s&l delay - the exercises the salt gave us don't work for us (DD not cooperative)

[chocjunkie]

we saw the salt a while back for DD (3, s&l delay, suspected asd) for an assessment. she was diagnosed with s&l delay (about 16 month delay for both expressive & receptive). we are on the waiting list for group therapy. for the meantime, salt gave us tips what to do (simplifying language, expanding etc which seems to help only very little) and exercises to work on DD's understanding of commands with 2 and 3 keywords such as teddy & dolly play (wash teddy's face, brush dolly's hair - these kind of things). problem is, DD is not cooperating at all. I just can't get her concentration, can't get her to focus. she just sits down with me and starts doing silly things...she is never really serious IYSWIM

anybody been there? any advice what to do? I so desperately want to help DD to develop her speech and understanding but feel at the moment that we are not really getting anywhere.

I think it is easier to tackle things like 2 and 3 keyword instructions if you can find an activity your DD likes and work them in that way. e.g. if she likes dancing about, you stand dancing then give commands like "hand on head" "sit down" "dance to table" "walk to kitchen" (hard to know what to suggest without knowing her level of understanding). Or make the teddy fall of the sofa then tell her to throw teddy to you/make teddy dance on his head etc etc.

Dd2 was the same, we started by using things that really intersted her (food), i don't think dd2 took much notice/listened until she could understand language a little better, are you using visual aids (pictures with her), she may understand instructions better with visual support.

We resorted to out and out bribery with DD#1 - in her case I used M&Ms on work sheets as counters, or she could "win" them if she tried a task. We gradually managed to wean off them though I still resort to bribery now and again!

thanks, I think I need to be a bit more creative and modify the exercises to tie in with DD's interests.

no marne, we don't use visual aids. DD has actually a biggish vocab
(well, 150-200 words) and understands lots of words. I always make sure that I use words she knows when exercising with her. and I know that DD can actually do commands with 2 keywords. I just find it so difficult to get her to engage as well. she just can't focus. should do it with things she is really into and follow her lead a bit more.

My other dd has AS and very verbal, we still use visual aids with her, sometimes its easier to follow instructions with a picture to back it up (just an idea). I use them to get dd1 to get dressed as i can tell her until i'm blue in the face to put her trousers on and she still ingnores me, sometimes if i back it up with a picture she puts her trousers on 10 times quicker .

thanks marne - will look into visual aids! this whole area is really new to me ;-)

one thing really puzzles me about DD. she has trouble following commands with 2 keywords but will answer questions such as "what colour is your bike?" in no time without any visual clue (I can ask her such questions completely out of context with no bike near). the correct answer comes straight away.

I would have thought that if she has trouble comprehending 2 keyword commands, then she shouldn't be able to answer these kind of question...

Didn't work for us either.
Main problem as I see it is that the SALT is telling you what to teach but not how - and most NHS SALTS don't get much in the way of ASD training so actually don't know how to teach a child with ASD eg who lacks motivation to talk.
In theory you should have autism advisory teachers or early years specialist teachers (usually part of portage service) who come in and show you the how. But our service was useless so we did ABA instead and they teach the expectation to look, pay attention, do the task etc by using rewards specific to the child and set up a clear expectation the child will do what you ask and then get the reward.
This actually has to be taught so don't sit there as I did and feel like a useless parent but go back to the SALT and say as my child has possible autism she will not pay attention, comply with an adult direction etc so I need you or someone else to come and teach me and my child that first and then I can teach her the tasks you have suggested. So say I need direct SALT regularly where you get to know her and demonstrate to me how to get her attention.
Other options are to look at specialist nurseries / S&L units where the teachers will have these skills. Or you can ask for portage / autism outreach (although often outreach only come in once you have a diagnosis and are often fairly useless also).
You should also apply now, if you have not already, for a statutory assessment so you can get specialist direct teaching on a statement of SEN so legally it has to be delivered.
Many professionals will try and pass this off as something you just need to persevere with as they don't have the training themselves to deliver it / or the time and resources. They will also try and persuade you all schools have been skilled up to do all of this. Don't be fooled, getting a child with ASD to look in the right direction and pay attention is a specialist job and in some cases months and years of hard work.
Does your DD know the purpose of language? eg does she use it appropriately to request, comment, conversationally, socially? If not all of this will have to be taught. Many children with autism don't see a need to communicate and the first thing to teach is the purpose of language - often people will use PECS to do this.
Cerebra charity do a scheme for £500 SALT vouchers for private therapy if you have to wait more than 6 months for direct therapy. It does not sound like your child is even on the list for 1:1 or small group therapy - what on earth makes them think she is ready for a large group when she does not follow a simple 1:1 instruction??? You should apply for the vouchers and get a private SALT with autism expertise.
Are you getting DLA? AFASIC and Cerebra have good guides for getting DLA with S&L needs. Again you can use that to pay for therapy.
But the fault lies with the SALT not with you. They are asking you to do a job they probably do not know how to do themselves.
I wish someone had told me that at the beginning it would have saved a lot of time and heartache.
teachmetotalk.com is an American website which has some good ideas for toys which can tempt communication

Oops just cross posted - clearly she does follow instructions!
Sounds like you need a reward system to expand the length of time she will pay attention - again they should come in and set one up and demonstrate it

thanks agnes - got the letter from speech & language department today. she will in fact start a SMALL group therapy shortly.

she is very delayed in her s&l. talking in 1 and 2 word phrases mainly. so no, we don't have conversations but she can (and will) ask for things she wants (certain foods, drinks, toys, going out...).

think you are right though - I need to get more informed and become more proactive. thanks for the cerebra and AFASIC tip. will check them out!

we haven't done really anything else yet (DLA & statement wise). we will have out first appointment with dev paed in a couple of weeks and I wanted to wait for this appointment first... the "normal" paed refered us as he things DD shows traits of ASD. her salt is not concerned about ASD at all but we (DP and I) know something isn't right with her and feel it could be possibly ASD but maybe it is something else...I don't really know. just feel lost and confused atm.