Credit Where Credit Is Due

When Little Bear’s Speech and Language Therapist and I met one another things could have gone either way. There was certainly a high risk of a strained relationship. As I had already made two formal complaints about the Service and she knew I was a Speech and Language Therapist too, she probably came to the first session with some pre-conceived ideas of how I might be. I imagine she thought I would be hard work, difficult to please and all-round a bit of a nightmare parent to have on your caseload.

I also came to that first session with some concerns. Our experience of the Service so far had been appalling (hence the complaints) and I was feeling embarrassed by association. I was worried that Little Bear wouldn’t get his needs recognised or met and that every session would be cringe-inducingly awkward.

Fast-forward seven months and I’m pleased to report that we have weathered the storm. Just as I felt it was important to speak-up when the treatment we received was poor, I also feel you should give credit where credit is due.

Things did go fairly well from the beginning because she (let’s call her Helen) listened to me and tried to anticipate what I needed from the sessions, as well as being lovely with Little Bear. We have now been working together (and I truly believe that is how we have done it) for some time and Little Bear has made a lot of progress. We have targeted three different vowel sounds in turn which he has learned to articulate and has successfully generalised into his everyday speech. Helen has also set language targets and provided materials for school to work on.

Helen has recently re-assessed Little Bear to decide on next steps. Her assessment showed that Little Bear has moved from the 5th and 16th percentile on two comprehension subtests to the 16th and 63rd respectively, both scores now within the expected range for his age. He has also acquired a 4th vowel sound which we haven’t targeted in therapy. He has made incredible progress.

At the session before last Helen wondered aloud whether Little Bear might be ready to switch to the school part of their service now. As he has top-up funding he is eligible (in our area) for speech and language therapy visits to school. As he had made so much progress she wondered whether the time might be right.

I didn’t say much as I knew we still had further assessment to complete but when I left the session I had some nagging doubts. If he got seen in school, who would the therapist be? I’d have to get to know them from scratch and crucially so would Little Bear. How much involvement would I be able to have? Would the session take place without me being there? Although Little Bear has done really well with therapy, his speech continues to be peppered with errors and he is by no means ‘cured’ yet. I’d have to voice my thoughts next time.

However, when it came to the next time, I didn’t have to voice anything. Helen was one step ahead.

She had gone away and spoken with the school therapy lead and almost had a supervision session about Little Bear. I think it’s a sign of a good therapist when you can go away and reflect and ask other’s opinions. She is a very experienced therapist but knows that another perspective and some time to think can be really useful.

She happened to have some students with her during our session and took advantage of having someone to entertain Little Bear, allowing us the chance to talk. She suggested we had an honest discussion about how we both feel Little Bear is getting on and what should happen next. We went through each area of Little Bear’s communication and I told her how he’s doing with it, in real life, outside of clinic.

She told me that on reflection, she has some concerns about Little Bear moving to the other part of the service. She is worried about how he will cope, given his background, with getting to know another new person. She feels that both she and he, and she and I, have developed a good, effective therapeutic relationship. She is wondering about the benefits of trying to switch this relationship to somebody else. I wholeheartedly agreed with both of these things. I think it made it easier for me to be honest as she was so direct.

We agreed that although it is not ideal bringing Little Bear out of school to go to a clinic environment it is working well for him, he is used to it and it is manageable. We agreed we would continue in this way as it is better for Little Bear. It is not the usual protocol but Helen sees the need to be flexible to best meet his needs, as good therapy should.

As Little Bear is entitled to school input, Helen and her Manager have agreed to some flexibility about school visiting and Helen can do a classroom observation if I think that would be useful (she is usually clinic based only). I definitely think it would be useful to have another pair of eyes in the classroom. I have been desperate at points to go and observe myself but obviously as a parent it wouldn’t be appropriate. However, I value Helen’s opinion and it would be useful to know what is going on communication-wise in school, especially with Little Bear’s TA.

We then completed the prioritisation system particular to our local Trust. Helen allowed me to be a partner in this. We were mostly in agreement anyway but where we weren’t we went for the middle of our scores. I think it must be extremely difficult for her having another SaLT in all of her sessions and I find it hard knowing what involvement I should/shouldn’t have. I’m so grateful that she has acknowledged my background and we don’t have to pretend I’m not a SaLT. Ideal or not I am one and I can’t pretend that I don’t have knowledge that I do (although initially that was my intention).

I did acknowledge this with Helen and she said she is very mindful that Little Bear gets what everyone gets and they don’t just rely on him getting what he needs through me. She also said that if a parent had learning needs, they would adapt their approach accordingly. I happen to have a little more knowledge about communication than the average parent but this needn’t be a problem, they can adapt their approach for that too.

I know that not every therapist would have been able to take my profession quite as in their stride as Helen has. It is because she is confident and experienced that she knows it needn’t bother her. I have also been very careful not to comment unless invited and have acknowledged things like how difficult it is to transcribe vowels and that I would have found this challenging. Helen is the therapist and I am the parent and generally we stick to those roles. However, we do seem to have found a comfortable place in the middle where we discuss Little Bear’s needs on a level and plan jointly, as two co-professionals would. I suppose she has allowed me the role of professional parent, the specialist in my child, in a way that many parents, particularly adopters, are often denied.

We went on to co-write aims for the upcoming sessions of therapy.

Helen was clear that she will not be keeping Little Bear on the caseload forever. I know this and I don’t want her to but I do hope we are in agreement about when the time is right to stop. The prioritisation score we agreed on indicated that direct therapy is still needed so we are in agreement at the moment that the sessions should continue. We have two more vowels in our sights as well as some updated language targets.

I came away from the session extremely grateful at the way things have turned out. It shows that you can stand up for your child, make complaints and still go on to have a great relationship with a professional. As a parent you can get your views heard and you can get your child’s needs met if you persevere. I think Helen has been surprised that I’m not the nightmare I seemed on paper, I am just a parent who wants the best for their child and I am fully prepared to work together to achieve that. I will say what I think and I will point out bad practise but if things are going well, I will acknowledge that and praise it. We have a good working relationship and despite the odds I would even go so far as to say we that we really quite like one-another.

When we have finished therapy I will be writing to Helen’s manager to thank her for the service we have received and to recognise the great job Helen has done.

 

I have written a lot about Speech and Language Therapy and our experiences. You can read more here if you are interested: Developmental Language Disorder, Communication Difficulties: Update, SaLT, EP & an Assembly, Another try at SaLT, A bit of a rant, Living with Speech and Language Difficulties

 

 

Advertisements
Credit Where Credit Is Due

Developmental Language Disorder

As both a Speech and Language Therapist and Mum to a boy with Developmental Language Disorder (DLD) this is a subject close to my heart. This week is DLD Awareness Week and tomorrow, the 22nd September 2017 is DLD Awareness Day. Through this blog I want to make a small contribution to raising awareness of this poorly understood condition.

Although DLD has been recognised as a condition for a long time, its name is new. The condition has previously been known as Language Disorder or Specific Language Impairment (SLI) but everybody used the labels differently and the lack of consistency wasn’t helping with making people aware of it. There is currently an awareness raising campaign taking place which is brilliant. There are more children in the UK who meet the criteria for DLD than there are children with Autism but nobody has heard of the former. This equates to 2 to 3 children in every class with a condition that is poorly understood and under-identified. I’m not quite sure what us Speech and Language Therapists have been doing wrong but I’m pleased that there is now a big push to raise the public’s awareness.

As part of the campaign a video has been made. You can watch it here: https://www.youtube.com/user/RALLIcampaign

You can also tweet about it using the hashtags: #DLD123 #DevLangDis

There are 3 key messages that are the focus of the awareness raising campaign:

  1. DLD means that a child (or adult) has difficulties with understanding and/or using language
  2. DLD is a HIDDEN condition but is surprisingly common.
  3. Support can make a huge difference to children with DLD

In order to bring these messages to life, I would like to share some of my son (Little Bear)’s journey.

  1. In simple terms, Little Bear experiences difficulties with both understanding and using language. This visual produced by Susan Ebbels is helpful in giving more detail:

FullSizeRender (10)

Little Bear experiences (or has experienced) difficulties with every area in the peach circle including Phonology. If you want to know more about his journey, the specific types of difficulty he has overcome and some of the things we have done to help him, you can read about it in these previous posts:  Living with Speech and Language Difficulties , Speech & Language & School, A bit of a rant, SaLT, EP & an Assembly, Communication Difficulties: Update

As part of the awareness campaign, the diagnostic criteria for DLD have been clarified. Crucially, for us, early neglect is not an exclusionary factor. This fits with my growing hunch that Little Bear was always going to have DLD but that his early adverse life experiences have served to deepen his difficulties.

2. DLD is a HIDDEN difficulty but it does show itself if you know what to look for. It is crucial that teachers in particular are able to see beyond ‘challenging behaviours’. A world in which you cannot understand much of what is happening around you and you are unable to verbalise your thoughts, fears and ideas is scary and frustrating. It is no wonder that many children with DLD express themselves through their behaviour. In general people need to get better at looking beyond behaviour – what are the child’s reasons for behaving as they are? In our case (and many other cases up and down the country) trauma could be at play too.

Children with DLD may not put up their hand in class, they might struggle to complete their work and their learning may not be progressing as you would expect. They may struggle in particular with literacy.

If you speak to somebody who is taking a bit longer to answer you or who doesn’t seem to be following your conversation or who is confusing to listen to, they might have DLD. Give them more time. Don’t worry about having a big pause – they might need that time to think. Try to keep your language clear. It doesn’t matter about flowery language – cut to the chase. Say what you mean. Your conversation will get much easier.

Children with DLD are not un-intelligent. Little Bear has the potential to learn many things but the way they are explained to him is crucial. He can struggle with too much or very complex language but if you can explain a complex concept to him in an accessible way, he will understand it. We have recently had chats about hurricanes, electricity and endangered animals and he is a sponge for knowledge if it is presented in a DLD friendly way.

3. The best message from our story is that support really does make a massive difference. A diagnosis of DLD is not hopeless. Despite having been neglected for the first 3 years of his life and having very poor language stimulation during that time, Little Bear’s language skills have gone from strength to strength with the right input. It is never too late to put support in place.

Of course Little Bear’s difficulties are ongoing but he is progressing all the time. He has gone from using 3 to 4 word sentences to full, compound, complex sentences.

His vocabulary has grown from a miniscule hand full of words to a wide and fairly ordered plethora. Although words do still have difficulty getting stored correctly and sometimes jumble together (Numicorn for unicorn (Numicon + Unicorn) or chicken yoghurts (nuggets + yoghurt)), Little Bear is getting better all the time at being able to analyse the parts of words and can mostly imitate them correctly now.

Little Bear’s grammar is not bad, though the order can be jumbled. We usually have one target on the go at a time. At the moment we are working on ‘bigger than’ instead of ‘bigger of’ which Little Bear is grasping and using appropriately.

Little Bear’s speech has gone from being completely unintelligible to just a few vowel and more common errors such as ‘v’ for ‘th’.

His awareness of the sound patterns in words has gone from non-existent to being able to say the first sound to being able to blend sounds together to being able to read.

This level of progress in a two year period is fairly transformational. He doesn’t sound like the same child any more.

The progress has meant that making friends is much easier and things like being able to sing are becoming a possibility (it is still a challenge but Little Bear tries very hard and repetition of songs is really helping him). Little Bear has learned lines and spoken in a class assembly. He can speak on the phone and family members can understand him and have a proper chat.

 

Little Bear’s DLD will be ongoing. It will probably affect him into adulthood but this doesn’t keep me awake at night because I have seen the progress he can make with support. I have every intention of keeping the support going and although DLD will always be a part of him, it needn’t stop him. With the right support, he will be able to reach his full potential.

 

 

Please share, use the hashtags and watch the video. We need to put DLD on the map. Perhaps you know someone who experiences it?

Developmental Language Disorder

Communication Difficulties: Update

Over the lifetime of my blog I have talked about Little Bear’s communication difficulties quite a bit: first of all in Living with Speech and Language Difficulties then later in A bit of a rantAnother try at SaLT and SaLT, EP & an Assembly. In the most recent posts I have focussed on our quest for formal speech and language therapy rather than Little Bear’s communication needs per se. As therapy has been going pretty well, I thought it was time for a look back at the development of Little Bear’s communication and how priorities have changed over time.

When Little Bear first arrived his primary communication need was to develop his listening and attention skills. Little Bear simply wasn’t tuned in to language – he ignored it in pretty much the same way you would ignore background noise. He didn’t see the point of it and sadly I don’t really think he thought it bore any relevance to him. Little Bear’s listening skills were poor which impacted on his ability to understand language and on our ability to get him to co-operate.

I can remember wandering around a beach with him during Introductions. In my typical SaLT fashion I talked to him as we wandered. I pointed things out and named what we saw. Little Bear found this completely alien and tried to shrug me off like a nuisance insect. I think he even took to shushing me. Equally he did not respond to his name or any other command. Getting him to behave and keeping him safe was incredibly difficult without the use of language.

Over time we worked on this, mainly by keeping listening fun to start with – lots of drawing his attention to passing noisy things such as aeroplanes or dogs or sirens. I definitely found that in order to engage Little Bear with listening, we had to start with non-language tasks. We were probably quite silly and playful too, which helped.

As Little Bear’s listening skills improved a bit, we were able to work on his comprehension at the same time. Probably as a result of the listening and attention issues, Little Bear’s understanding of language was certainly delayed for his age. We noticed that he often said “what?” and needed us to repeat things for him, sometimes several times. We all reduced our language from the beginning to help him understand as there was a clear pattern that the more complex the vocabulary or the longer the instruction/ explanation the more Little Bear struggled.

Little Bear’s vocabulary was very poor for a 3 and a half year old so we did lots and lots of modelling which has developed both his understanding and his expressive language. I think if I had to pick one strategy that has been the most effective I would say modelling. There are several reasons. Firstly you don’t need any equipment to model language – you can do it anywhere and completely spontaneously which makes it very practical within busy family life. You can easily work to your child’s level – either just modelling back their sentence without errors or by adding in an extra word to extend their sentence length. I would often have a couple of targets in mind at any one time e.g. for Little Bear to understand the concepts of same/different, so would model those concepts each time an opportunity arose in play or just when out and about.

You can use modelling to develop any aspect of communication – initially I used it mostly for vocabulary and sentence building. I have moved on to using it for grammar and speech sound accuracy. I don’t think I would have predicted that it would be as effective as it has been: Little Bear’s progress has been huge. The great thing is that it is a very positive approach and at no point has it felt like I’ve been nagging or correcting Little Bear. In fact he got so used to me using the strategy that if I didn’t model back his sentence after him he thought I wasn’t listening properly and would repeat himself until I did! This is in stark contrast to the boy who didn’t want me to talk to him at the beach.

Little Bear’s comprehension is now patchy on formal assessment. His understanding of basic concepts such as hot/cold, first/last, same/different is within the expected range. His understanding of different sentence types is at the low end of average and his understanding of complex sentences continues to be below expectations. However, in everyday life we have noticed leaps of progress.

I recall one day driving past some electrical cables that had come down in a storm. My natural instinct was to point them out and tell Little Bear about them but I remember stopping myself because I knew that he had no idea what electricity was and I wouldn’t be able to find a way to explain it that he would be able to follow. These days his wider understanding of life is growing all the time. I recently mentioned London in passing and he said “they had a nasty fire there, people died” and another time we were looking at a map and I said “that country is America” and Little Bear piped up “is that where Dobald (Donald) Trump is building his wall?”. He is full of surprises these days and it’s brilliant to see his understanding of complex concepts developing all the time.

Little Bear’s ability to express himself on arrival was also poor. I remember him saying “you came back” on the second day of Intros and this being quite a momentous sentence. On the third day he said “you came back again” which was poignant and sad and lots of things but also the longest sentence I heard him say for a while afterwards.

I don’t think it is any coincidence that Little Bear’s behaviour was as it was. His lack of ability to ask questions, negotiate, explain himself and talk himself out of situations certainly lead to a high level of frustration and anger and the unavoidable need for some very expressive behaviour.

For a long time Little Bear expressed himself through pointing and enthusiastic use of “that”. He had some stock sentences that all followed the same structure: I go running, I go playing, I go sleeping. He used the words he did have creatively to get his points across e.g.“bik” (big) meant lots, tall, deep, full, massive.

Little Bear’s expressive language now comes out as being within the expected range on the Renfrew Action Picture Test. I don’t honestly think this is an entirely accurate representation of his abilities but he does use lengthy compound sentences and I have noticed that being able to do so has helped him in many ways. Just today he had his IPad in the car and I heard a crash as though he had thrown it on the floor. “Did you throw that?” I asked him, “No Mum, I tried to put it on the seat but you went too fast and it slipped on the floor”. I have no idea if this was true but I had to credit him with the good explanation. Previously I might have wrongly assumed he had chucked it and he might have got into trouble and not been able to defend himself. Having improved language skills has definitely helped with behaviour in more ways than one.

A big indicator of Little Bear’s progress with his speech and language skills is that now he is having formal SaLT our agreed priority is his speech sound system. It is generally agreed that language should be the main priority with speech being more of a secondary skill. Our decision to focus on his speech is due to his language skills being good enough and his speech now being the biggest barrier to his communication. It is funny how priorities have changed.

Little Bear’s speech was pretty much unintelligible at the start. Then we tuned in and as he didn’t have many words it didn’t take long for us to be able to translate. That was all well and good until his vocabulary sky rocketed and then we were back to having no idea what he was trying to say again.

Using mainly the modelling strategy we have targeted voiced/ voiceless confusion (“beas” for ‘peas’), articulation of ‘l’ (there was a little more than modelling involved in that one but not much), production of l clusters (pl, cl, sl, fl etc) and some random inconsistent/ storage errors e.g. “gog” for ‘dog’, “nogat” for ‘yoghurt’, “mu-ey” for ‘money’, “di” for ‘dummy’ etc. However, despite all that, at the start of SALT, Little Bear was still fairly unintelligible to the therapist at the age of 4 and a half. It transpired that his vowels were jumbled which was resulting in very unusual sounding speech – his teacher had even asked me if he was foreign.

At this point, although I am a SALT and had worked on lots of aspects of Little Bear’s communication myself, I was glad and relieved to have another therapist on board. Vowels are complex, they are in all words and I couldn’t really see the wood for the trees. I was pleased to have somebody to defer to for clinical decision making. She didn’t really know where to start either so after identifying which vowels were going wrong, we pretty much just plumped for one to have a go at. It was ‘eye’ as in pie, pipe, kite, nine, five etc (for non-SaLTs think about how they sound, not how they are spelled). It turned out that Little Bear could make this sound and he could say it correctly after a consonant e.g. pie but as soon as a consonant was added after it (pipe) the vowel distorted. In this example it became “pap”. Little Bear could hear the difference between pipe and pap which helped.

Once we had figured this out and done one session of therapy, Little Bear had cracked it and was spontaneously generalising the sound. We were both unprepared for it to be that quick. I was also surprised by how often that vowel crops up in English and therefore what a difference working on it made to his intelligibility.

We have since worked on ‘ow’ as in house, mouse, brown which were coming out as has, mas, bran. Little Bear acquired ‘ow’ in much the same way as ‘eye’. We then tried ‘err’ for no particular reason other than because it was another he couldn’t say but for some reason that one just isn’t coming so we have switched to ‘ay’ as in pay, plate, eight. Little Bear can say it in words but is not generalising it as yet. I am now getting a bit tangled up with which vowels I need to model for him!

The formal therapy is pretty good though it is not completely plain-sailing.

I had thought it would be helpful for me to keep in touch with the therapist via e-mail between appointments so I could keep her updated and take away the need for her to change her session plan on our arrival – this happens most weeks due to Little Bear’s unexpected/erratic rate of progress. However, apparently this would be against policy which seems odd to me. I frequently used to use e-mail to keep in touch with parents and think this is a missed opportunity.

Also, it turns out that Little Bear is now entitled to therapy in school because he has top-up funding. However as his speech requires specialist input from a therapist only, he has been deemed more appropriate for clinic therapy. I suggested that maybe the funding could be used to train school staff to work on his language targets alongside this. Apparently it cannot be done because the school team and the clinic team are separate and you cannot be on two lists at the same time. Whilst I get this, I can’t help feeling frustrated at the lack of flexibility and feeling a little like he’s missing out on his entitlement. A system with two rigid lists does not have children and their individual needs at the centre of it.

Either way, Little Bear continues to make fabulous progress and for that I am extremely thankful.

Communication Difficulties: Update

Another try at SaLT

Regular readers will know that there has been a bit of a saga taking place over Little Bear’s Speech and Language Therapy (SaLT) input from our local NHS Trust. You can catch up with the tale here: A bit of a rant

The response to my ranty post was both unexpected and overwhelming. It had evidently hit a nerve, both with other parents who had experienced similar difficulties and with stalwarts of the SaLT profession. Afterwards I felt my only course of action was to make a second formal complaint to the Service Manager. I thought long and hard about doing so because I didn’t want to get labelled as one of those nightmare parents that nobody wants on their caseload and as a SaLT myself it’s kind of awkward. However, in the end, I felt I had a professional duty to maintain standards and I couldn’t stand by and allow that type of service to be provided to other children.

The Manager didn’t seem to mind and took on board all of my points. She didn’t think the service we had been provided with was acceptable either. I’m sure that raises a whole host of other questions but I won’t go there. The outcome for us was satisfactory as she agreed Little Bear needed to be seen for THERAPY not another review ASAP and she wisely gave me a choice of seeing one of the therapists we had already met or starting again with someone new. I chose the fresh sheet and acknowledged that though I am probably every therapist’s worst nightmare, if there was somebody out there with a bit of expertise that would probably suit us.

So today, both Bears and I found ourselves sitting in the waiting room again. Little Bear wasn’t having the best day and was finding waiting very challenging. He had already slithered underneath the seat in front and therefore under the lady that was sitting in it; started chanting “look he’s bald” at the top of his voice; wedged his feet between the chairs, dangerously close to a man’s bottom and was getting increasingly agitated by the minute. Thankfully we weren’t kept waiting long and pretty much as soon as the therapist came out for us I felt we would finally be ok. I knew this because I’m not sure she even said ‘hello’ to me as she was too busy speaking to Little Bear. He fell into step with her and went into the clinic room pretty confidently. She chatted with him about his t-shirt, admired his new shoes and listened when he told her he was 5 now; little things but important things that were sadly lacking previously.

The second thing she had done was anticipated that I would prefer to sit next to Little Bear at the assessment table not at the big desk. Again a small thing but I felt she had thought a little about what would work for us.

She started the session by openly acknowledging the rocky road that had brought us to this point. I would much prefer that she did this, rather than shying away from it. I felt it got us off to a better start. She said she had read back over the file and, reading between the lines, had not found the information she had hoped would be there. To make us both feel more confident in the process she suggested we start again. She would spend a couple of sessions getting to know Little Bear and assessing him and we would then draw up some suitable targets. This seemed a much better plan than following the targets that were previously written without any real understanding of Little Bear’s needs and is probably the plan that I would have come up with, had I been in her shoes.

The therapist then took some time to listen to me and my thoughts on Little Bear’s communication. She acknowledged the work that has already been done and never made me feel as though I was exaggerating.

Little Bear had pretty much taken the clinic room apart by now but she didn’t seem bothered and got down onto the floor to try to play and chat with him. It didn’t go brilliantly well but that was more down to Little Bear not playing ball than anything. She scored full marks with me for trying.

Next she tried some assessment at the table. The previous therapists hadn’t assessed his comprehension at all so I was pleased she was going to. With a bit of help from Big Bear and some imaginary gorilla glue, Little Bear kind of sat on his chair for the time he needed to. It was weird watching him doing an assessment that I’m so familiar with carrying out, especially as I knew how well he was/ wasn’t scoring. It was lovely to see how much progress he has made and how much he CAN understand now though. Towards the end I was a bit unsure whether he was pointing to the items correctly or not and the therapist explained how she was scoring it to me. That opened up the discussion a bit and I felt we were sort of speaking as two professionals when one of us would say “I’m a bit dubious about that one” and the other would agree.

I definitely need to try to have mainly my parent hat on when I’m in the sessions but there is no point pretending that I’m not a SaLT when I am and if she allows us to work together that would be a brilliant outcome. I felt like a little team with the staff at Little Bear’s preschool and I do now with the Reception staff and I think that if you can achieve that sort of working relationship the outcomes are generally much better for your child. I’m hoping that all is not lost and despite everything maybe we could manage it with SaLT too.

At the end of the session we got another appointment for next week when assessment will continue so it does look like we are finally having regular SaLT input.

When we came out, Big Bear said “she was a bit crazy wasn’t she Mum?”. I knew what he meant, she was a little, but a bit of eccentricity is no bad thing when it comes to managing the little dude. She didn’t seem in the slightest bit ruffled when he kept reaching over her to type on her computer or when he straddled her leg or when he told her a story about having his willy out! I’m quite optimistic…

After my ranty post I felt it was important to also record the positive experience we had this time. Yes we absolutely should stand up and speak out against poor standards but we should also celebrate the good and I’m very relieved to find it does still exist.

 

Another try at SaLT

Speech and Language Therapy Support for Adopted Children

As a Speech and Language Therapist and mother of a child with significant speech and language difficulties, this is an area that I’m passionate about. At the moment I feel that adopted children’s communication needs are not really recognised or prioritised.

As the majority of children entering the care system have been neglected to some degree, it is likely that they will also have delayed speech and language skills. Babies and young children learn language from the adults around them. If nobody speaks to them, they will not learn language as they should. They might not be used to listening and this impacts on their ability to follow instructions and understand what they hear. It also impacts on their ability to work out what sound patterns are in words. If this information about the meanings of words and what sentences sound like and what sounds are at the start and end of words isn’t going into children’s brains, age appropriate sentences and clear speech will not be coming out of their mouths.

I think it is now fairly widely acknowledged that adopting a child is not easy. This process is much harder if the child you adopt can’t listen to you, doesn’t understand what you are saying, can’t express their own thoughts and feelings and what they do say is not clear. A communication barrier is not conducive to bonding.

Thankfully I have been able to fall back on my professional knowledge and have known what strategies to use to improve things for Little Bear. Most adoptive parents would not have that luxury and I think their child’s speech and language difficulties would compound their stress at becoming new parents.

Unfortunately (despite having being an NHS therapist myself until very recently) our experience of getting the speech and language therapy input Little Bear needs has not been positive and I hope it is not representative of what other parents are experiencing. He was referred 8 months ago and although we have been offered 4 appointments, they have so far all been cancelled by them.

I would love to see Specialist Speech and Language Therapy Services available to adopted (and fostered) children which would be able to respond when they are needed (not several months too late) and would take an holistic view of a child and family, taking into account the impact of the child’s communication difficulties on behaviour, behaviour management and attachment. I would also like to see Speech and Language Therapy training being available to prospective and new adopters, as well as foster carers.

We are trying to make this vision happen in our little corner of the country but I’m not sure it is on everybody’s agendas yet.

Speech and Language Therapy Support for Adopted Children