SLTs

Working memory in school aged children

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By Sonali Dutta, Speech and Language Therapist

 

WORKING MEMORY IN SCHOOL AGED CHILDREN

As a speech and language therapist I come across younger and older children who struggle with classroom-oriented tasks in school. When assessed by specialists, a good proportion of these children are found to have working memory difficulties. Working memory is responsible for retention and manipulation of information. As children get older, the learning-based tasks in school become more structured and complex, demanding high cognitive skills. Therefore, working memory plays a crucial role in determining children’s ability to handle learning challenges effectively. At home or in other social situations outside school, the environment is more play-based and relaxed and so the demands on working memory are likely to be less.

 WHAT IS WORKING MEMORY?

Working memory is one of the key cognitive processes required for effective learning and is often confused with short term memory. Short term memory is related to short-term storage of information. Whereas, according to recent research, working memory is a component of fluid reasoning i.e. ability to effectively identify key information from the task/environment and apply that knowledge. We use our working memory to register, maintain and manipulate information we see (visual) and hear (auditory) making it an integral part in our decision-making ability and behavior. Therefore, we can see how working memory skills can be closely related to achievement and learning in school aged children.

The Wechsler Intelligence Scale for Children (WISC) measures working memory in one of its subtests for measuring intelligence. However, we should bear in mind that although working memory affects how a child learns and performs in tests, it is not a measure of a child’s overall intelligence and that the IQ (Intelligent Quotient) also has non-measurable components which do not correlate to working memory.

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WHAT ARE THE SIGNS OF WORKING MEMORY DIFFICULTIES?

Working memory deficits have been linked to attention difficulties, learning difficulties (e.g. dyscalculia i.e. problems with arithmetic) and language difficulties (e.g. following complex instructions) in children. Children with working memory deficits have difficulty in tasks involving memory demands in retaining and processing specific or structured information. Therefore, subjects such as maths, reading and science may be particularly difficult for these children. Attention, auditory and visual perception and concentration are required for successful processing of information.

The article ‘Working memory in the classroom’ by psychology professor Susan E Garthercole highlights a study where the teachers described children with working memory problems as having attentional problems. This shows that the underlying working memory issues in children can be masked as attentional problems and are likely to remain unidentified and unaddressed. The article further mentions that ‘zoning out’ or ‘mind-wandering’ are common behaviours in children with low working memory capacity when performing a highly demanding cognitive task as they cannot cope with the information overload and fail to complete the task.

Children with working memory difficulties may show the following signs:

·         Struggles to follow complex verbal instructions in a classroom.

·         Has problems in the area of maths, reading (comprehension) and science.

·         Takes longer than peers to complete tasks or does not completing tasks.

·         Has attentional difficulties.

·         Gives delayed responses to complex questions/instructions.

·         Provides non-specific answers.

·         Comes across as being disorganized

·         Comes across as being forgetful.

 

WHAT YOU CAN DO TO HELP

Speech and language therapists or educational psychologists can assess children’s working memory using formal or informal assessments involving specific recall/repetition tasks e.g. digit span (backwards and forwards repetition), picture span, letter/number sequencing etc. It is important to share with the child that they will have to work harder than most children to attend and concentrate in classroom tasks.

In our practice as speech and language therapists we always find that using visuals in  learning helps children retain and process information better. Being a mum with the knowledge of a speech and language therapist I know that hands on practical input and visuals helps my kids learn better. Recently I have used the hot kettle in my kitchen, a metal plate with ice and hand drawn diagrams to demonstrate the evaporation-condensation-precipitation to my 9-year-old daughter who was struggling to understand the water-cycle taught in school. She then went on to make her own illustration of the water-cycle and could not wait to show it to her teacher.

The following are some of the strategies teachers and parents can use to help children with working memory difficulties:

·         Eliminate distractions as much as possible during tasks (e.g. remove background noise, e.g. music, TV)

·         Gain the attention of the child by establishing eye contact with them.

·         Prepare the child for the task beforehand (e.g. provide an outline of what is going to be taught in the lesson). This will help information to go from short-term memory to long-term memory.

·         Provide clear and simple instructions.

·         Break down tasks and instructions into small chunks (not more than two-part instructions at a time).

·         Give the child the opportunity to rehearse or record the instruction (e.g. writing down the instruction).

·         Ask them to repeat the instruction to check if they understood.

·         Encourage the child to ask for repetition if they have not understood.

·         Encourage your child to keep notes, make outlines and use other brief reminders.

·         Encourage good organizational skills by using folders and dividers to keep work easily accessible and in order.

·         In school, providing notes and handouts will be useful when a child struggles to copy due to visual memory difficulties.

·         Visuals will help them understand and retain information better (e.g. visual timetable, flowcharts, diagrams, pictures, illustrations, videos).

A sensory approach to learning involving practical input and visuals will consolidate retention and learning (e.g. visual timetable, flowcharts, diagrams, pictures, illustrations, videos, demonstrations, hands on practical tasks).

My final week in Kisumu with Yellow House

By Catherine Clancy, Speech and Language Therapist

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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.

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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.

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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!

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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!

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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!

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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

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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.

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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!

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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.

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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!!

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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

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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.

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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!

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

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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!

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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

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14.07.19: Just before I flew out to Kisumu! 

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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.  

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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.

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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

https://www.youtube.com/watch?v=nFYnc4xcZ6k

https://www.youtube.com/watch?v=NMEhkD0W5Z8

 

 

How to survive and flourish in your first year as a speech and language therapist

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By Faye Nugent - Magic Words Level 1 Speech & Language Therapist

Your NQP year is a big learning curve, both clinically and emotionally.  I have come to the end of my NQP year and it’s been a journey!  I have a varied caseload across mainstream schools, general clinic and complex needs clients which I am thoroughly enjoying.

Here are some of the things that have helped me in my NQP year.


You’re not expected to know everything

I remember finishing university feeling the following: I can assess a child very well but what next? What therapy do I do? I had some experience from placement about different types of therapy but there is only so much you can fit in at university.

When I started my NQP role here at Magic Words Therapy I thought I was supposed to know all the assessments, therapy approaches and resources I should be using with all my clients.  Speech and language therapy covers such a wide range of client groups; from dysfluency to ASD to speech sound difficulties and developmental language disorder – the list goes on!  It would be impossible to be an expert in everything.

I have learnt lots different therapy techniques and strategies either from CPD training days, speaking to my colleagues and supervisor and reading up on the different therapy approaches out there.  Working alongside more experienced therapists has also really helped me take the pressure off myself and to realise that speech and language therapists are always learning in their careers and that no therapist knows everything; there is always something to learn!

My confidence has definitely grown through experience.I might not always know the answers, but I am learning the places to look for them and the people to speak to.I am always open with parents and teachers; if I don’t know the answer I will tell them so and I will research it and get back to them about it.It is okay to not know everything.I’m always looking out for ideas and inspiration to make therapy more fun and interactive for the children too – Pinterest, Twinkl and the shop ‘Flying Tiger’ have been life savers for me!

No one knows you’re a Newly Qualified Therapist

Nope, no one knows unless you tell them.  That goes for teachers, parents, SENCOs and other speech and language therapists.  A parent won’t know that it is your first ever initial assessment, and the school SENCO won’t know it is your first MDT meeting, unless you tell them.

In my first few weeks as an NQP, I thought everyone would know this was my first job and that I was inexperienced.  It did feel strange not having a clinical placement tutor with me all the time and having to make clinical decisions on my own.  With time I have become more confident in my clinical knowledge and decision making and now feel like a ‘proper’ speech and language therapist, not a student anymore! 

Everyone has to start somewhere: trust the process.In fact, other speech and language therapists find having NQPs in the team helpful; it’s good having someone on the team with fresh eyes, and recently trained up in the profession.Be confident in what you know, and the skill set you have. Remember you are qualified!

‘A problem shared is a problem halved!’

Being a speech and language therapist is a very busy role and it can become very overwhelming, particularly in your first year.  I have found it so helpful to speak to colleagues and my supervisor.  They’ve helped with advice regarding assessment, therapy and caseload management as well as listening to how I am feeling, both the positives and the challenges. 

Clinical supervision is an essential part of your professional practice, it gives you the chance to discuss your work with someone who is experienced and qualified.  Regular supervision meetings have helped me to develop my clinical knowledge and skill set.  My supervisor has guided me to the appropriate next steps to take with challenging cases or situations.  The meetings also provide the opportunity to reflect on how you are coping and feeling.  I have found that discussing any problems, big or small, has always been helpful.  Sometimes it is just good to get something off your chest!

Supervision sessions are also a chance go through and more importantly sign off your NQP competencies.  It is a big document, but I found it helpful at the beginning of my NQP year to read through each competency and think about how I was going to achieve it and the evidence required.  It meant I had an idea and plan of what I needed to do.

It has also been useful to speak to my NQP colleagues.Most of our questions and queries have been similar so it has been good to support each other on the journey!

‘Have a go!’

I am a kinesthetic learner so after doing some reading I always learn best by just having a go.  I particularly remember feeling very nervous about running my first dysfluency group session; What do I do?  What is this ‘Tortoise Talking’? Will the children know this is my first dysfluency group? 

After I did my first session I felt so much more confident; the children responded well, they had no idea it was my first session.I was able to reflect on what went well and what I could improve ready for the following week.

Be flexible

Things change all the time: fire drills halfway through therapy sessions; ‘Viking day’ at school and the whole school is off timetable, parents not turning up for meetings.  Initially, I found it difficult when plans changed, especially when I was nervous about the session or had taken a long time to plan and prepare resources.  Now, I try to plan ahead and I ask parents their preferred method of communication (face-to-face meetings, emails, phone calls) and find out about events going on at school (sports day, whole school assemblies) etc. 

However, you can’t plan for everything and sometimes you just have to roll with it.For example, doing observations of the client instead of a therapy session on ‘Viking Day’ or using the therapy time to complete client-related work.

Breathe!

It's important to take time and ensure you are getting a good work-life balance.  We are very busy day-to-day in our roles as speech and language therapists and it can be easy for this to spill over into our spare time: thinking “I’ll just finish the notes at home” or finishing a report in the evening.  I try to keep work in the work environment and once I get home to take the time to relax and do things I enjoy.  I feel I am able to do a better job because I have kept a clear distinction between work and home and not running myself into the ground. 

My confidence and clinical expertise have grown with time and experience.I like that in our profession we are always learning and developing.Coming towards the end of my NQP year it has been great to look back and reflect on how far I have come.

My Love for AAC (Augmentative and Alternative Communication)

By Melissa Mcilhiney - Highly Specialist Speech and Language Therapist and Complex Needs Specialist

When training as a Speech and Language Therapist you learn about AAC (Augmentative and Alternative Communication) methods in lectures. I have always been a more visual and hands on learner than one that can sit in a lecture theatre and take in what it being said.   So my love for AAC did not begin straight away but has evolved over the pathway of my career. It has shaped the therapist I have become and the type of client group I specialise in. This may sound cheesy, but it gave me a purpose and a role doing something I love. 


When I was at university I was adamant I would be working with adults on stroke wards or on the head and neck cancer wards in acute hospital settings. How wrong I was! Don’t get me wrong, I had placements on both of these types of ward and I did enjoy them and learnt lots, but this type of work just wasn’t me. To this day, I can’t really explain what was missing from either of these fields for me. I then went on a placement in a DSP (Designated Specialist Provision) attached to a mainstream school I knew this is where I belonged.  I was placed with an amazing Speech and Language Therapist called Sue. She showed me a completely different way of working. I learnt Makaton (signing), was introduced to visuals such as visual timetables and ‘now and next’ boards. I was encouraged to use all of these within my practice with the children I was working with. It was here that my love for AAC began and my career pathway totally changed.  This placement impacted so much on me that I walked away knowing that kind of setting was where I wanted to be. To this day I don’t regret that decision one bit. Seeing the way children can progress and communicate with others, become more independent with their communications and seeing things individualised to each child’s needs lead me to start applying for Specialist Provision posts.  

As a newly qualified therapist you don’t normally even start thinking about a specialism, but I had no doubt that I was taking the right route! It felt natural. So, I applied to a special school and got a job in an MLD (Moderate Learning Difficulties) school working in an Autism base. Here my love for AAC continued to grow. I was introduced to PECS (Picture Exchange System) and we used this daily to take a very functional approach to communication. We used regular visual aids and worked on sensory difficulties at the same time. Therapy there took a very holistic approach and to this day my therapy style is still very holistic. This holistic view of therapy is now supported by the Department of Health and research supports the premise that looking at the child as a whole results in the most progress in their development.   


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I’ve been involved in a few cases where we had to use PECs and visuals to support the communication of children who were going into hospital or in one case had to be interviewed by the police. I remember people saying, “they won’t be able to tell us what they have seen”. How wrong they were!

This role marked the beginning of my dedicated mission to ensure that all children have a “voice” whether via signing, PECS or another method. I was adamant that every child must have a way to communicate. We just need to find the method that works best for each individual child. We know that not everyone is the same and communication (and aids) need individualising around the child’s needs. For example, A child with Retts syndrome who can only eye gaze will need different aids to a non-verbal ASD child.   

After the special school placement I joined the NHS for 6 years and worked in mainstream, pre-school special needs and eventually ended up back in special schools, my most loved environment to work in. I continued to use all different types of no and low-tech AAC devices here and then saw another therapist introduce an electronic aid with a child. I wasn’t directly involved with the child but it sparked my interest and another branch to my love for AAC started to develop. 

I remember sitting in front of the TV one night and seeing an interview with the late Stephen Hawking. I listened intently to every word he said. Not because I understood a word of what he is was on about (quantum physics is just not my thing!) but because I was astonished by the hi-tech aid he was using. The way he was controlling it through eye movement and how quickly and intricately he could explain black holes!  I then got really into researching his story but also the other types of hi-tech aids like Stephen’s there were out there ranging from I-pads to eye gazing machines.  In looking into them I realised that I had children on my caseload these would benefit hugely. We started putting them into the therapy of two children on my caseload. They made amazing progress! I have continued to use these types of aids with suitable children on my caseloads ever since.  


Children are a lot more tech-savvy nowadays. A child on my current caseload was introduced to his aid last term and within days was able to order exactly what he wanted in Pizza Express without having to rely on an adult interpreting his wants and needs as he always had in the past. Children do not normally catch on to their new aids this quickly, but seeing how well children can progress with the right equipment makes this job worthwhile and again highlights the importance of giving each child their “voice”. 

Can you imagine living in a word where someone else speaks for you? Interprets what you want, what you need? Where you literally have no voice? To me this would be the ultimate nightmare and for the children I work with it leads to extreme frustration and behavioural issues. AAC methods give individuals a lifeline, a way of being able to communicate with others without requiring another person to interpret for them. It decreases frustration and most importantly gives people their “voice”. Research supports the use of AAC devices and has shown that using them increases the use of spoken language. Some parents are scared that AAC devices will replace speech this and from my many years of experience this is not the case. But that’s a whole other can worms that I will certainly open in a future blog!  

"I can’t think of a more rewarding job than giving someone their “voice”. And that is why I love AAC and my job"

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

Get to know us a little...

By Natasha White

Hello Friends!

Welcome to the Magic Words Therapy blog. Here you will find advice, handouts, interviews and links to useful pages, amongst other exciting features.  


If you want to get to know us a little more, here are some facts for you: 

Eleanor Harris

1) Magic Words was founded in 2009 by Director, Eleanor Harris. Shortly after our Director, Frankie Paterson, came on board. Since then we have expanded to meet the needs of our clients. 

2) We have 11 employed therapists, whose specialisms include: Complex Needs, Hearing Impairment, Selective Mutism, Autism Spectrum Disorder and Stammering. We also have 2 administrative staff to help you with your queries, all of whom have teaching experience. 

3) We have 4 qualified Elklan tutors and 1 Makaton tutor on our staff. We regularly run courses in Milton Keynes (just by junction 14 of the M1) and Sarratt (just between junction 18 and 19 of the M25). We also offer bespoke school training. If you wish to know more, please visit our schools page

4) Our therapists work in a wide range of settings and in partnership with a variety of specialist agencies. Currently, we work across 20+ schools (including nurseries, primary and secondary schools) in the areas of Milton Keynes, Bedford, Northampton, Luton, Dunstable, Elstree, Watford, Borehamwood, Kensington and Harrow. We have worked with fostering and adoption agencies, mental health professionals, NHS staff, occupational therapists, to name but a few. 

5) Since 2015 we have run Lego® Therapy sessions with primary and secondary school aged children. They have been extremely successful in promoting social and communication skills. Two of our therapists (Carolyn Fox and Elen Wales) have recently had an article, entitled 'Building Lego, Building Language' published in Bulletin, the Royal College of Speech and Language Therapy magazine. 

6) We run an extensive continuous professional development (CPD) scheme for our therapists and invite other professionals to join us. You can find our CPD diary and our booking page here. On previous dates we have welcomed Daniel Hunter (Treating Dysfluency in Pre-School Children and Working with School-Aged Children who Stammer), Sunita Shah (How to Work with Bilingualism in Children’s Speech and Language Therapy and Educational Settings), Melanie Cross (Attachment and Communication), Alison Bryan (Colourful Semantics), Dr Tony Sirimanna (Auditory Processing Disorder) and Pamela Williams (Nuffield Dyspraxia Programme Training). 

7) Between us, we have 18 degrees and 7 diplomas. All of our therapists are registered with Royal College of Speech and Language Therapists (RCSLT) and are regulated by the Health Care and Professionals Council (HCPC).  

8) We are a charitable bunch! From wearing our ugliest Christmas jumpers to donning our running gear, we love to support worthwhile causes and raise a little money along the way. Look out for our participation on awareness day events and sponsor us if you can.

Please note: all facts accurate at the time of writing. They are subject to change- we are busy growing our clinic!

Christmas Jumper Day 2016

Magic Words Therapy - a photo montage of the team in Christmas jumpers

We're getting silly for a serious cause- Save the Children Christmas Jumper Day!

Each of our therapists will be wearing a wonderfully Christmassy jumper today. Whether it's flashy or the ugliest thing they could bear to wear, everyone will be donating £2 to Save the Children for the privilege. 

If you would like to support us, please text TEAMMWORDS to 70050. You will be billed £2 plus standard rate text message. Save the Children receive 100% of your donation. To see what work this amazing charity does, please click here.


Or you could join us... Go on. Slip in to something sparkly, share on social media using #christmasjumperday and donate.