Speech assessment - feeling deflated!

[runikka]

Have just come back from a speech assessment for little Daniel (social comm disorder/asd)
and feel a bit helpless and very much a failure as a mum.

We were advised to try things such as:

Feeding teddy for pretend play.
Giving teddy bath.
teddy bear picnics.

This is all well and good but I have no idea how we engage him to do this. The speech therapist was testing his understanding by showing him an orange, banana and slice of bread (plastic). Well, he wont go near banana and at 2.5 we wouldn't give it to him whole. Orange, likewise. Bread I guess he might have an idea it was to eat but to him it is toast/sandwiches. he does see these things in books and we would point out what they are but I really dont expect him to relate to his life. Should I really be sitting with him reciting what all the different fruit and veg is when at the moment we just want him to make eye contact, learn some basic communication and maybe a few words that will help him "drink, bed, nappy" etc

He loves his teddies hence the association of tasks but he loves to chew on the ear and shake him (he has a rattle inside) and cuddle but I dont think he would feed him or bathe him. I just dont feel he would get what we were trying to do or associate it with his life.

Sorry rambling but feel so lost!

What are your concerns? Our first few years of SALT were complete waste of time as we kept on being given that sort of stuff to do and it was hopeless. I couldn't get ds1's attention for 2 seconds let alone shove teddies at him (he had zero interest in teddies). Eventually I was told by the SALT "he's impossible to do any work with becuase he isn't interested in anything". So I employed someone who knew her stuff, told her this "rubbish" she said and got to work with him and indeed worked with him for an hour a week every week, and of course gave us stuff to do.

Teddies, dolls and bloody "ooh look bubbles" aaaggggghh You completely have my sympathy.

Will he sit at a table - you need to work on that first.

One thing that someone gave me to do (that is a standard SALT thing) that ds1 loved was posting pictures. As he posted the picture I'd say the name of whatever it was- and he learned loads of vocab like that (we then moved onto "give me.....x"). We have taught basic play skills- but with lots of reinforcement at each stage.

We had all this too. Pretend play is still beyond DS2 at 4.5 and it certainly was at 2.5. I think some SALTS (not all) have a kind of check list of things they have to run through - and feeding teddies must feature very strongly!

Does he like music / singing? All DS2's early words were learnt from songs. I started just by singing to him and then I would pause to see if he would say the word. If not (and at the beginning it usually was not) I would sing it myself, in a very exaggerated and dramatic way. Gradually he began to fill in words - and some of them he even managed to generalise to other situations (farm animals etc)

The other thing we've had some success with is games based on domestic routines, eg going to bed. Literally pretending to go to bed, snore, wake up etc - over and over again. He will now request and initiate each stage verbally - it's taken a long time, but I guess it is a kind of pretend play.

The book 'More Than Words' has some good speech ideas.

Really sympathise with you - I used to come back from SALT appts feeling utterly deflated. DS2's speech only really took off (and he's still at single word stage) when I realised that he would only be motivated to talk by games connected with things he really really enjoyed - not by a game foisted on him by someone else.

Gosh - have gone on a bit! And realise that I don't know how good your son's speech is - so apologies if he already has quite a bit and I'm totally off the mark!

sphil- can I just hijack to ask where you bought more than words from. I linked to some hanen stuff on my website- but it wasn't easily availabel on amazon (and very pricey).

Hi there

Many thanks for your replies Sorry, my original message was a bit garbled.

Daniel has no real speech though he says words in nursery rhymes whilst singing (amidst babble) and occasionally we'll get mumma/dadda (not in context).

I guess I went along and came out thinking that I hadn't spent any time showing him th basics, what a banana is etc etc and it is my fault he has no understanding. In reality it is just unfortunate that it isn't something he comes across as food in general is an issue - he'll eat anything disguised as casserole but is not brilliant with textures so giving him a whole banana, apple etc is not an option. I guess we point these things out in picture books but he shows little interest. Had it been a train or ball or beaker we might have seen some signs of understanding because these are things he likes.

Some of the game ideas today were good but pretend play is an issue. Daniel likes peek a boo and action songs so we can get some words in there.

My post followed a major major tantrum on the stairs. He didn't want to come up and I was carrying his little sister (11 months) so couldn't carry him up. We were stranded for ten minutes when he just went into meltdown and it was quite scary. I am also having major issues that his little sister just isn't getting enough attention at the moment. I worry constantly about her development and whether she is stimulated enough. Daniel's strop started because his sister was crying but she is teething and was obviously in pain at the time. She needed the cuddle but I ended up with two screaming kids for over 45 mins with neither about to give in and Daniel wasn't going to share a cuddle. In the end biscuits ended the stand off but it is just one of those days when you feel that there is no light. It is so not helpful when "helpful" relatives say ahhh the joys of little children as if what we are trying to get our heads round is just run of the mill.

No. no. no. It is not your fault- please dont think that. The point is with NT children you don't have to teach them this stuff - they just get it- having ds2 and ds3 was a revelation to me. Some relatives still do that to me btw I tend to have a fit these days when they do.

I feel like I'm plugging this tonight but have a look at my website- I wrote a bit about SALT last night. The link to the Hanen program is worth checking out- there are some free ideas on there for things to play with your child etc.

Click here and scroll down to yesterdays entry.

Hi Runikka.
You sound like a fabulous mother.
If you weren't you would not have gone to the trouble to post the comments that you have.
As a salt myself,I completely sympathise with some of the comments on this thread disparaging my colleagues.It has to be said that some have so little concept of working with children with special needs that one wonders why they are doing the job at all,but hey there are crap folk in every profession eh?

Having said that,pretend play is the foundation of language for the vast majority of children,so from a developmental pint of view,it makes sound sense to work on this as a precursor (hopefully) to working on more formal language skills.It is the play itself that are important,not the objects themself so it is important for yuo to choose what makes sense to your family.

So,in my family,I would use pretend raspberries or strawberries as that is what my kids are mad for.I would use pretend rolls as that is how they mostly have bread and I would get a pretty cup with a straw (like they have) to play with.
I would include a favourite toy in mealtimes (making it jolly by including other siblings and father,having the teddy or whatever drop stuff,or spill his drink or tidy his plate away.)

At showertime,I'd have a doll in there with them,maybe even buy her her own toothbrush and wash and condition and comb her hair like my dd's,and have her squael (me making the noises) like my dd does.

This is the sort of stuff the salt means I think.Does it make sense?????

Nursery rhymes with signs are fantastic and a really great way of intrducing and developing early communication skills. Will do yuo a link to a woman I think is great...not specifically aimed at kids with comm. difficulties but really great.

Sing and Sign

i would really recommend that you buy the dvd and watch/act out with him.

I don't know that the SALTS I saw were crap- they just had no experience/training in communication disorders. And those that did had very little hands on experience.

The only thing I'd say about sing and sign is that imitation has to be in place first, or its depressing. DS1 loved makaton Dave anyway though.

Yes but Gess,that is the whole point of thev job-to have training in and experience of communication disorders!
If you haven't got that,you're not doing your job,no??

well to be fair they were either community SALTS (so no training) or specialist SALTS (so such ridiculous caseloads no time to do anything other than leave communication programmes).

DS1's specialist SALT visited him in mainstream. She was joined by his private SALT who worked with him on a weekly basis (and is ABA trained). He looked at her, grinned, and climbed on her lap for a cuddle. NHS SALT said "I didn't know he was capable of that"- and then kept saying it. She was trained, but the system gave her no chance to learn the skills she needed for hands on work.

I remember that story well.

What you describe sums it up really. It's bloody hopeless.

I am a specialist salt with a ridiculous caseload but work on fostering good relations with staff and hassling powers that be in education dept.

(Am putting my ABA stuff into practice btw and have my course supervisor coming into my school/s to give ABA training as staff so impressed by what we have done and how reveealing data is.)

Very exciting.

well that's it isn't it moondog- to work effectively with children like ds1 SALTS need extra training - e.g. in ABA - ABA training should be standard for specialist SALTS imo. THings like intensive interaction would be wonderful extra training as well.

Our NHS SALT told us that ABA would turn ds1 into a robot. I said if it gave him skills to cope with life then I would rather that he was robotic than floundering. I did make sure that I showed her video of ds1 doing his programme and I think she realised that she had been wrong about ABA- she was impressed with what she saw.

I'd love to meet that robot woman Gess.I would so love to meet her,listen to her spout guff,then slapp down 40 years of solid research on the table in front of her.

Very interesting the way those in the NHS and education world instinctively snner at what they don't konw or understand instead of saying 'Oooh that's interesting! Can you tell me more about it?'

I suspect it is because doing so would lead them to examine the current shabby system and see it for the house of cards that it is.

Oneo f the reasons I am wavering about going freelance.I feel I have more influence within the system,imperfect though it is.

They are intoducing 15 hours of ABA a week in the form of early intervention down here. A step in the right direction. None of the people in the system have any idea how it works though, and they've just fought (and lost) 2 tribunals to fund home programmes. I did hear earlier in the week that they've employed a VB consultant to advise and help with training, who I hear does know her stuff, so fingers crossed it will work well rather than be a watered down waste of time and money.

The thng that really cracks me up though is that they all loves PECS, and I always feel like saying "don;t you know what Andy Bondy does for a living, don't you know what method you're using to teach this "

Gess - I haven't bought More Than Words - borrowed it from library (for a VERY long time ). Had same problem as you when I tried to buy it.

Moondog - wish we had you as a SALT! Our NHS one was v similar to Gess's - our last few sessions together consisted of her sitting and watching me do DS2's ABA/VB programme with him, clapping and writing loads of notes! Wasn't her fault - just not trained. Our private SALT was brilliant (specialist in ASD) but even she didn't know much about ABA even though she was a PECs fanatic!

We've used Sing and Sign for a long time with DS2 - worked better once I'd learnt the songs and did them with him at his pace. I think it's fab!

Runikka - The people who run our home programme (same as Gess's) suggest not starting with speech at all but focusing on imitation - because without the ability to imitate, a child can't learn to speak. I can write more about this if you like (and i'm sure she would too)but you sound as if you're a bit snowed under atm. I know the feeling that your NT child isn't getting enough attention - I feel as if I spend my days tearing from one child to the other, and DS1 is nearly 6, which is much easier than having a baby.

She's doing the same as me dino. Growing Minds distance program with employed therapists.

(we employ the therapists independently).

Yes,it's so funny the way people love PECS and turn their noses up at ABA! Cracks me up.I love putting them right!

I have just broken the news to the powers that be that we are using ABA in the classroom and homes. As they have gladly funded thopusands of pounds worth of PECS training for staff and parents (at my recommendation!) I am really looking forward to hearing what they have to say. (Tbh I think it will be positive as I am working in collaboration with the uni. on our doorstep which is one of the few places in E|urope to offer an MSc in ABA)

I have spent the morning graphing up data.Noone can argue with that.

Hi, I use the "More than words" book. I got it direct from Winslow (Sorry new to site so no good at links) It costs about £34. The site is well worth a look for all the resources.

Hi

Thanks once again for your replies. There is certainly some food for thought here and I feel a bit less full of doom and gloom today. Is anyone near East Grinstead in Sussex, just wondered what the step by step school is like. Considering long term plans at the moment?

Best Wishes
Kirsty

Moondog - which area do you work in? I ask because DS2's special school (he starts in Sept) are keen to coordinate his home programme with his school work - but they don't use ABA at all atm (it's an MLD school not ASD-specific). We're having a meeting with them in a few weeks time and I'd like to suggest some sources of expertise that they could draw on. I'd be very interested in putting them in touch with schools who have started using ABA in the classroom or even consultants. Am intending to take the recent media reports about the effectiveness of intensive behavioural programmes to the meeting - though to be fair, the Head really seems very keen to work with us on this. The school is linked with a m/s+lang unit next door and the two are set to co-locate in 2008 - both Heads seem pretty 'cutting edge' and as such very willing to take on new ideas.

Gess - would be interested in the Early Intervention stuff in your area as well and as we're not far from each other it may be that links could be made?