The Theory Behind TALKABOUT

TALKABOUT was first developed in the early 1990s when I was working as a speech and language therapist in London, UK. I was particularly interested in social skills but was frustrated by two aspects of my work as a therapist. First, there was nothing in the literature to guide me on where to start intervention following assessment; and second, my experience showed me that I was not always successful in what I was trying to teach and I could not always predict which children were going to improve and which were not. I set about to solve these two problems over a period of four years.

I started my investigations at a college of further education where I was working with 60 students who had a mild to moderate intellectual disability. We assessed all of the young people I was working with using an adapted social skills assessment from the Personal Communication Plan by Alex Hitchings and Robert Spence – now published in Kelly (2000). The students were involved in this assessment which gave us some insight into their own awareness of their difficulties. From these initial results, we grouped students into their main area of need: body language, conversational skills and assertiveness. We evaluated success through retesting on the original assessment and also compared students with poor and good awareness of their needs.

The results were fascinating. They showed that the students who had been working on their conversational skills progressed more if they had good existing non-verbal skills (ie body language), and students who had been working on their assertiveness progressed significantly more if they had good existing non-verbal and verbal skills.

In addition, we found that students who had poor self and other awareness struggled with all aspects of the work. From this, we established a hierarchy which forms the basis of the Talkabout resources.

Over the next four years, we piloted this programme using different client groups and a group of willing therapists from throughout the UK. We all found consistently that the success of intervention increased if non-verbal behaviours were taught before verbal behaviours, and if assertiveness was taught last (Kelly, 1996).

This original hierarchy then formed the basis of the first Talkabout book (Kelly, 1996) but it has been adapted over the years to include self-esteem and friendship skills. The hierarchy now looks as follows.

Using this hierarchical approach, teachers and therapists can start work with the person at a level that is appropriate to that person’s needs. They can then progress up the levels to enable the person to reach their full potential, ensuring that basic skills are taught before the more complex ones. So a student who needs work on all areas of his social skills would start work first on his body language skills and then would progress to working on his paralinguistic skills, then his conversational skills and, finally, his assertiveness skills.

If this student also had poor self-awareness and low self-esteem, he would need to work on this before working on his social skills. And if a student also had difficulties with his friendship skills, he would only work on developing these skills if he had good self-awareness and good nonverbal and verbal skills.

Of course, success is not just about what you teach first; it is also down to how you teach it.

Extract from Talkabout 2e - LOOK INSIDE

Alex Kelly 
Speechmark author of TALKABOUT

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What do you think about when you have toothache?

Please consider that question before we move on?

I was in Bradford recently. Facilitating a team of workers who are on the frontline
and facing difficult behaviour and aggression daily. Yet they love the young people they work with.

Those who had been excluded from school, little response, little change and little sign of hope. Still each of the group yearned to be of developmental assistance to them.

I asked them that question:

'When you have toothache, what do you think about?'
No pause.
An immediate answer from one worker
as we all stood in the circle -
"Toothache"
was the answer.

If we have toothache we struggle to concentrate on anything else.
Restless as a wolf - we feel like the cheese is falling off our cracker. Nothing else really matters.

We can see a person's behaviour but we cannot see their experience.
We can be so preoccupied by their behaviour that we don't see
beyond behaviour.

Difficult behaviour can get under our skin.
Feelings rise within us.
As emotionally intelligent as we may be the feelings we have stimulate us, sometimes, to make a regrettable response.

This is applicable in the staff room, the classroom, the team meeting, the prison, the street, the office, at home, and certainly not only when we are transacting with humans with special needs.

The way I work on awareness and skill development is by using Experiential Exercises including Blob Tree Tools.

The objectives are:

•          Become more aware of our own feelings.
•          Becoming more able to get into contact with them.
•          Develop emotional literacy by being able to give each a feeling name.

So there in Bradford we throw the Blob Feelings Ball around the circle.
'Motion changes emotion' I say.

An activity, doing, is the best way to learn - to practise.
So the ball is thrown around the circle, the miss-catching it is part of the-bouncing-around fun as the ball creates smiles as humans live in expectancy as to who will receive the ball next.

The Blob figure nearest your right thumb -
'what does that Blob feel like?' I ask.
I ban the use of 'happy or sad' as all feelings can be tossed in those headings.
So minds are stretched - everyone engaging in the struggle to articulate.
Even seasoned professionals struggle to find the appropriate word.

I often ask more questions as 'right thumbs' develop their literacy.
'Describe a young person you know who feels like that?'

'When one of your youngsters feels like that, what behaviour does it drive?'

When a group is ready - the questions may become deeper and more personal-
'When did you last feel like that?'

Awareness always precedes skill.
By becoming aware of our own emotional literacy, or lack of, we can then be more sensitive to the feelings of others. More importantly, we can begin to see beyond behaviour to be more in touch with a person's toothache.

Next time I will click about working with special needs groups. I want to share some methods of how I engage them with the crisp objective of making available more tools for their life toolbox.

- Pip Wilson
Beautiful Human Person
Speechmark author of Blobs

Preparation is all important

The Pre-verbal Skills of Language

Whether we are baking a cake or building a house, we all know that good preparation is critical to the desired outcome of the project. For a cake to be delicious, the ingredients need to be measured correctly and strong, solid foundations are essential to ensure the stability of a house.

 

The same applies to language development. For a child to develop language that is functional and communicative, they firstly need to acquire the pre-verbal skills, the skills that provide the foundations on which language is built. 

It is easy to assume that if a child is able to speak, they have already acquired the pre-verbal skills but this is not necessarily the case. A child can often use words but not use these words to communicate effectively with others. Being aware of the pre-verbal skills and assisting their development is very important for the development of a child’s language. This can be done by;

• Encouraging the child to look at you or in your direction, even briefly, when they speak to you or want to show you something.
• Gradually developing the child’s ability to focus and concentrate on a range of activities; those he enjoys as well as activities chosen by other people, such as a parent or teacher.
• Drawing the child’s attention to objects around them and showing them how to look at things both inside and outside, rather then just looking at objects directly in front of them.
• Teaching the child to listen to the sounds in their environment such as planes, printers, dogs barking.
• Encouraging the child to copy actions and sounds made which is done most effectively through play and action songs.
• Assisting the child to wait and take turns, which is a skill that can be taught at the playground or at home, waiting for a favourite activity or at school or pre-school during group activities with other children.
• Developing the child’s awareness and control of their face and mouth muscles by playing games in front of the mirror, encouraging them to copy different facial expressions and tongue and lip movements.

Have fun with these activities and remember it is always better to spend a short amount of time doing these activities regularly rather than hours every now and again.

********************

Francesca Bierens Speechmark author of Assisting Students with Language Delays in the Classroom

Tell a Story, to Get a Story…

Having just completed a fun, productive and interactive presentation on storytelling at a RCSLT Clinical Excellence Network workshop for children with language impairments, I asked the audience to reflect on all the information they had received at the workshop, and identify 3 changes or actions that they would put in place at work the next day.

One speech and language therapist said that she would tell her client a story. I was intrigued by that and asked her to say a little more about that. She continued, that she was often asking the children with whom she works to tell her stories, and whilst she would read stories from a book, she never simply told them a story during her storytelling sessions.

What an interesting observation and a great change to commit to making - and one that can so easily be put into practice. At the workshop, I had shared strategies to facilitate the elicitation of storytelling in children and young people with language and communication difficulties, and one strategy that I have found really effective is simply to take my turn first and share a story with the group, whether it be a personal story about something I have done over the weekend, or a wonderfully wacky and obviously fictional story about a princess, dragon or fire-eater! This gives the students the time to get comfortable, to settle down in the session and enjoy the delights of storytelling, whilst at the same time, also, getting to know a little more about me, their therapist.

It provides the children with practice in a range of essential skills related to storytelling, including listening, using appropriate body language and facial expression to show interest, or, when needed, even confusion, as well as asking focused and appropriate questions. It also, of course, gives me the valuable opportunity to model storytelling and provide them with a helpful template on which to base their stories, if required. Of course my story will have a definite beginning, middle and end, on which the children can map their stories.

Have a go and see for yourself, if you have a group of children reticent at telling stories, try and start by telling stories yourself. Involve the children in different ways, perhaps they can clap loudly or roar every time they hear you mention the monster; or they can count the number of characters in your story. Make your story exciting, fun and interesting, use props like swords and other attention-grabbing objects, and dress up like the characters in your story. Be the wizard, the witch or the dragon. And by the time you are at the end of the story, you may very well found that you are no longer the sole storyteller, but one part of a very satisfied collaborative enterprise.

Go on, try it, tell a story, or even two, to get a story… 

Victoria Joffe, Professor, Enhancement of Child and Adolescent Language and Learning

School of Health Sciences, City University London

Speechmark author of: Vocabulary Enrichment Programme, Narrative Intervention Programme, Favourite Idioms and More Favourite Idioms

A look at creative storytelling with people with dementia

Clinicians and carers working with people with dementia would be familiar with approaches such as reminiscence therapy, but may be less au fait with the use of creative storytelling. 

The creative storytelling approaches used encourage people with dementia to tell stories based on a picture or photo. One of the important aspects of this technique, is that there is no “right or wrong”. Indeed this method allows and welcomes storytelling of all types – including made up stories. 

The benefits that clinicians using this approach noted included: 

·         An opportunity for people with dementia to engage in conversation 

·         An opportunity for verbal expression not bound by “rules” 

·         Individuals were observed to have increased confidence, quality of life and positively altered behavior 

The TimeSlips approach by Basting is a more structured format. Researchers from the University of Missouri found that participation in the TimeSlips storytelling programme improved communication between patients with Alzheimer’s Disease and had a generally positive effect on patients. Working in 20 care homes, researchers studied the effect of storytelling among residents with Alzheimers. Using a method developed by the TimeSlips Creative Storytelling Project, residents were encouraged to tell stories inspired by photographs. Working as a group, patients created a narrative inspired by the picture. The method replaces the pressure to remember with encouragement to imagine.

In examples where it was used in care homes, the whole community was reported to benefit. Read more about one particular study here .

Speechmark ColorCards lend themselves nicely to this approach – From Everyday Objects to What Can You See? With these ColorCards, photo based stimuli, it able's you to make your own storytelling aids in the care home; images that provoke discussion or images from a particular time in that person’s history.