SaLT wanting your advice

[Dontbringlulu]

I am an experienced Salt in the area of ASD and sit on the panel for assessment and also carry out some outreach visits and 2nd opinion visits for local therapists. I would love to hear what l could do to be a better therapist from some unbias sources. What do you value in your therapists. What should l always do or not. Clearly resources are limited but is there any way l can do a better job for people with my limited time. What was the best thing about your Salt.

wish you could assess my son for me, i didnt know there where SALT specialised in certain areas, we have been passed from pillar to post. I hav fould with theones we have seen is that no one will tell us what they actually think about my son, apart from the obvious that he has a language delay, bt i mean if they see other things like asd. sorry if not much help to you. thanks x

pokhara - you said it in a nutshell: "..tell us what they actually think.."
I know we live in a litigation society, but we need your ideas and opinions - or if you're baffled then say so.
The pillar to post business is demoralising.

(refering to my experience of Salt saying ask ed psych who said ask Salt...what a merry-go-round)

Hi, My son doesn't have ASD but has SN and needs regular SALT, so I don't know if my experience is really useful to you.

"What was the best thing about your Salt"

I like salts that are up to date, that know computer games that maybe useful, that have read the right books and and give me that right advice, that dont sit at the table for 30mins but actually try to get language out of my child by motivating him through play.

I also like SALTs that don't "bullshit", sorry for the strong word, and give me practical advice.

Get some hands on experience!

Most of the SALTs I have seen have been on limited use - including the supposedly specialist ones - because they have had so little hands on experience. My son is severely autistic with severe learning disabilities - so needs are complex and most SALTs have been unable to cope with him.

One could - she was brilliant, but had lots of hands on experience.

I know its hard to get hands on experience within the NHS, but you really need it if you are going to help the more complex cases.

I've written quite a bit about SALT experiences on here over the last few days so if you search for my name over the last week you should find some examples of good and bad SALT experiences.

Honestly? Don't turn up at my house, read my daughter a story book, tell me "she'll need some help at school, I'll set targets" then write a statement report stating that she has severe delay in language, speech & concentration. Don't then send me targets (3 months later) telling me to read a story with her.

DO tell me what you think DD's problems are (technical terms are fine - I can google), how likely intervention is to fix them, or alternatively be honest if you think only time will do it. Give me SMART interventions/targets that are additional to things that most parents do anyway. Tell me how often you will see me, for how long (I have seen SALT 4 times in 18 months with DD1, she still hasn't seen her at preschool. I have initiated 2 of the appointments, the last was required due to statementing).

There is nothing good about my SALT. She is simply biding her time for her pension, and has been for years. Nothing anyone will do or can do.

Don't just assume that all kids with ASD on your caseload are visual learners.

Do read the notes you have on my child before you come to visit so at least you remember how old he is.

Ha Ha DS1 was said to be 8 on a SALT report - He was 4 and in Nursery where the SALT saw him.

Find out what parents concerns are and concentrate on those thereby working with parents not against - saves wasting everyone's time.
Actually do some therapy rather than bull***ing and then recommending we simply buy a book on the subject when pressed on specifics.
Be honest about what problems are always going to be issues because of the nature of their disability and what will sort themselves out with time and/or help.
Write honest reports rather than ones that massively overstate your involvement.
Be good at your job - our private SALT sussed ds out better in one assessment session than the two NHS ones did in 18 months.
(Have to say ds has cp and clearly both NHS SALTs were overwhelmed.)

Get the child's name correct on reports too and generally get your facts right if possible - makes me distrust them from the off.
And why spend so long on reports anyway. Would rather have the therapy time if you were actually going to help.

From my experiences of SALT over the years I would say that actually reading the reports before you see the child would help a great deal.

Put pressure on the system from within to get more resources; parents cannot do this by themeselves.

In my area of Essex the waiting list to see the specialist SALT was closed due to excessive demand.

I've just thought of another one:-

Do not blithely write me a report recommending that the school buys book x or y (average cost £60) because school will clearly not do this (lack of resources).

Don't say he needs PECS and I'll teach that next time I come and then not ever come back. Be honest about how often you will be able to see the child. If you can't offer the help the child requires, be honest, don't pretend to the parent the child is fine without it because you know the NHS / LA won't fund it. Some parents will get private help if they know its needed but not available. If parents go the statutory assessment route don't buy into the LA line that they are greedy, unreasonable and deluded about their child's needs, be prepared to stand up for the family. When the resources aren't there think outside the box eg you could do a Makaton / PECS course for 10 families in one go rather than see every family once every 3 months.

As long as all the professionals pretend the resources are fine and the parents are unreasonable nothing is going to change. Its easy to dismiss parents when they are the only ones speaking up.

Don't let Panels dismiss requests on blanket policies. Really put the the child's best interests at heart.

When you see parents being bullied by the system speak up.

Learn about autism specific approaches eg ABA, Floortime etc and where you see this working say so.

Consider whether an approach eg a visual timetable is actually needed and consider what you are using it for; be SMART. Therapy should not be just about accommodating the disability it should be about addressing / reducing the disability.

Find out why very few children who start ABA / VB at a young age end up non verbal compared to UK eclectic approaches - and few of them need to rely on visual supports. Insist that what you do is based on the best and most up to date evidence.

Have high expectations for our kids. Don't say when a child is confused learning sentences - well does he have to can't he just use single words - understand that just because a child has exceeded expectations thats not a reason not to move the child on to the next target.

Campaign for your local library or a childrens centre to provide Boardmaker for free. Or even offer it in your own department.

Thank you for being interested in parent's opinions and coming on here.

I completely agree with this point "As long as all the professionals pretend the resources are fine and the parents are unreasonable nothing is going to change. Its easy to dismiss parents when they are the only ones speaking up.".

Otherwise - better elements of the NHS SALT experience:-

1. Hanen course - much better IMO at setting individualised SMART targets than bogstandard SALT.

1. willingness to communicate by phone or e-mail between appointments and to send out resource sheets etc.

Worst elements.

1. difficulty getting a referral before 3 years, and then first appointment being 9 months after that (even though had private salt report confirming severe delay)

1. waiting list jiggery pokery. after 8 months on joint clinic list, DS got booted off, and sent to a SALT with a shorter waiting list who "didn't normally deal with the joint clinic" cases - so didn't have the expertise to deal with receptive lang/social communication problems.

fortunately this SALT 1)put him back on joint clinic list and 2)referred him on to specialist salt team, but this wasted even more time.

Actually don'tbring can I ask you a question. Do you have to work to malcomess care aims (or something similar) and if so does this prevent complex cases from receiving salt?

I ask because my son was always deemed 'too severe' to be given salt. It was frustrating because actually he tries very hard to communicate (although many salts don't seem to think that's possible in severe autism) but we've had to do most stuff ourselves.

Oh I've thought of another - fund out if the child can imitate. If they can't don't waste the parents time on learning makaton (unless they're willing to teach hand over hand) - get the child going on pecs. And make sure any pros helping implement pecs have at the very least been on the 2 day basic pecs workshop.

Gosh - we're so lucky - our SALT is fabulous...really innovative. I'd like to second Flyingduchesse re: visual support and the presumption that it'll be a one-size-fits-all for ASD.

My DD1 has been verbally diagnosed with ASD - although her main problem is language. It was the SALT who realised that the pecs being thrust on her at pre-school was driving her nuts. I'd noticed something early on when she HATED (understatement!) and screamed at Mr Tumble....because he was signing. It distracts her...as do the pictures. She can't process the words you're saying AND do the visuals. The school defended it until SALT went in and showed them other ways of getting her to make choices...and she's doubled her vocab in 2 months

Reasons I like my SALT -
Talks to me
Sets targets
Shows me the reports
Goes through games and ideas to keep DD1's focus and that will bring out speech.
Goes to pre-school and physically shows them what to do!

reading the other posts I feel really lucky - just hoping the luck will hold out!

If I could be really blunt with my children's SALT, and she would actually listen to me, I would say:

Actually take the time to SPEAK to my child.

Listen to my worries and do something helpful instead of handing me some badly photocopied sheets.

Make referrals and appointments when you say you will....instead of me having to chase you and remind and beg you for 6 weeks.

Don't tell me you are waiting for a specialist SALT to assess my child for Verbal Dyspraxia, make me wait months and then fob me off with you doing a 'pre-assessment' assessment instead.

Don't tell me my child has made NO progress when I have worked really hard with him while there has been no SALT provision........and I have just told you what new sound he can now make.

Don't treat my nearly 8 year old like a two year old, when her understanding is not the concern.

Give the well-behaved children in group sessions more attention......ignore the one who throws the SALT cards and paperwork all over the floor and don't give him 1-2-1 sessions after the group, it isn't fair.

Do not allow noisy sibling toddlers who interrupt into the group sessions.

Do not tell me my child will have to go to a language unit at a special needs school - then give me the name of the wrong school.

And, most of all, DO NOT LIE TO ME . I have two children on the same waiting list.....do you not think I will notice if one of them (the least severe) gets 1-2-1 sessions after you telling me they are extremely hard to come by and my most severe child will need them to progress????????

another SALT watching and reading with interest. most of the above reasons are why i left my job in the nhs. i just couldnt deliver what i knew families needed. i know families with young children with a recent ASD diagnosis need consisitant, regular visits/support/coaching/information from a therapist skilled in ASD. what i was "allowed" to provide was an initial visit, signpost to a group, then follow up 3 months later. crazy.