Ensuring Children’s Speech and Language Needs Are Met: A Call to Action

As most of you know I am a speech and language therapist and my son, Little Bear, has Developmental Language Disorder   (DLD) so it is no surprise that meeting children’s communication needs is kind of a big deal for me. A recent report has come out reviewing speech and language therapy services for children and the findings are a little damning. It is called Bercow10 as it is written by John Bercow (of MP and having-a-bit-of- a-naughty-wife fame) in partnership with ICAN and the RCSLT and is a follow up to the original Bercow report which was written 10 years ago. It is a very important document and I want to share some salient points with you. As many of my readers are involved with adoption in some way, I am going to focus in particular on the bits of the report that are relevant for looked after children, children with mental health needs and children who become involved with youth offending. However, this is something that EVERYBODY needs to know about so please don’t look away, even if you don’t have any obvious connections to the content.

The report begins with an important message: “The most fundamental life skill for children is the ability to communicate” but it goes on to say that “as a nation, we have yet to grasp the significance of this”. This certainly seems to be the case as there are more than 1.4 million children in the UK with speech, language or communication needs (SLCN) yet it is not something we really hear talked about and most people have never heard of DLD despite it being one of the most common disorders of childhood. We hear a lot about the ‘obesity epidemic’ as it has a physical impact on children and a financial impact on the country. Bercow says that SLCN has a developmental impact on children as well as a social and economic impact and should similarly be considered an issue of public health. Being as SLCN impacts upon a child’s education, social, emotional and mental health and their future life chances it is a much bigger issue than it is given credence for.

A good starting point is to raise awareness of SLCN and what that means and what it looks like. If you want to know more about how Little Bear has been impacted by his language difficulties, see these previous blog posts: Living with Speech and Language DifficultiesCommunication Difficulties: Update

Children from disadvantaged backgrounds, whether that is due to social disadvantage or maltreatment, are disproportionately affected by SLCN: in some areas as many as 50% of children have language disorder and Looked After Children have poorer language on school entry compared to those who are not Looked After. Children considered high-risk for harm, such as those on a Child Protection Order face a higher risk of SLCN as do children who live with domestic violence. Across the care system as a whole, 63% of children have SLCN, compared to 10% in the non-care experienced population. This makes our most vulnerable children even more vulnerable to poor life outcomes. Children with SLCN in early years are twice as likely to develop social, emotional and behavioural difficulties and are at greater risk of depression or anxiety. Children with poor vocabularies are twice as likely to be unemployed as adults compared to those with age-appropriate language skills.

The statistics are pretty scary. What is also very worrying and makes my heart break a little is that many children’s difficulties are missed or misdiagnosed. Studies have shown that 81% of children with social, emotional or behavioural difficulties, including those with conduct disorder or ADHD have significant undiagnosed SLCN. If we extrapolate that a little, the picture seems even worse. These children, who cannot learn in school (because the curriculum is not accessible to them and teaching is not differentiated for them), often go on to engage is risky behaviours – drug-taking, crime etc. and unfortunately many will go on to find themselves in the youth justice system. Another study shows that 60% of children in the youth justice service have low language skills, often lower than an average 11 year old. Imagine having to be interviewed and appear in court when you cannot access classroom language let alone legal jargon. Many of these young people are then expected to engage with various programmes to aid with their rehabilitation. Statistics suggest that 40% of young people cannot access the content of these ‘verbally mediated interventions’ due to their language difficulties.

If children do not get their needs identified at any early stage and do not receive the therapy they require, the consequences can be dire. This is what Bercow means when he talks about social and economic impact. I think this particularly upsets me because had life been a little different for Little Bear, he could all too easily have fallen victim to this pattern. His behaviour did come before him and had we not been able to see beyond that and not recognised his DLD (and developmental trauma), things could have been very different. Before Little Bear was adopted at the age of 3 and a half, although there was a vague indication in his paperwork that he might have some language delay, he had not been formally assessed by a speech and language therapist. I was shocked at the severity of his communication needs the first time I met him and his language was later assessed as being more than 2 years delayed. I’m not quite sure what other signs would have been needed for a referral to have been triggered but he was certainly at risk of falling through the cracks.

I think there are two key things here. Firstly, if a child is presenting with social, emotional or behavioural difficulties, they should have a speech and language assessment as a matter of course. Behaviour itself is a communication and people in general need to get much better at looking beyond it. The second thing is that other professionals need to become more knowledgeable about SLCN; teachers, health visitors, the police etc. all need to be aware of the ‘red flags’ and seek help to prevent life escalating away from vulnerable children.

The bleak picture I’m painting could possibly all come good if there were excellent speech and language therapy services available to meet need once children were referred. However Bercow is pretty damning about this too. There continues to be a post-code lottery when it comes to availability and quality of services: of all the 2500 respondents, only 15% felt services were available as necessary. More than 50% of people had waited longer than 6 months to receive the therapy they needed and 34% had waited more than a year. This is a statistic I can empathise with as we had to wait over 8 months for Little Bear to be seen for the first time and a year for therapy to begin (see A bit of a rant).

This isn’t good enough. I was lucky to have my professional knowledge to fall back on and could begin helping Little Bear from day one. However, most adopters or foster carers do not have that level of knowledge and couldn’t be expected to. A year is too long to wait for a child who has already been neglected and needs immediate support. Due to Little Bear’s behaviour, our adoption began at crisis point. Thankfully we were able to identify there was a communication element to his needs, as well as developmental trauma, and could begin to tackle it. As most adopters do not happen also to be speech therapists, they would be unlikely to be pre-armed with the knowledge and strategies required. The impact of not receiving support in a timely fashion could be catastrophic.

Our story does provide some good news though, thankfully. The thing is that when quality speech and language therapy is provided, it is extremely effective (see Speech Therapy Works). Despite starting pre-school at the level of a 16 month old across all areas of development, with communication being one of the most difficult areas for Little Bear, by the age of 6 his language levels had improved to within the expected range for his age. Admittedly he received a high level of input, both at home, in clinic and at school but that input was effective. Our story shows that as bleak as this situation seems to be, it doesn’t need to be hopeless. If change can be brought about, services can be improved and awareness can be raised, we can literally transform lives.

Bercow 10 doesn’t just highlight problems, it makes practical recommendations for change under the following headings: communication is crucial; a strategy for system change; an accessible and equitable service for all families; support that makes an impact; early identification and intervention are essential. You can read the full recommendations document here: Bercow10 recommendations

And if you are feeling very keen, you can read the whole report here (it’s really well written and a lot more accessible than I expected): Bercow10 whole report

What can you do to improve outcomes for children?

In order for change to happen, people need to know about the current situation. They need to know about Bercow 10 and its contents. @GillianRudd has begun a petition to bring discussion of Bercow10 to the government to ask them to ensure the implementation of the recommendations so that children’s communication needs can finally be met appropriately. 10,000 signatures are needed for the government to respond to the petition and 100,000 for it to be considered for debate in Parliament. You could help by signing the petition and asking one person you know to sign it too. Just follow this link: petition

Please share this post far and wide to get the message out there.

It is essential that schools, health visitors, psychologists, CAMHS services, doctors and the Police know about Bercow10. Could you share the link with your child’s school or other professional?

If you want to get even more involved than that, see the Calls to Action section of the website: Calls to Action 

Thank you very much in advance for signing petitions and sharing etc. Change has to happen.

 

 

*This post is based on my personal reading and interpretation of the Bercow10 report. If you want to know the sources of my statistics, please see the report.

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Ensuring Children’s Speech and Language Needs Are Met: A Call to Action

Unwanted Changes

Things have been going really well for a few weeks here. That way where you begin to think you might have cracked it and that having no specific difficulties is the new normal way of life. I wasn’t getting complacent about it; if anything it was making me feel a bit uncomfortable and suspicious, not because I want to have difficulties but because it seemed a bit too good to be true. About a day after having that thought, some problems predictably began to arise. I don’t think it is anything major at this stage, hopefully not, but we are at the point of thinking Little Bear’s behaviour might be escalating and we are keeping a close eye on what’s going on.

There are two issues, both school based. At the start of the school year we had some School Worries and then various things happened to resolve them (see Alleviating School Worries). Since then there have been niggles but generally an upward trajectory with Little Bear and Mrs C, his TA, getting to know one another better. Over the past two months or so I would say they have got into their groove. Little Bear feels safe with Mrs. C; he listens to her and accepts her authority. Mrs. C has come to understand Little Bear and what he needs and how to help him. Consequently Little Bear’s behaviour has been very settled and he has made fabulous progress. We have been very pleased with how everything has been going.

Unfortunately, Mrs. C is now experiencing some personal issues; a member of her family is very poorly and understandably she needs to take time out to care for them. She is still coming in most days but sometimes only helping Little Bear for an hour before leaving. Obviously I know it can’t be helped and I really feel for her, having been through it all last year with Supergran, but at the same time, with my parent hat on, I’m a bit gutted. Consistency is so important for children who struggle with attachment and trauma. It has taken a long time for this relationship to be properly established and just as things have settled seems an unlucky time for disruption to happen. Mrs. C is Little Bear’s safety net at school now. He knows she is there to help him and without her I suspect he is a little lost.

We are lucky in that Little Bear has made good progress and can now cope with a bit less support and still get some work done, where he couldn’t have managed to earlier in the term and would have become very disruptive. However, we are all too aware that things can escalate quickly when much needed support is taken away. We are keeping an extra close eye on how Little Bear is and checking in with his teacher more frequently.

The school are not currently covering Mrs C’s time when she isn’t there as it likely to be a short term situation but we are concerned that they may need to if Little Bear shows us he isn’t coping.

When I picked Little Bear up yesterday he appeared dyregulated and really struggled to listen on the way home. He did daft things like hide in someone else’s front garden and tried to put a Hula Hoop in his ear that he would not normally do these days. Could this deterioration in behaviour be a sign he isn’t coping quite so well as we thought?

Well, it could, but equally it could be due to the other school issue that we are also concerned about. For some reason that I can’t fathom, the school have changed the entire dinner menu. They have changed it on the premise of it becoming healthier. In practise, they have removed all carbohydrates. Cauliflower rice or celeriac mash anyone?

I’m all for healthy eating and children having their vegetables, of course I am, but I do think this menu has gone about three steps too far. Little Bear loved buying some toast at break time and I always encouraged it because he gets very hungry and I felt it was regulating for him. I am sure there is some evidence about children who have experienced trauma needing more fuel because they expend so much energy trying to stay within their window of tolerance (if anyone knows what I’m on about please point me in the right direction). I also think Little Bear has to work harder due to his Developmental Language Disorder, another reason to keep his energy levels up.

Anyway, needless to say he can’t buy toast anymore because bread is the food of the devil or some such nonsense.

The lunchtime menu now has one choice only so I guess you eat it or you don’t. Previously there were always two choices and personally I feel there still should be – aren’t children allowed to have preferences? My feeling about the food now is that it would probably be delicious for me, a grown up with developed taste buds, who is conscious of my waistline but either I have failed as a parent or my children are lacking in some way as they are very unlikely to eat it. I don’t know many children who would eat harissa lamb or Greek salad or greek yoghurt and berries for every pudding, to be honest. Apparently they have done it on purpose to get the children tasting more things.

The thing is I feel as though they have misunderstood the function of a school lunch. In my eyes yes, it should be as healthy and fresh as possible, but it should be appealing to most children because the most important thing is that they eat it, fill their tummies and are able to approach the afternoon well-regulated and able to concentrate. I think that pushing boundaries and trying things can happen at home or during special events at school but the last thing I want is for Little Bear to push his posh nosh round his plate, not eat any of it and spend the afternoon swinging from the lampshades. Being well-fed is crucial for Little Bear’s behaviour regulation. If he is hungry he will not be able to control himself and he certainly won’t be able to learn.

I feel as though the school has inadvertently created a very exclusive menu which will inevitably exclude many children. There has been no consideration for children who may have restricted diets due to underlying conditions such as Autism or children who have had limited life experiences. Before Little Bear came to us, he didn’t eat any vegetables and perhaps only one or two fruits. The fact that he will happily eat a range now feels like a success to me; I don’t feel the need to push him beyond his comfort zone and I don’t appreciate the inference that my child (or my parenting) is somehow lacking by him not wanting to eat anything on the exclusive school menu. I feel as though it has somehow become an elitist basis on which to separate the parents – those who have succeeded in getting their children to eat like grown-ups and those who haven’t. Bring back jacket potatoes and roast dinners I say, are they really that detrimental to our children’s health?

As an aside, the children are no longer allowed to bring a cake in when it’s their birthday either which I find very sad. I know we are meant to be concerned about childhood obesity but neither of my boys sits still and Little Bear has a six pack to be jealous of. I think he can eat a slice of cake now and again without any of us getting too concerned.

Anyway, menu-related rant aside, I am mainly concerned about Little Bear’s wellbeing and him pushing his friends about and trying to shove crisps into his ears could well be due to hangry-ness. Little Bear not eating his lunch could well be a disaster and could easily lead to an escalation in his behaviour. I am trying to keep a close check on whether he is eating at school, though it is proving difficult as, according to him, yesterday’s lunch was soup and porridge which even by the new menu’s standard seems unlikely.

I know change is unavoidable but on this occasion I really wish they’d left things well alone. For our children, those who have been through enough already, small things can be big things and medium-sized things like not having your trusted adult or being expected to survive a day without carbs can be enough to upset their wagons completely. Here’s hoping this is just a small bump in the road and not the next dip on the rollercoaster.

Unwanted Changes

Books

With it being World Book Day this week, I thought it might be a good time to share some of our favourite children’s books and the reasons they have become important to us.

First Books

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The board book pictured was Little Bear’s first book. I know this because we gave it to him during introductions when he was 3 and a half years old. The average 3 and a half year old is likely to have progressed beyond board books quite some time ago and is most likely enjoying a range of picture books with maybe a couple of sentences on each page. I’m going to assume that Little Bear had seen a book somewhere and on occasions someone had read one to him. However, he certainly didn’t own any books and a bedtime story was not part of his bedtime routine, which appeared to involve wrestling him into his pyjamas and beating a hasty retreat, shutting the double height stairgate behind you.

There has been some recent Twitter chat which would suggest that Little Bear was not alone in not having a bedtime story during foster care. This makes me incredibly sad. I know the majority of foster carers work extremely hard and give the children in their care everything they could possible need but evidence suggests they don’t all. For me, a bedtime story (or a story at some other part of the day) is not a pleasant add on, it is an essential part of childhood. Books have so much to offer children, not least in terms of their language development, and not having a bedtime story is a huge opportunity missed, particularly if the child in question has Developmental Language Disorder

The lack of books felt like such a fundamental omission to me that I couldn’t wait until we got home to introduce them. Thankfully I had popped this one into our packing and read it to Little Bear the very first time I put him to bed (after the wrestling into pyjamas part). I was surprised by how quiet he was and how much it held his attention, considering his behaviour the rest of the time. He LOVED it and asked for it repeatedly in the days and weeks afterwards. From there on in he has had a bedtime story. In fact, I feel as though so much time has been wasted for him, he actually has three bedtime stories every night.

Transition Books

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We read Little Bear board books for as long as he needed us to and he still has them on his shelf in case he fancies one now. However, when I felt the time was right to move him on, I needed something that bridged the gap between board books which usually have few words on a page and proper picture books which have quite a lot more. The books pictured here and others like them are the ones that bridged the gap nicely. They held Little Bear’s attention well and were good for extending his vocabulary with words that would be within his grasp.

The length of these books was just right at the time, helping to stretch Little Bear’s attention span little by little.

I especially love the bright pictures in the Meg and Mog books and they contain a good level of drama too!

First Picture Book

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We’re Going on a Bear Hunt is an important book to us because it was the first book from which Little Bear started to learn parts of the text. The repetition really helped him and he loved anticipating seeing the bear (he has always enjoyed an element of peril!). I remember being so chuffed that he could recite parts of it and fill in blanks when I paused because it was such a leap in language skills. It’s always a pleasure to see a child enjoying a book but especially so when they have been denied the opportunity sooner. It has been an honour really, to be able to take Little Bear by the hand and gently guide him into the world of literature. It’s been an exciting and lovely expedition for both of us.

This is a book that has spilled into our play too and we have been on many walks and adventures looking for bears and chanting “we can’t go over it, we can’t go under it, we have to go through it” and getting very muddy.

Books about Lions and Tigers

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The thing about books is that you can get them about anything. ANYTHING. The infinite possibilities are brilliant for a child with a wild imagination (see Fantasy versus Reality) and I love the way you can use a child’s interests to engage them with learning without them really knowing it’s educational. Little Bear is partial to a book with a lion or tiger in it (the element of danger again) and we have built up a bit of a collection. In fact on World Book Day, he will be dressing as a lion and taking The Lion Inside by Rachel Bright as his favourite book.

Never Tickle a Tiger is a relatively new one but it’s a good one as the main character can’t help but fiddle with everything and she really does remind me a lot of Little Bear! He did notice the similarity too.

This collection also shows that Little Bear has progressed with his attention span and can now listen to three of this type of book at bedtime without difficulty. Moreover, he can follow the more complex texts and vocabulary in them which he previously would not have been able to. Books have certainly played their part in his progress.

Books that Rhyme

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I think the go-to rhyming books are usually those by Julia Donaldson. We do like those and several feature in our book collection but they generally have quite a lot of text and it has only been more recently that Little Bear has been able to engage with them. For maximum exposure to rhyme and lots of repetition in a short space of time, I don’t think you can beat the Oi Frog books. They are just a little bit naughty too which appeals to boisterous boys. We have read these a lot and they have definitely resulted in laughing out loud. They have also been great for helping Little Bear learn to rhyme (a fairly recent development) which has helped him with his vowel work and with beginning to spell at school.

The Cat in The Hat has been a surprise contender for favourite book. Big Bear never really engaged with it when he was younger but something about it has really grabbed Little Bear. It is also a long story but for some reason he manages it (if he chooses it, it’s the only time we don’t have three stories because we’d be there all night). I suspect he likes it so much because the cat is so naughty. It is a good book for phonic development though and sometimes Little Bear has read some of it to me, helping to build his confidence that he can read other things, not just his school book.

Books that Have Issues

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These are books that tackle big emotions and might help with adoption-related things. I Will Love You Anyway is a really lovely book that I struggle to read without a lump in my throat. It is about a dog that keeps running away and is difficult to look after. He hears his humans saying that they can’t cope with him and he’ll have to go. He runs away at night and gets lost and scared until the boy comes and finds him. The message is that no matter what the dog does his humans love him anyway and want to keep him. I suppose its art reflecting life and it really does talk to a child’s insecurities. We like this one.

Where the Wild Things Are is quite an out-there, random book. I’m not really sure how much it speaks to me but it does speak to Little Bear. He seems to really understand the analogy of the boy becoming angry and going off somewhere in his head and I think it makes him feel better that he is not the only one it happens to.

There are quite a few other books like this available. All the ones by Sarah Naish and things like The Big Bag of Worries. We just haven’t dabbled much yet and where we have dabbled, these two are clear favourites.

Books that Get Us Talking

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These You Choose books are a recent addition after a teacher friend got Little Bear one for Christmas. They’re absolutely brilliant for language development and I’m going to invest in at least one more for Little Bear’s birthday. On each page there are lots of choices like which job you want to do on the rocket, what you’re going to wear and where you’re going to go. It means that each time you read the book you can make different choices and have a different adventure. They are great for vocabulary development, generating narratives, developing imagination and formulating questions. You could also work on turn-taking, listening and following instructions if you wanted to.

We have been known to use the book to generate verbal sentences which we have then written down for writing practise. I really think they are a fabulous resource and can’t believe I’ve only just found them. They would also be good in a work capacity for building relationships with children you don’t yet know well – it would give you a shared context to begin chatting.

More to the point, Little Bear loves this book and chooses it frequently.

Books for Big Bear

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Big Bear is an independent reader now. He’s a good reader but rarely reads for pleasure. We have tried all sorts of different books to engage him but to my surprise it has been The Goosebumps Horrorland series that have really grabbed him. He discovered them at school and has taken to disappearing to his room to read one which is pleasantly surprising. He also enjoys Michael Morpurgo books and we went through a phase of devouring all things Roald Dahl.

He has always enjoyed non-fiction, leaving picture books behind at quite an early stage and still does to some extent. We got him a subscription to The Week Junior for his birthday which has encouraged him to read more (though it’s a newspaper not a book) and has led to some interesting conversations. Just tonight he was getting hot under the collar about Donald Trump (he has a point).

His football information books have really held his attention too, though he likes me to read them to him. I’m secretly very pleased that my big boy isn’t too old for a bedtime story yet.

 

These are just some of the books we have enjoyed together and some of the benefits we have gained from them. I haven’t even mentioned that reading together is great bonding time – Little Bear likes a good snuggle-in at story time and it has been a way for other family members like grandparents and aunties and uncles to spend some quality time with him. It is also a predictable and familiar part of his routine now, which may well have contributed to his sleep settling down.

I wonder what books are popular in other people’s houses. Do you have any recommendations for us?

Happy World Book Day everyone,

The Bears xx

 

 

 

Books

Speech Therapy Works

As a Speech and Language Therapist it shouldn’t really be a revelation to me that speech and language therapy works. Obviously I have always believed in it otherwise I wouldn’t have stayed with it as a career for over 14 years. It’s just that trusting something works because you understand the theory behind it and actually experiencing something on a practical level, within your own home, with your child, is quite different.

Obviously I have experienced success in my professional life, but that has been within the confines of a large caseload and various time and resource pressures. In the latter part of my NHS career, as a more senior clinician, my main role was assessment and report-writing. I rarely did any therapy as we had a structure where skilled assistants carried out care plans under our supervision. It meant I didn’t get to know children as well as I’d have liked and I didn’t get to share in their small steps of progress week by week. I re-assessed and reviewed progress, seeing improved assessment scores but that isn’t the same as cultivating progression yourself.

Now that I’m an independent therapist I’m really enjoying being able to properly get to know the children I work with. I’m completely invested in their therapy and am just as pleased when they move forwards or overcome something as I am when Little Bear does. I do see (and feel) therapy working now.

However, what we have experienced at home has taken my belief in speech and language therapy to a whole other level.

I was recently running a communication workshop (for adopters, prospective adopters & professionals) when somebody asked me a question that made me realise the examples I talk about in it, from Little Bear’s communication profile, paint a bleak picture. The picture is totally accurate and reflective of his communication skills when we first met him, aged 3 and a half. The picture, detailing significant difficulties with attention and listening, comprehension, expressive language and speech sound disorder was bleak. At the time I was fairly overwhelmed by his level of need and the magnitude of the task ahead of us.

Here is a very brief summary of Little Bear’s presentation then:

Little Bear was not tuned into language at all and did not respond to verbal instruction, including his own name. His comprehension was better than it appeared but significantly delayed for his age. Little Bear had a very small vocabulary that didn’t meet his needs. He did not have words for common, everyday objects such as cow, train, television, food items etc. Little Bear couldn’t answer ‘what’s your name’, his only size word was ‘big’, he couldn’t name colours or count and he couldn’t put more than about 3 or 4 words together. The words that Little Bear did have were unintelligible. Little Bear was extremely frustrated and he was often left with no other option but to express himself with his behaviour.

I quickly realised this wasn’t a straightforward language delay and that Little Bear’s needs met the criteria for Developmental Language Disorder

At the time I had no idea what the prognosis would be but I suspected it wasn’t rosy and that speech and language therapy would be a big part of our lives for years to come. It was hard to know where to start and easy to become overwhelmed by priorities. There were times I really questioned my faith in what I was doing and wondered if we’d ever get to where we were hoping to go.

I did not expect, in my wildest dreams, that 2 and a half years later a speech and language therapist would observe Little Bear in his mainstream classroom and say there was no discernible difference in language skills between himself and his peers and deem him ready for discharge. Yes, his attention and listening skills still mark him out and there are some minor speech errors but his comprehension and expressive language skills are now within the expected range for his age.

This near miraculous improvement is due wholly to one thing: speech and language therapy.

Admittedly our circumstances are unusual: most children with DLD do not have a parent who is a speech and language therapist and able to provide targeted intervention on tap 24/7. Little Bear has essentially undergone an intensive 2 and a half year block of therapy. Strategies have been used by the whole family and are an automatic part of the way we talk with Little Bear, not something we use for just a couple of minutes each day. The key strategies have included: using environmental sounds to capture Little Bear’s interest as a way in to listening to language; reducing our language; modelling of vocabulary, sentence structures and sound patterns; repetition; showing, explaining & checking understanding of complex concepts or new words as well as seizing every possible communication opportunity. We have done some direct work on auditory memory, phonological awareness (initial sounds, syllables, rhyme, blending sounds together) and speech sounds.

I suppose at any one time I have always had a current communication aim in mind, whether it has been a specific language concept or speech sound and I have found ways to weave this into play or our usual day to day lives. I have very rarely, if at all, asked Little Bear to sit at a table and ‘do speech therapy’, it has been a much more holistic and inbuilt approach than that.

Little Bear has also been seen by an NHS speech and language therapist throughout the past 10 months or so. She has taken the lead on sorting out Little Bear’s disordered vowels which have been complex to assess and set goals for. Generally she has started us off with a sound or activity and we have carried it on between sessions.

The NHS therapist has also set language goals for school and has provided them with programmes to carry out, which they have done.

All of these strategies, techniques and approaches have worked. Their effectiveness is inarguable. Yes, the sum total of the input Little Bear has had is massive and yes, me being a speech and language therapist does make things different. However, I truly believe that a similar impact could be gained by providing parents with good quality, strategy based communication training alongside regular sessions with a speech and language therapist, who could do the assessing and target setting bits, as well as providing resources and guidance. Similarly, if speech and language techniques can be embedded into teaching and used holistically as part of the curriculum (not here and there for 10 minutes) that too can be highly effective and impactful.

Little Bear is living and breathing proof of the efficacy of speech and language intervention. Prior to treatment when I’m almost certain that no strategies were in place, he made negligible progress. In fact, on entering pre-school shortly after coming home, Little Bear was assessed as having a delay of more than 2 years in all areas of his development, with speech and language and numeracy being the most delayed areas. Within 2.5 years of therapy, that gap has closed (meaning that Little Bear has essentially made 4.5 years’ worth of progress) and his comprehension and expression now measure within age expectations on standardised assessment.

Speech and Language Therapy works.

Whilst his progress has been phenomenal, I should point out that speech therapy is not a panacea. Little Bear still has DLD and I suspect it will impact him to a greater or lesser degree into adulthood but what therapy has done for him is allowed him to reach his communication potential, despite having DLD. Little Bear still finds it difficult to learn new vocabulary and to figure out the sound patterns in new words but we know what to do and the strategies work. The approaches that we have built into our daily lives will continue as Little Bear is still going to need them and it is imperative we continue to strive for that meeting of full potential. As the demands of the curriculum increase, we might find we need to access formal therapy again and that would be okay too.

I feel extremely proud of Little Bear’s progress and find myself constantly marvelling at the things he can say now. Last week he took part in his second school assembly. He learned more than double the words he managed last time and was able to recite them in front of the school without any prompts at all. The naughty streak in me did notice that other children in his class had to read their lines or forgot them completely (I don’t mean that badly, it’s just he has never been able to keep up with them before, let alone outshine anyone and he’s more than earned his moment of glory). Not only that but he sat really well throughout, no teacher attached to his side like previously, and he spoke loudly and clearly. Several people came to me afterwards to comment on how well he had done, the difference being so stark in comparison to previous public appearances.

I am truly grateful to speech and language therapy for not only giving me a career I love but for unlocking my son.

 

 

I think I had better make some changes to my workshop too. Although people need to see the bleak picture, they also need to see the sunshine over the rainbow picture that can be gained by using the strategies and applying them diligently. Little Bear’s prognosis appeared extremely poor so his progress really is a beacon of hope.

 

 

Speech Therapy Works

Football: A Yardstick for Progress?

Back in the summer of ’15 (no, I am not re-inventing a song) Little Bear had just arrived. It was both a blessing and a curse that this momentous event had taken place during the summer holidays. It was great because it answered the question of how we were going to possibly manage meeting our youngest son a couple of hundred miles away whilst also managing the needs of our elder school-age child.

However, once we were back, the days stretched out interminably ahead of us. Grizzly and I were both on leave and there was no school or pre-school to give some much-needed structure to our days. There was just us and a very unruly seeming energetic mass of a child who at the very minimum needed to be kept out of immediate danger all the livelong day. With the benefit of hindsight I can say that he was traumatised and emotionally at sea. At the time I don’t think we quite knew what had hit us and I’m pretty sure we had barely a second to think about it.

We discovered, within the first hour of his arrival, that being inside the house with Little Bear was kind of difficult. He could not be contained in one room and wandered, nay prowled about, seemingly looking for the most dangerous or unwanted (by adults) tasks to engage in. He was everywhere: up shelves, in cupboards, under furniture. Little Bear was not in any way tuned into language so didn’t respond to any verbal means of trying to shape his behaviour. We spent the first weeks trailing after him, like a Police dog trailing a criminal, trying to anticipate what he might do next, trying to keep up with him, trying to offer distraction. We had to physically remove him from dangerous situations, which triggered his fight response and we were often bitten, scratched, hit or kicked.

It quickly became apparent that we might fair slightly better outside. Wide open spaces were good because there weren’t many things you couldn’t touch and Little Bear could be freer. Obviously the not responding to language thing was tricky, especially when you wanted him to come back. There was many an occasion when Grizzly had to sprint after him but notwithstanding that, things were easier.

You cannot actually live your life in a field though so we did have to try to make do with our small-ish back garden some of the time.

Left to his own devices, Little Bear would have spent the whole day watering the garden with the hose until a flood came and we would have needed Noah on speed-dial. We did of course allow Little Bear some hose time but it was essential we introduced some parameters if we were ever going to gain a modicum of order. As an aside, on one occasion of supervised hosing, Little Bear accidentally caught the sunlight at just the perfect angle to create a rainbow. It was one of the first times he responded to my communication to “look” and together we shared the same reference point and together marvelled at the amazing rainbow. I remember feeling more happy than you might think about that because I had actually reached him. After that we often tried to make a rainbow collaboratively and he began to see the point of me in an interaction. He also learned the word “rainbow” which was a big deal in his otherwise depleted vocabulary.

While the rainbow moment was a mini-turning point, I still did not want a flooded garden and knew that Little Bear needed help to engage with other outdoor activities too. Big Bear was 6 at this point and had recently got very into football. He was keen to be outdoors and was never far from a ball. Little Bear was also interested in the ball and generally ran straight though the middle of a kick-about with the sole purpose of nicking said ball. This was incredibly annoying from Big Bear’s point of view.

We tried to explain that Little Bear was little and didn’t understand games yet or that there were rules and he was really just trying to play. Big Bear could entertain this type of reasoning and would try to follow Little Bear’s lead. Little Bear would pick up the ball and run off, saying ‘catch me’ and looking for you to chase him. Big Bear or one of us would oblige. As he was shouting ‘catch me, catch me’ that’s what we tried to do. Only, when we did catch him, all hell would break loose. I guess because when the catching actually happened he decided he didn’t want it after all. I suppose being grabbed by people you aren’t sure if you trust yet is pretty frightening.

Little Bear would cry, we would be scratched. We would try some reasoning but Little Bear couldn’t process it. Five minutes later Little Bear would be running off with the ball shouting ‘catch me, catch me’ and the whole merry-go-round would begin again.

It was very difficult to manage or to see how to manage it a different way. All we knew was, it was a very inauspicious start to a footballing career and we probably had not just adopted the future David Beckham.

In the summer of 2016, things had developed a little. Big Bear was now getting good at football and wanted to practice properly. Little Bear had fallen totally in love with his brother and wanted to do whatever he was doing. If Big Bear was playing football, Little Bear was close by. Unfortunately he still had a penchant for ball-snatching and though Big Bear is extremely patient with him, it really did push his patience to breaking point. Most football games ended in one or the other or both in tears or storming off.

By this point Big Bear was pretty knowledgeable about the rules of the beautiful game and both he and Grizzly did their utmost to teach the basics to Little Bear. There were a few problems. One was that Little Bear could be (and still can be at times) rather oppositional so rules were like a red rag to a bull. If you told him he wasn’t allowed to pick up the ball, his first urge was to pick up the ball. Another problem is that Little Bear had very poor resilience then and the smallest knock or comment or his own perception that he had done something bad would be enough to cause him to purposefully kick the ball out of play or boot it at someone or call someone a name or hit them. Football continued to be a source of stress, distress and very little enjoyment for anyone involved.

Thankfully for Big Bear, he played football at an after-school club and he joined a club outside of school so he could get his fix somewhere. Interestingly, he had had a rough time because he didn’t like football when he was younger and it had really impacted on his ability to be accepted by the other boys. We had been reluctant about allowing him to join a club as it can be so competitive and the last thing we wanted was for his confidence to take a further knock, for example by being kept on the bench if he wasn’t perceived to be good enough.

Grizzly researched all the options and found a club with an inclusive ethos where all children get an equal go, irrespective of how good they are. Despite our reservations, it was a fantastic experience for Big Bear and did wonders for his confidence, both inside and outside of school. He continues to play for them now and apart from a recent appearance of nerves (a whole other tale, there is always something!) he loves it.

By the summer of 2017 a glimmer of football-related hope began to appear. Little Bear was beginning to tolerate the rules. He accepted they were there but was often in conflict with himself over sticking to them. He was still easily upset and something like the other team scoring a goal could be enough to cause a bit of a situation. However, the situation was generally less dramatic than before and mostly involved him stropping off to a corner of the garden for five minutes.

Alongside this, Little Bear’s language skills had now developed unrecognisably. We could start to talk about how he was feeling and what might be causing his behaviour. We could say things like “I think you are feeling a bit frustrated because the other team scored. That’s ok. Sit there for five minutes then join in again when you’re ready”. We generally didn’t make too much of a fuss and often if we ignored the outburst he would just join in again a few seconds later by himself. We always praised the good decision he had made to come back. We also tried some other techniques like bringing a squidgy stress toy outside with us and Little Bear would go and squeeze that if he was getting annoyed, rather than shouting at somebody or running off with the ball.

Football still had its moments but as the summer wore on I realised that the boys were starting to have a kick-about on their own after tea, while I did the washing up (handily positioned in front of the back window where I could keep a watchful eye). More often than not, the game would go without hitch and I would silently count my blessings when they came back in. They even started to set each other up for specific bits of play e.g. Little Bear would throw the ball so Big Bear could volley it in. Maybe football could be fun in the Bear household after all?

Not long after term started again, Little Bear began asking to join the after school football club that Big Bear attended. I had a lot of concerns. He is extremely tired after school, making listening harder than usual. We were having a very rough phase in the classroom and Little Bear was frequently in trouble for being disruptive. The guy who runs the football is lovely but not especially firm and I’d always rather suspected the children ran amok. Little Bear is not a child who should be allowed to run amok. It is not wise. It could be extremely detrimental.

Little Bear clearly wanted to go though and I had to listen. I decided this was a rare time that a sticker chart might work. I was clear with Little Bear that I couldn’t let him go to the club if he wasn’t going to listen to what he was told because that could be dangerous. The rules would be there to keep him and his friends safe. He gained stickers by doing what he was asked in school, at home and if he was with others like his grandparents. If he didn’t manage to do as he was asked, nothing happened. If he did manage to, a big fuss was made about his ability to make good decisions and he got a sticker.

By October half term the chart was full and I kept to my word and signed him up. I did speak with the football coach about Little Bear’s needs; that rules need to be clear and consistent for him and that he needs to know that the coach and I will talk and if things are not going well, the coach will tell me.

I knew I had to let him try but I was worried.

Last week, out of the blue, I received this message:

Just a quick one, I know you were unsure about signing Little Bear up for football but he has been amazing! I love coaching him, football or PE, just wanted to drop you a message to let you know. And then Big Bear is something else, great kid that doesn’t get the credit he deserves, he’s fantastic.

And my heart melted.

How lovely of the coach to take the time to send me that? I wonder if he really knows how much that means?

I couldn’t possibly have predicted, back in 2005, mid back garden flood, that my little dude would be able to overcome so many hurdles that he would be able to not just cope but flourish in a football club only 2 years later. He’s a phenomenon.

Maybe we did adopt the future David Beckham after all?!

 

And as for Big Bear, he is an extremely patient and lovely big brother and I hope that I at least give him the credit he deserves.

Football: A Yardstick for Progress?

Fantasy versus Reality

Little Bear has been everywhere, man. He really has. He has been to America, Spain, the Eiffel Tower, Australia, the jungle. He has even been to Paradise. Any country you can name, he has been there.

And the things he has got up to! He’s wrestled sharks, ridden elephants, punched President Trump in the face and even witnessed the death of Princess Diana. Many people have tried to harm him along the way but he’s killed them; or punched them in the face at the very least. He’s very strong. SUPER strong. In fact, probably stronger than Batman or maybe even the Hulk. And he’s got guns. A whole arsenal of them. He’s taken out many a good man.

And he has two Fathers, but sometimes one is dead. His Father is also VERY strong. He can do ANYTHING. He has fast cars. He’s encountered a plethora of sharks, tigers and poisonous spiders himself.

Oh, and did you know Little Bear has a special car? One that can fly to heaven and bring people back from the dead! He quite often pops there and back in the day apparently. And all those songs you hear on the radio? Little Bear sang those. And all the sportsmen on the television? Little Bear.

As for that school he attends! Well, there are frequently brawls in the classroom and the teacher seems a right one for throwing the first punch. Sometimes the Head teacher joins in. Sometimes they do PE on roof. And they hardly ever feed them lunch.

Apparently.

According to Little Bear, anyway.

I wouldn’t describe it as lying, because Little Bear thinks these things are really true. I think I would describe it as a very fertile and fantastical imagination. Most of the time, Little Bear’s high tales are very entertaining and I’m sure that when he is a little more adept at writing, he will be able to conjure up some amazing stories. Perhaps he will be an author, or film-writer; he certainly has the creativity for it.

It does have its drawbacks though. It is virtually impossible to know when he’s telling the truth, especially as he seems so good at convincing himself that things that haven’t happened really have. Due to that he can get genuinely annoyed with you for saying something isn’t true (even though it very clearly is not) as he is so bought into the idea. We can’t rely on reading his responses because his own position of what he thinks happened is so skewed.

Most of the time, I don’t attempt to call him out on his stories. The only parallel I can draw (and please bear with me as it is a bit dubious) is that if somebody had confusion (Dementia) and kept forgetting things, you wouldn’t continually tell them they were wrong and draw attention to the forgetting and the repeating. You would just go along with them so as not to upset them. There would be no real benefit to either of you to insist upon correcting them.

It feels the same with Little Bear and his fantastical tales. What does it matter if he claims to have met the Queen or have been on a midnight adventure with a friendly lion? It doesn’t matter and there is no harm in it. To be honest, we mostly find him hilarious and he often takes us by surprise with a new, even wilder tale. The story-telling is part of his charm and we wouldn’t want to discourage it.

However, it is essential that, as he gets older, he does learn to know the difference between truth and lies and that he can be relied upon to tell the truth (even if he still likes some fantastical escapism). There are times therefore that I do call him out and label what he has said as a lie. This tends to be when he has said something that sounds more like an accusation or relates directly to one of us. For example, he does have a tendency to say that people have hit him when they blatantly haven’t. I could sit with him and a grandparent or Grizzly the whole time and despite me having seen everything, he might still claim that somebody present hit him. It’s not generally malicious, more that things just come out of his mouth and sometimes he can be purposefully provocative.

At these times I will call out the lie. I will say “you shouldn’t say that Little Bear, because it didn’t really happen. It is a lie.” I generally go on to explain what the possible consequences of telling the lie could be e.g. the person you are saying hit you could get into a lot of trouble with the Police. Occasionally, over recent weeks, when he has a made a wild claim and I have asked him whether it is true or not, he has sometimes admitted it is a lie, which is reassuring and shows he is starting to develop some awareness.

Obviously I have no idea if this is the right way of handling it, I’m just following my instincts (AKA making it up as I go along).

I have to admit that I have also duped him into telling me he’s lying sometimes by convincing him that our noses really do grow like Pinocchio’s when we tell an untruth. I have no idea what possessed me, it’s a very un-me thing to have done, but I’m reluctant to reveal the truth just yet as sometimes Little Bear will make a bold claim then a few seconds later say, “has my nose grown?”. Then I know I’ve got him. It’s the only time I can be certain he’s lying. It’s quite useful for situations such as ‘have you washed your hands after the toilet?’ where you really do need to know the right answer.

Don’t worry, the irony of me lying to him about his nose having grown is not lost on me in a blog about lying! I have to be a little bit wily though otherwise I would be constantly outwitted by a five year old.

We have discussed this issue with school and with PAS. Not because we are really worried about it but because school obviously experience it too – apparently Little Bear’s account of our summer holiday began with the boys enjoying the sea in their wet suits and ended with some sort of killer shark massacre.

The conclusion we have drawn is that Little Bear is in a developmental phase that would usually happen earlier. A quick bit of research suggests that typically developing 2 and 3 year olds lie frequently and spend a lot of time exploring the boundaries of fantasy/ reality. Most studies seem to suggest that around 3 is a pivotal age for being able to separate your imagination from real life.

Little Bear has such a spiky profile that it is quite possible that this is the level he is functioning at for this particular aspect of his development. We do wonder though how much this has been impacted by his language difficulties and whether he would have been able to move into this phase earlier had he have had a wider vocabulary at his fingertips. His language skills have leapt forwards again recently; perhaps this has allowed all those thoughts and ideas that have been in his brain for a long time to finally get out?

Often, when he is telling his tales, I am not worrying too much about the content but am marvelling at his fantastic turn of phrase and narrative structure. Only a Speech Therapist would say that, obviously, but nevertheless, I stand by it as a year ago, when he started school, Little Bear really struggled with those reading books without words that require you to make up one sentence to describe what is happening. And here he is, using words like ‘return’ and ‘sadly’ and ‘supposed’ and structuring a whole story that is cohesive and makes sense. It’s incredible really.

Whilst I do think this is likely to be a developmental phase, I came across something else today that really resonated. I was reading the Coventry Grid*, a resource developed by Heather Moran, to pull out the differences between the presentation of children with Autism and those with attachment difficulties. In the ‘mind-reading’ section, there is a subheading of ‘problems distinguishing between fact and fiction’. Here are the descriptors for children with attachment difficulties:

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I’m sure you can see why it resonated. Who knew that this type of presentation could be another result of a neglectful start? Adverse Childhood Experiences (ACEs) have so much to answer for I’m finding; their effects being so pernicious and wide-ranging.

It also amazes me how much there is to learn about our children and despite reading a lot and thinking about Little Bear a lot and writing about him a lot, I am still learning new things and continuing to grow in my understanding of his behaviour.

 

 

*The Coventry Grid is an excellent resource that I would highly recommend. You can find it easily on Google.

I don’t actually spend all my days reading sensible things; I was working at the time. I was interrupted by a giant anteater appearing from my computer screen though. It sipped my tea with its long snake-like tongue before engaging me in a sword fight. I won.

 

Has my nose just growed?

 

Fantasy versus Reality

A Confession

Readers, I have a confession to make. It is something I expect Society will disapprove of. It will certainly be frowned upon, if not judged very negatively, by most. I’m just going to spit it out: Little Bear still has a dummy.

I suspect this is controversial for two reasons. Firstly because Little Bear is 5, on the nearer to six side of things, and typically children give up their dummies whilst still pre-schoolers. Secondly, because I, his mother, am a Speech and Language Therapist (SaLT) who not only should know better but should be militantly opposed to dummies full stop.

It may make me a rubbish SaLT (I’ll take the chance) but I am not opposed to dummies. I certainly think they have their uses. Big Bear had one (ok, about nine) and was particularly attached to them, often sleeping with one in his mouth and one in his hand.

Initially, I tried extremely hard not to give him one, thinking it would make me a bad parent (as well as a bad therapist) if I did. However, after about 7 weeks of following the NHS guidance to demand feed, I had been feeding Big Bear around the clock and when I wasn’t doing that he was latching on to anything and everything (my arm, Grizzly’s nose etc.). I had to acquiesce to save my sanity, as well as my nipples.

Looking back, there are so many things to beat yourself up about as a new parent that I genuinely don’t think a dummy should be one of them. There are two main risks with dummy use: the impact on the infant’s teeth and the impact on their speech. Unless a child is plugged in constantly (wrong on many levels), an average amount of dummy-use is really only damaging to speech if a child speaks with the dummy in their mouth*. I have found that fairly easily solved with a ‘no talking with your dummy in’ rule, which I do stick to religiously. It hasn’t hampered either Bear from being a chatterbox. The dummy hasn’t stopped them talking, they have just got used to taking it out of their mouths to do so.

As Big Bear approached three years of age, his speech was developing well but I began to notice a change in his teeth. They were starting to angle outwards a little. It was obvious it was the dummy and it had to go. Although I knew he didn’t need it, I did know that he liked it A LOT and I was pretty trepidatious about the big withdrawal. Exactly how many nights would he scream for?!

I knew cold-turkey was really the only way but I wanted him to be as prepared as possible. We talked about dummy fairies and invented some sort of fable about what good purpose they put discarded dummies to (I can’t quite remember the details). I’m not ashamed to say we also used a good portion of bribery – those dummy fairies give a good reward! We left all the dummies outside on a plate on the allocated day (because clearly the fairies live outdoors) and the next morning a Lego truck had magically appeared in their place. The deed was done.

In reality we had one or two nights of Big Bear struggling to get to sleep but there was none of the fuss and palaver I had imagined. The big dummy withdrawal was, dare I say, pretty easy.

Several years later when we were in the process of Matching with Little Bear, it transpired that at the age of three and a half, he still had a dummy. Tut, tut, we said. How awful! He really should be rid of it by now! Just give it to the dummy fairies: how hard could it be?!

In our naivety I think we even suggested the Foster Carer’s should do the deed before he came to us.

The outrage! A three and a half year old with a dummy!

Yet, here we are, over two years later, the three and a half year old is now nearly six and he still has the dummy. So what has gone wrong?

Have I been too chicken this time?

No. Not too chicken. A little older, a little wiser and a LOT more tuned in. I haven’t taken Little Bear’s dummy away because he still needs it. Along with his blanket, it is the only thing that is guaranteed to calm him.

Usually the dummy and blanket live in his bedroom and Little Bear only has them after his bedtime stories when the light is going off. Most of the time he half forgets about them and can fall asleep without them. However, there are still days when he pads sheepishly downstairs with them, lays curled in the foetal position on the sofa and disappears off into his calm place for a couple of hours. If I didn’t let Little Bear have his dummy on that sort of day, he would prowl about, itchy, discontented and ill at ease. He would seek trouble, struggle with instruction and generally have a very difficult day. The relief and release when he gets the dummy is almost palpable.

When Little Bear was younger/ newer to our family we daren’t go on any car journey without the dummy and blanket secreted in my handbag “just in case”. There were months when they were literally the only way to calm him (though there was also a risk he’d lob it at your head).

We have many more available and effective calming strategies now and don’t take the dummy anywhere any more (apart from on holiday). However, when Little Bear starts wandering around the house with it, it is the equivalent of a red warning light. It means that Little Bear is not feeling good. We might not know why and neither may he, but it alerts us that he needs something different today. It generally means he needs few demands, lots of TV, cheesy pasta for tea, somebody to feed it to him and an early night. As yet, Little Bear can’t communicate this to us any other way so we have to rely on the medium of dummy interpretation. He has a wide enough vocabulary now but I don’t think he can pinpoint how he feels, let alone interpret the feeling enough to be able to voice it.

Although these are all valid points, there is something else, more fundamental, that is holding me back.

The dummy and blanket are the only things I can think of that Little Bear has always had. They have travelled with him (one assumes) from his birth family to foster care and from there to us, providing him with a reliable and consistent source of comfort along the way. Perhaps I should say that they are the only reliable and consistent source of comfort he has ever had. You would usually anticipate that the reliable and consistent source of comfort would be your Mum or Dad but as Little Bear has had three different ones of each and not one of them has accompanied him on his whole journey, he has had no choice but to seek an alternative source.

How can I, hand on heart, take away that consistent and reliable source of comfort? I genuinely don’t think that I can or, more importantly, that I should. Having had so little control over what has happened in his life I think I can hand over the reins of this one to Little Bear himself.

I know that Society will stand in judgement, as I too probably would have done a few years ago. I know Society will consider him too old and my behaviour in allowing it to be atypical. I have decided that I care not one jot. Sometimes I make that type of decision quietly. What wider Society doesn’t know about won’t bother them. However, if I really don’t care what anyone thinks and I genuinely believe I am acting with the best of intentions, why should I hide it? Society needs to become accepting of the fact that not all children follow a typical pattern of development and therefore will not adhere to the rigid expectations we set out, whether anybody likes it or not.

Last week I read a blog on a similar theme, though it was about using a baby carrier with a three year old, and I realised this type of age-related pigeonholing is happening left, right and Chelsea (It was written by @LivingtheTheory and you can read it here: http://living-the-theory.blogspot.co.uk/2017/12/thats-no-no-now-hes-getting-bigger.html ) Can we please quit it with the chronological age expectations and think developmental needs? So what if a toddler still needs to be close to his Mum when they are out and about? So what if my 5 year old still needs me to feed him sometimes? So what if a sixteen year old with severe learning difficulties still wants to carry a teddy around? So what if a ten year old still needs a pull-up at night? So what? All children have different needs. I’m not sure we need to get our knickers in a twist about it.

I have no idea how long Little Bear is going to need his dummy and blanket. I don’t think it is something I can set an age-related target for. Will he still have it when he’s a grown man? Somehow I doubt it.

 

*The main impact on speech of having a dummy is that children talk around it and inevitably start to form some of their speech sounds incorrectly. It is usually the tongue-tip sounds that are affected the most as the dummy prevents the tongue tip from reaching the alveolar ridge (the flat hard ridge behind your top teeth) , a place it needs to be in order to make accurate t, s, l, n, d, z sounds. A tell-tale sign of too much dummy use is the presence of a process called ‘backing’ in a child’s speech. The front sound ‘t’ is made at the back instead, so it sounds like ‘k’. Everywhere a child should use a ‘t’, they will use a ‘k’, so ‘tea’ sounds like ‘key’ etc.
Dummy use isn’t the sole cause of this process, it could just happen anyway, but it is not a process usually seen in typical development so can be a red flag.
As Little Bear has Developmental Language Disorder, with accompanying speech disorder, I would be stupid to allow him to speak around his dummy. Interestingly, although he has had many atypical processes in his speech, backing has not been one of them.
However long a child needs their dummy, I do believe that speaking with it in is a massive no-no at any stage.

For the record I do care about Little Bear’s teeth too. He has regular checks at the dentist and so far they are lovely and straight (as are Big Bear’s adult teeth).

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A Confession