ABA PECS and SALT

[mizmiz]

Just looked through this for the first time. Fascinating for me as I am an SALT for people with special needs. Feel that I am getting an insight into parents' minds , something that isn't always easy.

Do any of you use PECS at home, with/without ABA? I have been working on this for a while and consider the two to be the most exciting stuff I have come across in 12 years in this field (although as some of you note, some SALTS are suspicious of it, which drives me nuts as I don't think they understand what it is about.)

Do ypu find using these methods at home sustainable, or is it too much bother and fuss? I would love to know. I have introduced it with some dramatic results to some of the families and schools I work with, but now that I have gone abroad to live, I worry about their ability to carry on.

BTW if you have any questions about SALT, I would be glad to try and help. help. Time lies heavy on my hands in a new country.......

Twiglett, the fact that your ds is so at ease socially will be an enormous help to your ds. He has a permanent role model around! (And she sounds delightful too!)

I am not familiar with the game you refer to, but you are spot on! These sorts of role play/make believe games are really useful for children with these difficulties as they can work out what needs to be done in a safe environment.
SLTs in lang. units use loads of these sorts of things.
Your SLT should be able to give you lots of ideas.
(I used to run groups dealing with this sort of stuff for older children with Aspergers who, as you can imagine, often had a really hard time.)
Wendy Rinaldi and Alex Hitchings are s/lts who have developed useful packages for this sort of stuff, and there will be loads more. Often hard to keep up, esp. as I haven't done this sort of work for a couple of years (have focussed more on p/mld)

Thanks so much for your kind offer!
I will let you know if I need anything, but at the risk of sounding like a real prig, I just find this whole arae so interesting and could discuss it for ever! It's not a chore for me, and I know that committed parents working with an on the ball s/lt can make an enormous difference!

Sorry,m eant that last message to be for binkie (getting confused!)
Twiglett,shall deal with you next!

Dingle, sorry that you have given up on NHS therapy. (Wonder why? Would love to know!)

150 signs is FANTASTIC!!! Even if your dd is not yet talking, as I am sure you know she is laying down a good solid foundation for using and understanding language in the future and of course she is communicating now! (Wish i could take you along with me to see some of my families.)

(Do you know the book 'Reading and writing skills in children with Downs Syndrome'? I think the DSA publish it. My copy is old but it is fantastic, full of really sound advice on the above skills and language in general.

Twiglett, I did that course and it was tough (largely due to the fact that you are cramming into 2 years what an undergrad. does in 4!)but I enjoyed it tremendously, and the staff are second to none.

I had a related first degree but we did have people with unrelated degrees (more than I would have thought actually, remember one person who had done Electronics!) and they were fine. Maybe tussled a little more with some terms but came through it all. I also think being older and a parent is an enormous advantage. Unlike some 19 year olds you are not going to be paralysed with fear in a clinical situation.

Ypur reading matter is commendable! Don't worry if a bit heavy going. With some preactice to go with the theory it all becomes easier and far more interesting! (Was lucky enough to have Crystal as an u/g lecturer. He sparked my interst in the field.

It is a great job, lots of freedom to pursue areas and methods that interest you, very family friendly (there is such a shortage of us that most trusts are happy for you to have unpaid leave and so on. eg Lots of my colleagues don't work in holiday time.)
You will never be unemployed and the money not bad at all (I earn around 35K a year-goes further in my part of the world than it would in London.)

Only minus to my mind is NHS bureaucracy, targets and paper pushing, and of course v long waiting lists so hard to give everyone sufficient time and energy.
Think it's a great idea to shadow a therapist and no, City wouldn't think you were a nutter for making enquiries now!

ABA is Applied Behaviour Analysis, based on Behaviourism. Just completed some research with p/gs involved in ABA who were looking at PECS.
Was about to embark on an ABA p/g diploma, but pregnancy intervened! Maybe in a few years?!

Thanks mizmiz

Do you think it would it be possible to do the 2 year course with young children .. ie does it fit in with the school holidays?

.. would ideally love to be able to drop off and pick up children from school but will probably need childcare to do the course ..

Don't see why not?! There were people on my course with kids. It will be tough (what isn't with kids?) but possible. There are academic terms which coincide with school holidays, and quite a lot of clinical placements throughout the course that they will arrange in a place convenient for you. A lot of our lot would go home for these if they weren't London based.
Obviously a lot easier if you are in/around London.

Good luck Twiglett. I thought about doing this myself but I am only educated to o'levels! I really don't see how I would ever manage it.
I think I'd be better sticking to the "hands on" approach. I have volunteered my "services" as a Parent member for the SALT that we attend for dd. It specialises in DS,and we are trying to build up another group to help cut the ongoing costs.
I am waiting to hear the outcome with fingers crossed! DD will be a nursery 5 mornings a week next year so I will be sitting at home twiddling my fingers!! (as if that will ever happen!)

Go for it Twiglett. Dingle, that sounds fab, good luck! I definitely want to do something 'useful' and practical, just not sure what. Thought about retraining as a teacher and trying to become a SENCO at a secondary school as this seems to be an area of need. And, blimey, do we need more speech therapists!
Anyway, asked DD's therapist about PECS. She HAS been on a course but a long time ago and agrees we should go together with DH ASAP. She's going to bring her PECS manual in tomorrow and we're going to look at what we're doing in more detail. Think, to be honest, that when everybody started with DD she was so totally 'unreachable', we underestimated what she is capable of. So people thought she wouldn't cope with traditional pecs and would needc more help making the association, 'I hand something over in exchange for something'. But think we need to go back to the drawing board, so to speak. Have our new speech therapist coming to the house on Wed so will also ask her what she thinks. But DD's supervisor is very pro-PECS and she gets annoyed when VB bods are publicly 'pro-signing'! She's got a child who uses signing and a VOCCA, one who uses a computer and DD on 'bespoke' PECS!
Anyway, thanks for all your input. We are in a rut with it and I think your thoughts will definitely help us sort it out

Dingle, you sound as if you are worth your weight in gold...probably would be wasted as an SALT, sound as if you will be very influential from a parent perspective! (Don't see why you couldn't do it if you wanted too though!)

Jakbrown, sounds very promising! Looks like they are going to review the whole approach. Get hold of a PECS manual yourself. It is really easy and logical to read, with every step explained in minute detail, possible questions raised and answered, trouble shooting and so on (make sure you have the most recent one as it has been revised and refined quite a bit over the last two years.)

One further thing-I have often crossed swords with other salts because they think that a child is 'not ready' for PECS. This is balderdash. PECS is designed to reach the 'unreachable' if you like. You don't have to 'prepare' for it. Best way is to launch straight in. I have seen it work very well with a child who I can only describe as the most autistic individual I have ever seen!

I would not deny that PECS is time consuming and that keeping track of the pics can be a hassle (although it may have been like that for me as I was trying to keep track of about 20 people at one time) but it really can be the key that opens the door to positive and effective communication,so is well worth the effort.
Keep us informed!

Jak, I don't understand why anyone would think your DD couldn't use PECs in the usual way, even if she only got to stage 1. It really is the best way to make those associations, I choose a picture, you give me the item.....

Yes, well, I'll get to the bottom of it.

A quick update for mizmiz - had our visit from SALT on Friday - ds performed perfectly, in that he was typically intensely enthusiastic about the games, did a fantastic vivid recounting of the Phantom Tolbooth (current favourite book) - while throughout getting nearly every vowel wrong. So we're going to work on those first.

It is a funny difficulty. I wonder if his pragmatics might sort themselves out once he gets confident about people understanding him first off (which he isn't at all at the moment)?

Sorry to sound like talking across lots of other people's posts - lots of issues on this thread but mine doesn't merit a separate one.

hi mizmz

Would love to ask question about my son if you still have the energy for all this typing! my son is 5 and has receptive and expressive speech and language problems. He also has articulation problems -very hypernasal and problems producing c/g also some vowels sound weird too. He has very limited attention span. His last assessment he scored 3 (out a possible 7) for all receptive/expressive areas apart from naming verbs and nouns where he scored 5. Can't remember the name of the test. Apart from that he is a lovely lively little boy with good observational skills. I have to hide the Christmas pressies bags something I never had to do with my older child!!

We are trying to get him moved to a language unit but for now he is in mainsteam school with a 1:1 help. He has a history of ear infections and glue ear & has missed alot of school as a result-we are seeing an ENT who thinks he might need his tonsils out. he has already had his aedenoids removed & grommets fitted but the ear infections have continued. Also we adopted him at 19 months and he spent alot of his early life in care sitting in a car seat infront of the tv sucking a dummy. When he came to us he was silent (no babble) and didn't understand any language.

My question is could his health problems and lack of attention in his ealy life be enough to cause his problems or is there an underlying problems that will cause lifelong difficulties? A part of me is still hoping he might eventually catch up. It's probably a difficult question to answer but I've never had to courage to ask his SALT and now we are in the school system we never see anyone (everything is done in writing).

Thanks for reading this & if you can make any suggestions for improving his attention I would be really grateful!!

mum38, I just spotted your term "hypernasal" (never seen it before). Have had a look on websites and it's exactly ds - the funny vowels AND the physical side too: he doesn't have cleft palate, or anything really medically significant about his throat as far as I know, but he has got absolutely cavernous nostrils - first thing I noticed about him when he was born! And presumably that must mean his interior nose/throat passages are similarly open, hence making breath management different for him than others. How fascinating!

It does mean he's the king of efficient nose-blowing, though. Often wished I could clear my head that easily.

we use pecs and makaton

binkie hi, my ds is getting good at the nose blowing too! But its a nightmare if he sneezes too soon after eating. I'll leave that to your imagination!! He has always been a bit hypernasal but when they took out his aedenoids he got even more so.

Does your son have a "cathedral" tpye of palate? We have been told that is part of ds problem. The rest is due to lack of tone in his soft palate. We are doing lots of bubble/candle blowing to help but progress is slow. Let me know if you find any wxercises that help!!

Hello again mum38 - sorry for delayed reply. Re palate, had a look - certainly is pretty high behind his front teeth (dh's is too) but not all the way back - have a very proactive dentist who did say we'll have to watch out for his adult teeth getting crowded, but I'm sure she would have mentioned if palate itself was unusual. I think for him it's just a case of rhino nostrils.

But I will share any exercises the SALT suggests, definitely.

Sorry for delay in response. Been off this for weeks. Binkie, glad to know that your salt visit went well.
Mum38, your query is one that has fascinated people for ages. (Ever heard about 'Genie' and the wild boy of Aveyron, two famous examples of children with an early history of extreme neglect and/or lack of human contact?)
There is no doubt that your ds's early history of lack of stimulation would have a negative effect, compoinded by a history of middle ear problems (notorious for causing language delay.)
However that is NOT to say that this cannot be reversed to a large (if not complete) extent.We know that children are surprisingly resilient and most, even in less than ideal conditions thrive.

I would discuss it with the SALT. She cannot predict the future but by being honest about what specifically is an issue, she will be able to suggest activities/resources/further reading. There are masses of useful things out there. I have lots of brilliant books and manuals from which I take ideas (would recommend titles but am abroad and brain is a mass of post natal mush..). If you are willing to fork out, ask to look at her catalogues (eg Psychological Corporation, Winslow Press where you will find a wealth of useful and reasonably priced stuff dealing with attention which is suitable for parents.

At its most simple level, if you have the time and patience, designate a time every day for table top activities and/or stories with you. Start with 5 mins and work up to about 40 mins over time. Reserve a treat for him at the end (eg fave toy, video) I do this with my dd. Found delaying the opening of the advent calendar a great incentive in the run ujp to Christmas.
Limit time in front of the tv, also too much background noise (hi fi, tv, radio) which will help, and reduce quantity of toys available. Too much choice a very bad thing for a child with a poor attention span-they can't deal with it.
Hope this helps.

thanks for replying mizmiz!

Speaking to his SALT is hard as he is in school system now and everything is via the school. We have tried ringing but she is always out assessing other children. We are waiting to see if he will get a block of 6 sessions with a speech assistant this term. Hopefully if he does we will get some info/feedback. I wish we could afford to go private.

Thanks for all the ideas though. I try and play table top games with him at the weekend 1:1 when DH is around to keep the other 2 amused. I feel very guilty that its not every day. I think the reward idea would work with him.It's one of my NY resolutions to find more time!!

congratulations on the new baby!!

Actually, I think you have a right to speak to the salt. Not such an outlandish request surely?!
Yes, time is always tight, but impo if I have a very keen parent who wants a word and is able to fit into my school timetable then I would damn well make sure that I saw them. What on EARTH is the point of salt if the parent doesn't know what is going on?!I can always squeeze in 20 mins with someone if they come into school and are happy to wait for me to finish a group or something.
Make a request, follow it up with a letter if necessary and cc it to the manager (that'll make them jump to it a bit!!)
If you are clear about what you want to see her for then you are actually making her job easier.
I ask parents too PLEASE come and see me or phone me and am always disappointed when they don't because we should be working together, not in isolation (sorry, don't mean to sound like a goody goody) I have my goals which I want to make sure are theirs otherwise as I said, what IS the point!?

I know how hard it is to fit in time for 1:1 stuff, but you're obviously managing some of it so that bis great. Yes,a reward really does work. Also useful is to use something like an egg timer or oven timer.
I try and have a sort of 'family session' of games immediately after dinner when we are all at the table. Hard to manage often but dd loves the fact that we are all doing the same thing rather than imposing something 'worklike' on her.
If dh and other two willing then it's fun!
Just something simple like dominoes or snap. What all kids love most is ATTENTION to them.

Sorry mizmiz-could you have a look at
this I have only heard about it today and although I haven't had a good look there seems to be lots of info and downloads available.
I love the idea of the forum but it seems so poorly used.
I would love to promote the site and spread the word about it but would like your opion first please.
Sorry for being such a pain but it seems criminal that there is such a shortage of therapists and yet something like this is not in use more!I know it is not the same as actually seeing someone but surely it's better than nothing!

Hi Dingle

Yes I had a good look and as you say, seems like an excellent idea. Appears to be something put together by a web designer who has a daughter with speech/lang difficulties. She has put in a lot of work and as you say,what a great idea to share ideas and expertise. Her links are pretty good too-a lot of very respectable bodies are included.

Yes, forum seems rather underused at present so it would be great to spread the word.
Obviously SALT is a prefessional field, but no point being precious about it! I'm all for anything that takes a bit of pressure off SALTS.

My only concern is the title which suggests that sppech can be 'taught' like elocution (I'm sure the web designer knows this but it may come over badly to some people.) Also reference to 'speech therapy' which in UK at least is technically inaccurate. We are speech and lang. therapists as we do not work solely with speech (ie ability to make and string together correctly the sounds that make up a language.) but rather also with the global concept of understanding and being able to put words together with appropraite grammar to create conversations (put very simply)

My only caveat would be to run any ideas gleaned from the site by a salt to make sure that they are appropriate. Peolpe in their enthusiasm can get confused and pursue something inappropriate however intelligent. I find myself having to remind my own (v. intelligent!) parents and dh that some of their tactics/ideas are inappropriate for our dd and her lang. difficulties.
(Still, that's the nature of any advice offered on the Internet isn't it?)
(BTW, have volunteered to help out with a questionnaire being done by a student salt regarding provision for people with ALD om it, so hope I've done my bit!)

PS Have you checked out the ICAN website (ashamed to say haven't yet, but mega respectable charity whose remit is children with s&l difficulties?)

mizmiz hi

My DH finally got through on the phone to the SALT (we & the SENCO at DS school have been trying for weeks)& she has agreed to send us some work we can do at home. DH said she was v. defensive though but has said DS will get some therapy this term!! She said she was v.concerned about his attention (or lack of it!). My DS hates being tested and was probably very unco-operative in his own quiet way. One of the reasons I think I should of been able to have a word with her on the assessment day. Every child has their querks and surely a parents input is important?! Apparently it won't be a SALT that comes to a school but a trained speech assistant so maybe I will be able to have a word.

I like the sound of the after dinner games-unfortunetly I am a commuter widow!! DH doesn't get back until late. I could bribe my older DS to play games (I hadn't thought of that or the egg cup idea). My little one is toddler stage and causes mayhem with any game. Maybe I could brible older son to look after toddler while I have a quick game. Thanks -it has got be thinking.

Well mum38, still think you should be able to see salt, partic. if she says she is concerned re attention.
The assistant may be very good, but remember that they have had minimal training (no disrespect intended-we have some excellent ones) and are not in any position to give specific advice/guidance,

I know that she probably was defensive. I think we all are. Time is so short, there is so much to do and so few of us, that any request for more can be met with dread (beding honest now!)
If people just want to complain about lack of salt, then face to face meetings are a waste of everyone's time. If it's any consolation, ALL salts feel the same and it is something that can only be dealt with at a higher level-managers or the govt. even!

However if you are calm and civil and had a specific request/points to discuss then INHO your request should be met.