If your child has very unclear/limited speech what communication aids do you use?

[used2bthin]

DD has severe SLI/ specific learning difficulties. Just been thinking aout this since the LAMP thread. And was trying to have five mins extra in bed but could hear DH not understanding DD when she was saying "bee bupbee" (me hungry) . I often have to really try to work out what she's saying but know most stuff in context but at school it must be impossible.

We use a bit of signing as does school but not enough as she isn't as good as she used to be with it. Also her one to one TA was about to do a communication book which I think waspictures but the teacher thinks DD is too lively to use it and it isn't a fast enough form of communication. Had been told PECS isn't appropriate by a SALT too as she is talking just its hard to follow. She needs something that works wherever she is though and is fast.

We had a dynavox machine for a while, but DD got frustrated with it's slow speed. Tbh. We also had books full of pictures, which she used for a while, but she really wanted to speak we had a fabulous TA - we were very lucky. We had the Specialist Cleft SALT come in and train the TA to do twice daily SLT with her. 20 mins each time. Practicing with blowing, Tongue placement, modelling sounds back to her. DD doesn't have learning difficulties as such, but she is deaf and had a trachy plus a small jaw with huge palate issues. It literally has taken years of therapy, which we still have.
The other thing that the SALTs can use (but they don't like to as it's expensive) is an EPG. Electropalatography. It's a plate with electrodes on it that map on a pc SW where the Tongue is placed for certain sounds. This then gives the SALT an idea of what areas to work on. If she also has a lot of articulation issues, they should have targets set, to help achieve better sound production. HTH.

Not heard of an EPG sallybear, thanks will ask the SALT. TA has been trained to do her SALT work with her and it includes speech sound production stuff, I do it at home with her too it has improved but really minorly and she has had SALT since two years old- I woke at 4am this morning worrying that nothing has really changed and maybe we need a specialist referral to GOSH or somewhere.

Since she has been on the SALT outreach programme since starting school I feel I have had less chance to have input over it all- I think I will ring the SALT who writes the programme. the last one has left and she kept saying lets get her talking then worry about speech sounds which felt a massive backwards step-DD doesn't stop talking she just can't make herself understood!

My dad talked about private therapy to focus more on the speech sounds side of things so it is an option and I know a good therapist but can't help but worry that we need it looked into more-and whether it is normal to be that severely affected with an SLI with no one having mentioned anything physically wrong other than weak muscles. She also has OT which involves strengthening mouth muscles.

Thanks Sallybear, it is hard when they can't make themselves understood isn't it, DD gets so frustrated. She has severe word finding problems too so it doesn't help that what she is trying to say is usually not a normal way of putting things-eg big raining would be raining a lot.

I'm surprised they dismissed PECs though. DS2 had speech problems (struggles to find the right words when distressed) and PECs was immensely helpful - we still use them for numerous things. I would think that if she is having difficulty with words, the last thing she needs is further distress in trying to communicate. I can't imagine it's helping her confidence or her speech to be trying to get her point across repeatedly and not being able to do so. Not to mention if she can get them to understand what she is saying with PECs, then they will be able to understand her speech better, which can only lead to helping her more.

Our DGS2 has problems with his speech and from what I can understand, the SALT has just signed him off. But it is still such a huge struggle to understand what he is saying (he's 5yo), I cannot believe they are not planning on working with him longer. It really makes no sense.

Ooops. meant to add, we were given a keyring by the school with a number of the pictures on it that DS2 uses, so we can take it anywhere and use it. It's in my handbag and brought out when needed. Easily done.

DD1 is probably clearer than your DD, used2be, because I can understand her saying 'i'm hungry' - it sounds more like 'i'm hungee' but relatively easy to decode. She is much harder to understand by other people than I, even her Dad & Grandparents (who see her daily) find that I have to interpret.

Re. Word finding, DD1 works around it by describing it (often by function). So, the slide is 'pink and goes weeeee' or a frube is 'long yoghurt' or chicken satay sticks are 'chicken with handle' (that took a while to work out!).

The difficulty there, is that DD's associations can be quite abstract. So, for example, we had a salad with chicken and beetroot. The next time we had chicken salad, she didn't have any beetroot. She said she wanted 'pink chicken'. Took me a while to think back and try to work out where she had seen 'pink chicken' and it made me realise she wanted beetroot.

Complicated lives!

DD1's school uses 'total communication' which means that all of the school staff use makaton all the time, no matter how verbal a child is. I've been amazed by how much DD1 has used it to supplement our understanding of her. When she's anxious, tired, or confused, she turns to signing.

We had photos on a key ring at one point but it never really took off. I wonder if DD would respond better to pictures/symbols though. Totally agree its not helping her confidence to not be understood and this was the argument I gave to the SALT - she needs the incentive of getting a response to want to communicate. Grr. Anyway the school were in agreement and for a while we were lucky enough to have a TA who was a qualified SALT-SHE HAS NOW LEFT BUT SHE HAD A LOT OF INPUT INTO THE WORK THEY DO WITH dd. The teacher recently said DD seems happier to talk to people she doesn't know at the moment which they put down to her being more confident she'll be understood so there must have been some progress but I still feel fairly desperate about it.

I think I will ring the SALT and also put a really big emphasis on it at our neuro disability paed appointment which is coming up soon. So frustrating not having answers.

Shocking if the SALT has signed your DGS off triggles, really scary how short the whole SALT service seems to be-ours wasn't replacing the people who left or went on mat leave so they weren't seen tobe cutting staff but they also had way fewer staff.

Will also order some visual and communication aid stuff and try using it at home then I can tell school if it works for her.

x posts lougle! Those descriptions sound very on my DD's wave length! DD's school also are meant to be using makaton with all children but although I know they must use some from what DD is doing, I have never actually seen them so they must only use it sometimes or with certain children.

I am now going to have to dig out her statement because in her ICAN report it said DD needs a signing environment , I think but am not certain that the lovely statementing officer (who unfortunately has now retired) just took that and put it straight in the statement -I will have to check.

I also interpret for DD all the time lougle. Even my parents who see DD all the time and are really in tune with her struggle. Do you have a diagnosis for DD? They sound very similar.

used2bthin if it helps, we used to use the keyring and practice words by having DS2 find the picture of things. So if we were going out to the car, we would have him find the "car" picture. If we were going to the supermarket, we would have him find the "supermarket" picture. It familiarised him with all the pictures, and gave him loads of practice with words.

His favourite picture? Mcdonalds.

Thats a good idea triggles. I think I will order a pack of stuff from asd visual aids and see what works and will try that. DD doesn't have an ASD diagnosis but I think the stuff on there looks appropriate.

The nice thing is that if it is helping at home, you can then bring it up at school and say "these work well at home, I'd like them to be implemented in school." Sort of bringing it in by the back door.

We do a fair bit of digging for pictures online, then print them off and laminate them with the laminator we bought. We also laminate picture lists of bedtime routines, house rules, toilet routine, and such throughout the house. We have "STOP" signs on doors and things that are unsafe to touch, as a reminder that they are off limits (although we also have other safety precautions in place).

I feel some days like we live in a preschool. Nothing like a "how-to" in the toilet to make you feel about 5yo.

Thats the sort of thing I hope to do at home triggles. DH moans about DD not washing her hands I can't wait to see his face when there are step by step instructions on the wall to a toilet visit! I have always wanted to label and picture DD's toys so its obvious which basket each thing goes in but thought it too nursery (ex nursery nurse)here's my chance!

Therabite is good for strengthening jaw muscles. But I think that you should sit down with the SALT and ask her to list all the sounds that she can achieve, the ones that are nearly there and the ones that are difficult for her. then build a programme around those, using exercises to help her produce those sounds. They should use some type of symbol program alongside to relieve frustrations. My DD was dreadful with back sounds. Nearly everything had a gg sound. Granny was graggy. We worked on m, p, th, f, first. Sh eluded her for ages. There are so many different types of sounds which is why the EPG was so important to see where her tongue was when making them. Warm up exercises are also very important too.

Thanks Sallybear, just googled therabite, can't imagine my dd tolerating anything in her mouth but we are working on that with the stuff so you never know.

The SALT only comes to school every six weeks to oversee the programme but the SALT assistant comes once a week and the TA does daily stuff. So I will ask when the SALT is next in and ask to meet with her. I think they are already working on specific sounds-at least the previous TA was but it won't hurt to check. She had group therapy on speech sounds using jolly phonics but it hasn't been enough even with me doing stuff at home too. Never is is it!It has helped her with phonics at school though as the signs and pictures are the same.

you have just reminded me she calls my mum raaey (granny) but till around a year ago she just called her mum as she heard me do that and no doubt found it easier! She also called her keyworker mum at playgroup till she learned to say an approximation of her name (Daff instead of Steph.) She uses d or b generally.

She doesn't have dx yet, except for abnormal MRI.

Bear in mind the wider context, though, when talking about speech sounds. DD1's school have NHS SALTs whose offices are in the school, and they say that if a child is generally 'behind' developmentally, then it is 'normal'for their speech sounds to also be behind because it is a developmental process (in the absence of physical conditions, ofc). So they look at speech in the context of general developmental level & would be more concerned with a child who was cognitively at 6 year old level with 3 year old speech sounds, than a child who was cognitively at 3 year old level with 3 year old speech sounds, for example.

But, I'm no SALT!

My DD doesn't either really but had normal MRI-abnormal EEG and small head size means that she is still having some genetic testing but pretty much at the end of what they can look for.

Yes that makes sense with development. DD is developmentally ok in some areas eg physical, although she is still behind it is not the same as her s nad l. And she is cognitively ahead of her age with pictures according tothe ed psych at ICAN but then her understanding of language is way behind that-makes me think I should try again with visual aids though even if it just helps with her understanding what I am saying.

I have been told it is hard to assess where DD with a lot of stuff because of the language.

Dd2 was v similar to lougle's dd, and used makaton (nursery also used it and she was statemented for mostly communication issues for yr yr. she has cp, so her speech has neurological cause)

The huge breakthrough with us was daily use of the Nuffield dyspraxia programme (and dd2 had had a SLT since she was born, lol). She didn't start Nuffield until she was four or five, and her speech clarity began to improve. In the end, we could tell of she wasn't doing the exercises at school, because her speech clarity suffered.

For neuro stuff, most improvement before 7or8. So at that point, speech is likely to remain the same.

We were told dd2 was likely to need AAC for life, as her oromotor was so poor. These days we can't shut her up and it's infrequent that we have to ask her to repeat... She's 8 now.

DD1 also had an abnormal EEG, that's why they did the MRI. Also small head.

She's in the DDD study. Is your DD?

madwomanintheattic that is really encouraging-also been told taht DD likely to need AAC and memory prompts for word finding for life. Also taht we won't know till she is 8 or 9 to what extent things will improve. Keep feeling like time is ticking and its only me who gets the urgency but I am sure I am not alone with this!

Lougle yes she is or will be when the pack arrives. The geneticist found a small deletion on chromosome four which may or may not be relevant as she then found I have the same deletion!

nuffield prgramme I have heard of actually and asked about a while back-did you have to be referred for that to somewhere else? Is it GOSH?

Nope. Did it through SLT.

Should say, we did it through SLT, but out of school (and just got TA to implement in school). It wasn't the school based SLT... Who was frankly a bit rubbish. Dd2 used to go to specific sessions during the school holidays at the local CDC.

Thanks, you have given me an idea as we are currently getting some social skills and SALT work through the local children's centre-the SALt is our old one and much more approachable than the school one.