SALT advice - lingle, TotalChaos, others?

[sc13]

We saw SALT for DS (3, ASD) - she's nice and experienced. BUT instead of doing things like teaching him verbs and prepositions, SALT said not to worry about language: DS (she said) has a lot of language. Would that be the same DS who repeats scripts from tv and whose receptive language is 18 months behind? [hmmm]
Right now, SALT said, we need to concentrate on communication - not on what DS says, or indeed on whether he says anything at all, but on him wanting to communicate and interact with us and others. That's more important than the past tense or the plural. What about school, says I. You worry too much, take it easy, he'll be alright, says SALT.

1. Is SALT right or is this NHS-speak for 'we only have three SALTs and there are kids in the borough who don't talk at all - you're not a priority'?
2. What do I do now? Do I spend the little time I have with DS (I work f/t) teaching him verbs in an Italian accent? Do I get a private SALT behind their back? Do I Hanen DS out of his skull until he interacts 24/7 and then demand 'verbs-and-plural' SALT? Aarghh

I don't know if this is what you want to hear, but I think the SALT is spot on. My Ds1 is very verbal but struggles greatly with language used for social communication and with understanding. Him being able to repeat back something is not the same as him being able to tell us how he feels, to understand how to communicate with us. To continue to get the concept of turn taking. To learn that other people won't automatically understand him when he says things out of context and thus learn to explain further. To understand the concept of why things are happening. He can watch "Thomas and Friends", for example, and repeat back "Edward had to get the coal" but can not understand why or what the overall theme of the story is. He cannot link things up with other things.
He will be six in July and at the moment he can repeat back a story, he can say what he sees, he can count, he can write a fair few words (with better handwriting than me ) and he has learned the correct responses to many questions, eg "what do we wear when it's cold? A hat and coat?"
But for all this fantastic memory and language what he can't do is first of all express how he's feeling, he has significant impairments in being able to communicate, to maintain a conversation, to answer questions that aren't familiar, to understand that verbal communication is very often a two way process. When he goes out he has a little booklet on his coat with his details on because if he got separated from us he would struggle to give more information than his name or age and any unexpected questions would run the risk of either silence or a completely irrelevant answer.
So to me verbs and perfect grammar isn't important. I verbal model the correct way to say the sentence if Ds1 says it incorrectly, but I don't worry that he's mixing up tenses etc. What matters to me is that he is able to get his wants and needs across and to understand to communicate even when we're not talking about his obsessions.

He's 3. When is school? 2009 or 2010?

You need moondog or another SALT to answer this question.

But I have a gut feeling that she may be right.
The emotional stuff is the foundation.

Are you overwhelmed with books because if not I want to recommend Greenspan's "The Child with Special Needs". It talks about this ........

Thanks bullet, that is what I need (if not want) to hear; what you're telling me is very useful and I'm sorry that you sound a bit sad telling me these things. With a lot of work I'm sure both our DC will get there!!
Thanks lingle, I trust your gut feeling more than I trust mine . I'm reading Greenspan's Engaging Autism and it matches what the SALT says. Unless they change the rules, DS should start reception in January 2011

sc13, SALT may have been oversimplifying things so they sounded incoherent.

Stan Greenspan's "The Child with Special Needs" is full of explanations about why getting the emotional stuff right first is the key - are you overwhelmed with reading stuff already because if not I recommend it (and as you know I despise most ASD literature).

agree with lingle about oversimplification.

I dont' entirely agree with the previous posters - I think very basic language such combining verbs and nouns in phrases and filling in any gaps in concepts can go hand in hand with generally boosting communication. i.e. that the 2 aren't incompatible aims at all. When DS was 3 and severely delayed, I'm pretty sure the advice from private SALT (who was v. experienced with working with kids with ASD) was to do both (and work in signs/pecs/gestures/visuals etc for good measure!). I would fully agree that getting the past tense and plurals right isn't a priority - that sort of thing does come in time after lots, lots and then some of correct modelling. At 5 DS's past tenses are shaky - but that doesn't really affect him at school.

Thanks again guys. I see what you're saying Total - the SALT made me notice than even when I do Hanen things with my DS which are meant to get us playing together, I'm trying to insert a very targeted language element that (in her view, if I understood her correctly) stresses me out and interferes with the playing together. So I should be aiming to do both, but setting myself (or rather DS) simpler linguistic targets for the moment, and making them secondary to the interaction/playing together thing.

Do you think the SALT is saying that you aren't following his lead enough?

I realised after posting (and agree with Totalchaos) that it's hard for us - especially those of us who are a bit on the cerebral side anyway - not to have "targets" - but could you make a target that involve having more and longer back-and-forth "turns" with each other per interaction? Then you'd still get that sense of progress and achievement but you'd be building more on those foundational emotional and listening skills so that it can become more rewarding for him to listen to people.

Ooh, 2011, lovely, nice and far away.....

Well Lingle, that's a key issue for me.
I don't think that things can done without targets so I think things have to be made measurable. Up to the therapist to consider how to do that.

Guff about not being able to quantify sucvh things is often an excuse for poor intervention.

Once again, ABA blah blah blah blah

SC, really interesting point too and although what SALT says is valid and I agree with it, again it often becomes a reason to not do concrete things.

Just gets all wafty and touchy feely. Nowt wrong with that (I'm a wafty sort meself) but it often means nothing is done.

moondog ?
would aba work with a chid with sever apraxia ?.he doe snot have any main behavoiur issues apart from odd bout of frustaration ,Does have GDD as well

thank you

ABA is not a set treatment.It is use of principles of effective learning and can thus be applied to any situation where you want someone to learn how to do something, be reinforced by it and maintain that learnt habit.

I don't have specialist knowledge of body or verbal dys/apraxia though.

Thank you
hmm ok not sure if will works salt explained its not becuase he does not want to more that he physically cant ,infact he wants to desperatley is doing well on makton though has 50 or so signs now

I agree with Moondog - it's completely obvious that you need to work on the fundamentals of communication and not just the top level - verbal language but why does that become a reason in itself not to work on any language? Parents of non verbal children long for a word or two, parents of one word children long for phrases, parents of phrase children long for sentences. If the wish is realistic, this area should be covered too. The Hanen course I went on was excellent in that it had a good balance of underlying communication and trying to coax out more words.

That's great!
Of course you can't make someone do something they can't.
Often you can however break something down into tiny steps and work on these systematically, allowing someone to gradually master something that was previously unachievable thoguh.

Very few SALTs use or understand ABA (more's the pity).

think ned todo some reading on it has anyone got link to a good but simple ABA site please
All ds really ever been able do is amakesqueals and few other noises but am not going give up , just need to start looking at other options

There is the Mariposa school manual which you can download from their website. I found that had very detailed info.
Moondog also recommends a book called 'Don't shoot the dog' (see Amazon), but I haven't read it.
There is an association called PEACH which can send you an info pack.
But I have no idea how suitable this would be for your DS; especially if he is willing to communicate and does not have behaviour problems. If I understand it correctly, the key principle of ABA is modelling behaviour (including verbal behaviour) you want the child to have/learn in a situation where they can speak but kind of choose not to, iyswim

If I understand it correctly, the key principle of ABA is modelling behaviour (including verbal behaviour) you want the child to have/learn in a situation where they can speak but kind of choose not to, iyswim

Hmmm, not really, no.
Phoenix, it's impossible to give you accurate guidance over net on this one.

Ooh good glad you found this moondog

I'm ploughing through Greenspan and I was thinking "hmm, I wonder what moondog would make of this".

I don't honestly think there is anytihng bad about focussing on emotional stuff. I'm sure Greenspan is a good guy (not familiar with it but have had a look just now). I just think that more concrete things need to be done too and too often they aren't.
atherine Maurice' Let me hear your voice is a very interesting well written book.
She is the mother of an autistic (two actually) child and describes very well her need for something touchy feely along with the cold hard scientific programming and data collection.

It's relevant to any parent cuaght in this sort of dilemma and a really easy 'human interest' read.

Phoenix I think (from reading all of one bookthat ABA is about training a person to change their behaviour.

Some problems are training problems, other problems are not training problems.

For instance, a roommate who leaves their clothes on the floor can be trained not to do so. You take it in tiny measurable steps and reward every change in the right direction.
But a newborn baby who cries in the night shouldn't be "trained" not to do so - it is a hunger problem, not a training problem.

Where that leaves your little one I have of course no idea.......

yeah did wonder if that was the case and if so ABA not going work for this .He so badly wants to communicate so i know its not case of him not wanting to

Yeah I expect the apraxia experts know exactly how to try to get the mouth movements going.......

Must admit I'm with the "getting them to communicate" thing. DD told me today "DD's hungry". First time she has EVER told me that!!
OTOH, she can come out with really involved sentences like "The children are having carrots for lunch at school today" (no, this is not rehearsed, it's genuinely constructed by her). Her problem is not inability to form sentences. She even has some past tense, and occasionally gets her pronouns right, but she just doesn't feel the need to communicate! If DS (23 months) drops his toy car he'll say "Mummy dropped it CAR" and point so I'll pick it up. If DD drops her teddy she'll just shriek "Mummy do it! Mummy pick it up" without bothering to tell me where she is, what's she's dropped, why it's a problem for her.

'Right now, SALT said, we need to concentrate on communication - not on what DS says, or indeed on whether he says anything at all, but on him wanting to communicate and interact with us and others. That's more important than the past tense or the plural.'

SC, I am with you there.
My salt side fights constantly with my ABA side.
Sometimes they work together in hamorny, other times, sparks fly. I sometimes wince at lengths an ABA therapist will go to to elicit speech whereas i would be more than delighted with successful communicative attempts, no matter what the medium.

It is a point of great tension heated debate between myslef and colleagues from dark side.

One more thing: all of these peopel have great and useful things to stay.Noone is denying that they do.The key issue to consider as a parent is how effectively these theories and ideas and visions filter down to the generally unqualified, poorly trained and poorly paid 1:1 assistant who will probably be supporting your child. (There are 24 000 of these people in the UK and number growing.)

I think you know the answer to that one.

That is why you must fight tooth and nail to have proper training and supervision specified and quantified on your statement of special needs, not meaningless guff like 'advice and support as appropriate/as and when needed'.

My final words on the matter for now.I'm off to Arizona for that ABA conference and need to pack!