Therapy Ideas blog

Therapy Ideas Live 2011 Wrap Up

December 25th, 2011 by Rhiannan Walton

It’s been a big year here at Therapy Ideas Live HQ. We’ve held three free evening events in London, each of which sold out, featuring 30 amazing speakers in total. They used their five minute slots to talk about diverse topics ranging from therapy approaches and new resources to goal setting and counselling, and everything in between.

The events were featured in the RCSLT bulletin: I was interviewed for My Working Life (page 34) in September and Janice Tucker wrote a lovely letter about the events in the November issue (page 4).

We’ve drunk wine together, socialised with our SLT colleagues, and recorded all the talks on video! It’s completely exceeded my expectations.

What’s next for 2012?

The first Therapy Ideas Live of 2012 is on March 14th, when we’ll be returning to City University. We’re keen to mix things up, Therapy Ideas Live with a twist: added speed dating! Okay, not the dating part so much — watch this space.

We’re publishing all the videos from the last three events and integrating them with some new features on the website. And I’m starting a podcast, so get in touch if you fancy being interviewed. It’s exciting stuff!

Thanks for all your support this year, hope to share ideas with you in 2012!

Watch the first ever talk

Watch the talk that started it all: Gina Davies at the RCSLT in July, which has been viewed more than 870 times by therapists all over the world!


Next Therapy Ideas Live event: City University London, 20 Sept. 2011

August 14th, 2011 by Rhiannan Walton

The first Therapy Ideas Live event on 5 July 2011 at the Royal College of Speech and Language Therapists in London was fantastic: the speakers were amazing, the format was engaging, and attendees left feeling inspired. The RCSLT bulletin is featuring the event in their September issue, so check it out!

Watch these videos of Gina Davies and Louise Coigley giving their stunning 5-minute lightning talks:


We’ll be publishing more videos of the presentations over the next few weeks, so stay tuned to the blog, or follow us on twitter.

Next Therapy Ideas Live: City University London, 20 Sept. 2011

The second Therapy Ideas Live event takes place on 20 September, hosted by City University, London. Sign up to our email list to be the first to know when we release the tickets. And if you fancy getting up on stage and sharing your experience, send us your talk idea by 23 August 2011. See you there!


Therapy Ideas Live: “Enlighten us, but make it quick!”

June 5th, 2011 by Rhiannan Walton

Although there’s plenty of formal education for Speech and Language Therapists (SLTs), we need more opportunities to share ideas, learn from each other, and develop our skills in an informal environment. I had a blast at Ignite London last year, and it inspired me to organise a similar event for SLTs. Meet Therapy Ideas Live.

With some friends and colleagues I’m trying something new: an evening of informal and informative lightning-style talks presented by ten SLTs from a range of backgrounds. Broaden your perspective, learn from others, share your own experiences, and socialise over a glass of wine—it’s a more inspiring version of CPD!

The first Therapy Ideas Live is happening on the evening of 5th July 2011, hosted at the Royal College of Speech and Language Therapists in London. Ten amazing speakers–including Gina Davies, Marie Gascoigne, and Stephen Parsons–will each present for 5 minutes, with slides that advance automatically. Find out more on the event page.

Amazingly, all 50 free tickets for this event sold out within 24 hours, and we closed the waiting list when 50 more people had signed up. Thanks for your support! We plan to film the presentations and share them on this website.

We’re also planning another event at City University in the autumn. Register your interest and be the first to hear when tickets are released. And if you fancy sharing your experience, perspective, case study, or challenge, send us your talk idea using this form. You don’t need experience of public speaking: anyone can give a lightning talk (read this post for some handy tips), and we’ll give you plenty of help.

You can follow the event live on twitter, using the hashtag #therapyideas.

See you there!


The challenge of discharging children with lisps

April 29th, 2011 by Rhiannan Walton

Resources are tight in the National Health Service: think one full time therapist with a caseload of around 125 children. So we have to pay close attention during our initial assessments to make sure children meet our criteria for therapy.

For speech sound therapy, children need to have at least 3 processes and reduced intelligibility, as well as age appropriate language and attention skills to qualify. So we give children with lisps, or difficulties with /th/, activities to practise at home, and discharge them. In some cases that’s easier said than done …

I can understand why parents are anxious about lisps; they worry about teasing and bullying. Sometimes I find it hard to reason with them; they’re trying to do the best for their child and I’m trying to manage the needs of a large caseload. We’re in conflict.

I almost want to play them video clips of my pre-verbal child with autism, my dyspraxic child, or my child with a severe stammer and explain that these children are my priority. Not great for confidentiality and probably not effective either!

Empowering parents to support their own child seems like the best strategy. If I can elicit an accurate /s/ in isolation during the session, I can usually convince the parents to agree to discharge. I explain the hierarchy for generalising the sound into conversation and give them written instructions for home practice.

If I can’t prompt the child to produce the correct sound in isolation (I find those lateral lisps tricky!) I tend to go down the ‘your child is not stimulable / ready’ route. I ask the parents to practise discrimination tasks with their child, talk about how the sound is produced and come back in 6 months to a year if the child hasn’t made progress and they’re still concerned.

How do you deal with parents who won’t accept that their child doesn’t meet the criteria for intervention?


Video Interaction Guidance

February 6th, 2011 by Rhiannan Walton

I recently connected with Liz Panton via twitter. Liz sent me this comment after reading Clare Chilvers’ idea about using video:

SLTs, clients, students, etc. can have an entirely positive video experience with no tears and nasty surprises using Video Interaction Guidance (VIG) – also knows as SPIN and VEROC (Video Enhanced Reflection on Communication).

There is evidence that the VIG approach, focussing on strengths in interaction, is a very effective way to use video to improve communication.

I have tried it with clients with severe communication problems, eg. no speech at all many years post-stroke, with other health professionals and SLT students. Even the most video-phobic have enjoyed the experience and have improved in confidence as well as communicative competence.

I would recommend the VIG approach to anyone interested in using video as a clinical or reflective practice tool.

Liz Panton MRCSLT
Gateshead PCT (South of Tyne and Wear)

Thanks Liz! That website looks like a really useful resource.


Where’s my visual timetable?

January 8th, 2011 by Rhiannan Walton

A recent experience gave me a powerful reminder that the children we work with need to feel calm in order to learn and develop their communication skills.

We were about to fly to South America on an evening flight. I’d planned to come home from work and travel to the airport with my partner. But for some technical reason, we couldn’t check in online. Panic! Suddenly the plan needed to change.

When my partner suggested a new plan—going directly from work to the airport—I started mumbling incomprehensibly about not having the right shoes on and my ID badge. I said it was impossible and insisted that the original plan was better. The more anxious and angry I got, the harder it was to think rationally.

Looking back, I realise I needed a visual timetable! If my partner had used symbols to talk me through the sequence of events, it would have reduced both my anxiety and my difficult behaviour. I would have been able to think more clearly, see that the steps were logical, and realise they allowed me to reach my goal: getting to the airport on time.

The same principle applies to the children we work with: they need to feel calm in order to learn and develop their communication skills. We should take the time to prepare a visual timetable for each session, to minimise anxiety and create the right conditions for learning.

In one of her workshops, Gina Davies reminded me that visual support can be quick to produce and low-tech. She demonstrated using an A4 sized whiteboard to produce a “now” and “next” style timetable in front of the children. This can also support the development of early literacy skills if you hold the board so the children can see you drawing and writing.

At the other end of the technology scale there must be visual timetable style apps on the iPhone or iPad. Have you used any? I’d love some recommendations.


When I’m 64

August 20th, 2010 by Rhiannan Walton

A colleague recently retired. She’d been working as a Speech and Language Therapist for longer than I’ve been alive! After the bosses talked movingly about what she’d achieved, others tried to wrestle her stylish red leather briefcase from her, insisting she wouldn’t need it in retirement.

She talked about what speech therapy was like when she started out:

  • Makaton was just being developed. She got involved with the charity and ensured the signing system was widely used in our area. Recently she taught the team to sign, “I’m dreaming of a white Christmas!”
  • The Derbyshire Language Scheme didn’t exist.
  • Some children were considered “ineducable.” This changed with the 1970 Education Act, after which all school age children were entitled to an education.

I might have 30+ years ahead of me as a Speech and Language Therapist. When it’s time for me to retire, what will I tell colleagues about starting out? They may be astonished to hear that we write clinical case notes on paper by hand. We consider assessments standardised if data has been collected from 1000 children. And in this era of “inclusion” hundreds of special schools still exist.

Maybe I’ll tell them I was one of the first UK therapists to start a blog! Times are changing; what will the therapy world look like in 30 years time? (I see iPads, lots and lots of iPads!)


Start tweeting, speechies!

May 9th, 2010 by Rhiannan Walton

I recently went to Paris to eat pastries while my partner attended a conference. Lots of people at the conference were using Twitter. They commented on presentations, shared relevant links, and arranged evening soirées.

Speechies: get with the times

Okay, so it was a content strategy conference for web people, but I think therapists need to try new ways of interacting with each other too. There’s a small community of us using Twitter. You should join us.

Share information

Therapists post links to interesting content, like this information sheet about creating social stories (PDF link) which was shared by several people I follow (e.g. @specialquest).

We also ask questions and share resources. For example @speechreka asked:

Anyone has access to this?: Quick Screen for Voice and Supplementary Documents for Identifying Pediatric Voice Disorders- LSHSS vol 35:308

And then:

I’d really appreciate it if someone can share that article. And anything dealing with paediatric voice disorders. Have an ax tomorrow…lost

Shareka got several responses from around the world, and later on shared what she’d found. Excellent timing. I was expecting a voice client for an initial assessment the next day!

Join the community

Twitter is a place to have an SLT-related chat, to share struggles and successes like this one from @speechbob:

just had the school psych tell me that one of my fluency students was talking up a storm with his strategies, made me smile.

We’re a friendly bunch, so what are you waiting for? Start tweeting and pick the brains of colleagues from all over the world. I’m @RhiannanW. See you there!


Drawing a new map in speech and language therapy—thoughts from Seth Godin’s “Linchpin”

April 4th, 2010 by Rhiannan Walton

I’ve just finished reading Seth Godin’s Linchpin and his message resonated with me. Godin asks readers to make a choice and then share his ideas, so here goes!

Godin describes a linchpin as “an individual who can walk into chaos and create order, someone who can invent, connect, create and make things happen… linchpins are geniuses, artists and givers of gifts.” He says that although we were trained to be cogs in a giant machine, we can choose to re-train ourselves to become indispensable.

Linchpins don’t wait for instructions, they make their own maps. They overcome the resistance (the lizard brain that tells us our ideas will never work and everyone will laugh at us) and get their ideas out into the world.

In a recent team meeting at work, it was easy to see the therapists whose lizard brains were in control; they suggested we stop trying new ways of working and go back to the old way! Fortunately my team also has a linchpin or two; they’re generous with their gifts and keen to make change. I’m trying to be a linchpin too; we’re starting to draw our own map, overcome the resistance, and ship our ideas.

I recommend checking out the Linchpin Manifesto (PDF link) and reading the book. We need more linchpins in the National Health Service! What do you think?


Video as a tool for teaching adult-child interaction strategies

March 21st, 2010 by Rhiannan Walton

I visit nurseries to train staff as part of my job; we aim to support the language development of all the children by improving the communication environment. I observe the staff and complete a check-list about the communication environment; it covers areas like adult-child interaction, the listening environment, snack time, and story time. I discuss my observations with the nursery manager and we decide what to focus on.

I’ve recently trained several practitioners in adult-child interaction, with varying degrees of success!

Training package

The training package I offer is still evolving. I usually:

  • give the practitioners some written information about adult-child interaction from Elkan Early Language Builders;
  • discuss the dual strategies of following a child’s lead and commenting rather than questioning;
  • model these strategies; and
  • make a brief video of the practitioner interacting with a child, and give feedback.

Effectiveness

I have used this package with five practitioners over the last month. Three of them responded really well: they asked thoughtful questions, reflected on their skills as they watched the video, and were able to adapt their interaction styles to become better communication partners. Result!

What about the other two? Well, one was able to identify that she asked a lot of questions; with support she began to think about how she could use comments instead. However, at the end of the session she still seemed unaware that she was being directive. The other practitioner felt she was already using both strategies, but didn’t notice herself asking questions when we watched the video. Hmm.

Reflecting on the sessions that didn’t go so well, could I achieve more by fine-tuning how I use the video? There’s lots of useful information on this topic in the Hanen “It Takes Two To Talk” programme. After reviewing it, I’ve found three ideas to try:

  • considering the adult’s stage of learning,
  • using coaching methods, and
  • asking rather than telling.

Stages of learning

The Hanen programme describes three stages of learning: pre-aware, aware, and active. A pre-aware learner might be able to explain the strategies, but doesn’t realise that she’s not applying them. An aware learner knows the strategies and knows that she’s not yet applying them. An active learner has applied her knowledge and changed her behaviour.

So the practitioner who thought she was using the strategies but didn’t notice that she asked questions was at the pre-aware stage of learning. I should try to move her on to the next stage: to increase her awareness of her own behaviour. The Hanen information suggests making tentative statements about what you see and then “letting the tape do the talking.” I’ll try it.

Coaching

Hanen suggests coaching as another way to support an adult’s learning process, by improving the specific interaction. You can do this while the camera is running, during a brief break in filming, or by demonstrating the strategy.

So for the practitioner who was unaware of how directive she was, I could try some coaching: while the camera is running I could say something like, “don’t suggest what to play with: wait for him to show you what he wants to do.” Something else for me to try out.

Feedback: ask, don’t tell

Reflecting on the feedback I gave, I think it started well, but could be improved. I asked what the practitioner thought about the interaction, and then offered a specific focus; for example, “let’s look at when you made comments.” So far so good. But then I told them my own observations, rather than asking for theirs! By asking rather than telling, I could provide a more active learning experience, to increase the chances of learning new skills. Looks like I’ve got lots to practise!

Any ideas?

Do you use video as a teaching tool? What techniques have you found work well with pre-aware learners?


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