What if you DON’T do the big heroic thing for your child’s communication development?

It is traditional at the beginning of the year to either set a big audacious goal, or to shrug and say you won’t be bothering (has anyone noticed that the world seems to have got together and decided to have a ‘word of the year’ instead of resolutions, when did that happen?  Was there a meeting?).

It can feel like either we need to make heroic life-changing efforts to affect change, or we should just accept things as they are, with nothing much in between.

No-one seems to know exactly who said it, but it is a truism that

most people overestimate what they can do in a year, and underestimate what they can do in ten years’. 

This is as true in working with your child with communication needs as in any other life area.

Some people respond to their child’s communication needs by buying into programmes that take hours every day to deliver.  This is fine, but I am a bit suspicious of approaches that promise huge results, but only work if you deliver them for 5 hours a day.  It has been my experience that these are unsustainable in terms of time and the impacts on family life.  When you are unable to maintain the efforts involved, then it can be easy to feel bad about this and feel like you have let your child down.  But this was not your fault, that programme was unfeasible by any reasonable measure!

More commonly, families get as much done as they can, as often as they can, quietly beating themselves up about not spending more time devoted to their child’s communication.

The fact is that small amounts of regular effort add up.  They might not add up in the big showy heroic ways that we might wish for, but they add up in the way that matters:  your child’s progress.  I often have the conversation that a child has made loads of progress, but a family can’t see it because it has happened so gradually.

The tiny things you do every day to support your child add up to real progress.  They even add up to progress when it looks like nothing is changing in your child.  I know that weeks and months can go by where you see no change, but every day you have spent even a little time prioritising a communication strategy or activity for your child, you have strengthened the foundations of their future progress.

So I hope 2020 is the year you do tiny things, as often as possible! (If I had to make this into a word of the year, I guess it would be ‘incremental’).  I happen to think turning up and trying your best is pretty heroic too.

Angharad

key trans

For pragmatic but effective ways to help your child with their communication, I’d love to see you in my Facebook group,‘Find the Key for Families’.  Practical information and advice from an experienced Speech and Language Therapist, and the support of other families who know what you are going through.

 

 

 

Why you are missing out on ideas and support for your child’s communication

I am an NHS Speech and Language Therapist, and run my business on the side at the moment.  When you work in the NHS, you don’t really need to worry about ‘finding your market’, because we all know that there is way too much work for our NHS Speech Therapists to do!

It’s a bit different when you are a private Therapist though, and you need to ‘find your people’ who are a good fit for your skills and knowledge.  This is a bit of a learning curve for me.

One of the things you do to get yourself ‘out there’ is to put out free content and help people to find your social media and website pages.  So with this in mind, I was writing a ‘freebie’ yesterday, about things you could do to support your child whilst you waited for a Speech Therapy appointment.  I posted it in one of my online business groups, to see if the Parents in the group felt I had hit the mark.  The feedback I got really got me thinking.

The feeling was that the information would be valuable but that in order to get people to read it, I would need to present it to a very niche group.   So for example, ‘Things you can do to support your child who is a late talker whilst you wait for a Speech Therapy appointment’, ‘Things you can do for your child with Down Syndrome whilst you wait for a Speech Therapy appointment’.  The advice wouldn’t be any different, I would just be changing the front cover and title to attract the groups who needed the freebie.

This made me feel frustrated.  I want to get my knowledge out in front of people who need it.  If I was going to have to market this information to every individual group of people, it will take me all year just to get it to the families who would benefit.  Now, there is a thought process, business-wise that says this is a good thing, because I can repackage the same information endlessly and sell it over and over again.  I see this, business-wise.  But I’m telling you, when you know families are desperate to be doing the right things for their children’s communication, and you know you have the information they need, this feels a bit depressing.

The internet is a wonderful place, full of information.  But I have lost count of the conversations I have had with families who have been online and either failed to find the info they needed to support their child, or have been overwhelmed with information.  People are often looking for information based on their child’s diagnosis, or their suspected diagnosis.

I’ll let you into a secret- children are all fundamentally the same.  No matter what their diagnosis (or none), all children need the same underlying communication skills, and the same approaches will often benefit children with many different diagnoses.  Your Speech Therapist doesn’t think all that much about your child in terms of their diagnosis (though that has a bearing), they think about them in terms of what skills they have and what skills they need.

If you are just looking for diagnosis-based information, you are probably missing out .  Think about what skills your child needs instead:

  • Attention skills?
  • Speech clarity?
  • Independence?
  • Learning vocabulary?
  • Social skills?

Try looking for these instead of a child’s diagnosis.  Ignore the fact that the page says ‘Autism’, and just think about whether the information might suit your child.

So, the world being how it is, I’ll market to families of children with all types of diagnosis, and none, if that means families get the information they need.  But I’m also sending the message that you can help your child, right now, if you get help to understand the skills they need to develop.

If you are looking for help filtering through all the information out there…..

If you are looking for simple things to do with your child that work…..

If you want to inform yourself and feel confident that you are doing the right things to support your child’s communcation..

Come over and see me on ‘Find the Key Speech and Language Therapy’ on Facebook, and sign up to my ‘Find the Key for Families’ group, where you can get information and support that works

Or

Sign up to my newsletter to get monthly info and freebies

https://findthekeyslt.co.uk/p/contact

No hard sell, just the stuff you need to help your child!

Angharad

key trans

 

Feeding your premature baby: Pre-feeding skills – Non-Nutritive sucking

If your baby is not yet ready to start oral feeds, it can be a frustrating time. Learning to feed orally is a barrier to being discharged in some units, though not all.

This post looks at one of the things you can do with your baby to support their path towards oral feeding:  Non-nutritive sucking (NNS).

NNS is any sucking that doesn’t involve actually taking milk.  Non-nutritive sucking may be from an ’empty’ breast (after you have expressed), on a dummy (pacifier) or a finger.

Non-nutritive sucking has been associated with earlier discharge from hospital.  It uses a different part of the brain to nutritive sucking (sucking for feeding), and so practising NNS does not necessarily mean that a child will be a successful oral feeder, since this is a much more complex skill. It also does not imply that a child can swallow effectively.

However, there is evidence that NNS can support physiological stability and be supportive of a child’s capacity to stay in or move into a ‘calm alert’ state, both of which are associated with better feeding outcomes.

As we have talked about in previous posts, premature babies need a good grounding of physiological stability in order to start feeding.  This means, for example, that they are able to regulate temperature,  or tolerate being handled without desaturating.

A common recommendation is that your baby is offered the opportunity for NNS at the begining of a tube feed, so that they can start to learn an association between feeding and sucking.  We may also suggest that you offer a ‘dummy dip’- a dummy dipped in your baby’s milk.

NNS is a recommendation that is fairly common in units, but every baby is different, especially if they are unwell in addition to being premature.  A Speech and Language Therapist will help you to understand whether NNS is the right choice for your baby, and when to start.

Many of the things that are suggested for you to do to encourage your child’s feeding may seem like very small, even insignificant things.  It is so important that we value the opportunities we have to support our babies.  Aside from the potential impact on feeding, taking opportunites such as supporting your baby with NNS will help you to learn to watch them closely and learn their individual signs, and to bond.

Posts from Find the Key Speech Therapy are intended for information.  They are not intended to, and cannot take the place of advice from an appropriately qualified Speech and Language therapist who knows your child.  Find the Key Speech Therapy does not take responsibility for the use of any advice without appropriate professional guidance. 

Feeding your premature baby: When waiting is the intervention

One of the things that I have learned working in children’s feeding is that the interventions we offer often seem very simple.  The hard bit is usually persuading everyone to keep doing them, and stopping everyone rushing around trying to add more interventions.

As adults, the urge to intervene so we feel like we’re doing something is very strong.  It is so important to remember that feeding is a developmental skill that must be learned.  When we constantly introduce different approaches, feeding regimes, feeding equipment, positions etc etc, we give our babies something new to learn each time.

Imagine that you were learning a new skill, and each time you thought you were cracking it, someone came in and told you you weren’t ging to be doing it that way next time.

Babies learn things.  We may teach them that feeding is pleasant, and a skill they can learn, or that feeding is unpleasant and difficult, but they will be learning either way.

Many times the interventions sugegsted by your Speech and Language Therapist seem tiny.  You may wonder what they could possibly be doing.  It can take a lot of faith to keep going, doing the same little things, when you do not feel they are getting anywhere.

If you can’t maintain faith in your Speech and Language Therapist, please keep faith in your child’s capacity to learn.  Learning can be difficult when we are tiny or unwell, and even the most basic things are difficult for us.

Less is often more in the neonatal unit when it comes to feeding.

Posts from Find the Key Speech Therapy are intended for information.  They are not intended to, and cannot take the place of advice from an appropriately qualified Speech and Language therapist who knows your child.  Find the Key Speech Therapy does not take responsibility for the use of any advice without appropriate professional guidance. 

“Have you tried….?” and other frustrations when your child has feeding difficulties

I have been thinking about this lately, as it is something I have been talking a lot about with a family I am working with.  This post is by way of solidarity from your Speech and Language Therapist.  I can’t tell you how much time I spend talking to Parents who previously had a plan they were happy with, and have been sent into a tailspin because ‘someone’ mentioned (insert poorly informed opinion here).

In a spirit of light-heartedness, some common sightings include:

  • The Mother or Mother-in-Law intervention

Unsolicited advice from a family member always comes with a side dose of implied ‘you are failing at this Parenting thing’.

  • The ‘in my day’ intervention

In the ‘good old days’, children didn’t get diagnoses, we just made them feel bad about themselves.  Closely related to the “I have no experience of this so it must in some way be your fault”, and “children don’t starve themselves, you know” .

  • The ‘I have diagnosed your child based on something I read online’ intervention

Closely related to the ‘do you think he’s got……’, and the ‘my neighbour’s Aunty’s cousin’s child has Autism’, so I know all about it’ intervention.

  • The one who says ‘just’

A personal bugbear, there is no ‘just’ in feeding therapy or working with children with developmental difficulties. That ‘just get them drinking milk’ that was thrown out in passing in that appointment?  6 months of hard work on your part.

  • The Health Professional  intervention

Health Professionals are as bad at this as anyone.  It is often in the nature of a Health professional to be a ‘fixer’.  The downside of this can mean that your health professional will try to fix things that they actually don’t know anything about.  This is a side-effect of sitting in meetings hearing other health professionals talk a lot.  You start to pick up a sense that you know their job too.

The problem with this type of unsolicited advice is that people take it very seriously.  It is particularly difficult when the health professional involved is a doctor, as anything doctors say instantly become gospel.. even though your Therapist has probably trained for many years in this very specific area of therapy and so are likely to be better informed than them.

  • The ‘have you tried..’ person

This person manages to imply that you will not have thought of any number of entirely sensible and reasonable-sounding things that you have either already tried, or in no way apply to your child.

  • ‘Your baby will be picking up on your stress, you know’

This may well be true, but I have never seen any statement more likely to increase someone’s stress.  Except maybe, ‘calm down’.

So why do people do it?

  • As mentioned in a previous post, the brain likes to make a nice neat narrative out of things.  It makes us feel anxious when things don’t fit into this narrative, and so we try to make your story fit.
  • The medical model is a very prevalent powerful ‘story’ in our culture.  The ‘story’ goes that illness gets treated and then it is gone.  Tell that to the millions of people with lifelong conditions.
  • People are uncomfortable with other people’s emotions, and try to make them ‘go away’.  This is actually about making them feel better, not you.
  • On some deep subconscious level, humans need to believe that if they just do the right things, then bad things will not happen to them.  This is part of a deep human need to feel in control.  Sometimes the only way we can maintain this illusion is if we subtly put the blame for things that are happening to you on your shoulders.

And to end, some unsolicited advice from me:

  • Often the best thing to do is what you are already doing

The belief that there is a better, quicker and less painful way to get where you are going is a very strong pull.  It is very hard to keep doing your best, sticking to your plan, day after day.  Do it anyway.

  • Make sure you feel firm on why you are doing things, so you don’t spiral into self-doubt

Have as many conversations, and ask as many questions of your Speech and Language Therapist as you need, to feel secure on the reasons why you are following a particular goal or style of intervention.  This will put you on firmer ground when you get questions and comments.

  • Prepare yourself

You will get comments like this, especially if your child has a visible feeding tube. For some reason, they tend to come when you are feeling tired and overwhelmed.   It might help to think of some stock phrases to say in advance.

  • Sign up to the approach that fits your temperament. 

In my experience, you will be most shaken by the unsolicited advice of others if you are following a plan that doesn’t quite ‘sit right’ with you.  This might be something like taking an approach that manages feeding issues as a behavioural issue, with strict rules and protocols, when this does not really fit with your temperament.  The more secure you feel about the approach you are taking, the more comments are likely to ‘bounce off’.  There will be times when the only approach available to you is something that ‘goes against the grain’ .  It is important to take the time to explore your feelings about this so that you can commit to whatever approach you are taking.

Here’s hoping you have a week free of unsolicited advice, and may I be forgiven for all the times I have probably indulged in giving it myself!

 

 

The Tactile System and your child’s eating-What do I do? Tops tips for the feeding environment.

You may have read previous posts about the sensory systems, and what over- and under-sensitivity look like with regards to eating.  And maybe you’re thinking, ‘yes, but so what?’.  This post begins a series on practical things we can do to support children with these difficulties.

So, first off, we’ll start with tips that are useful for most people.  If your child has difficulties that are not as severe, they might be enough to make a big difference.  Future posts will get more in detail into therapy techniques for more severely effected children.

The biggest thing you can do for your child’s eating is to make efforts to make the eating environment less stressful.  You might need to start by addressing things about your environment that don’t even involve food.

  • If your child has a negative reaction to sitting at the table:
  • Make sure you do other things around the dinner table and/or in their chair that they think are fun.  If they associate their chair and meal times with stress, then their negative responses will kick in way before the food gets there. Try having a time every day where they play in their chair, or you sing songs, or look at a book etc etc.  Let them choose the fun thing- our feeding chair is not a place where we want children to feel powerless.
  • Read about the ‘division of responsibility’ model (see previous post).  It is not your job to make your child eat, but to offer them opportunities.  I know this is easier said than done, but putting power back into balance in the mealtime dynamic can go a long way.
  • Offer foods that you know your child will eat, alongside other foods.  Starving children into eating will usually not work if your child has complex develeopmental and sensory issues.  If it does work, it will often come at a heavy cost with regards to your relationship, and your child’s relationship with food.  Offering a food you know a child will eat will bring down your stress,and their’s, and that’s a good thing.
  • Offer foods you actually like and eat yourself.  It is amazing how often we offer foods that we don’t like ourselves, beacuse we believe them to be good for us.  Your child is not an article in a magazine about nutrition, they will learn to eat the foods they see the family eating.  If you don’t eat kale, then don’t focus your time on it (NB I am not a dietitian- obviously making efforts to eat a healthy balanced diet are a  good thing, but it’s about being realistic).
  • Try and get everyone on the same page.  If you are taking a low-stress approach, but your Partner/Grandparent/childminder etc is putting the pressure on, this is less than ideal.  Our deeply-held views about food are often instinctive, and a child who is not eating will often trigger deeply held unspoken views (you shouldn’t waste food; children who don’t eat are being badly behaved etc).  Make efforts to help people see things from your child’s perspective.  However, if the discussions in themselves are causing more stress, maybe it is more appropriate for you to just control the interactions you can, and let the rest go.  People may well change when they see your way of doing things working.
  • Think about how you serve food.  Giving your child more control can really help the dynamic shift.  Think about serving food ‘family style’ (on shared plates on the middle of the table), and supporting people to serve themselves.  People can take as much or as little as they like, they can try small portaions of new things, and it makes it less easy to track what volumes have been eaten (a good thing, generally speaking!)
  • For children who do not like food touching (there are lots of good reasons for this, which we’ll talk about in another post), consider a divider plate.  If your child knows the foods don’t touch, they will be more able to relax and eat.
  • Check your own stress levels.  If mealtimes represent stress to you, then get the support you need to be able to bring your levels down.  Find a good feeding therapist, friend, counsellor, online support group etc who really gets it and is supportive.  Bringing your own stress down even a notch at mealtimes will support your child.
  • Educate yourself about your child’s developmental stage and their sensory processing.  It is really common for the stress levels at a family mealtime to drop massively once we know that a child is not showing these behaviours on purpose, or as a reaction to us personally.  Keep your eyes out on this blog for information, and for links to high-quality resources.

Posts from ‘Find the Key Speech Therapy’ are for information only.  They are not intended to, and cannot, take the place of advice from an appropriately trained Speech and Language Therapist who knows your child.  ‘Find the Key Speech Therapy’ does not take responsibility for the use of advice without appropriate professional guidance.