SALTS?? come here please. Or, any parents whose children have been through SALT and now finally speak!!

[MsMargotBeauregarde]

Background. My son has been dx with mild autism. Not sure I believe this. He does have a severe speech delay, and some quirky little behaviours and isn't GREAT at transitioning, but he's not terrible either. We arrive early and can manage.

Anyway... The SALT rang and asked how the PECS was going. My son isn't interested in PECS. I can't MAKE him do it. He's very certain of what HE wants!! And in this regard, I don't blame him. He can now say about 50 or 60 words and even though they aren't that clear, I can guess. I think that it'd be madness to try and make him miserable by pushing him into using this PECs folder. Especially as now, at the stage he's at now, when he can't make himself understood, it's a more complicated idea than a pure noun. ie, he wants me to leave a door ajar, or I've put too much water into his juice, or put it into the wrong cup... NOT something that can be expressed by a picture.

I took on board what the speech therapist said about his being a visual learner and we do go through some very good picture dictionaries and I prompt him to say words. He is coming along.... I feel now, finally, that he will talk eventually.

The speech therapist clearly feels that I'm ignoring her and I'm foolish not to respect her superior knowledge ........

I saw an ABA tutor recently who said that he wouldn't use PECs with my son, that his speech has gone beyond the point of needing PECS; that he'd only use PECs for a child with NO speech.

It 's a bit complicated but at this point I don't want to mention to the SALT that I was talking to an ABA tutor (not through her). She is supposed to be arranging that for me.

Any thoughts..? My son is 3 btw.

SALTS say all ASD children are visual learners, I have been told this by people who have never met him. To be fair, visuals can be important for some children on the spectrum and most will make some use of visuals. My son did not take to PECS either and we were made to feel this was a failure on his part rather than a failure of their assessment of his needs. My DS could ask for red or green grapes when PECS was started but the SALT kept telling me how exciting it would be when one day he could hand over a card with a picture of grapes on it. I'm not anti PECS but would tend to agree that it's best for non verbal children.

I will put the health warning first - DS could already communicate before he used PECs, so we didn't have to start from the beginning and we could miss out several of the preliminary phases. Also DS is supposedly "probably" language delayed rather than on the spectrum.

PECs worked absolute marvels for my son even though he was verbal (just about at combiner stage) when he first started using PECs. It got him speaking in sentences. The focus was on him saying "I +want +more +juice" rather than on him using PECs instead of his words iyswim. Within ten days of using PECs as a support to his speech, instead of a garbled "havva more juice", we got "I want more juice". Within three months of using PECs, he started putting together sentences spontaneously "I want mummy run on grass".

So - I think you need clear answers from SALT about how to make PECs work for you and DS, and to support his emerging speech.

btw I feel that DS genuinely is a very visual learner - that's why private SALT suggested PECs to us. Whereas local NHS SALT seem to go for Signalong/Makaton to augment communication.

I don't think TC's experience is typical though - I did ask our NHS SALT about building up to sentences with PECS (cos I'd read about in on MNnet) but she looked a bit baffled/startled. But I do agree visual learning can be very important if used the right way for the right child.

Oh NHS (I don't normally deal with the joint clinic cases) SALT looked very blank when I showed her DS's PECs book and said "but doesn't it overstimulate him?". Do you mean my experience is atypical because of how how well my DS responded to it, or because NHS SALT wouldn't use PECs in that way?

and I completely agree cyber that PECs isn't right for every child.

Margot - have you ever got hold of a copy of "It takes two to talk" Hanen book? as that has very helpful advice about building up language.

My son is at combining stage too. So he can say "more apple" or "My milk". To replace that combination of words with a picture of ONE thing (eg an apple or a glass of milk) seems like a step backwards to me.

Not to mention a battle with my son that HE sees as being utterly ludicrous.

the way we did it was to have pictures for "I", "want", "more" and "apple", so DS would point to the pictures and say as many of the words as he could - obviously to start with I had to model a lot....

I meant I have not come across it used in that way though I'm sure others could well have other experiences. PECS does seem to go in stages from basic exchange to 'commenting' with cards so I'm not sure where the pronoun bit comes in - but my knowledge of it is very limited. I think PECS is meant to augment/kick start communication not teach language but I could be wrong.

How do you express "I" and "want" in a picture TC?

trainland.tripod.com/pecs54.htm

that's got "want", from memory the "I" one is someone pointing at themself but not 100% sure.

this is a very informative site, with a lot of links to PECs symbols halfway down

trainland.tripod.com/pecs.htm

NB - I don't want to seem as if I am trying to railroad you or persuade you into PECs - just to show that it's not impossible for verbal children to benefit, but if you and/or your aba guy don't feel it's right for your DS then of course don't feel obliged to go down that road....... cyber is right that the primary purpose of PECs is to supply a communication system, rather than to teach language/build sentence length.

www.autism-help.org/communication-augmentative-alternative.htm

I found this which does mention sentence strips - eventually so I suppose you could ask the SALT what is the best way to start PECS at the level needed? If she does not agree, is that because she has not heard the level of language he has or does not think it important?

SALT is another word for the ARROGANCE

what are they anyway/ they arent teachers, they arent psychologists, yet they so often think it is their right and duty to take on these roles.

PECS - they love pecs because of their limited belief in our children, that they will speak - so they dole out pecs cards providing access to 'functional' language, after all, they dont really believe our kids will do much more than ask for juice, water or a hug right??

we fought against pecs and SALT opinions from the start (stress the word 'opinion' cause that was all it was)

anyway, our boy is doing great with speech and langauge now, understands all we say, can read and is now learning to write.

thanks for nothing SALT.

the worst thing a parent can do is take these people seriously. they are glorified technicians.

what is exactly that they do??

Isn't Moondog a SALT? She might be able to answer some questions.

Not all SALTs are bad tho mmddww to be fair. My dd is in a language unit and didn't really speak until she was 4. Was dx with a severe speech and language disorder. Now at 9, nearly 10 she is well within the normal range when tested but still struggles when out in the big wide world. Although I would say that is more to do with her asd than anything. As she is in a language unit and received daily SALT in her 1st year and had had continual SALT intervention ever since so I think it has really helped dd.

Agree totally with mamadadawahwah. Every SALT I have ever come across has trotted out the same three truisms about autism : 1) they are visual learners (yeah, because you can't be arsed to teach them to verbalise, so pix are easier) 2) they need visual timetables (see earlier arsed point) and 3) they should use PECs, even before we have had a go at teaching them to talk (again, the can't be arsed factor). Whatever course SALTs do (and for my money, it's a Mickey mouse qualification), the module on autism is woefully inadequate and out of date. IMHO, you could try the Verbal Behaviours principles to get your child talking, and ignore the SALTs' receieved nonsense about how speech is "innate" and can't be "grafted on to the child, before they have the precursors of speech in place, eg eye contact and turn-taking". These ludicrous views set me and my son back 8 months and £100s spent on a private SALT. VB, a form of ABA, teaches that language is a behaviour like any other, and can be taught through reward and motivation (at its simplest, the child gets a piece of choc when they learn to say choc, or to make an approximation at the sound, and you build from there). The other thing that drives me titless is that SALTs turn up at annual reviews and other statutory meetings as a proxy for the whole LEA, and opine on all sorts of issues for which they are eminently ill-qualified - eg behaviour, reading, writing, you name it - the SALT will trot out a visual timetable or PECs symbol for it! Phew, got that off my chest. Now I'd better duck for cover before I get targeted by the SALT mafia (apart from wonderful Moondog, who is an honourable exception to all of the above, as she is a SALT who also knows ABA/VB, and who should therefore be put in charge of every SALT training course in the land, imho).

Hello, I am a SALT bit frightened to post. I am a specialist in ASD. PECs should never be a one stop answer for all children/adults with ASD. However l have used it very successfully with some verbal children. I would look with the families at the reasons behind communication, the direction of communication and see if we needed to develop these. With some children l might move through the first 2/3 phrases in a session. For other verbal children it is a short term teaching tool. I would discuss the ABA with your therapist l work closely with some tutors to create joint targets. I would explain your concerns to your therapists. Also initially it should be v. highly motivating using fun and rewards. I normally lend out high interest toys to get requesting moving. Most children and adults love it and it is an activity they should enjoy not a chore.

OOh dear, some harsh words about SALTs here!

Many of them warranted I may add!

Ok, let's get a few things straight:

-Lot of salts out there who think they are experts in Autism but aren't.

-Lot of salts out there who don't understand how to use PECS (ask if they've been on at least the 2 day course.If not, they absolutely have no right in trying to implement it

-PECS can be used with kids with language as there are 6 stages, and once you get past the 3rd, it becomes complex and children can use it to convey sophisticated needs and wants. BUT you do need to go through all the stages first, even if this initially looks like a step back.This is because we need to ensure that the child understands the 'rules' by which we are abiding.

A salt who really understands PECS (like moi) will explain this to you and whizz the child throguh these preliminary steps in minutes/hours, so no harm done. One who doesn't thoguh, may indeed spend too long faffing at early stages which will frustrate the child and annoy the hell out of you as parents. Additionally, it will be hard to work out if you have a salt who knows what she is doing (ie is doing the whizzing throguh thing) or one who is faffing with basics.

So many don't get PECS so you are well in order to be cynical.I had one SALT come to me, all enthused asking about PECS for a child we both work with. I let her ask questions then said 'But..er...he can ask for this stuff verbally'
Her f ace was a picture.In the heat of the moment she had completely forgot.

I gree with much of what Socalled says, too.

But may I add Mama and Sick ,that it isn't a 'Micky Mouse course' neither are we 'glorified technicians. SALTs have such a wide remit-dealys, disorders, neurological damage, hearning impairment, ASD, various syndromes, CP, hearing impairment, cleft palate, phonological disorders and so on and so on (huge amount more if dealing with adults as well).

They can't know/do it all despite the rigorous training (4 years as undergrad. and 2 as a postgrad. with a relevant first degree such as Linguistics or Psychology. the problem is that a lot of their hard earned skills (detailed knowledge of phonological analysis/linguistics/symbolic development/acoustics) just aren't relevant to (most) kids with ASD.

I think there should be SALTs who only work in the field of paediatric SALT otherwise, as you have all discoverd, you get someone who doesn't really know what s/he is doing

very interesting point about the degree training. Can I ask how much of salt training would be spent looking at receptive language problems and/or learning difficulties? Have had very mixed experiences with NHS SALT, some very positive, others less so. IME even within paediatric SALT people can be overspecialised, one lady happily told me "I don't normally see the joint clinic cases ".

Just wanted to say, i think SALTS are great , dd has had a great SALT at her nursery, sadly she has now retired and dd is now without a SALT (for now anyway), Dd2 has Suspected HFA and is almost non-verbal, she started using PECS 6 months ago as well as a few signs and she took to it well, we also use picture symbols with dd1 (AS) who is very verbal, we use them for schedual's etc. Since using PECS and signing dd has started to try and talk (and sing), she can now say Please, Drink, cookie, Biscuit and chocolate and is trying to sound out other words.

I love PECS and i think its is worth using with your DS if you can.

my ds has HFA and has been helped since 3 by SALT he too would use visual with SALT and pre school but would not do it at home

although we found many things on internet and he would look and learn from there i spent alot of money on buying now and next , how many sleeps and a cd packed with pecs but he had no interest at all

put him at the computer for it and he would sit and learn for hours

anyway ds is now 4 and speaks in full sentences his speech sounds are being worked on but he didn't start with sentences until 3.5 and now his 4 and his range of words and use of words is age appropriate

speech sounds his under but his SALTS have been great and he responds well with them he has just started asking what and why questions so in 6 mths he has come along way indeed

and no doubts he wouldn't have got there without the SALTS not so much with what he was doing with them but the advise given to me with what i can do also

best thing i found was repeating everything i was doing i mean everything as to understand language you have to understand the actions and this was great for ds and he came along within weeks as he was watching and absorbing and then one day woke up and said i cant reach it this was from one word talking

but SALTS still try to use pec cards and he does visual at pre school but just refuses at home

Hi!
After reading the above;
I am now very worried!

My DD (23mth) has her first SALT appt next month.

What should we be asking?
Are they a Paed SALT?
Are they looking at her speech (lack of) as well as her awkward eating habit?
What advice should we expect to come away with?

????????