came around I thought I would try something new and ordered the local vegetables with chapati and beans – YUM!


30.07.19: On this day I continued to see clients for their weekly therapy sessions. The picture above shows a mother supporting her child through parent-child interaction strategies that aim to promote language development. The mother was focusing on following her child’s lead and using 1-2 key words to comment on her play. Videoing was used as a therapeutic tool to empower the mother to continue using those strategies that she used positively to support her child.


31.07.19: How was it Wednesday already?! (the weeks fly by!). I travelled to the EARC centre and continued seeing clients for their weekly therapy sessions. The photographs above show parents interacting with their children and supporting the use of low-tech augmentative communication. For these children, they were unable to communicate successfully using only speech and therefore a total communication approach has been adopted where we are using speech, gestures, key signs and a communication board to help them express their wants/needs/interests etc. Parental education is fundamental to the success of therapy as parents have to feel invested and motivated to use the strategies advised by us in order for therapy to have positive outcomes. Fortunately, both parents are open to learning to ways to communicate with their children and they are now aware that the belief ‘signing/pictures with stop my child from talking’ is only a myth!!


This week has been empowering and also eye-opening. It has been lovely to see parents and families so invested in supporting their children as ultimately, they are the experts on their child and have the opportunity to make the biggest impact - I have found videoing a great way of supporting this! However, the policies and procedures within the care system are very different to those we experience in the U.K. and it has required me to adapt a very flexible way of working to continue supporting children with the limited access to resources and early interventions.

My second week working for Yellow House

By Catherine Clancy, Speech and Language Therapist


19.07.19: On Friday I said goodbye to Maggie, one of the volunteers who has spent 10-weeks working with Yellow House Health and Outreach Services as a Speech and Language Therapy student from Torono University. It is great when students complete their clinical placements with Yellow House as it is a fantastic opportunity for clinical development, not only for the students but for the team themselves.


23.07.19: David (one of the Senior Speech and Language Therapists employed by Yellow House) and I spent the day working in the Speech and Language Therapy clinics situated within Russia, a hospital in Kisumu which is government funded. Here, I was working with children and their parents with a focus on augmentative and alternative communication (AAC). This is about supporting children and their families to implement other forms of communication which is building on the child’s strength. An example might be using key word signing alongside speech as well as supporting the child to communicate through symbols on a communication board. Parent education plays a critical role here as it is vital for parents to be invested in the therapy for it to prove beneficial for the child!


The team work alongside other professionals in the hospital including occupational therapists who support patients in their own clinic (see picture above).


24.07.19: I travelled from Kisumu to the EARC (assessment and resource) centre on a matatu (local mini bus) which takes around 45 minutes. Here, I saw more clients for therapy, again focusing on the use of AAC. I incorporated the use of videoing with parents to support their interactions with the children and it was lovely to see parents getting down on the floor and supporting their child in the best way they knew how. After a busy morning, Duncan (one of the Speech and Language Therapists employed by Yellow House) and I enjoyed a local lunch of chapati, skumowiki (green vegetables) and green grams (lentils) – it was delicious!


26.07.19: After another busy day supporting clients from Russia, I went back to the office and caught up on paperwork and resource making. This is the office for Yellow House and where the team carryout all the administrative duties, including planning for communication camps – this is when they invite children and their families to a 2-day training camp where they learn all about different diagnoses, the impact on communication and how to support their child using a total communication approach.

My second week on working with Yellow House as a speech and language therapist has really allowed me to get ‘stuck in’ and see clients and their families for therapy. However, it has been essential for me to collaborate with the therapists working for Yellow House to support their clinical development and to ensure the interventions I am suggesting are realistic and functional for this setting. It has been great to learn from the team working here and I hope that I have supported them to feel more confident using AAC within their own practice!

My first week in Kisumu, Kenya

By Catherine Clancy, Speech & Language Therapist


14.07.19: Just before I flew out to Kisumu! 


23.07.19: My first day! I visited Russia, the hospital in Kisumu where Yellow House support clients with speech, language and communication difficulties. This is where I had a lunch of chapati and cooked greens during my lunch-break.  


24.07.19 The Educational Assessment & Resource Centre (EARC) in Vihiga, a 45-minute journey from Kisumu on a Matatu. Here, I supported assessment for new referrals to the service. 

I have had a busy but very eye-opening and rewarding first week with Yellow House! It was lovely to hear from families about how the use of Alternative and Augmentative Communication (AAC) has given them a new way to successfully communicate with their child. Recently, a client with cerebral palsy was taught to communicate using eye gaze with a symbol communication board and the mother has been overjoyed with how this has enabled her to talk with her son which for the past 8 years has not been possible. This mother is very proactive and supportive of her son and does her best to raise the awareness and acceptability of disability in her local community by ensuring her son is treated with respect, compassion and integrity. 

WARNING! The following blog will make you sing a song in the supermarket when you see a BUCKET!!!

By Wai Seng Thong (Speech and Language Therapist)


What is Attention Autism?

One of the things I love about visiting schools is the expressions of joy on the faces of the children I work with. When they know it is bucket time some children can barely stay sitting down. In case you have never heard about Attention Autism, it’s an intervention designed by Gina Davies, Specialist Speech and Language Therapist, aiming to develop natural and spontaneous communication through the use of visually based and highly motivating activities for children with Autism Spectrum Disorders (ASD).

Attention Autism is one of my favourite activities as it makes learning fun and memorable for children. Before I start, NO you don’t need to be an X Factor level singer, but you do need to be able to hold a tune as this helps the children sing along. You also need to prepared to collect strange and fun toys to make the activity differ from week to week. I tend to use eBay and pound shops to add regularly to my collection.

All you need to do is have fun, as it engages the kids with your activity. If you are engaged, they will be too. It’s all about engagement, fun, motivation and showing them something worth communicating about.


Benefits of Attention Autism

Attention Autism is a regular part of my week. In the school I work in the children are always desperate to know what is in the bucket and jump up and down trying to look inside (this makes me think of children trying to take a sneaky peak in Santa’s toy bag on Christmas Eve!).

What is fascinating about this programme is that it sparks their curiosity and therefore creates reasons for them to communicate by asking questions, commenting and guessing what might be coming out of that mysterious bucket. From my experience of using this programme, it does not merely work on the children’s attention and listening skills, but also on their language skills (both receptive and expressive language skills). These can be a challenge for children with ASD. The sessions can be tailored to build on their vocabulary knowledge, for example, they can be themed around dinosaurs or superheroes etc.


What a session looks like and example activities

A myriad of themed activities can be incorporated into an Attention Autism programme. For example, bucket time can be filled with dinosaur toys (from sensory to wind up dinosaur toys etc).

I start with the song, ‘I’ve got something in my bucket, in my bucket, in my bucket. I’ve got something in my bucket, and I wonder what it is. Let’s look and see!’. The children sing along transfixed on the bucket, wondering what might be inside. Just a warning this song will take over your mind and at times I can hear it when I am mopping the floor or shopping! You then demonstrate the toys one by one and the idea is the kids watch, pay attention and do not touch. Hard to imagine, but it is surprisingly easy to achieve when following the attention autism programme.

The activities ‘Sleeping dinosaurs’ and ‘Roll the dinosaurs’ involve the children pretending to be asleep and rolling each other along the floor and more song singing. There are also more hands-on activities where children make dinosaurs with Play-Doh or arts and craft materials with big googly eyes. My kids love it all!

Useful tips when running an Attention Autism group

Always remember these useful tips when you are running an Attention Autism group:

•       Say less.

•       Use lots of pauses.

•       Exaggerate gestures and facial expressions.

•       Give time for thinking and stay quiet!

•       Show first then add words.

•       Have a clear idea of your objective.

•       Make sure your activity is the most exciting thing in the room! Cover up or remove distractions.

•       Turn disasters into ‘part of the plan’. It doesn’t matter if it doesn’t work out, this is a great way to model ‘uh oh’ and ‘oops’ etc.


As Gina Davies says: ‘let’s create an irresistible invitation for learning’. Attention Autism principles can be generalised into curriculum activities, for example, literacy and numeracy to facilitate learning and skills development.

Let’s really think about the activities we plan for kids. Is the activity irresistible? Is our activity worth communicating about? Fun and engaging activities create good memories. Let’s create a shared experience that is memorable and share laughs with our kids to help them learn.

For further information and more ideas on Attention Autism, take a look at these:

Facebook page - Gina Davies Autism Centre



Social Stories Help Reduce Anxiety in Children with Autism

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By Sarah Kassam-Hirji - Speech and Language Therapist

Social stories are exactly what their name suggests; very short and simple stories that illustrate a particular social scenario, often in picture format. They aim to help increase a child’s understanding of how to behave and what is expected of them in a given social situation. 

Visual strategies are highly effective tools to support language skills, and social stories can provide support to help children who struggle in social situations.  Examples may be using a social story to help a child line up, lose a game or stay in bed through the night.

It is important for a social story to be short and focused to keep the child’s attention. They are frequently used with children on the autistic spectrum to help them understand social cues and reduce anxiety, especially in unfamiliar settings.

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A social story should provide the basics of what will happen in that setting/situation, and how the child should ideally behave.  The idea is to write out exactly what happens and why, how it makes the child feel and the expected response.  Symbols are used to show these language concepts, but for some children it can be useful to have photos of themselves in the situation as well.  

As with all things in life, there will be unexpected variables that a parent/caregiver won’t be able to control for, but the story should provide a basic foundation of support and understanding.  

Key points to remember when writing social stories:

  • target one specific situation at a time

  • keep language simple

  • keep it positive

  • remain consistent

  • Children thrive on repetition and learning takes time

My experience has been that all children with language difficulties benefit and respond really well to the visual cues and prompts that are provided within each story.  We all struggle at times with how to behave in social situations and social stories can help give a child the ability to maintain emotional wellbeing as stress and anxiety are reduced when understanding increases.

A story that I have used time and time again with my children is ‘When I’m Frustrated’. Please note that the word ‘frustrated’ can also be substituted for ‘cross’, ‘upset’ or ‘mad’ – whichever the child will relate to best.   The story helps support understanding of the emotion of anger and has been useful across many social situations.  In general, emotions are difficult to understand and explain, and stories that help target emotions in relation to stressful scenarios can be very beneficial.

This story in particular illustrates the idea that sometimes situations will make us feel upset or angry, but there are different strategies that we can use, such as counting or breathing, that can help regulate our feelings once again. This then helps us return to the social situation and ask for what we need.  It also shows that these feelings pass and that we will feel better soon enough.

As  a wellbeing expert and speech and language therapist, this is a vital story for me to use with children that struggle with maintaining and regulating emotions when social situations become highly stressful for them. I believe stories that help children understand emotions can really impact how much a child continues to be motivated for peer engagement. This can then help develop other key skills such as turn taking and problem solving.


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By Sunita Shah - Service Lead for North West London and Specialist Speech and Language Therapist in Bilingualism

Early Intervention is Key

Who Am I?... My Reflections...Reality

I have been a practicing Speech and Language Therapist for over 20 years; and an Author; a mother of two crazy boys aged 18 months and 5 years. Oh, how my practice changed overnight seeing the other side.  Before eyebrows would be raised if patients were late or if homework was not done but seeing the other side of the coin of what parents must do in their daily routine opened my eyes.  I simply ‘’’respected my parents for getting to the appointment to support their child. I remember the first day back at work I saw a child who had transferred to our Trust the child’s mother had left; the father had special needs and the child was severely Autistic and nonverbal at 4 years old.  The family were homeless; as soon as they left the clinic, the waterfall of emotions took hold.  Suddenly it was not about the hour in clinic supporting the child’s communication it’s the reality of what the parents experience 24-7.

My degree was intense but fascinating. I am so blessed to have worked with such wonderful children and amazing parents.  I once read “A child with special needs does not come with a manual... it comes with a parent that does not give up”.  I studied for over 3 years too gain my qualification as Bachelor of Science in Clinical Language Studies (Speech and Language Therapy).  I studied so many modules within the course, Child development, child psychology, neurology, various therapy models etc. I was fortunate to work in the NHS system for over 20 years and gained so much knowledge, skills and experience which I feel so grateful for.  I left public sector in 2017, and now work independently.  This was an extremely hard decision to make but I have enjoyed life post NHS so much.  The flexibility to not follow unrealistic expectations, KPI’s, endless growing waiting lists for assessment and therapy.... to give the family the type and frequency of intervention they REALLY need, which makes a difference... and quicker.... Early intervention is key.

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Has Social Media Made A New Breed of Health Care &Education Professionals?

 I have been following various national and local groups on social media for parents. It’s a humongous network that supports parents in so many ways, from advice on sleeping, toilet training, weaning, behaviour, chicken pox, and overall development etc. There is nothing like having support from another parent about what they have gone through.  For many parents this is the first point of call.  Within the network there are parents who are Health Care Professional too.  It’s that comfort factor, to put the anxious parenting mind at ease.

My Concerns... Because I Care

Recently I have started to get slightly alarmed with some responses especially regarding communication development. Over a year ago I saw a parent who came to me when their child was 3 years old, it was evident this child had severe communication needs. I asked the mother when she started noticing when things were different the mother replied from 10 months old.  I asked why she waited so long, she reported she followed advice from her NCT friends and other people to just let him develop and in time the child would talk. The mother missed 18 months of vital intervention which would have made such a difference. I’ve seen this on several social media posts recently when people are asking about communication advice, a child of 2 years SHOULD be talking, if there are not they need support. Please see the ages and stages section on my website: Using the wait and see approach can miss vital months of support. Also, children have come to me at 4 years old with severe stammers, they started stammering at 2 years old.... why refer now? The parents said they waited as they thought the child would “grow out of it” .... no… again Early intervention is key. If you are concerned particularly about your child’s communication consult your Children’s Centres, GP’s Health Visitors, Early Years consultants, they are all very experienced, and they will always support you in the steps to taken.  Always remember the walk-in clinics and 111.

I see so many pictures of children’s rashes and suddenly the world of social media can be quick to diagnose, but in a quick snapshot post there is no medical history taken how can advise be given on what to do, when the child’s rash may look the same as what your child had, but the child may have other health concerns or allergies to take into account.  A parent has the most unique gift called “Gut instinct” parents never under estimate this. You know your child more than anyone in the world, if you think there is something wrong.... see a professional.  Please do not wait.

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Use Your GUT instinct... Don’t Always Wait and See....

I guess what I’m trying to put across is although there is a place for support on social media... and some useful articles and advice, please be vigilant... The people of social media are not all qualified Health Care Professionals, go with your gut instinct. Also remember Early Intervention is key.  Certain advice I have seen from members on groups goes against what we practice as clinicians and concerns me. Medical and development histories are very important in the treatment and diagnostic process.

Keep doing what you AWESOME parents are doing.... it’s the best gift in the world being a parent and it’s our job to make sure our children stay happy and healthy.

Makaton: signing your way to successful communication

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By Eleanor Harris - Director of Magic Words Therapy and Specialist Generalist Speech and Language Therapist

Want children to understand you better in the classroom? Increase your gesture and use key word sign!

As a Speech and Language Therapist working with children with Speech, Language and Communication Needs (SLCN), I use key word signing whenever I speak to my clients to help to support their understanding. I also use key word signing to scaffold their spoken sentences, cueing them in with sign for the next word or idea in their spoken sentence. 11 years of experience tells me that this works really well and benefits the children, but what is the evidence to support this?

The answer is that there is a lot of research that confirms my clinical experiences – there is a neat summary of this evidence here

Why does it work?

Imagine you can’t hear at all, or you can hear but you can’t make sense of the sounds you are hearing, as though you are hearing an unknown foreign language. You can see your teacher is talking, but her hands are still, and her face is expressionless. You don’t understand one word of what she says. You feel a rising sense of panic, what are you supposed to do? Everyone is looking at you. Your body begins to go into fight or flight mode. You don’t know what is expected so you have an emotional reaction. Perhaps you freeze, absolutely terrified. Perhaps you hit the table and run from the room. Perhaps you internalise this feeling of panic and never want to communicate at school again.

Now imagine you still can’t hear or process the sounds that you hear, but this time your teacher is pointing at the things she is talking about AT THE SAME TIME that she says the word, for some words she is doing a SIGN at the same time that she says the word and the sign looks like the object or action. She is gesturing where things start and finish and she has a really expressive face so I can tell when her words are a question rather than an instruction, and I can tell how she is feeling when she says them. As she signs each key word, her speech is slowed down, giving me a chance to process the sounds and words a bit better. I understand 2 or 3 pieces of information from each sentence, I am learning what some words mean because the sign is said at the same time as the word, I learned a new word because the rounded circular outline you just mimed with your hands when you said the word ‘balon’ gave me a clue to understand that it means ‘ball’. I can see you want me to put the ball in a particular place behind me, I can tell because you pointed there after you said ‘balon’. I feel comfortable, I know what to do, I’ve learned new words and I achieve success. I want to communicate again next time.

We know key word signing and increased gesture doesn’t just help SLCN children, but also helps an increasing number of English as an Additional Language children in our schools, as well as typically developing children – listening to a person that uses more gesture is much easier than listening to a person who stands still and expressionless.

For further information on MAKATON, take a look at their website

True Colours

By Natasha White

February. The month when all that mushy emotional stuff is celebrated. An overwhelming amount of Valentine's Day cards and gifts line the shelves of the shops and what colour strikes us most? Red. Maybe pink. Clearly, we have come to associate a particular colour with love, just as we load all other colours with meanings and feelings.

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Anna Llenas, a Barcelona based illustrator and author, explores this in her beautiful book, The Colour Monster(Templar Publishing). 

A rather confused little monster is feeling a little muddled inside. Luckily, he has a friend, a little girl, who helps him sort through and focus on each emotion separately. As they work to place each emotion in a jar, Llenas cleverly provides several perspectives from which to explore the feelings in greater depth:

Label: the emotion is given a name

Describe: uses a metaphor or simile to create a comparison to a concrete object or noun

Action: shows how it can manifest and what it can feel like

Once the feelings are sorted and understood, the monster begins to feel better. He even starts to feel a warm and cosy feeling. He is surrounded by a mixture of pink flowers and hearts and the reader is asked: 'But what's this?' Something I think we can all recognise... 

Importantly, the monster's private feelings are linked back towards seeking social engagement. The little girl suggests ways in which he can 'deal' with the different emotions and most of them stress the importance of 'togetherness', such as holding hands.  

As a result, the book could be used as a classroom or therapy tool; The Colour Monster provides a fun platform to teach emotional literacy. 

Some tips for teaching your child emotional literacy skills:

 For the younger ones:

  • Create and colour your own colour monster and label the feelings

  • Make colour cards for the child to signal how they are feeling today

  • Make your own jars and put coloured counters or items in to describe feelings

  • Contextualise: think about times when they felt the different emotions. There is also an official activity book available, which puts the colour monster in different situations and asks you to colour him in to illustrate his emotion. 

  • Discuss practical strategies to cope with emotions 


For the older ones: 

  • Consider empathy: learn that you can inspire feelings in other people too 

  • Explore why did the little girl want to help her monster friend

  • Explore what happens when more than one feeling gets mixed up together