Calling all SALTS - help please!

[TheTimeTravellersWife]

I have just had what I can only describe as a bizarre conversation with DD's SALT. She called me out of the blue, to update me on DD. Great, I was really pleased that she had taken the time to call me to talk about DD.

BUT, she then proceeded to say that as DD's progress had slowed, she would be recommend at our AR that her SALT provision is reduced from weekly to termly! The reason she gave for this reduction was that DDs social communication difficulties were due to her autism, that she would have life-long difficulties with social communication and that further weekly SALT sessions would not help.

DD has also been diagnosed with a speech and language disorder, that is separate from the difficulties caused by the ASD, but apparently, that has now been overcome and all the difficulties now are with social communication which is ASD related and cannot be overcome by weekly SALT sessions. She said that her speech was now "age appropriate" but she had on going difficulties with social communication.

I maybe a bit thick, but unless you are talking to yourself, isn't all communication social?! Therefore, she has communication difficulties, therefore she should continuing having regular SALT sessions.

Can any SALTs out there point me in the direction of some research on SALT and ASD to that I can use to counter the argument that as her progressed has slowed, she should have less SALT input.

Surely, she should at least retain the same level of input if her progress has slowed.
I just don't accept that because she has ASD, she cannot make further progress with her communication skills.

She caught me "on the hop" cooking lunch for DS, so I didn't think to ask her for copies of her latest assessment tests.
But I did try to explain that 1:1 with someone she knows well she will perform much better than with a stranger or in a group situation.

Just looking for evidence to counter her recommendation that DD's SALT is significantly reduced.

Oi, Pleasant, Not seen you for a bit and forgot who you were/are before Pleasant!

Visual learner gets on my proverbials too.
Granted, we are all visual learners unless blind, but if I had a pound for every time I have to point out that waving a picture/symbo at someone only means something if they know what the picture/symbol means.
There are many ways in which pictures/symbols can be faded out and reliance on speech increased.

The example that springs ot mind is rampant, well meaning and utterly pointless use of Widgit and Makaton symbols.
What the hell for? Are threy imbued with some magic which means they are instantly processed and understod by kids with SN? If so, then they are cleverer than me because it might as well be hiero glyphics.

Most painfully of all, the time spent buggering about with this stuff is time not being spent on the most important visual information gaining/producing skill of all.
READING

I went on a LA run training morning for parents and schools to go on together (ds' new school didn't turn up and didn't send apologies either, but that's another thread).

The first question on the evaluation sheet was 'How confident do you feel at managing a child with autism?'.

The rest of the presentation was a woman talking about children with autism as 'they' followed by sweeping generalisations plus anetdotal stories of Harry or Freddie for us all to chuckle at.

But that was all by the by really. The thing that upset me the most was when they showed me a 'workstation' with nothing in it except a visual timetable, and a box with activities to complete. There were also two key rings, one with emotions on it, and the other with 'requests' on it such as 'toilet' or 'drink'. This was held up as extreme good practice because the girl who used this workstation was apparently 'independent'.

No she wasn't. She was dependent on laminate.

There was no explanation about how this could apply to her life, how she would develop communication skills, how she would move on from laminate hell. I didn't see that girl but I can see her face clearly all the same. She is very lonely.

oh, sickof - you too? the same place (I suspect) did the same thing with dd1...

I remember asking them, on the day I took dd1 to look around there, why they insisted on visual aids so much - the teacher waved a picture of the table in front of dd1 at snack time. dd1 (used ot flashcards, and loving photos as she did) wanted to take the card, label it (she used ot do this for fun!), and then either put it in the "yes" pile or the "no" pile (ie was it right or not - she knew herself whether she knew a word or not, and insisted on the separate piles so that she knew which ones she had to "learn").

of course, she was supposed to grasp that actually, this picture of a table meant "time to wash hands, sit at the table nicely and wait for snack" - funnily enough she didn't get that (picture was of an empty table, btw, not one laid for snack time)

so I helpfully intervened, and said "dd1, it's snack time now" whereupon she trotted off, found herself a place at the table, and waited nicely until I came along with her raisins.

the teacher said "hmm, she needs work with the visual cues" - no recognition of the fact that dd1 could happily follow instructions in a new setting, or anyhtign like that. nope, just an insistance that she needed to have followed the visual cue, because obviously, actually speaking to her was going to be a problem , and naturally, being ASD, the only way she woudl understand anythig woudl be if it was presented visually...

Silverfrog, I think it sounds like it may even have been the same person! By the way, this place we are both talking about is widely thought of as one of our country's foremost examples of a TEACCH school.

What pisses me off , above all, is that people like her are by their own actions sentencing my son to an institutionalised life, when he is aged only 2.

No-one speaks in makaton, or PECs, or visual timetables in the real world. So the only world they are equipping him for is the SN world.

In the real world, people tend to use WORDS, or - as Moondog so aptly put it - that ultimate tool of visual learning - reading!

See, this is why I have faded from being an active member on this board, to mainly a lurker.

We do use visual clues all the time in the mainstream world.

What are street signs? What sign is on the majority of toilet doors? Why do most pharmacies have some sort of cross to signify that, and often in european countries, a lighted symbol?

What works for the child is what is the best method.

Sickof, I'm sorry for your experience. I am myself currently experiencing the same trot about visuals from an outside service with DD1. I also have told the 'professional' that his methods do not work with a child like DD1, and will never work, and in fact all we are seeing is exactly what I told him we would see 18 months ago.

But then instead of people discussing the difficulties they face with methods, they turn it in to ABA vs TEACCH.

One more thing. I would NEVER sacrifice DD1's education for the sake of keeping good relationships with professionals. Never. I have in the past told professionals that I wasn't satisfied with their management, and would do the statement myself. I have told the SALT that their therapy was inadequate, and got DD1 transferred. I would again.

I've no objection to TEACCH.
I love order and designated places for things.
I love structure.
My kids' homeowrk is in big old fashioned wooden in/out trays.
They know what they nedd to do at any given time.
This approach works naturally for me and my dh.

I've no objection to anything done properly.Most of the time it isn't though.

'We do use visual clues all the time in the mainstream world.'

Yes we do. And it is why I come across as a nutter when you are given two seconds of a teacher's time and all you can get across is 'No visuals' when you really want to discuss all the issues I have written about here with thier USE of the visuals but aren't allowed because they have 30 kids and 30 parents and have been told that I am a nutter not to be tolerated anyhow.

I know Star, and you are in an extended nightmare, to be fair.

I just wonder why I return to this board, when every thread I come on to seems to turn to ABA vs TEACCH.

I am so sad. I loved this board. I really did.

hey starchart, I don't often get a chance to come on mumsnet, like to try and pop in now and again as always such useful info on here!

Lougle, It's here, but I think you have been unlucky this time. It's been a fair ole while but frustrations do re-surface.

Well the bottom line for me is that I have a SALT who has all but given up on DD making further progress and it is very likely that I will find myself back at Tribunal again, as it is so clear that the LA/NHS are looking to reduce DD's provision. Which makes me feel both and very
PS That was my attempt at a "visual learner" joke!

Oh TTTW. Your joke made me smile but I'm sad for you.

SALT seems to be being cut across the board because LA's don't lose their own salaries by targetting them do they? But I don't understand why SALTS aren't fighting to stay in children's statements and guarantee themselves a job for a year.

I guess there is a political element that I don't understand.

Not sure why my ds was labelled a visual learner. He is extremely verbal. No-one has ever used visual aids with him in any setting, so why/how on earth would anyone come to this conclusion is beyond me. It was something the SALT (sorry) put in her SA report

Lougle, I haven't been around this board long enough to know the history of what you're referring to, but afaiac there seem to be several posters (me included) who are just pissed off that our children are being offered the same old rolled-out techniques (TEACCH, visual aids, work stations etc) with no real examination of the children involved, their skill levels or their specific difficulties. Despite the fact that we haven't ever seen the efficacy of these methods, they are being recommended - yet in our case we have provided overwhelming evidence of the progress made under ABA which was totally, utterly ignored. Yep, it's doubtless because of resources, and, as in the OP, the case that LA providers do not know what they do not know. It's not about ABA vs The Rest. It's about the fact that there is no bloody direction or incentive for SEN provision to look beyond the textbooks of the 1980s into other approaches, even when there is real evidence of how well something has worked.

I have no real idea about TEACCH, actually, and perhaps it won't be a disaster for ds to learn under this system. But I am pissed off beyond belief that despite the detailed level of evidence I provided for my ds' statement, the evidence of progress under ABA from me, his nursery, and (informally) the EP, his statement still trotted out the generic provision of a work station and now and next boards. This is so inappropriate to ds and his needs it's laughable.

Lougle,

I have no problem with visual aids being used appropriately.

Waving a picture of an empty table at dd1, and expecting her to glean form that that she shoudl wash her hands, get a plate and sit at the table is beyond stupid. A picture of an empty table cannot convey that (and shudl not). dd1 correctly said "table" and wondered why she was being tested on vocab.

I said not a thing about ABA vs TEACCH. but sickof is right - this school hold themselves (and the rest of the educational group of which they are part) as a stellar example of TEACCH. they pride themselves on it, and claim that it works (by that I mean their interpretation, not TEACCH). it doesn't. form dd1's time there, there are 5 families that I know who feel let down (ie came to realise that the school did not know what they were talking about. again, I do not mean ABA by this - of the 5, I think 2 of us are "doing ABA") - bear in mind that each class was only 10 children max, and that is half her class (and that is only the ones I am still in touch with!) - no way is htis acceptable as a "success rate".

yet the school continues, spouting this nonsense.

I do not disagree that we all use visual cues in life, and yes, dd1 needs to be taught how to recognise the important bits. but they are not the be all and end all. and they are not the only way that ALL autistic children can and will learn.

no one insists, for example, that my step daughter must learn to tell the time (she has mild learning difficulties), because she is wel able to ask when she needs help (at train stations, perhaps). but no one (at the TEACCH school) expected dd1 to be able to ask for help - this, most basic skill, was neglected in order to teach her non-existant symbols and cues which she would not ever see again (with the same meaning) outside of their four walls. my argument (with them) was always that for dd1 teaching her how to help herself was more productive than teaching her to rely on symbols with arbitrary meanings. but this fell on deaf ears (maybe they were all visual learners - I shoudl have tried drawing it out on a story board - another technique they recommnded when in the midst of a meltdown was to whip out a pencil and paper and draw a little film strip of the situation for dd1. again I was and asked why they had no suggestions for calming techniques, and why not work on her receptive language (since she had the skills for this) - no answer.

it was the same when I went around the (again, very well thought of, suposedly gold standard) state provision that dd1 would have gone to if the LEA had their way.

I think to say that this thread has been all about ABA vs TEACCH (as it is practised in a lot of provisions in this country) is not fair. yes, most of the posters who have stated issues with TEACCH have been ABAers. but that does not mean that what we have said is not true (of TEACCH, rather than our anecdotes not being true).

we are all in different areas, with different LEAs, differetn experiences (other than sickof and I with the same ASD school experience), yet we are all experiencing the same problems with sweeping generalisations and crappy use of visual aids.

I woudl suggest that you are very lucky indeed to have a school which uses TEACCH effectively. great. the majority of posters here have not been so lucky.

'But I don't understand why SALTS aren't fighting to stay in children's statements and guarantee themselves a job for a year.'

Because most of the work of a generic paediatric s/lt is within clinics which are awash with m/c kids with mild speech issues or language delay.There are neough referrals there to keep them going for years.
It is something that I pesonally am not happy about.The bulk of our service should be aimed at children who have both a real need and a legal right to it (ie those with statemnts) and it is something that I fight for.

Silver, what the hell is the filmstrip all about?? Madness

I had a meeting last week with a really great individual involved in providing after school activities with kids. Said person had got hold of some visual aids and prompts and bought them to me .I was able to tell them how they would and wouldn't work and what the limitations were. It was so pleasing to talk with someone who had bothered to ask for help with a specific issue. They left saying 'You've made me think of a lot of things I hadn't thoguht of before.'

That made me very happy. Person was thinking and using commonsense.

Moondog's point about the "worried well" is a good one but it's not the whole story.

I work in settings that require children to be statemented. I quite like my job and would like to continue doing it but the funding will be withdrawn due to cuts to the Standards Fund.

We write quantified reports for statements. I have always written quantified reports for statements with a specific bit, in bold, saying it needs to be put in part 3 of the Statement. Interestingly, it never is. We could write 20 hours a day of therapy or 1 a year and both become "with an individual programme drawn up on the advice of a speech therapist" e.g. totally meaningless.

I have pointed the dangers of this out to parents and to my manager and to be honest, I think they thought I was a total nutter. My manager certainly likes the LEA money so I don't think she is in cahoots with them, she doesn't seem to be thrilled with any of the cuts etc... but the ramifications of the wording of the statement seem to have been lost on her. The parents don't understand it either, though I have laid it out baldly in the past.

I really don't want to be in clinic seeing a generalist caseload and I don't know many therapists working with kids with severe needs who really want to be back in clinic, even if there are enough to keep food on the table until my son is a man. I hate clinic. I hate seeing kids who are just late developers, it feels like a total waste of resources.

OK I tell you what pisses me off more than anything else, and that is the denial of visual learning, and the preoccupation with auditory learning.
I am a visual-spatial learner, I think in pictures, and have problems processing auditory information. So from my perspective many on this thread have been talking total crap because they do not understand how humans learn and only want the easly life getting all to be auditory learners via ABA or whatever, when they do not know what they are talking about, especially about visual learning.

I think what's important to remember is that if a visual is waved at someone after they have processed and acted on a verbal instruction that has preceded it or if a visual is waved at someone without explaining it, this is just poor communication and teaching. It doesn't show that visual learning is in and of itself a waste of time.

Unlike dolfrog, I am a largely auditory learner with a superior working memory. This led to no end of trouble at work in my early career where I used to try to remember too much information via an auditory channel as it was the easiest route for me. This can be true for learners with autism as much as it is true for me. Learning visual systems for filing and note-taking and putting everything in its place has been crucial for me, as a neurotypical learner.

Sometimes, remembering a long list of information is not the most efficient way for any learner to remember.

Every term, the students at both my settings fill in a questionnaire about teaching methods - what has helped, what hasn't. Many students with both SLI and ASD express a preference for visual modes of learning. A few express a preference for text or looking at text and hearing audio at the same time. This doesn't mean that everything we do is visually based, as we live in a world where multiple intelligences are required... but I'm not going to deny my students what they tell me is useful for them.

We use a system for some of our students for teaching complex syntactic structures that is largely visual (shapecoding). The students work very well with this system and we fly through things that would otherwise take a very long time to target. We are also doing some rapid/fluent learning of these in a more formalised way this term, though we always worked in an intense teach-test-teach way with multiple opportunities for practice across the day. This has not meant that we don't use visuals in teaching though.

Yes, it is totally and utterly irritating to see visual learning trotted out without any individualisation as a cure all and believe me, I am no fan of any visual that locks a person with SEN in at a low level of learning or that operates as a replacement for rather than a conduit to appropriately adapted teaching but I don't think that visuals are the devil and I can't see why they would be seen as a bad thing in and of themselves. We all need and use them. We don't need and use the same visual cues as when we were kids.

Also, any ABA programme I was ever on relied heavily on visual means of teaching as stimulus cards were nearly always pictorial. Colour cards? We used comic strips to review social situations in an ABA programme run by international, respected providers. We wrote down things we were practising with stick men to act as an aide de memoire in word games etc. We used visual token boards, including a TEACCH style jigsaw type one. We used to have a - wait for it! - choice board with visuals! Shock! Horror! Many VB practitioners use sign. PECS uses visual learning too. If you are manding in the presence of a desired item, there is a visual cue that's massive there. Some of the research on video modelling and peer-mediated intervention for kids uses visual modes of presentation - video/text cue (ABA approaches) and if you read the articles, they do reference the visual learning style of kids with autism. Where are all these programmes for kids with autism that don't utilise visual learning?

In any well-designed programme, visuals are a HUGE tool for learning and why shouldn't people with autism benefit from multimodal teaching when others do? It slightly reminds me of the controversy where Deaf kids are the only group that don't get recommended to sign even though they're the only group that it comes naturally to. Yes, it needs to be taught just as verbal communication does and it needs to go somewhere and not be used as a babysitter or in place of actual interaction with a child, and be used for the right things to scaffold a child to get from somewhere they're not to somewhere they want to be.

And before someone says, yes, but in an ABA programme they are faded, my experience is that not all visuals need to be faded but they do need to be adapted. Some of our secondary students have PDAs with reminders as opposed to visual timetables but they would have had more "SN" type visuals as kids. They've outgrown them as all children outgrow some teaching tools. I can't comment on if they helped them to get here or not but I do know that what they are doing now bears no relationship to what they would have done in their early years, no more than I doubt any child reads the same books at 16 that they did at 2 or 3. Reading Dear Zoo at 3 doesn't mean you will never be able to read War and Peace.. having a visual timetable at 3 doesn't mean you have to end up in a sheltered worshop.

I hope this makes sense. Perhaps it is symbols that get everyone's goats?

Do frog, no-one hear is denying the relevance of visual learning for children. We are talking about bad teaching, and teaching without having thought about what is to be achieved. FWIW I am a predomently visual learner, to the extent that I don't even need to use a diary, as everything can be placed in the calendar in my mind.

But Star, can you see that for the most-part, there hasn't been that distinction in the postings? The general theme was 'visuals=lazy, bad, irrelevant teaching', not 'lazy, bad, irrelevant teaching which happened to rely on visuals'.

Take makaton. An augmentive system of signing with spoken word. You could argue that only people who know makaton will understand. But, for DD1, who surprises me daily with the signs she has learned at school, when a situation overwhelms her, and she can't speak any longer, she resorts to signing. Before that, she would have simply melted down. Now, she has a way of communicating once her lips cannot co-ordinate.

Dolfrog, it stands to reason that people diagnosied with Auditory Processing Disorder would be visual learners. My boy has a diagnosis of autism, not APD, and to say all autistic children are visual learners is a sweeping generalisation with no basis in any research.

I have no investment in any particular method of teaching. I am happy to follow suggestions, until they are proven not to work.

Example:

LD nurse wanted to try 'quiet time' DD1, sitting her on a step for 30 secs. I said 'she'll just treat it as a game, and you won't keep her there'.

LD nurse said 'stay with her'. I do. It's a game.

LD nurse changes mind, and says '2 minutes' and starts doing it for me . Behaviour escalates, week by week, each time he visits.

LD nurse decides it has become a game

LD nurse now says 'take to quiet step, say 'quiet time' and remove immediately, redirecting to activity, so that she knows you have always won'. BARKING.

My view: setting the stage for a clear behavioural transaction.

Step 1:
I hit my sister.

Step 2:
I walk to a step, sit on it, then get up.

Step 3:
I get to do something nice.

Step 4:
I hit my sister........

Trouble is, I don't have an alternative either. I am on my own (DH at work) with 3 children under 6. I can't keep DD1 safe as well as keeping DDs 2&3 safe.

If she starts getting in 'the zone', I have to choose between protecting the other children, or comforting them. If i choose protecting, it gives DD1 the exclusive attention she wanted.

If I choose comforting the other children, DD1 is free to hit and pinch and kick.

I cannot safely take her to her bedroom (slightly low muscle tone, drops to the floor, kicks and pinches as you try to carry her, and throws herself around), and other professionals have advised that the bedroom should be seen as a nice place, not a punishment zone.

I have a lounge, hallway strip and tiny kitchen. There is no safe place to 'exclude' DD1, and nowhere to take the other children to safety.

DD1 is so self-directed, that actually, any method only works if she wanted it to anyway. Reward chart...meh. Treasure box for good behaviour...well if she wants it, fair enough, but majority of the time, couldn't care less. Taking toys away, doesn't care anyway.

I digress, but simply put, I do not 'believe' in TEACCH, as much as I don't 'believe' in ABA as a branded phenomenon. ABA should be just common sense stuff, isn't it? Common sense says you work out why someone does something, tackle that, then reinforce desired behaviour.

I am just saying don't throw out the baby with the bath water. There is a place for the concept of TEACCH. We cope with the fact that physically disabled children need a different environment, why is it so hard to accept that neurologically children do too?

I would put it another way Lougle, I would say that most SN teaching for autistic children in this country is lazy, uninspiring, patronising, low in expectations and generally sub-standard. It is not the same in other countries. I think that the TEACCH system just happens to be the condult for the ineffectiveness, as it is so widely used. I would like there to be higher standards in SN education, higher expectations. In my experience, those higher expectations have come via ABA as a methodology. I don't know why you are feeling so hounded; TEACCH is far and away the prevalent system of education for autism in this country. It's not you who have to had to fight every single person they have ever come across, often with expensive legal assistance, due to blind prejudice against ABA. It's easy to like TEACCH in this country, it is the establishment's pet system; at least Mumsnet forums like this can give alternative methodologies, outside of the mainstream, a voice.