What if the best Speech Therapy was your Physiotherapy?

You may notice that all the blogs I am writing this month are loosely arranged around a theme of  “do your best, don’t beat yourself up”.  This is because this pretty much summarises how I encourage families to think about their child’s Speech Therapy.  I truly believe that beating yourself up is a waste of your precious emotional bandwidth, and it’s not the best way to get things done.

I also think this is a good theme for January, the time of year when you are supposed to be most motivated and coincidentally – a cosmic joke – the time of year you most fancy staying in your pyjamas in the house.

Obviously, I think Speech Therapy is important.  In fact it can be a transformative force in a child’s life.  But the fact is, especially when you have a child with complex medical, developmental or learning needs, it can be just another thing on your list.

So I hope this blog brings you good news when I tell you that there are many children that I work with where I advise families to focus on their Physiotherapy if they want to support a child’s feeding and communication.

Oral skills for feeding and for talking are fine motor skills, growing out of the underpinning gross motor skills such as head control and trunk control.  In addition, movement is an important foundation for:

  • Motivation (if you can move, you can explore, which gives you lots to talk about)
  • Body awareness – the use of your body sensations to understand where your body is in space.  An important underpinning skill for our sensory learners, for children with feeding aversions and for many children with Autism diagnoses.

We need the best skills in the body that we can if we want to support children’s communication.  So next time you are carrying out your child’s Physiotherapy, you might just have their communication work covered too.  And next time you see your Physiotherapist, ask them if you can see them with your Speech Therapist, so they can enhance each other’s work.

Angharad   key trans


If you would like support and information about your child’s communication and feeding, I would love to see you in my Facebook group for Families

In March we will be having a Physiotherapist come into the group to talk about the impact of low muscle tone (hypotonia) on children’s learning


Things Your Speech Therapist Wants You To Know #3 Who’s On Your Feeding Team (And Why)?

The world of complex developmental and feeding needs can be a confusing one.  Just why do I need this many people involved?  What do they all do?

Here’s a quick guide to some of the people who might well be the main players on your team. You may well find variations in different countries, and in different parts of the country as to exactly who does which things, because roles in feeding tend to have a degree of overlap (which can be brilliant, or a pain, depending on how well this is managed).

  • Dietitian.  It’s your dietitian’s job to monitor your child’s nutrition, and optimise growth and nutrition in the light of any developmental and medical needs, and any recommendations made by your Speech and Language Therapist, such as texture modifications or supporting your tube-fed child to experience hunger.
  • Speech and Language Therapist (aka SLT or SALT) in the UK/Speech Language Pathologist (SLP) in the US.  SLTs usually have additional training to work with children with feeding difficulties.  We assess your child’s oral skills (sucking, chewing etc) and the safety of their swallow.  We may also do work with their sensory systems in as much as they impact on eating and communication.  In this role we can overlap with OTs.
  • Occupational Therapists (OTs), support children with their ADLs (Activities of Daily Living).  Luckily for us, eating is one of these!  Our OTs help us with sensory processing assessments and therapy, adaptations (such as seating and adapted eating equipment) and with fine motor skills (so important for self-feeding skills). In some countries, OTs take on more of the feeding therapy roles that SLTs tend to take on in the UK.
  • Physiotherapists.  Not always remembered as being part of the feeding team, but Physiotherapists often do the work on which many of our feeding skills are grounded.  We’ve talked previously about the need for both stability and mobility in our motor structures in order for feeding skills to progress.  Without Physiotherapists doing this work, we wouldn’t be able to progress feeding.  Physios also support your SLT to understand how to handle and position your child to optimise their feeding development.
  • Nursing Teams.  Supporting your and your child with issues around tube-feeding (and so much more).
  • Paediatricians and other Consultants.  Your child may be involved with many consulstants.  They may not have a direct day-to-day role in your feeding team, but us therapists need their direction on your child’s medical conditions to know how to proceed safely and effectively.
  • Play Therapists and Portage Workers.  If you’re lucky, you will have access to one or more of these services, to help your team and you make therapy playful and fun for your child, and help you break big targets down into smaller, play-based ones
  • And most importantly……….



The reason we all come to work every day, we love to celebrate your child’s successes with you.


Have you got anyone on your feeding team that I’ve forgotten?  Sing their praises in the comments.


Things We Love #5 Life with Greyson + Parker

One of the fantastic things about the internet is being able to find people in your ‘tribe’.  As a Speech and Language Therapist, I enjoy being able to hear from Parents who are going through similar things to the families I work with.

It is reassuring too, when you can see families implementing ideas like the ones we suggest in therapy all the time, and seeing them working, and celebrating their successes with them.

Chrissy is Mum to Greyson and Parker, two boys on the autism spectrum.  She talks about, and posts videos of, a lot of their Speech Therapy sessions.  She also is a powerful advocate for their use of their AAC (alternative and augmentative communication) devices, and shares videos of the family modelling.

Chrissy also posts about family life and lots of other things.  Following this page is a life-affirming experience.

If you’ve got a page, website, book, blog or resource you’d like to share, please do so in the comments.  They might make it into a future blog post, too!

Things We Love #4 ‘We Speak PODD’

Today I am wandering away from feeding to talk about communication (yes, I do work on that too!).  This week’s ‘Thing We Love’, or more accurately, ‘People We Love’ is the Facebook page and Youtube Channel, ‘We Speak PODD’.

For anyone unfamiliar, PODD (Pragmatic Organisation Dynamic Display), is an AAC (Augmentative and Alternative Communication) system, an alternative means of supporting people to communicate.  There are lots of AAC systems, and I’ll get round to some posts on those at some point!  But you don’t need to know anything about AAC, or to have a child who needs it, to benefit from getting to know ‘We Speak PODD’ better.

The Owens Family have taken the PODD system into their lives and hearts, because, fundamentally, they believe that their children have a right to their say.  They recognise that communication is key to independence and asserting yourself.

Karen Owen is passionate about the messy business of real-life communication.  This AAC system goes everywhere, communication happens when it’s inconvenient, it happens when the things that need to be talked about are difficult (death) or when they might be considered frivolous (hair styles).

We Speak PODD videos show the family using the system when they have ‘done it wrong’, when the children are grumpy, when the Parents are tired and sweaty.  All of it.  Because communication happens all the time.

We Speak PODD will gladden the heart of every Speech Therapist and anyone who lives or works with children who have communication challenges.  And if you’re visiting this page, you can leave your excuses at the door…..

“I’ve said this a million times but it’s worth repeating a million more: communication happens everywhere.

It simply never stops.  My kids must always have access to their voice.


Guys, if you are looking for easy then you have come to the wrong place.

If you’re looking for convenience, go ahead and click unlike….

Every human has something to give- every individual can make a meaningful contribution to society and it is our job to enable kids from a young age to find their power and their voice.

It’s not easy.  It’s not convenient.  But it’s worth it.”

Karen Owens, We Speak PODD

I couldn’t say it any better.

If you know any inspirational pages you want this page to share, or any fantastic resources you want some help to spread the word about, comment on the Facebook page and let ‘Find the Key’ help you to spread the word.

Things We Love #3 The Kids’ Guide to Staying Awesome and in Control

Today’s ‘Thing We Love’ is something for Parents (or Professionals) with children with sensory needs, or difficulty with regulating emotion for other reasons.

It gives children and adults great ways of describing how their bodies feel (like ‘fast and wiggly’), and then lots of really simple activities you and your child can try to self-regulate when you feel that way.

I’ve used this book in lots of ways in feeding therapy, both individually and in small groups. I think it could be such a great basis for talk about self-regulation in the classroom too.

It is always off the shelf and being used in the Speech Therapy office.

The Author, Lauren Brukner, has two other books on similar themes too.

A great resource that’s really practical.

Things We Love #2 Cerebra

Today I’m spreading the word about a great charity that I mention to so many Parents, Cerebra.

No-one ever seems to have heard of them, and yet they do such great work.

To name a few: A free toy and book library, support services around sleep, conferences to support Parents, guides to your rights under SEN law, and their fantastic Innovation Centre, that develops products in response to the things families tell them they need.

It is well worth signing up to their email news letter, as it’s a great way of keeping an eye out for new articles, services and inspiration.