Specialist Techniques

Attention Autism

What is Attention Autism?

Attention Autism is an approach developed by Gina Davies, a UK-based Speech and Language Therapist. It is based on the Joint Attention Stage of SCERTS. Attention Autism was originally created for children with Autism Spectrum Disorders (ASD), however it can be useful for many children who struggle with focusing and sustaining their attention on an adult-led activity. It aims to provide a learning experience that children will remember, by engaging them in visual and dynamic activities. Attention Autism is designed to create fun, lasting memories and ‘an irresistible invitation to learn’.  The approach follows the developmental sequence of attention in typical development and is comprised of four stages. Each stage targets new skills and they are designed to be carried out sequentially. 

Here are some examples of Attention Autism being used:

A bit of Maths and sequences in a sparkly night’s sky:

Or focusing on colours in a car race:

The 4 stages are designed to be in line with the child or young person’s attention and listening skills. They are only expected to engage with activities for as long as they choose, and this would not be expected to be above their skill level. If the child or young person moves away, this shows us that they are not quite ready to complete this stage and it is our job to try and support them to develop these skills. We can do this by being as engaging and exciting as possible! Using items that are exciting and visual are a good place to start.

Here are the stages 4 stages:

  • Stage 1: Focus attention (bucket task)
  • Stage 2: Sustain attention (watching a fun activity)
  • Stage 3: Shift attention (taking turns in a fun activity)
  • Stage 4: Focus, sustain and shift attention (independently completing a fun task)

Our Speech and Language Therapists are experienced in supporting children with Attention Autism. Please see our team page to view their profiles and find out more.

Hippotherapy

Hippotherapy (‘Hippos’ is the Greek word for ‘horse’ so nothing to do with hippopotamuses!) is the use of a horse’s movement as a tool to help achieve therapy targets. It is used widely by Physiotherapists, Occupational Therapists and Speech and Language Therapists in Europe and the US to work towards functional goals. A horse’s movement helps a child’s central nervous system to become more organised and helps to improve postural control, coordination, motor planning and sensory integration all of which helps with speech, language and communication.

We will be launching our hippotherapy service soon. If you would like more information on this, please contact us.

PECS – Picture Exchange Communication System

What is it? 

PECS is a form of symbol based low-tech AAC (Augmentative and Alternative Communication), meaning that symbols are used to communicate messages.  

PECS does not inhibit speech – it may act as a main communication method for non-verbal communicators. For those children who are able to develop speech, it may help to bridge the gap between non-verbal communication and the development of speech. PECS aims to support this through consistent use and repetitive models of vocabulary and functional language. The opportunity and encouragement to use speech is built into the teaching phases.

 How does it work? 

PECS teaches individuals ‘how’ to communicate through using structured steps to aid with gaining the attention of their communication partner and having some form of conversational ‘exchange’. Initially this is through handing over a single symbol of something they are motivated by to request that item or activity 

For example, if an individual loves playing with cars, they would be supported to exchange a ‘car’ symbol with their communication partner. Upon exchanging the symbol they will immediately receive the car. This supports understanding of the cause and effect element of communication. 

Once the initial ‘exchange’ skills are learnt, individuals are supported to work through phases building up to discriminating between symbols (being able to ‘read’ the symbols to know that ‘car’ is different from ‘biscuit’ for example) and forming simple sentences.  

Traditionally, there are 6 phases to PECS and each phase is taught within structured teaching sessions before the individual is supported to generalise the skills across activities, within different environments and with a range of people.  

At The Talking House, we begin to incorporate other communication approaches once an individual reaches phase 4 (sentence building). The aim of this is to support wider language development, such as the use of: 

  • Verbs (like ‘help’, ‘stop’, ‘give’, ‘pour’, ‘find’, ‘open’) 
  • People’s names  
  • Adjectives (describing words like ‘hot’, ‘blue’, ‘soft’, ‘funny’) 
  • Flexible phrases (such as learning that the word ‘close’ can be used with lots of words across different contexts e.g. close – door/ window/ box/ fridge etc.) 

We will always advise on how to ensure an individual’s communication is as functional as possible. Our aim is to support an individual across both home and educational settings in order to provide the most opportunity for learning, generalising and successfully using spontaneous communication. 

All of our Speech and Language Therapists are very experienced in supporting children with PECS. Please see our team page to view their profiles and find out more.

PROMPT

What is PROMPT? 

PROMPT stands for PROMPTs for Restructuring Oral Muscular Phonetic Targets. PROMPT is mostly known as being an approach which uses tactile (touch) and auditory stimuli to support speech development, with the therapist using their hands on the client’s face to guide their jaw, lips, and tongue to help them produce speech accurately.   

However, PROMPT trained therapists use this approach to focus on the child or young person holistically, looking at their language skills, social communication and interaction, and physical and sensory needs as well as motor speech skills. Therapy using PROMPT integrates all these areas to support accurate speech production as well as communication as a whole. 

 Who is PROMPT for? 

PROMPT is beneficial for children and young people of many ages and abilities. We have had lots of success at The Talking House using PROMPT alongside traditional therapy approaches and oral placement therapy to support children and young people who have complex speech, language and communication difficulties such as:  

  • Dyspraxia
  • Dysarthria
  • Developmental delay
  • Hearing Impairment
  • Cerebral Palsy
  • Down’s Syndrome 
  • Complex needs 
  • Phonology delay and disorder
  • Autism Spectrum Condition 

 How does it work? 

The therapist will assess your child’s communication as a whole, looking at the areas mentioned above. Your input as a parent or carer is vital in this process as you know your child best. The therapist will also complete an assessment of your child’s speech, looking at where the motor difficulties may be in relation to the movement of the jaw, lips and tongue. During assessment and therapy sessions, the therapist may take short videos of your child’s speech during play or conversation, with your consent, to allow further analysis outside of the session. This enables us to look at your child’s communication and motor speech skills in as much depth as possible and helps us to form our recommendations. 

When completing therapy using a PROMPT approach, specific speech sounds are not always targeted. The focus is on developing accurate production of speech in whole words and phrases as this is more functional in everyday life. The therapist will use their hands to guide the child’s jaw, lip and tongue movement by touching their face. 

You will be given activities to practise at home as repetition is essential in supporting progress of speech and communication using the PROMPT approach. However, parents and carers are not taught specific PROMPTs to complete at home, as if done incorrectly, this can impact progress. 

If we feel PROMPT therapy would be beneficial for your child, we will work together with you to: 

  • Provide specific information about the nature of your child’s speech sound and communication difficulties. 
  • Make recommendations and provide tailored therapy to support your child’s speech sound and communication development. 
  • Provide advice and training on how you can support your child’s development at home.  

The following SLTs are trained in supporting your child with PROMPT – click on their name to view their profile:

PODD books, Communication books and Aided Language Displays

Communication books, PODD books and Aided Language Displays are all forms of low-tech, paper based Augmentative and Alternative Communication (AAC) meaning that symbols are used to support or possibly replace speech 

Aided Language Stimulation (ALS) is used to support a child to understand language and to learn how and when to use words themselves. It is important for the child to see you, as their communication partner, using this throughout the day. This will show them that their communication method is effective and valued. 

The use of symbols does not inhibit speech. If an individual is able to develop speech, then the use of modelling spoken words alongside symbols from key adults is often a vital step in supporting the development of verbal language. ALS can (and should) be used as part of a Total Communication approach. This means in conjunction with other communication methods the individual will experience and may already use such as Makaton, PECS, spoken words etc. 

As well as specific vocabulary, different communicative functions are modelled to teach individuals how they can use words for a range of needs. For example: 

  • Communication Functions include: asking for things, rejecting things, social greetings, asking questions, making comments, giving opinions and expressing feelings etc. 
  • Core Vocabulary: words used across lots of situations like ‘more’, ‘go’, ‘help’, ‘stop’ 
  • Fringe Vocabulary: words specific to a situation like ‘bread’, ‘phone’, ‘wheel’, ‘paintbrush’ 

PODD: Pragmatic Organisation Dynamic Display (communication book) 

What is it? 

PODD is a communication book using symbols and written words to support both receptive (understanding) and expressive (use of) language. PODD stands for: 

  • Pragmatic – how we use language socially 
  • Organisation – words and symbols are arranged in a systematic way 
  • Dynamic Display – pages change according to which word is used 

 

PODD books come in 3 main forms, in various sizes and can be adapted according to individual physical or sensory needs. Books vary in the language level they aim to support, and your therapist would advise on the appropriate number of symbols per page for your child. 

 

How does it work? 

PODD books incorporate key features of language including: 

  • Quick access’ chat pages such as ‘sorry’, ‘I’m joking’, ‘how are you?’ 
  •  Categories like food/ toys/ places 
  • Links between word functions. For example, one word/symbol may guide you to another page where more vocabulary is available e.g. the ‘school’ page has a few actions listed (like ‘play’, ‘work’, ‘listen’) and a link to the ‘actions’ page for a much wider range of words you might want to use when talking about school. 
  • Presenting vocabulary in the order of speech (words are arranged from left to right in the order that you would say them e.g. I – like – bubbles) 

Key aims of PODD books are to: 

  • Provide individuals with a wider vocabulary 
  • Ensure the vocabulary reflects the individual’s activities and interests 
  • Model multiple examples of how to combine symbols to create flexible phrases and sentences for generalisation across contexts e.g. ‘open’ can be used in a phrase with a wide range of words in lots of different situations such as ‘open – door/ packet/ box/ bubbles/ envelope’ etc. 
  • Offer opportunities for the individual to experiment with combining symbols (linking words together to make phrases and sentences) 

 If a PODD book is recommended for your child, your Speech and Language Therapist would advise on which level of PODD book to begin with and would provide the necessary training and support for key adults working with the individual (e.g. adults across both home and school).  

In order for effective use of AAC an individual should be ‘immersed’ in it and for this to happen, adults communicating with the individual require the skills and confidence to use AAC with and around them. It may be that an individual (and their family) begin with a few core pages alongside ‘aided language displays’ (see below) to build confidence before transitioning to a full PODD book. 

Aided Language Displays

Aided Language Displays (ALDs) are used to provide ‘core’ and ‘fringe’ vocabulary linked to specific activities such as playdough, a themed role-play area, mealtimes etc.  

Key vocabulary linked to the activity is available on a single page, meaning quick access to the words needed within the game/ activity.  

The aims of an ALD are to support:  

  • understanding and use of key words 
  • generalisation of ‘core’ words used in other activities 
  • linking words to create flexible phrases  
  • use of a range of communicative functions.  

Communication Books 

Our communication books follow many of the principles of PODD in terms of words being categorised, vocabulary being organised in the order of speech and each page containing ‘core’ and ‘fringe’ vocabulary needed for a range of communicative functions.  

Each book is personalised to the individual therefore contains ‘personal fringe’ vocabulary. This means words that are important and meaningful to the individual and are combined with other vocabulary needed for effective communication and language development. 

At The Talking House we choose to colour code our ALDs and communication books using the colours from ‘Colourful Semantics’. This is an approach used to support language and literacy and by modelling words in line with their ‘function’ (such as verbs, objects, subjects, adjectives) we aim to support the child’s understanding of words and how to link them together.  

Our Speech and Language Therapists are experienced in supporting children with Attention Autism. Please see our team page to view their profiles and find out more.

TalkTools

What is TalkTools? 

TalkTools is a therapy approach which was devised in the USA by an American Speech and Language Therapist called Sara Rosenfeld-Johnson. TalkTools is known as an Oral Placement Therapy which uses a combination of auditory, visual and tactile (touch) stimulation to support the development of speech. It can also be used to support early feeding development, as this and speech development go hand in hand.  

Who is TalkTools for? 

TalkTools is beneficial for children and young people of many ages and abilities. It is especially helpful for people who find it challenging to access more traditional approaches focusing on speech. TalkTools can be used to support children and young people who have complex speech sound difficulties. We have had lots of success at The Talking House using TalkTools alongside traditional therapy approaches to support children and young people who have: 

  • Dyspraxia 
  • Dysarthria 
  • Cerebral Palsy 
  • Down’s Syndrome 
  • Developmental delay 
  • Hearing Impairment 
  • Complex needs  
  • Phonology delay and disorder 
  • Autism Spectrum Condition  

 This is not an exhaustive list, if your child has a diagnosis or needs which are not listed above, please feel free to get in touch to discuss whether TalkTools may be helpful with one of our therapists. 

How does it work? 

TalkTools uses ‘tools’ and specific therapy activities to teach the feel of speech. It focuses on teaching children and young people where and how they need to make specific speech sounds. This makes it very effective when working with clients who find it challenging to produce or imitate speech sounds or have not had much success using more traditional therapy approaches.  

TalkTools works well alongside more traditional speech therapy activities and is never completed as a stand-alone activity. Homework activities are given to support continued practise at home, which supports the best outcomes. We advise parents to purchase specific ‘tools’ related to your child’s TalkTools programme so that your child has their own set and you are able to continue practise at home.   

During assessment and therapy sessions, your therapist may take short videos of your child’s speech during play or in conversation, with your consent, to allow further analysis outside of the session. This enables us to look at your child’s motor speech skills in as much depth as possible and helps us to form our recommendations.  

If we recommend using TalkTools in our therapy, we will work together with you to: 

  • Provide specific information about the nature of your child’s speech sound difficulty. 
  • Make recommendations and provide tailored therapy to support your child’s speech sound development. 
  • Advise which ‘tools’ to purchase to support your child’s TalkTools programme and will provide information on where you can purchase these.  
  • Provide advice and training on how you can support your child’s speech following their TalkTools programme at home 

The following SLTs are trained in supporting your child with TalkTools – click on their name to view their profile:

TEACCH

What is TEACCH?

The TEACCH approach (“Treatment and Education of Autistic and Related Communication-Handicapped Children”) focuses on supporting the fundamental needs for an individual with communication difficulties. Highlighted areas of support include: 

  • Making sense of the world 
  • Predicting what will happen 
  • Giving a sense of control 

Aims of the TEACCH approach include: 

  • Organising the environment – making sure this is predictable 
  • Providing ongoing visual support (such as schedules, Social Stories, Task Plans) 
  • Sequencing information and incorporating routines for familiarity 
  • Narrowing interests in order to engage the individual before supporting them to then broaden their interests 
  • A focus on the development of independence 

How are the aims supported? 

Daily Timetables and Work Systems identified by TEACCH are something we provide regular support with both at home and in educational settings.

Areas identified for support by TEACCH are: 

  • Schedules such as visual timetables, now-next boards, activity schedules, visual calendars 
  • Start/finish boxesto break tasks down by showing how much there is to do, when the task will finish and what is next 
  • Outlining physical boundaries such as clearly marking areas of a room (e.g. construction area work area, snack area) and use of a workstation (individualised to the person’s needs) 
  • Activities showing a clear beginning and end 
  • Use of the same resources, words and pictures across contexts for repetition and generalisation 
  • Practising skills in structured, safe environments. For example, social skills such as losing a game, taking turns and self-monitoring during team games might be practised in a structured, adult facilitated task 
  • Additions to Social Stories based on the individual’s needs. For example: 
  • Scripting – practising what they might say in a specific situation such as wanting somebody to stop talking e.g. ‘I can say: I need a break now, please can you tell me later?’ 
  • Narratives – using films and individual interests to talk about what the characters did, how they feel, what they did next and why 
  • Use of comic strips with speech bubbles to explain how a situation went and how it could be done differently next time 

A key message from TEACCH: ‘Remember: You can always adapt a task into smaller steps than you think you can’. 

All of our Speech and Language Therapists are experienced in supporting children with TEACCH. Please see our team page to view their profiles and find out more.