Posted in communication, education, leadership, learning, policy, schools, SEND, talk, teaching, technology

Speech and Language Therapy, What do I do exactly?

Today we welcome guest blogger, Claire Johnston, a Speech and Language Therapist at Springhill High School in Birmingham, who sheds light on how to support pupils with speech, language and communication difficulties, through the context of her day-to-day work.

“Hi, my name is Claire.”

“Hi, what do you do for a job?”

“Oooo, I know a little boy who has a lisp, I bet you loved the King’s Speech Film.”

And so it goes on!

For Speech and Language Therapists (SLT) I think that this is quite a familiar conversation. Certainly when I first start talking to people, most think that SLT’s just work with children who have difficulty with their speech sounds or we work with people who have a stammer. Many are surprised when I explain it as a birth to grave profession and that we are not a quasi-science. Our work is guided by evidence based practice and scientific research. Speech, language and communication difficulties can occur at any point in our lives and it may hit us like a ton of bricks, a life changing event. We are a birth to grave profession.

From birth we may work with families and new born babies who have been born with a cleft palate or other facial structural abnormality to support safe feeding, and will support the child and their family on a long journey.

We work with children who have an autistic spectrum disorder, attention deficit hyperactivity disorder (ADHD), pathological demand avoidance syndrome (PDA) and other developmental conditions. We support them by working with the child and the team around them to develop communication skills using various methods from signs to symbols and voice output devices. We also develop behaviour modification strategies and support the school team with differentiation of the curriculum.

Click here to see a video about how speech and language therapy can help pupils with autism to communicate.

We work with teenagers, adults with learning difficulties and young offenders. It is estimated that up to 90% of young offenders have undiagnosed speech, language and communication difficulties. Negative behaviour for some is the only communication tool they have to express their anxiety, embarrassment at not being able to do class work, stresses, peer pressure, bullying, self-harm and trauma, or mental health difficulties. Never dismiss negative behaviour as “Oh, they are up to it again disrupting the whole class”. It is hard to find the time with the pressures of the school day to spend time with students but there is always a function to the behaviour.

Part of our caseloads may be working with adults with learning difficulties to support them in becoming fully active members of their communities. We also work with individuals who have had a stroke and lost their ability to express themselves or understand what loved ones are saying to them and people who have degenerative conditions such as motor neuron disease who lose their ability to speak, individuals who experience a traumatic brain injury, or Parkinson’s disease.

We work with every professional under the sun from teachers to social workers to child and adolescent mental health services (CAMHs) to the police/young offending teams (YOTs) to carers to neurologists and audiologists. Most importantly, the person who needs us themselves is central to our role, for many we give them a voice to say thank you and I love you to the people who matter most to them.

And yes we work with children who have difficulty with speech sounds and individuals who have a stammer! This isn’t an extensive list by any means of the client groups or the professionals we work with but this video gives you an idea as to what we do!

I currently work in a specialist independent secondary school based in Birmingham, where we have young people from many different local authorities. Many of the young people attending the school will have experienced numerous placement breakdowns due to challenging, negative and often very aggressive behaviours but behaviour is communication, it is how it is interpreted that is often the challenge. The staff team within school and the residential placements (not all of our students live in our residential provision) work within, and have a thorough understanding of, social learning theory and the need for unconditional positive regard. Every day is a new, fresh page.

As a Speech and Language therapist, I support the staff team within the school and the residential placements in many ways. This is managed by working directly with young people and indirectly by supporting the staff team and families.

First is the development of a whole school approach to understanding speech, language and communication. This is achieved with training to understand speech, language and communication difficulties, starting with development, this is very important.  If a 14 year old child is scoring on an assessment of receptive language skills at an age equivalent of 6 years, what is the point of handing this information over to the staff team without the support to understand the developmental level the child is presenting to then differentiate the curriculum to meet their needs?

Many of our young people have not accessed speech and language assessments, for those who comply (not all do and there has been the odd **** it, I’m not doing that ****) assessment has been very useful in identifying areas of difficulty with receptive/expressive language skills that had not previously been identified. An example is a young person who was not able to recall sentences during assessment as they increased in length and complexity, secondary curriculum language is complex! These difficulties had not been identified by previous settings, by picking this up the staff team were able to plan with this in mind and chunk verbal communication and use additional supports, such as pictures and bullet pointed information, to support comprehension and engagement within the lesson.

I support the development of one page profiles, this is a very useful document which contains:

  • The young person’s details.
  • Diagnosis.
  • Statement objectives.
  • Speech, language and communication assessment findings.
  • Recommendations from speech and language therapy.
  • Recommendations from educational psychologists or specialist support teams to then differentiate the curriculum.

Using this information, and understanding the need to chunk information for one child to allow time for processing of information, or presenting information with visual supports for another, can mean the difference between engaging or not and interacting in a positive manner or not!

I work very closely with all departments within the school and work jointly with many teachers. Examples of this are joining a P.E lesson to support the staff team by modelling ways to encourage turn taking, waiting, encouraging eye contact and extending communication from one word, for example “Claire” to “throw ball to Claire”. Along with support to develop a sensory activity programme for students to engage with during the day to help students focus. I work with and join drama sessions supporting students who may have specifically focused on body language and communication in 1:1 sessions to then use those skills in drama.

I work very closely with the English department supporting planning for students who are working at P levels to GCSE, this can be from supporting sequencing activities to the development of narratives, understanding who, what, when, where questions and sentence structures.

I support some students with small social skills group activities to develop turn taking, conversation skills, and environmental awareness, as many of our students often start off with 1:1 or 2:1 staffing due to risk. This has developed for some KS4 students into coffee sessions at a local coffee shop where skills became generalised.

Support was provided to PSHE planning to support students with understanding passive, aggressive and assertive behaviours within social situations and how we communicate using different behaviours. This has proven very effective for some students to reflect on both theirs’ and others’ behaviours and then modify them.

1:1 work is provided for some students who have very specific difficulties due to trauma, cognitive, mental health, developmental or environmental challenges. This can be to support many areas such as to develop emotional vocabulary, develop inferential skills, consequential/problem solving skills, receptive language skills, expressive language skills and yes, speech sound work!

The support and benefit of a Speech and Language therapist in school can be massive and the feedback from the headteacher and staff team is that it has supported the understanding and development of the school’s special educational needs (SEN) and speech and language knowledge, but the key to this is good team working and communication.

If you have read this blog, I hope that you have found useful!

Claire Johnston

Speech and Language Therapist

Claire@springhillhighschool.co.uk

cjohnston4slt@gmail.com

If you suspect that a child or young person you work with has a speech language and communication difficulty you can find information to support at;

NHS – Referrals can be made to local speech and language services through GP’s, SENCO’s, child development centres and self-referral.

The Royal College of Speech and Language Therapists

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