Why Time Matters

Imagine you had no idea what month it is or had no idea how long your lessons are, when school ends or when the holidays are. Imagine trying to figure out a bus timetable when you don't really understand clock time. Imagine feeling cross when your teacher says 'wait a minute' and you keep waiting and waiting and waiting...

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These are some of the real difficulties experienced by young people who have an insecure understanding of time concepts. These difficulties can impact on their behaviour, learning and ability to function independently and may be masked by young people using a range of strategies to 'hide' their lack of knowledge. 

Time Matters contains resources that will help to:

-assess knowledge and functional use of time concepts including calendar time, clock time, estimating time and self-organisational skills

- provide fun and age-appropriate resources to help teach time-related skills to children and young people from the end of primary school through secondary school and beyond

-suggest strategies to support time-related difficulties in a variety of settings

- raise awareness of the impact of difficulties of time-related concepts

- provide case studies based on the author's experiences of working with young people

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Recent case

A young person (aged 17) recently gave a great example of the importance of having secure knowledge of calendar time and in particular the short date. He was working at a Food Bank and was asked to sort out the tins. He had to put the tins with the shortest shelf-life at the front of the shelf so they would get used first. He used his knowledge of time to carefully sequence all the tins by their 'use before' dates. This is impossible to do if you don't know the months in sequence...

It is always interesting to hear other examples of time difficulties so please share some of your stories.

Case Study

A Speech and Language Therapist had assessed a young person (aged 14) and established they found it very difficult to estimate time and would give wild guesses. This information proved important when the young person was questioned in court and without it there may have been questions about the reliability and truthfulness of their answers.

Let us know which resources you have found useful from Time Matters.  We are really interested in hearing the impact of time-related work...

-Clare Doran, Sarah Dutt and Janet Pembery

Speechmark authors of Time Matters

5 tips to help nursery children prepare for school

Help! A child in my nursery is not listening or talking and he is going to school next September.  How will I help him get ready for school?

It is common for practitioners working in nurseries and preschools to be worried about one or two children in the Autumn Term.  The year will fly by and it is hard to imagine these children catching up so that they will cope with the demands of school.  When young children are delayed the most common areas of concern are about speech, language and communication.  Problems in these areas have knock-on effects upon behaviour, play and friendships.  Here are five tips on how to help:

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Talk to the parents.  First off share your concerns with the child’s parents.  Have some concrete examples of what you have observed the child struggle to do.  Parents typically also have concerns so you can start a dialogue about what they have observed in other situations and make suggestions for some simple ways of helping.  Other parents know less about typical child development, so this is your first opportunity to raise their awareness and involve them in your plans to discover more about their child.  As you go through the academic year having the parents on board will be vital to ensuring that they make simple changes to help their child progress.

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Allocate a key worker.  Most nurseries and preschools have a key worker system where one practitioner is allocated to a child.  This arrangement is often loose as all staff on duty interact spontaneously with any children nearby.  But when there is concern about a child’s speech, language and communication it is vital that the key worker system is rigorously applied.  This has two major benefits.  First it gives the child the opportunity to form a strong attachment to one person.  This is a secure base for a vulnerable little person.  If the child has difficulty forming social bonds then this will become apparent if the relationship with the key worker does not emerge.  Second the key worker will be well placed to make detailed observations about how the child manages interactions with others and can learn what helps the child to communicate successfully with others.  This type of support has to be delivered ‘in the moment’ to be effective and of the right ‘dosage’.  Too little support and the child can become emotionally unregulated (e.g. passively despondent or stimulation seeking).  Too much support and the child can become dependent on the adult, lack self agency and stop interacting with children.  

So what is the ‘just right’ amount of support? Here are some examples:

It is when the key worker spots when the child has not understood a spoken instruction and so will repeat the words simply, showing or demonstrating to the child.  The result is successful comprehension in the moment.  

It is when the key worker spots when the child is asking for a toy but can only point or grab, and so she models the word they child needs to say.  The child then experiences how using the right words can lead to a peaceful toy exchange with another child.

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Plot the child’s progress.  Create a baseline profile of the child (e.g. using the Early Years Foundation Stage tools) and repeat it six weeks later to monitor progress.  Keeping good records means you have concrete evidence to show parents.  This can demonstrate and justify your management decisions; for example to show how your support is helping the child to develop or to show why you have decided to ask for additional support from the Speech and Language Therapy Service.  If you do get professional support your records will help answer the therapist’s questions about the child and your intervention.

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Get Informed.  Speech, language and communication difficulties maybe an unfamiliar area to you but there is plenty of help on the internet from organisations such as I Can and The Communication Trust.  Your local authority and speech and language department will have training that you can access.  Link up with local nurseries and preschools to discover how other early years settings support speech, language and communication.  Sharing resources and experiences of the support that is available locally can save time and money.

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Plan and Deliver Intervention.  Be realistic about what intervention you can provide.  Consider the physical layout of your setting, the knowledge and skills of the staff, funding for additional resources and your ability to commit to the form of intervention that you decide to deliver.  For example, if you are in a pack-away Church Hall with a small group of children then you will need to support language through play with all of the children.  Whereas a preschool setting with a separate quiet room could set up a language group that plays the language game at a set time each day without distractions. Your local speech and language therapist can make suggestions about published interventions that you could deliver.  The best programmes will include a form of monitoring so that you can detect the child that fails to make progress, even with your support.  In this way you will know when it is appropriate to refer the child to speech and language therapy.  However, it is highly likely that you will the child (and others in your setting) flourish with your language and communication games.

Handout:  Universal Skills for Practitioners Talking with Young Children in Pre-School Start Sessions

Have Fun!

Speak….	Do….	Be….
add-on repeat model pause chunk	show gesture wait listen follow	warm alert involved creative available

Speak….
Add-on expand what the child says with an extra word or two: “yes, ball, blue ball” Repeat repeat the phrase exactly to give extra opportunity for understanding: “a blue ball, a blue ball” Model Say the phrase or word you want the child to say, but don’t force them to repeat you Pause Break you phrases up with pauses; this slows down your speech and gives children time Chunk Break your words up into short chunks; simplify your language Do…. Show Show the child what you mean: “here is the Gorilla” Gesture Point, use exaggerated hand movements and facial expression Wait Give the child time to process what you said and create a reply or action in response Listen Listen to what the child actually says and acknowledge this first (rather than what you expected them to say) Follow Follow the child’s interest to map your words onto their actions and words Be…. Warm A kindly tone of voice and patience helps learning Alert Observe all the children and watch for indications they are ready to interact, like looking at your face Involved Reduce distractions so you can devote yourself to the children during the activity you lead Creative Use your playful to side to make the activity motivating for all Available Use your body to show you are ready to listen to the children -Catherine de La Bedoyere Speechmark author of Pre-School Start

5 essential pre-verbal skills parents and professionals need to know about for early communication

The learning of a young child’s first word is an exciting moment for both parents and professionals, and especially so for those with communication difficulties. There are many skills which precede the acquisition of language, and for those with special needs, it may take a little longer to get there. 

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It can be disheartening for parents waiting for the first words, but a little knowledge of pre-verbal skills and their importance in laying the foundations for later speech and language can help to set small learning goals and recognise progress in communication before language takes off.

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1. Eye contact is needed to maintain social interaction between two people, and communication can break down if eye contact is only fleeting . It can be encouraged through everyday interactions such as waiting for eye contact before giving children something they want, or setting up motivating activities such as blowing bubbles or peep-po games.

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2. Attention is needed to understand language and concentrate on one activity. Children with communication difficulties may have a short attention span but this can be developed through playing with the same toy in a variety of ways such as building towers with bricks, lining them up to make trains, playing peep-po games, hiding bricks, making animals or people, making shapes and patterns.

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3. Breath control is needed to control the use of breath combined with mouth movements in producing speech, and those with speech and communication difficulties may have poor control of the muscles used for speech. Breath control can be improved through blowing games such as blowing on the hair or the skin, blowing bubbles in the water or on the hair.

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4. Copying is needed to observe or imitate speech or signs, but some children with communication difficulties may be engrossed in their own world. Copying can be encouraged by playing alongside children and joining in everyday routines, as well as fun and easy activities such as copying funny faces and sounds in the mirror.

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5. Turn taking is needed for understanding of the rules of conversational turn taking. If two people talk at once, communication can break down. Games such as rolling balls and wind up toys to and fro can help encourage turn taking as well as everyday turn taking and sharing with siblings.

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Over 100 fun and practical activities to encourage pre-verbal skills and early communication can be found in the third edition of the popular resource ‘early Communication Skills’ by Charlotte Lynch and Julia Kidd.

- Charlotte Lynch 

Speechmark author early Communication Skills 3e

Planning your intervention with Alex Kelly

Here are a few of my top tips for making your intervention work..

I like to put any intervention into the following four-step plan before I start my group or one-to-one sessions. This will help you to work out how best to work with someone on their social skills difficulties.

Step 1: The behaviour … what is it?

Make sure that you choose the right behaviour or skill to work on first. So, having assessed the person, you need to consider the hierarchy and the complexity of the skill you want to work on with them. Ask yourself: are you setting up the person to succeed? Is the behaviour too complex?

Now consider whether the behaviour has a function or a reason. Maybe the person is behaving in this way because of an underlying problem that has not been addressed, eg a sensory need. Or they may be getting something out of the behaviour: for example, people leave them alone and they like this.

Finally, try to really describe what the person is doing – the more detailed you can describe the behaviour, the more likely you are to be able to help the person understand what they are doing wrong. You may need to add how it might make other people feel or what they may think to give them insight, although I would do this jointly with the person.

Step 2: The rules … what are they?

We need to help people to understand what they should be doing instead – what are the rules?

What should be happening? So many adults I have worked with have asked me why they were never taught the rules as a child. Of course, before we can do that, we do need to know them ourselves, so that is where I hope the Talkabout resources will help you out!

Step 3: The motivation … what is it?

Every person you work with will need to be motivated at some level to come to your group, change their behaviour, and become more socially skilled. Often the key to success is to work out what the motivation is going to be for the person to want to change.

We cannot assume that all people are motivated by ‘being friendly’ or ‘friendly behaviour’ or ‘people will like me’ or ‘mum will be pleased’. It may be better to reward them with something: for example, an activity, a smiley-face chart or just saying ‘This is the polite thing to do’ or ‘This is the grown-up thing to do’. If we don’t consider the motivation, the intervention may fail.

Step 4: The strategy … which one is best?

There are many different ways of helping people to improve their social skills and usually the best intervention is the one that includes a number of them. There are eight main ways in which we can help someone.

1 The environment – in the school or at home. It is essential that the environment backs up what is being taught as much as possible. Think about getting all of the teaching staff on board with what you are working on. Making sure that everyone is encouraging and discouraging in the same way can go a long way to helping someone transfer those skills out of a group and into their everyday life. This doesn’t mean I wouldn’t work with someone if I can’t get the environment to back us up, but it may explain a slower progress. You may see people beginning to get the behaviour in certain situations but not all of them. This is OK. It shows you that the person has the ability to get it right when the environment is conducive.

2 Talk it through with them or use comic strip conversations. With many skills and behaviours, it is very helpful to talk it through with the person or to draw it using stick figures and speech bubbles. You will gain an insight into how they may describe what is happening and why it happens, which will help with your intervention.

3 Social storyTM. Carol Gray developed this approach in the early 1990s and I often use stories to help teach social skills. A social story gives someone insight into  their difficulties and helps them to know what they can do instead. It also contains perspective sentences about what other people may be feeling or thinking which can be very useful for people with ASD.

4 A visual cue or schedule. It is important to remember that many people are helped by working visually, so the worksheets and activities in this book will help, but people may also be helped by a prompt card or a poster displayed in the classroom. At our Day Service, ‘Speaking Space’, in the UK, we use a lot of ‘now and next’ symbolised strips which can work well to cue people in to what is expected of them in certain situations.

5 A reward system. Rewards can help if the motivation is very tangible: for example, stickers to get a financial reward or do an activity, or a certificate of achievement. Other rewards can include a special time with someone to talk about something specific – for example, 20 minutes at the end of the day to talk to their mum about dinosaurs. Any reward needs to work for the person, so you need to refer to their motivation.

6 Use of other media. Using DVDs and clips of cartoons or television programmes, or even video clips of you modelling behaviour, can really help to teach social skills. Many people find visual methods of learning much easier and showing a video will usually motivate most people. I often use this method in groups as well as in one-to-one sessions. The Talkabout DVD includes video clips of actors modelling inappropriate and appropriate behaviours for all of the key skills covered in Talkabout (Kelly, 2006).

7 Role play and modelling. In this book I often suggest using role play and modelling to help teach skills. Modelling is when the facilitators model a behaviour, both inappropriate and appropriate, and role play is when the group members practise the behaviour themselves.

Here are a few important points to remember when modelling:

• Keep it short and simple.

• Model one behaviour at a time.

• Start with bad behaviour and end with good.

• Never use the group members to help you model behaviours.

• Keep the situation as ‘real’ as possible – it is better to model a normal conversation between two group facilitators than to pretend that one is a child, shopkeeper or teacher.

• Ask the group what they thought was bad about the behaviour. What should have happened?

Here are a few important points to remember when role playing:

• The group members are asked to act a scenario or to practise a skill.

• It is a stressful experience for some people.

• Try a ‘getting into role’ exercise such as the magic carpet or twisting into a role like ‘Superman’.

• Remember to de-role, especially if the group members have played the part of someone else.

• Consider using puppets.

8 Social skills group. This is my favourite way to teach social skills and the Talkabout programme should give you all the resources you need to run a successful social skills group.

The advantages of group work over one-to-one work are as follows.

• It is a more natural and comfortable environment in which to learn.

• We learn from each other.

• It is easier to problem solve, play games and to set up role plays.

• It gives the opportunity to try out new skills in a safe environment.

• There is an opportunity to transfer skills to other staff, improving the chance of carry-over into the environment.

Extract from Talkabout 2e - LOOK INSIDE

Alex Kelly 
Speechmark author of TALKABOUT

Get 20% off when you pre-order today! Hurry though this offer ends on the 30th April, enter code TA20

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

Get 20% off when you pre-order today! Hurry though this offer ends on the 30th April, enter code TA20.