Have you ever wondered what a therapy session actually looks like? Let’s take you behind the scenes. One observation we often get is ‘but you’re just playing.’ It might look like just playing, but there’s a lot more going on.

You may also be asking, ‘what will my child actually do?’ The answer to this question – it probably looks different every time! This depends on your child’s age, their goals, what they’re interested in or how they’re feeling on the day. One session may be more structured, another may be on the floor, running round the garden or baking cakes. Good therapy isn’t about following a fixed plan of activities, it’s responsive. It’s about knowing your child so well, that you can adapt, accommodate and follow their lead. It’s about knowing why you’re doing what you’re doing. 

What you see/What we see:
You might see a therapist decorating biscuits, playing in the water, filling and refilling, blowing bubbles or doing crafts. What is harder to see is that within this we are simultaneously working on attention, turn-taking, speech sounds, vocabulary, sentence structure, emotional understanding, confidence, self-advocacy or conversational skills.
You see: your child choosing what to play with. We see: motivation, an opportunity to follow their interests, joy and regulation. 
You see: us playing in water. We see: opportunities for modelling new vocabulary, turn taking, making requests and comments, managing what happens when we get wet
You see: lots of repetition. We see: thought out practise opportunities to help new skills become easier and more spontaneous
You see: a therapist changing the activity halfway through. We see: us constantly assessing, adapting and responding to what your child needs that day.
You see: us chatting to you at the end of a session. We see: one of the most important parts of therapy: helping skills move beyond the therapy session and into everyday life.

Starting therapy can feel like a big step, but it doesn’t have to.
We recognise that starting therapy can feel huge. It can come with lots of questions, barriers and fears. We’re here for it! We are here for the highs, the lows and everything in between. We want you to feel confident and empowered to take this beyond the therapy session. So let’s tackle some of those common fears you may be experiencing.

“Does starting therapy mean something is wrong with my child?” No! Therapy is about understanding your child’s communication profile and giving them the right support, at the right time. Sometimes a child’s needs are more significant; sometimes they are just in a specific area of communication. Either way, getting advice early can make things feel clearer.
“Will my child be expected to sit at a table and ‘perform’?” As we said above, good therapy is responsive. Your sessions may involve movement, conversation, games, drawing, books or everyday classroom activities. We adapt to a child rather than expecting them to follow a rigid plan. Above all, sessions are always child led, strength and interest based with strong foundations of connection, regulation and joy. I don’t know about you, but sitting at a table being expected to ‘perform’ does not bring me joy!
“What if my child doesn’t talk to the therapist?” This is one we see all the time! Building trust and safety is a fundamental part of therapy. Observation, play and interaction can tell us a lot, even before a child feels ready to ‘communicate with us directly.
“What if my child refuses to join in?” Again, this is all information. We are thinking on our feet all the time and perhaps we need to adapt something. Is it not an activity that makes them tick? Change it!
“Will we be given lots of homework?” We always want therapy to fit into your family life. It has to work for you. Often the most useful strategies are the small changes to everyday routines. We also want you to feel empowered and confident to carry on between sessions, so we’ll ask you. What do you feel you can do?
“Will I be judged as a parent?”  Some parents may worry that the reason behind their child’s speech, language or communication difficulties is something they’ve done wrong. Your child’s challenges are not a reflection of you.  Therapy will always be collaborative, not about blame or judgement.
“Will the recommendations be impossible to fit into a busy classroom?”  Schools are busy, we know this. Strategies and targets need to be realistic, manageable and integrated into what staff are already doing.
“Once we start therapy, are we signing up forever?” Therapy should always have a purpose. We are constantly monitoring, reviewing and adapting based on your child’s response and progress in sessions. Sometimes children need more intensive input, sometimes occasional monitoring, and sometimes a period without any direct therapy at all.

Things we wish you knew before starting your Speech and Language Therapy journey.
-You don’t need to prepare your child to behave perfectly.
-You don’t need to practise beforehand.
-You don’t need to know exactly what is wrong.
-Your child doesn’t have to talk to us immediately.
-You aren’t being assessed as a parent or teacher.
-And it’s absolutely fine to ask us questions.

Sometimes families and teachers can  spend months wondering whether they should wait and see. Asking for advice doesn’t automatically mean a child needs long-term therapy; sometimes reassurance, assessment or a few practical strategies are exactly what is needed.

Therapy is not about finding what your child can’t do; it is about understanding what helps them communicate successfully.
 

We’re often told we have a magic wand! As much as I love the mystical and magical world of fairies, unfortunately speech and language therapists have no such luck. What we do have though is a passion and a drive to support our young people to be seen, heard and valued. That is our magic power. 
 
In doing so we also have the joy of working with the families, friends and professionals around each and every child we work with. Families who play together, grow together. .

Connection, Regulation and Trust
 
All joyful communication is routed in connection, regulation, safety and trust. Without these things, communication can’t work in the way we’d like it to. It becomes harder for a child to access their language skills without first coming from a place to connection and trust. So we begin….
 
What makes your child tick? That’s where we’re starting. You can guarantee our sessions will always be child led, strengths based and intrinsically motivating. Does your child love to bake? That’s where we’ll start! Does your child love to sort the washing? No washing is too much! Do they like hide and seek? We’ll find every tiny space you have. We often wonder what people think when they see our sessions. Is that really speech and language therapy? If it looks like play, fun and joyful connection then yes, it absolutely is. 

What areas can MTW support?

We find people are often surprised at the range of areas we cover as Speech and Language Therapists. We can wear many hats, often at the same time!
 
Over the years, we’ve developed our tree to explore these areas a little further. After all, who doesn’t love a visual? You’ll see from our tree that we’ve tried to capture our holistic approach as much as possible.
 
Let’s start with the roots. What’s happening below the surface? As we’ve mentioned above, all communication is rooted in connection, regulation and the nervous system. We need balance, safety and trust to be able to access higher level language skills and to connect and communicate with others.
 
Play. We’ll often be told ‘you’re just playing though.’ Play brings a lot of joy to our lives, even as adults. It’s a lifelong process, what it looks like just changes. It helps us to connect with others, find joy in small things and to balance our nervous system. It also helps us learn about the world, work through and process things that our systems have experienced. It also helps children to learn new skills more quickly than just hearing or seeing something. In play they get to experience it too. That’s why everything we do with the children we work with is through play and all play is ok. 

Early communication skills covers a few areas including attention and listening, body language and facial expressions and turn taking. These are often described as the building blocks to communication. We know as parents that it’s harder to process language or what someone is saying to us if our children are talking to us while we’re cooking dinner and loading the dishwasher at the same time. It’s hard to switch our attention and this can be particularly difficult for children. 

Have you had a long day and feeling tired? Your body language and facial expression will tell those around you before your words do. 

Having a conversation with a friend? The turn taking skills you’ve developed have started early on, through play. Now we’re using them in day to day conversations. 

Understanding is another building block in communication. For analytical language learners, we’ll often find that they are understanding words and concepts before they are using them. From there we begin to understand a larger range of vocabulary and questions. For our Gestalt Language Processors, they may be developing their understanding through intonation, emotions and meaningful experiences. Whichever way your child is developing that language, we’re there to help them. 

Words and Phrases are what most of us use to effectively communicate our wants and needs. As we’ve seen above, we communicate in lots of ways but these tend to be the quickest. That’s why we want to support our children to communicate to their fullest potential in a way that works for them. Whether your child is learning through single words and gradually building sentences, or whether they’re learning language in chunks, scripts and intonation, we want to support them to be confident communicators with opportunities for joyful conversations.

Speech Sounds: The cherry on top. You’ll notice these are the leaves on our tree and are the sounds that children are putting together to make their words. This is because, often, the speech sounds are the last thing to fall into place but you’ll notice them start developing them form early on, through babbling to early words. The more our children’s language and communication develop, the more opportunities they have with practising their sounds. Are you concerned that your child’s speech sounds aren’t developing as you’d expect? Check out our early speech sound assessment here.

Fluency refers to how smooth or bumpy a child’s speech is. You’ll have heard this referred to as stammering or stuttering and is another of the many areas we work in. Whether it’s finding what environmental changes help your little one be as fluent and confident as possible or helping your teenager feel confident enough to order their pizza at the end of the week, we’re here to help. 

Social Communication is being able to understand, connect and communicate with the world around us. For some young people that may be finding their self-trust and being able to advocate for themselves. For others it might be developing friendships including where to set boundaries to keep ourselves safe. Whatever it is, we’re there for them. 

So there’s are whistle stop tour on the life of a Speech and Language Therapist. Still have questions? Contact us here or find us on Facebook or Instagram.

What is AAC?

AAC refers to any form of communication that is used in addition to spoken language and can be used by anyone, of any age. It stands for Augmentative and Alternative Communication. AAC refers to objects, symbols, photographs, signing and electronic devices that help communication. There is a distinct difference between visuals used to support understanding of language and visuals used for AAC to support expressive communication. This blog is focussing on AAC.

How can AAC help my child to communicate?

AAC supports children’s communication in numerous ways. Children who have communication difficulties can know what they want to say but are unable to communicate it effectively. AAC can bridge this gap. It makes communication accessible and supports children to communicate their wants and needs, leading to independence. This also supports children’s emotional needs: to feel heard and connected with others, supporting  wellbeing and reducing frustration.

Types of AAC 

AAC comes in many forms, including but not limited to, signs, choice boards, communication books, Objects of Reference, switches, tablets with symbol based communication and eye gaze technology. AAC supports expression (the output of ideas and thoughts). It can use a combination of photos, objects, symbols and words. The choice of AAC should be dependent on your child’s interests, strengths and abilities. For example, some children may enjoy using objects of reference, others may prefer photos, pictures or symbols. If you think your child might benefit from AAC or you have any questions, ask your Speech and Language Therapist.

How do I help my child learn to use their AAC?

The specifics of how to use AAC vary depending on which one you have. However, all types of AAC supporting children’s expression are taught through modelling how to use their AAC. When modelling AAC you first want to familiarise yourself with their AAC. You want to be able to show your child how to find what they’re looking for, what they can communicate and what to do when something goes wrong.

When you feel ready to model:

1. Choose a familiar activity that you do every day
2. Choose key words or phrases to focus on
3. Speak alongside using the AAC
4. Reduce the pressure. They don’t need to copy you. 
5. Model to your child each time you do that activity, then try other activities.

Another aim in modelling the AAC is showing your child how it can create more connections and how it can help them communicate their wants and needs with ease. This is why it is important to keep it low pressure! Remember that all communication, whether it’s with spoken words or AAC should be built on foundations of connection, regulation and joy. When modelling the use of AAC, ensure that the activities you choose are child led and interest and strengths based. For example, if your child likes bubbles and enjoys playing with them throughout the day, you could use them as an opportunity to model the use of AAC. If you’re introducing signs you could model ‘bubbles’ or ‘more.’ If you’re using symbol based AAC you could point to ‘bubbles’ or ‘let’s have bubbles,’ each time you blow them. If you’re unsure, chat to your Speech and Language Therapist.

Things to remember:

• AAC provides the child with a voice and should always be available 
• The vocabulary used on the AAC should be individualised and what the child might want to communicate
• If you use an electronic AAC have a paper version available as a back up

Common myths around AAC:

•  Will AAC prevent my child talking?  No! Research shows that AAC can have a positive effect on children’s language development. A lot of AAC involves making language visual and this helps children remember words more easily. The goal of AAC is not to replace speech but to enhance the child’s ability to communicate.
• Is AAC just for children who have trouble with language? No, AAC can help children with speech sound difficulties too. This could be because a child’s speech is unclear and unfamiliar people have difficulties understanding them, or if the child benefits from support when trying to find words for talking.
• Is AAC just for children who don’t talk? AAC can support all children. The questions that needs to be asked areis can the child communicate their needs and wants in all situations and with everyone? Are communication breakdowns occuring? Could AAC reduce frustration? For example, communicating in difficult situations such in an emergency or when upset can be tricky for some children as processing language is harder when dysregulated or they might feel more pressure using spoken language with people they’re unfamiliar with.

What are concepts and why are they so important for children to understand?

Concepts are used everyday. They help children understand the world around them and enable everyone to include enough information for others to understand them. For example, if your child keeps requesting “dinosaur,” how do you know which dinosaur they want? The green one? The noisy dinosaur ? Two dinosaurs? Colour, sound and quantity are all examples of concepts. As children develop their understanding of a concept, this supports them to start saying them.

Did you know that pupils in schools, using strategies to target learning and understanding of concepts, have increased early numeracy skills.

Some concepts do not relate to a physical attribute, such as again, now and after. For example a child may be upset because they want a snack now,  but they are told to eat it after dinner. Understanding time related concepts supports children to understand the world around them and when things are happening. Some children worry when things are different and understanding time concepts supports them to know when things will be back to normal such as “after lunch you have speech therapy, then you have maths.”

.

How many of the following concepts do you use and does your child understand? 

Below there are some lists of early concepts and level 1 concepts. It’s likely that you use more of these when talking to your child than you may be aware of. Some concepts develop earlier, such as go and stop. Understanding and communicating these concepts is very important for not only communication but also everyday life. For example, understanding ‘stop’ is very useful when it comes to safety. After a child develops early concepts, such as stop and go, these develop further into concepts such as fast and slow. 

How can I help my child learn concepts?

Relate concepts to your child’s favourite toys or familiar experiences and talk about what’s in front of you. It is better to teach concepts with a familiar toy, so your child is not learning about the new toy at the same time as learning the concept.  For example, if your child loves building blocks, try the following. Have a big and a small building block in front of you and say “I want a big block” , pause and look at the two blocks, then pick up the big block (ignoring the small block) and say “I found a big block!”. Many concepts come as opposite pairs, such as big/small and hard/soft.  Having visuals and being able to compare to something which is the opposite supports understanding to develop. However, only teach one concept at a time. When referring to the big block, label the small block as “not big.”

Things to remember

• Teach one concept at a time.
• Understanding a concept comes before children use them
• Your children will learn concepts based on their experiences. For example, if you have a dog they might learn wet and dirty first!
• If you would like some support with concepts you can ask your MTW Speech and Language Therapist for more information!

Storytelling brings us together – whether it is cuddling up on the sofa and sharing a picture book, reading a chapter side-by-side with a teenager, or simply flipping through the pages with a toddler – there is something really special about it. It brings us together. Human beings have been telling stories since the beginning of time, ages before words were recorded and pen was put to paper. It slows the world down for a few moments, lets us dive into different worlds, meet new characters, and experience a whole variety of emotions. It isn’t a passive experience, it is a deeply human one.

As children grow, stories grow with them. They may not always remember the earliest stories they heard, but they remember the sharing of them. In a world full of screens, alerts and never-ending ‘content,’ children are often absorbing more than they are expressing. The digital world can entertain but without support it doesn’t always invite them to think, imagine or share their ideas. Telling and sharing stories helps children to create meaning, it is more than just hearing words. It is a way of using language to connect, communicate and build relationships.

From a developmental perspective, there are lots of skills that are nurtured through sharing stories. Shared joy and attention for one. Laughing together at the funny bit, realising at the same moment what wonderful or shocking thing is about to happen, or eagerly anticipating what will happen next, all build connections and strengthen relationships.

Books and stories expose children to rich vocabulary we don’t hear in day-to-day conversations and routines. Stories have a beginning, a middle and an end. Characters often encounter problems to be solved or an adventure to undertake. When we talk about the order of these events, we are learning to organise and express our ideas. These are all important skills for literacy and when children have been exposed to storytelling, the skills they are expected to demonstrate in their writing, often come easier to them 

Teachers play a powerful role in nurturing these early literacy foundations through the way they share and talk about stories. Simple strategies such as pausing to wonder aloud, asking open-ended questions, revisiting favourite books, or retelling a story together, all support children to deepen their understanding. Children need a framework for organising their thoughts – talking about characters, predicting what will happen next, or connecting a story to a real-life experience are all ways of offering them this. Literacy grows when stories are explored playfully and responsively – this doesn’t need to be scripted or formal. 

Stories are also a rich and meaningful context for using AAC (Alternative Augmentative Communication). Whether it is pointing to symbols, using a communication device or signing, AAC allows children to actively take part in storytelling instead of just listening. They can comment on pictures, choose favourite characters, express feelings or help retell events using their own communication system. When AAC is used alongside books, children see that their ideas matter and that stories belong to them too. This shared experience supports language development, comprehension and confidence, while reinforcing that communication, in all its forms, is valued. 

Within stories, we get to watch characters develop. They experience problems, feel deep emotions, make mistakes and find solutions .This gives children a safe insight into the world around them. It gives them an opportunity to explore ideas, topics and emotions. They can think about what they might have done differently, or what caused a character to end up where they did. They may be drawn to stories that resonate with their own lives or ones that take them far away from reality. The options are truly endless. 

Stories spark creativity. The cardboard box becomes a spaceship, the cleaning cupboard the time machine, the stick the magic wand. Children begin to imagine beyond what they can see, and this promotes writing, pretend play, and problem solving to name but a few skills. 

Some children may not be ready to sit and listen to every line in a book. That’s ok. We don’t need to read the text at all. Talk about the pictures – this can be just as rich and even more meaningful. Describe what you can see, talk about what the characters might be saying or feeling, or let your child tell the story! This goes for their school reading books too. It is always exciting when our kids bring home their first reading book but storytelling doesn’t need to stop when this happens. If anything, continuing on this journey of sharing stories will help with all the other stuff that they are doing in the classroom. 

So, next time you pick up a book with your child, let it unfold naturally. Forget about it being a task that needs completing. Get lost in the connection and joy that comes with telling a story and sharing the moment with someone you love.