schools therapy resource pack - solent nhs · pdf filethe schools therapy resource pack has...

Schools Therapy Resource Pack

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Acknowledgements The Schools Therapy Resource Pack has been compiled and written by the Solent Children’s Therapy Team

with significant input from OT School Action produced by the Winchester and Eastleigh Paediatric

Occupational Therapy Team, the Language Resource Pack for Schools produced by the Basingstoke Speech

& Language Therapy Team and the Yr R Screening Pack produced by the Winchester and Eastleigh Speech

and Language Therapy Team. Special thanks go to Jo Johnson for pulling together the initial draft.

Many thanks go to everyone who has contributed information, suggestions and content and to the schools who provided invaluable feedback

November 2014

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Schools Therapy Resource Pack Page Section 1 - Purpose of the Pack

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Purpose of the Pack Introduction Working together with Schools Definitions of the service Link Therapist information and Photo Information on Telephone advisory service Universal, Targeted, Specialist (UTS) model How to use this pack

6 7 7

10 12 13 14 15

Section 2 - Developmental Information 18 Developing Children’s Skills Expected skill level Identifying Functional Difficulties Intervention Record Form

19 23 31 40

Section 3 - Motor Skill Development

45

3a Gross Motor Skills Achieving Body Control (ABC) Clever Bodies

46 65

3b Fine Motor Skills Reception Fine Motor Skills Programme (FMS) Clever Hands

105 116

Section 4 - Speech Language and Communication 130 Contents Listening and Attention Understanding Language Auditory Memory Descriptive Language Skills and Vocabulary Grammar Concepts Sequencing Process of Hypothesis Pragmatic Skills Stammering Voice Phonological Awareness/Working on Speech Sounds DevelopmentalTh Verbal Dyspraxia

131 133 140 152 162 188 225 244 253 266 297 300 301 313

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Section 5 - Skills for living and learning 318 5a Managing sensory processing difficulties 319 5b Improving visual perceptual skills 322 5c Developing better attention and organisation 327 5d Developing handwriting 336 5e Developing self-care skills 349 Section 6 – Glossary 365 Speech, Language and Communication definitions 366 Physical skills, Posture and Movement 368 Assessment Terms 377 Conditions 378 Section 7 - Equipment /Resources 379 Items a school might be advised to purchase 382 Specialist Equipment which may be used at school 384 Section 8 – Training 386 Free Generic Training 387 Targeted Workshops 388 Section 9 – How to refer 391 Referral Checklist 393 Integrated Referral Form 397 Section 10 – References 403 Section 11 – Appendix 407

Section 1 – Purpose of the Pack

Section 1

Purpose of the Pack


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Develop or create an environment conducive to learning and developing skills

Education staff receive general training from Children’s Therapy Services

Child identified by school and parent as needing additional support

Screening tool used to identify which support is required

Use of School Therapy Pack by school / parent

Additional Training available from Therapy

Services

Refer to Therapy Service using integrated therapy

referral form Include information of

strategies used and outcome

Contact Telephone Advisory Service to

discuss

Parent takes child to drop in

clinic (Availability dependent)

Review of skills by school / parent

Universal

Targeted S

pecialist

Continue Strategies

Unresolved difficulties

Difficulties have

resolved


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Introduction

As part of the package of support that the Solent Children’s Therapy service gives to children we have developed this resource pack for schools The aim is to help schools provide appropriate and immediate support for children experiencing difficulties. Where a child improves, a referral to the Children’s Therapy Service may not be required. However, the activities are not intended to take the place of direct therapy where it is needed and children should still be referred appropriately to the Children’s Therapy Service. [See ‘How to refer’, section 9] If after using the advice provided in the pack the child still continues to find tasks hard it may be appropriate for the child to be referred to the therapy service. The strategies you try can then be used as part of the referral. We have also included a suggested format of how to log the strategies that have been tried. Please see Section 2, page 42. A suggested list of equipment with suppliers may be found in Section 7, page 361. Please feel free to contact us if you have any questions, comments or suggestions about the pack. Working together with schools Occupational Therapists, Physiotherapists and Speech and Language Therapists are concerned with developing children’s functional skills in all areas of their daily lives. A major part of their day is spent in school and the curriculum and environment can create many challenges. The main focus for most children’s therapists is working in schools, providing support to education staff and parents. The need for partnership working is highlighted in the ‘The (0-25) Special Educational Needs Code of Practice (Children and Families Bill 2014)’. ‘Many children with special educational needs have a range of difficulties and the achievement of educational objectives is likely to be delayed without partnership in the child’s education between all concerned’ (5.27). All services should aim to provide an integrated seamless service, keep each other fully informed and help each other in various ways. Alongside other services, ‘support for children with special educational needs requires a concerted approach from healthcare professionals’ (5.27). The Children’s National Service Framework 2004 reiterates the importance of ‘good collaborative arrangements’ between therapists and other professionals. For children with special educational needs, ‘taking part fully in school life, whether in mainstream or special schools, requires good communication between health, social care and education services so that the child’s needs are understood and met. The right school policy or approach can transform the life of these children’ (NSF Standard 8: 3.14, 5.12).


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With improvements in newborn survival rates, greater recognition of developmental disorders and increasing inclusion, the resources of children’s therapy teams are becoming increasingly stretched. Early identification of difficulties and appropriate provision cannot be over emphasised. ‘The earlier action is taken the more responsive the child is likely to be’ (SEN Code of Practice, 5.11). ‘It is vital to identify quickly and accurately where children and young people have SEN that requires additional support so that this can be put in place.’ (SEN code of Practice, 2014; 5.1) ‘The benefits of early identification are widely recognised; identifying need at the earliest point that a physical, sensory, learning or mental health need presents itself, and then providing good interventions, improves long-term outcomes for the child.’ (SEN code of Practice, 2014; 5.4) ‘Improving partnership across different services for children and young people with SEN or disabilities. (SEN code of Practice, 2014; 3.1) ‘All teachers need to be equipped to teach children and young people with a diverse range of need. Early years providers, schools and colleges should plan their staff training, development and support to ensure all teachers are able to do this.’ (SEN code of Practice, 2014; 5.1) ‘The educational setting should have a clear approach to assessing SEN which is known by all staff. This should include the use of effective tools and early assessment materials, as well as arrangements to draw on more specialised assessments from external agencies and professionals.’ (SEN code of Practice, 2014; 5.6) Children with the most severe difficulties are usually identified and receive therapy at pre-school but the needs of others may not become evident until they start school. When a child is identified as not making adequate progress ‘the school should provide interventions that are additional to or different from those provided as part of the school’s usual differentiated curriculum and offer strategies’ (5.43). With this in mind, the Children’s Therapy Service has developed this pack to help meet children’s needs more effectively in the context of partnership working. The need to support children with speech and language difficulties Speech, language and communication needs (SLCN) are the most common type of special educational need in primary-aged children. On average, in each primary school class, there are two or three children who have SLCN. Providing effective intervention to support children with SLCN is essential, as having a speech, language and communication need can have a significant impact on a child’s future: 60% of young offenders have a SLCN, only 25% of children with SLCN reach the expected levels for their age in both English and Maths at the end of key stage 1 and only 10% get five good GCSEs including English and Maths. Early intervention for


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these children is key. Children whose language difficulties were resolved by 5½ are more likely to catch up with their peers and pass as many GCSEs as children without a history of language difficulties.1

The benefits of school-based management Key bodies interested in speech, language and communication needs (SLCN), including the UK government have conducted much research into best practice for supporting children with SLCN. It has been concluded that collaboration between speech and language therapy services and education is essential and ‘in best practice settings the main responsibility for supporting the children’s needs rested at the school and class level’. Effective intervention for SLCN provides support in the most relevant environment for the child and is managed by those ‘most relevant to the child’. This is true of all areas of child development. Intervention should happen in the environment that is most functionally and socially appropriate for effecting change. It is therefore really important that teachers and therapists work together to provide support for the child at school; an environment that the child encounters every day. There are many benefits to providing interventions in school. School based provision allows intervention to be embedded within the curriculum, which should support children’s access to learning. School based intervention also allows children to practice new skills in small group settings within a naturalistic environment. Setting up effective language learning environments can also impact on literacy learning. Ofsted have commented that ‘a common feature of the most successful schools ....was the attention they gave to developing speaking and listening’ The effectiveness of school based management It has been found that staff who have received appropriate training in speech, language and communication needs are as effective as speech and language therapists in carrying out specified intervention programmes to develop expressive language. This was found to be the most cost-effective form of management.2’3 Providing children with opportunities to develop their language and movement skills at school is an effective method of intervention. In cases where children have very complex difficulties or who are not progressing despite effective input at school, specialist, clinic-based provision by the Children’s therapy service can be provided.

1 Bishop D.V.M & Adams (1990) A prospective study of the relationship between specific language impairment, phonological

disorders and reading retardation. Journal of Child Psychology and Psychiatry 31, cited in ‘The cost to the nation of children’s

poor communication’ ICAN Talk Series – Issue 2

2 Boyle JM, McCartney E, O’Hare A & Forbes J (2009) Direct versus indirect and individual versus group modes of language

therapy for children with primary language impairment: principle outcomes from a randomised controlled trial and economic evaluation. International Journal of Language & Communication Disorders, 44, (6), 826-846. 3 Dickson K, Marshall M, Boyle J, McCartney E, O’Hare A & Forbes J (2009) Cost analysis of direct versus indirect and individual

versus group modes of manual-based speech and language therapy for primary school age children with primary language impairment. International Journal of Language & Communication Disorders, 44, (3), 369-381


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Definitions of the service: The Therapists Children’s therapists work closely with other professionals, parents/carers, teaching and welfare staff at school and nursery to ensure that the children’s abilities are maximised and prevention strategies implemented to reduce harmful effects of abnormal movement, postures, and techniques. Therapy advice should be incorporated within the daily routine of their life at home and school. All therapists hold a recognised qualification and are regulated by the Health and Professions Council (www.hcpc-uk.org). They are autonomous practitioners, responsible for the assessment and interpretation of investigations to provide expert, holistic intervention. The therapists work in teams to maximise the skills available to support children which may mean that more than one therapist will see a child to enable the most appropriate therapy to be provided. All therapist are supervised and undergo regular training and development. Occupational therapy Occupational therapy is the use of purposeful activity and play to help a child attain maximum levels of functional performance, thus gaining self-esteem and independence. Motor, sensory, perceptual, social, behavioural and self-care skills are assessed. Occupational therapists use a combination of approaches and therapeutic techniques, advising on equipment and environmental adaptations where appropriate, to improve the child’s ability to access the physical and learning curriculum. Physiotherapy Children’s Physiotherapy aims to help maximise movement and function when children are affected by injury, illness, developmental delay or other disability. Physiotherapists will use a combination of approaches to develop gross motor skills and provide intervention programmes, including equipment, which may be carried out by non-professionals if taught how to do so. Speech and Language Therapy A Speech and Language Therapist works with children with speech, language, communication, feeding and swallowing difficulties. They may assess a child by observing them in the classroom, playing some games and engaging them in a range of structured activities (which may include formal assessments). Following assessment, the therapist will work with school staff and the child’s family to set and monitor specific targets that will aim to maximise the child’s communicative potential.

http://www.hcpc-uk.org/


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Therapist’s Roles & Responsibilities

To support staff in providing a developmentally rich environment for all children with SLCN, motor and functional difficulties.

To signpost education staff to resources, training and appropriate strategies which can maximise a child’s potential.

To assess children highlighted by the school as not responding to targeted strategies identified on the screening tool.

To review the progress of children on the caseload and to update advice and targets as appropriate.

To discuss the needs and progress of each child on the caseload on a regular basis until the child’s needs can be met in the classroom environment through a differentiated curriculum or by school staff.

To provide general advice, as appropriate, for all children for whom the school have concerns about their development.

To signpost education staff to resources or appropriate strategies as the child is approaching discharge.

Schools Roles & Responsibilities

To provide a stimulating environment to allow the development and generalisation of gross, fine motor and communication skills

To follow the guidelines laid out in this pack to identify children who need greater support with the development of skills, to implement appropriate strategies and to record progress and then to refer to the service if required.

To implement activities and strategies in the classroom and in small group work as directed by therapists.

To identify a skilled member of staff, or someone who is willing to learn through observation and joint working to carry out programmes with individual children.

To organise time for therapists to meet with the SENCO after each visit to provide feedback and advice about individual children.

To provide an opportunity for the therapist to discuss children with their class teacher and provide advice where appropriate.

To keep the therapist informed about changes to children’s contacts details, changes in parental responsibility and social situation.

To keep parents informed of the therapist’s visits and provide contact details to arrange a visit to discuss their child’s needs/progress.


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Your Link Therapist is: Name Profession Contact Details Blurb about link therapist Please contact me to discuss any issues about therapy provision within school or any training required. I work closely with my colleagues from the other therapy professions as part of the team supporting children in your school. Other therapists that you might see in the school are: Physiotherapist Occupational Therapist Speech and Language

Therapist

Photo of Therapist

Photo Photo Photo

I am a qualified Speech and Language Therapist / Physiotherapist / Occupational Therapist who is registered with HCPC (Health and Care Professions Council) and a member of RCSLT (Royal College of Speech and Language Therapy) / ACPC (Association of Paediatric Chartered Physiotherapists) / COT (College of Occupational Therapist).

I am here to support you and your pupils with a variety of additional needs impacting on their education.

I have a special interest in __________

I am a qualified Speech and Language Therapist / Physiotherapist / Occupational Therapist who is registered with HCPC (Health and Care Professions Council) and a member of RCSLT (Royal College of Speech and Language Therapy) / ACPC (Association of Paediatric Chartered Physiotherapists) / COT (College of Occupational Therapist).

I am here to support you with children with a variety of additional needs impacting on their education.

I have a special interest in __________


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What can your link therapist do to support you and the children in your school? Come and talk to me about your concerns regarding a child’s speech, language, communication and feeding needs; fine motor, visual perceptual, handwriting and dressing skills; gross motor skills and motor co-ordination needs. Without the need to refer a child to the service I can offer:

Universal training – via an inset day (see section 8)

Verbal suggestions for strategies to try based on your assessment of the pupil

Standard advice sheets for identified difficulties (included in this pack)

Suggestions for other places / people from whom to seek support

Another therapist to contact you to provide advice If you want more support you can

Access standard or bespoke training (see section 8)

Buy in additional time from our Service (contact SPA)

Contact your link therapist to discuss your requirements Telephone Advisory Service The Children’s Therapy Service offers a telephone advice service Monday to Friday from 8am to 6 pm. Contact the Single point of Access (SPA) on 0300 300 2019 and speak to the operator who will log your call. A therapist will contact you within 24 hours or on the following working day to discuss your call. The therapist will be able to provide general advice and information on any child not currently seen by the service. This service is available to school staff, parents and health professionals. What happens when I refer? When a child has been referred to the service an assessment appointment will be offered. This may be at school or within a local clinic. The child’s skills will be compared to the pupil’s chronological age AND to their general level of learning. Following assessment, the therapist will discuss their findings and may offer:

Training

General advice regarding strategies to support difficulties

Help to set up a group e.g. narrative skills, social skills group, motor skills, handwriting

Help in developing visual support e.g. visual timetable

Individual or group intervention either provided by the therapist or therapy assistant or by school staff trained by the therapist.

If needed, a one-off review and advice can also be provided at any time. For instance, this may be helpful at transition, i.e. Jan – July of Year 6 or Sept – December of Year 7.


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Secondary-age pupils with a statement of special educational need for speech, language and communication needs who attend schools within Hampshire LEA will be eligible for support from the CAL team.

For pupils with long term difficulties such as: physical disability, neurological conditions, arthritis, speech difficulties, voice disorders, stammering/stuttering, feeding/swallowing difficulties and those who use communication aids, therapy will continue until difficulties have resolved, are being successfully managed or until the child’s ability is functional for their everyday needs.

Universal, Targeted and Specialist support model The Children’s Therapy Service are using the Universal, Targeted and Specialist support model to ensure that children and families receive the support they need when they need it. To enable us to do this we will be offering training and resources to develop skills within schools and other settings.

Universal services Targeted service Specialist services

Population All children’s needs are met by families, carers and the general children’s workforce

Children where there are concerns about motor and language development. Needs are met by families, carers and the general children’s workforce with support from Children’s Therapy

Children and young people requiring specialist assessment of their abilities and areas of difficulty. Needs are met by parents, carers and specially trained workforce.

Role of Children’s Therapy Service

Training provided on ‘normal’ development of skills e.g. communication, gross and fine motor skills Health promotion e.g. ‘Tummy time’ talks to new parents. Use of Schools Therapy Pack in schools. Development of supporting information for Health Visitors use of Ages and Stages questionnaire (ASQ)

Training and advice given on specific areas of difficulty e.g. classroom strategies to promote communication or maximise attention. Specific activities to promote development which may be reviewed by a therapist

Individual assessment of need. Targeted therapeutic advice, requiring regular review and measurement of outcomes together with those involved in child’s care. Individual training of parents and staff


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How to Use the Pack

Identifying Areas of Functional Difficulty – complete the Preliminary Checklists (Page 32) which is useful to help pinpoint a child’s difficulties and which sections to implement.

Section 3a includes two gross motor programmes:

Achieving Body Control (ABC), focuses on core stability and postural control and is likely to benefit all children starting school as well as being used individually with children experiencing difficulties.

Clever Bodies further develops balance, motor planning, body awareness, coordination and ball skills.

If you are using the BEAM programme already this can be used instead.

Section 3b contains General Suggestions to Improve Hand Function and Clever Hands, a hand function programme. If you are using the Reception Fine Motor Skills Programme for reception age pupils this can be used instead.

Section 4 contains activities to develop speech, language and communication skills

Sections 5 provides guidance on skills for learning and living

- managing sensory processing difficulties (5a)

- improving visual perceptual skills (5b)

- developing better attention and organisation (5c)

- developing handwriting (5d)

- developing self-care skills (5e) Note: Sections 3 to 5 follow an approximate developmental sequence but stages of development overlap and skills need to mesh together and enhance one another. ‘Handwriting ‘and ‘Self-Care’ which require particular combinations of skills are therefore found in the later Section 5

Where relevant, it may be helpful to share information with parents.


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Record child’s performance Consider including targets in Individual Education Plan (IEP) Complete:

- Achieving Body Control (ABC) Individual Progress Sheets - Identified activities - Intervention Record Forms (see Section 2)

If difficulties do not resolve, initiate referral to the Solent Children’s Therapy Service Referral for a Therapy Assessment

See ‘How to refer’ Section 9.

Complete additional checklists according to the child’s age and the referral form detailing strategies used and outcomes (see ‘How to refer’; Section 9)

Send with any additional evidence to the Children’s Therapy Service

Figure 1 Requirements and Process

See Section 9 – How to refer

Complete DCDQ or infant checklist (Motor

skill difficulties)

Complete SLCN checklist

Complete Referral Form and send to Children’s Therapy Service

Discuss with parents/carers


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Training and support

Training for school staff to support implementation of this pack is available from the Solent Children’s Therapy Service: see Section 8 for course details.

See Using This Pack Figure 2, page 44, for full summary of the process involved.

If questions arise about this pack or further information and help is needed, please contact:

Children’s Therapy Service

Stoneham Centre,

Moorgreen Hospital Site

Botley Road

West End

Southampton

SO30 3JB

Tel: 0300 300 2019

Section 2 – Developmental Information

Section 2

Developmental Information


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Developing Children’s Skills Children enter school at different stages of development and there can be considerable variation between children in an ordinary reception class. Many will not have developed the underlying communication, postural control, attention or organisational ability needed for more complex skills. Babies and young children are driven to move and they use movement to learn about the world. Movement allows exploration, which in turn stimulates the senses of touch, taste, smell, vision and hearing. Efficient body movement is one of the primary tasks of childhood. These underlying abilities are the essential foundation for more complex skills. Balance and coordination rely on core stability (the body’s central muscles working together to maintain posture) and are prerequisite for classroom skills such as the ability to sit still, eye contact and tracking, listening, concentration and hand-eye coordination. Such skills can be significantly affected if there is a delay in the acquisition of core stability and the child cannot sustain upright postures or stabilise the shoulder muscles to enable smooth, coordinated hand and arm movements. Development follows a recognised sequence from postural control and coordination towards ‘higher’ skills which include making sense of the world around and being able to plan and carry out complex activities such as handwriting. Perceiving, understanding and using sensory information plays an important role in this process. As well as learning classroom skills, children also need to be able to rely on these abilities to develop practical, everyday skills such as self-care.

Postural and joint stability, muscle strength, body awareness,

mid-line crossing, dominance, perception

Bilateral coordination, fine motor manipulation,

eye hand coordination, balance, motor planning

Ability to sit and maintain position,

preferred hand dominance, endurance,

tool use

Concentration, attention, behaviour


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HAND SKILL DEVELOPMENT

What Are the Building Blocks of Fine Motor Skills? Stability Stability is a combination of strength and balance that enables us to keep one part of our body still while another part moves. Bilateral Coordination Bilateral coordination refers to the efficient use of both hands during an activity. Most daily activities require the coordinated use of both hands, one as the “doer” and the other as the “helper”. Bilateral coordination leads eventually to the development of a dominant hand (becoming right or left handed). Body Awareness/sensation We all know the five senses: vision, hearing, smell, taste and touch. We also have three other senses;

Kinethesia – the sense of where our body and limbs are in space

Proprioception – the sense of joint position and movement, perceived by sensors in the joints

Vestibular system – the sense that tells us our head position in relation to gravity

Daily Living Skills

Handwriting, dressing, eating

Dexterity

Stability

Bilateral

Coordination

Body

Awareness

Stability

Bilateral

Coordination

Body

Awareness


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The Second Level in the Hand Skills House: Dexterity/Fine Motor Manipulation Dexterity/Fine Motor Manipulation This ability enables us to make small, precise, accurate and efficient movements with our hands without tremendous effort. When your child has established some of the foundations and is developing dexterity, he/she is able to use these abilities in her daily living skills. Sensory Processing Is the ability to take in, sort out, process and make use of information from the world around us. Concentration, Attention & Behaviour Children need to be able to respond to sensory information in order to behave in a consistent way and plan what they need to do.

Dexterity/Fine Motor

Manipulation

Stability

Bilateral

Coordination

Body

Awareness


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Play Skills

Attention & Listening

Turn-taking

Eye Contact

Use of

gesture

Use of

noises

Understanding of

single words

Understanding of simple

instructions

Use of

single words

Speech sound

development

Understanding of a range of instructions and linking of

2-3 words

……………..Motivation, Confidence & Self-Esteem……………….

Speech Language and Communication Skills

Adapted from Wood, 2001, TalkingPoint and consensus of opinion of Solent NHS Trust Speech and Language Therapists


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Expected skill level The following tables suggest skills we would usually expect children to have at school entry and at the end of the school year indicated.

School Entry

Gross motor Skills/ Stability

o Stable in sitting on a small chair at a table

o Can walk, run and stand on tiptoe o Can stand on one leg for 3-5 seconds o Can hop on preferred foot o Can stand/walk on heels when shown o Throws ball overhand and catches o with more skill o Kicks ball forcibly with skill

Bilateral Coordination

o Climbs ladders in the playground o Can use a bat o Threads medium beads o Supports the paper when ‘drawing’ o Has developed hand preference o Knows how to hold scissors and uses

them to cut a piece of paper in half o Use fork and spoon together

Body Awareness

o Draws a person with three different body parts

Fine Motor Skills

o Builds tower of 10+ bricks o Holds pencil using a static ( still ) tripod o grasp on the pencil o Engaging in messy play

Activities of Daily Living

o Drinking from open cup, o Stabbing with a fork and scoops o Washes and dries hands and face. o Unbuttons large buttons. o Toilet trained o Can get on / off the toilet unaided o Puts on garments such as a t-shirt

with some help, o Shoes put on (possibly the wrong way

round), o Pulls up trousers o Uses knife & fork competently o Child knows what he does & doesn't

like to eat

Visual Perception

o Copies a cross ( + ), with a pencil /crayon.

o Places 5 rings on a post in order / 3 shapes into inset puzzle / 4 part nesting toy


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Attention and Listening

o The child has single channelled attention, alternating his full attention between the task and the speaker (looking and listening), but can now switch between them independently.

o Able to concentrate on 2 speakers. o Can attend to an adult's choice of

activities for increasing periods.

Play Skills

o Can imagine things that are not present, e.g. play includes make believe characters.

o Early symbolic play, e.g. using a banana as a phone.

o Can hold simple pretend conversations.

Understanding of Language o Follows more complex sentences

though may not understand every word.

o Follows 3 key words in a sentence, e.g. ‘shall we wash big teddy?’

o Understands concept of size (big/little), numbers 1-5 & colour.

o Understands simple positional language, in/on/under.

o Understands past tense verbs. o Answers ‘Why?’ questions. o Begins to make inferences and can

predict what will happen next.

Spoken Language

o Puts 3-5 words together to form simple sentences.

o Uses positional language, e.g. in, on, under.

o Uses words which represent people, e.g. I, you, me, yours, he, she.

o Talks about past, present and future. o Asks a lot of questions, what? where?

who? o Still makes grammatical errors, e.g.

mouses, sleeped. o Uses comparatives.

Speech sounds

o Vowels and syllable structure established.

o Becoming more intelligible. o May use sounds in some words but

not others. o ‘c’/’k’, ‘g’ may be replaced by ‘t’, ‘d’

respectively. o Beginning to use sounds sh, ch, j, z, v

and l. o ‘s’, ‘z’ may be lisped. o ‘th will be replaced by ‘f’ or ‘v’ o ‘r’ will be replaced by ‘w’ o Beginning to use blends, e.g., bl, pl -

otherwise reduces them to a single sound.

Social use of language

o Chooses own friends o Generally cooperative with playmates o Enjoys playing with peers and will argue

if they disagree o Able to plan construction and make

believe activities o Initiates conversations o Takes turns in longer conversations o Uses language to gain information,

negotiate, discuss feelings/ideas and give opinions

o Talk freely about their home and community

o Beginning to accept the needs of others with support.


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End of Early Years / Foundation Stage

Gross motor Skills/ Stability

o Uses arms for climbing o Shovels and pours with control o Can carry large objects o Balance on either leg for 5 seconds o Jumps forwards and backwards o Hops on either leg o Throws a ball to hit a target


o Starts to show preferred hand o Uses one hand to steady while other

manipulates o Uses scissors to snip o Threads large beads o Skips, alternating feet o Uses knife and fork competently

Body Awareness

o Knows body parts o Draws a person with head, legs and

trunk

Fine Motor Skills

o Places small pegs in pegboard o Can move things from palm of hand to

fingertips o Uses thumb and fingertips to grasp, turn

small knobs, etc


o Draws a circle and other shapes independently

o Draws house with windows and a door

o Can dress/undress with some assistance

o Uses a spoon and fork

Visual Perception

o Copies square and cross o Matches and names 4 primary colours


o Is now two channelled, i.e. understands verbal instructions without having to interrupt their activity to look at the speaker.

o Concentration may still be short, but can be taught as part of a group, e.g. to follow a story or join in a discussion.

Play Skills

o Organising and co-operative play with other children, e.g., sharing a toy/game and negotiating.

o Imaginary play includes other children e.g., pretending to be doctors and nurses.

o Can follow rules of a game, e.g. Snap.


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Understanding of Language

o Follows 4 key words in a sentence, e.g. ‘put the big doll behind the cupboard’.

o Understands increasingly complex grammar and concepts, e.g. between, above; future tense; simple opposites; same/different; time (e.g. night/day).

o Understands 2500-3000 words. o Asks meaning of new words. o Can give 3 objects on request. o Can identify the odd-one-out. o Can understand stories. o Beginning to use language to think,

problem-solve and understand simple humour.

Spoken Language

o Talks in more detail about everything and asks endless questions, e.g. Why? When?

o Grammar is increasingly correct, e.g. uses he/she correctly and a range of prepositions.

o Names categories. o Can explain meaning of simple words. o Makes longer sentences using ‘and’,

‘but’ and ‘because’ to link ideas (coordination and subordination).

o Tells/retells familiar short stories, sequences of events and jokes.

o Correctly sequences 2 – 4 pictures. o Uses ‘yesterday’ and ‘tomorrow’.

Speech sounds

o Mature use of most sounds including blends.

o Possible exceptions include ‘th’, ‘r’ and 3-consonant blends such as ‘spl-‘.

o ‘s, ’z’ may be lisped. o Intelligible to strangers.

Social Use of Language

o More skilful at initiating, holding and ending conversations.

o Will take turns with 8 – 9 other children. o Adapts conversation content to a

variety of partners, but not yet fully aware of the listener’s needs.

o Contributes to adult conversation. o Begins to understand indirect requests,

e.g. “Dinner’s ready” could mean ‘Wash your hands’.

o Uses and understands a range of communicative functions, e.g.

To gain attention

Ask for help

Request things

Reject

Greet

Name/label

Comment

Express feelings

Plan – future events

Report – recent activity

Seek or give information

Give instructions


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Key Stage 1

Gross Motor Skills/ Stability

o Throws, bounce and catches a tennis ball

o Turns a skipping rope o Performs a running kick o Balances on one foot for 15 seconds o Rides a bike (with or without

stabilisers)


o Threads small beads o Hand dominance evident o Folds paper o Cuts out simple shapes with scissors

Body Awareness

o Draws a person with head, trunk, legs, arms and features

o Use a computer mouse o Uses appropriate force for grasp and

play o Negotiates obstacles

Fine Motor Skills

o Controls pencil to draw between 2 straight lines

o Can touch each finger end in turn o Plays with small construction toys o Holds pencil in a tripod grasp


o Beginning to use a knife o Uses toilet independently

Visual Perception

o Recognises 10 colours o Copies a triangle o Accurately throws ball at target o Completes simple interlocking jigsaw


o Attention is well established and child can concentrate for longer without being reminded to do so.

o Listens with sustained concentration to others in the class and to an adult speaking.

Grammar

o Understanding and use of more complex constructions, e.g. passives (‘The book was read by the teacher’), relative clauses (‘Tell the girl that is drawing a picture to come and see me’) and constructions which reverse the sequence of events (‘Before you line up, put all your books in a pile on my desk’).

o Awareness of the grammatical function of prefixes/suffixes, e.g. past tense endings.


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Meaning o Understanding and use of an

increasingly broad vocabulary. o Less reliant on pictures and objects to

learn new language and, although these still help, they can learn just by hearing/reading new words.

o Understand increasingly abstract ideas, such as feelings and descriptive words, e.g. ‘carefully’, ‘slowly’ or ‘clever’.

o Understanding that some words have multiple meanings, e.g. ‘orange’ = a fruit/a colour.

o Understand that different words can mean the same thing, e.g. ‘minus’ and ‘take away’.

o Follows instructions. o Remembers main points. o Asks relevant questions.

Speech sounds o Accurate use of all speech sounds (as

appropriate to the child’s accent). o Phonological awareness at the

individual sound level, enabling segmentation and blending of the individual sounds in words.


o Ability to adjust the form of language for a range of contexts, e.g. talking to the headteacher, other children and family members.

o Shows awareness of what the listener needs to know. o Speaks clearly and audibly to a large group. o Varies voice and intonation with purpose. o Takes turns when talking. o Understanding and use of idiomatic language. o Using language for an increasing range of functions, e.g.

Initiating conversation with familiar adults and children

Awareness of feelings – anticipating and describing feelings that might be experienced by others in familiar, emotive situations

o Use of questions – to gain information about the present, past and future, e.g. ‘What’s he doing?’; ‘Where’s he gone?’; ‘What happened?’; ‘What will happen if..?’

o Give descriptions o Reasoning/Explaining, e.g. comparing/classifying, understanding cause and effect o Prediction of events o Drawing conclusions o Imagining o Argue/Debate o State rules o Evaluate o Persuasion o Negotiate o Beliefs/Opinions o Entertain o Tease


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Key Stage 2

Gross Motor Skills/ Stability

o Uses PE equipment well o Increased refinement of complex

gross motor tasks


o Ties a knot o Shuffles and deals cards o Uses scissors well

Body Awareness

o Plays computer games without looking at hands

o Consistent identifying right and left o Writes right to left

Fine Motor Skills

o Opens packets o Mature pencil grip o Handwriting becoming fluent


o Does up buttons, zips, etc

Visual Perception

o Visual memory developed o Copies diamond and triangle


o Listens attentively, following up points, agreeing or disagreeing with others and making their own notes.

Grammar

o Consistent use of grammar across longer sections of discourse/narrative.

o Understanding of how some words can change the relationship between other words in a sentence, e.g. ‘John is easy to see’ vs. ‘John is eager to see’.

Meaning

o Further expansion of vocabulary, including words for items outside the pupil’s personal experience.

o Increasing ability to select the most appropriate word for use in a particular context.

Speech sounds

o Ability to manipulate individual phonemes in words, e.g. in order to perform spoonerism tasks.


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o Ability to produce cohesive narrative in which different characters and events are clearly marked.

o Understanding more complex humour, e.g. sarcasm. o Using language for an increasing range of functions, e.g.

Initiating conversation with unfamiliar adults and children

Projection of thoughts or feelings – what might be felt by self and others in a range of situations, familiar and less familiar

Giving a sequence of instructions

Explaining clearly and concisely

Imaginative use of language – drama, puppetry, etc. o Extended use of questions – a set of questions to pursue a line of enquiry o Hypothesising o Inferring and deducing o Reflecting on and exploring language – puns, etc. o Presenting a sequenced oral account – in clear, concise chronological order o Giving opinions – a reasoned opinion on a range of issues; will consider and discuss

alternative opinions o Planning and organising work in a group o Negotiates, taking account of alternatives and consequences


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IDENTIFYING

FUNCTIONAL

DIFFICULTIES


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PRELIMINARY CHECKLIST You may wish to complete this checklist in conjunction with parents. For a younger child, it may also be useful to draw on information from the Foundation Stage Profile. For children with suspected speech, language and communication difficulties the Yr R Screening Assessment (See Appendix page 389) maybe used to provide a more comprehensive assessment of the child’s abilities and will help inform completion of this checklist. The dated columns allow a child’s progress to be reviewed once interventions have been tried. If difficulties do not appear to be resolving, this checklist can be used as additional evidence when referring a child to the Children’s Therapy Service. NOTE: when answering each question, consider the child’s abilities in relation to same age peers - to be considered a difficulty, performance needs to be significantly different.

Gross Motor Skills

Date Date

The child:- Y / N Y / N

Appears to be weaker than peers and lacks endurance

Demonstrates good posture when sitting or standing

Can stand on one leg in a stable position

Can hop in a controlled manner on either foot

Can jump across / over obstacles that might be found in the play environment

Can use fixed playground / gym apparatus

If child has difficulties with the above skills, s/he may have poor core stability, balance, body awareness or coordination. PLAN: work through first gross motor programme Achieving Body Control (ABC), Section 3a, or BEAM programme.

Date Date


Can follow a movement sequence e.g. keep time to a musical beat by clapping hands or tapping feet

Can throw a ball / beanbag into a container

Can catch a ball using two hands

Can catch a small ball using one hand

Can hit / strike a moving ball using a bat, racquet or stick

Can continually bounce a football sized ball while standing still

Can kick a ball rolling towards him/her


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If child has difficulties, s/he may still have immature balance or poor motor

planning/coordination. PLAN: work through second gross motor programme Clever Bodies (balance, motor planning and coordination, and ball skills), Section 3a

Fine Motor Skills

Date Date

The child can:- Y / N Y / N

Pick up small objects using blocks, beads, puzzle pieces

Use blocks, beads, puzzle pieces to complete an activity

Turn pages of a book singly

Hand out sheets from a stack of paper

Hold tools using appropriate tension and grasp (scissors / pencil)

Cut / draw / trace with precision and accuracy

Do up buttons and zips

If the child has difficulties, s/he may have weak grasp, poor hand/eye coordination or manipulative skills.

PLAN: carry out General Activities to Improve Hand Function and Clever Hands’ programme, Section 3b, Or

Reception Fine Motor Skills Programme. Sensory Processing

Date Date

The child appears to:- Y / N Y / N

Withdraw from touch

Prefer only certain types of clothing

Need to touch everything

Chew on clothing or objects

Avoid being too close to others

Avoid playground equipment or some apparatus (fearful of being off the ground)

Be constantly moving

Be sensitive to noise

PLAN: if child has difficulties, carry out suggestions in Section 5a, Sensory Processing


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Attention and Organisation

Date Date

The child appears to:- Y / N Y / N

Lack energy

Have difficulty staying on task

Be unable to remain seated

Have difficulty following instructions

Have difficulty organising self for activities

Have difficulty completing activities on time

Copy others rather than follow instructions

PLAN: if child has difficulties, carry out suggestions in Attention and Organisation, Section 5c

Perceptual Skills

Date Date

Body and Spatial Awareness


Recognise own body parts and point to them

Differentiate between left and right

Demonstrate understanding of directional commands by moving forwards / backwards, over / under, in / out

Walk / run in the environment without bumping into objects / people

PLAN: if child has difficulties, carry out Clever Bodies programme, Section 3a

Date Date

Visual Perception


Discriminate shapes, letters and numbers

Copy basic shapes, letters and numbers

Organise shapes, letters and numbers on a page

Copy accurately from a distance or nearby source

PLAN: If the child has difficulties, carry out suggestions in Section 5b, Visual Perceptual Function


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Handwriting

Date Date


Has problems holding a pen / pencil

Produces writing that appears very dark or very light

Presses heavily onto the writing surface

Has poor sitting posture

Writes slowly and with effort or rushes

Writing lack fluency and is illegible

PLAN: if child has difficulties, carry out suggestions in Section 5d Handwriting

Self Care

Date Date

The child has difficulty managing independently with

Y / N Y / N

Eating/drinking

Washing hands

Dressing/undressing

Toileting

PLAN: if child has difficulties, carry out suggestions in Section 5e, Self-care.

Auditory Memory & Processing

Date Date

Y / N Y / N

Does the child find it difficult to remember what they have heard e.g. cars, stories and discussions?

Does the child have difficulty following instructions?

Does the child have difficulty remembering/doing things in the right order?

Does the child lose concentration when listening?

Does the child find it difficult to remember what has been taught previously?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Auditory Memory & Processing” NB If the child has difficulties in both of these areas also consider information in Section 5 “Sensory Processing”


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Understanding Spoken Language

Date Date

Y / N Y / N

Does the child look blank when spoken to?

Does the child not realise instructions include them when they are given to a whole group?

Does the child have difficulty answering questions e.g. repeats parts of questions or gives an answer which doesn’t match what they have been asked?

Is the child hesitant to start a task after an instruction has been given?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Comprehension” Spoken Language & Vocabulary

Date Date

Y / N Y / N

Does the child only use a few words joined together?

Does the child use simplistic or immature sounding sentences e.g. leaves out words?

Does the child use words in the wrong order?

Does the child use empty speech with lots of non-specific vocabulary e.g. ‘it’, ‘thing’, ‘there’, ‘makes’

Does the child have problems reporting events or retelling stories

PLAN: If the child has difficulties carry out suggestions in Section 4 “Expressive Language & Vocabulary”


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Sequencing

Date Date

Y / N Y / N

Does the child have poor organisational skills?

Does the child have difficulty remembering the order of familiar activities?

Does the child have difficulty remembering how to approach an activity?

Does the child have difficulty remembering time concepts e.g. days of the week, when their birthday is, yesterday, today, tomorrow, etc?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Sequencing” and section 5c Attention and Organisation NB: Consider whether the child has more general organisational difficulties. See Section 5 “Sensory Processing” and ensure that child has completed Clever Bodies Section 3a Concepts

Date Date

Y / N Y / N

Does the child use concept words incorrectly e.g. ‘up’ for on or ‘in’ for all word positions?

Does the child have difficulty using adjectives (‘wow words’) to describe things?

Does the child understand first/last/in front/behind/when lining up to leave or enter the classroom?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Concepts” ensure that child has completed Clever Bodies, Section 3a.


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Word Finding

Date Date

Y / N Y / N

Does the child have difficulty remembering or finding the word they want to say?

Does the child know and understand a word, but find it hard to use it?

Does the child use an incorrect word that may be, in some way, linked to the word they wish to say e.g. ‘cat’ for ‘dog’ or ‘arm’ for ‘wing’ or ‘hap’ for ‘cap’?

Does the child describe a word instead of using it e.g. ‘bouncing thing’ for ball?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Word Finding” Sound Awareness

Date Date

Y / N Y / N

Does the child have difficulty pronouncing words clearly?

Is the child struggling with phonics, literacy or spelling?

Is the child difficult to understand?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Phonological Awareness” Social Communication

Date Date

Y / N Y / N

Does the child find it difficult to use appropriate eye contact?

Does the child find it difficult to take turns in conversations or group discussions?

Does the child talk too quickly/slowly/loudly/quietly for the situation?

Does the child find it hard to interpret gestures, facial expressions and tone of voices?

Does the child find it difficult to approach other children to talk to or play with?

Does the child have favourite topics or interests which they try to include in all interactions?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Social Communication”. If the child has been diagnosed with an Autism spectrum condition we would expect them to have difficulties in these areas


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Stammering

Date Date

Y / N Y / N

Does the child repeat whole or parts of words e.g. when, when, when or c-c-coz?

Does the child stretch sounds out e.g. s_____unny?

Does the child get completely stuck on a word and have trouble getting any sound out?

Does this happen every day?

PLAN: If this happens every day refer to the Children’s Therapy Service for Speech & Language Therapy advice. If the child has difficulties carry out suggestions in Section 4 “Stammering” Voice

Date Date

Y / N Y / N

Does the child have a hoarse/breathy/rough or croaky voice all the time?

Does the child often lose their voice?

Does the child have times when their voice “cuts out” for a second?

Does the child speak in an effortful or strained way?

PLAN: If the child has difficulties carry out suggestions in Section 4 “Voice” NB: Please also refer child to their GP, who will contact the Children’s Therapy Service and the E.N.T. department as appropriate.


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INTERVENTION RECORD FORM

Use the form to record evidence of a child’s response to intervention. This helps track progress and where Children’s Therapy is needed, contributes to evidence to support referral. It will be useful to share this information with the therapist/s when the child is seen. A sample form follows, together with a blank form (which can be photocopied). Note: Achieving Body Control incorporates ‘Individual Progress Sheets’ and these should be completed for each ABC Block.


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Sample Intervention Record Form

Name: Toby Smith Date of birth: 6 February 2003 Date of assessment: 9July 2007 Chronological age: 4yrs 5 mths Year: R

List identified difficulties from Preliminary Checklist

Gross Motor

Fine Motor

Dressing (putting on T-shirt, doing up buttons)

List interventions used to address identified difficulties

Achieving Body Control (ABC)

Clever Hands

‘Backward chaining’ method for t-shirt Button practice (method from Self-care Section)

Date Activity / Strategy Performance Sign

11/7/07

Clever Hands Level 1 Playdough, pegs, tongs

Weak grasp, could barely squeeze pegs enough to open.

A Davis

18/7/07

As above Can now place pegs on edge of box. Next: peg the pegs onto paper plate, pick up cotton wool balls with tongs

A Davis

11/7/07

For PE, Put one arm in T-shirt sleeve, (other arm and head already in t-shirt)

Toby struggled to locate the hole. With some prompting he successfully put his arm in.

A Davis

18/7/07 Putting one arm in t-shirt sleeve (as above)

Completed task without prompting. Next stage: put both arms through sleeves (head already in T-shirt).

A Davis


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Intervention Record Form

Name: Date of birth: Date checklist completed: Chronological age: Year:

List identified difficulties from Preliminary Checklist

List interventions to be used to address identified difficulties

Date Activity / Strategy Performance Signed


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Date Activity / Strategy Performance Signed


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Concerns about child’s functional ability in school

Implement Achieving Body Control (ABC)

Check Learning environment

Complete Preliminary Checklist to identify areas of functional difficulty

Refer to appropriate section and carry out suggested activities / strategies. Include in IEP

Gross Motor

Fine Motor

Speech

Language and Communication

Sensory

Processing

Visual Perceptual Function

Attention

and Organisation

Handwriting Self-Care

Difficulties continue despite intervention Difficulties resolve

Follow Process and Requirements for Children’s Therapy Referral

Referral to Children’s Therapy not required

4-5 Years Complete Developmental and additional Checklists

5 – 15 Years DCD-Q

(see page 376)

Complete Case History

Continue activities / strategies while awaiting

assessment

Send referral with evidence of Schools Pack intervention to Children’s Therapy

S

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A

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Figure 2

Children’s Therapy Training

Section 3 – Motor Skill Development

Section 3

Motor Skill Development


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Section 3a

GROSS

MOTOR

SKILLS


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Many children entering school will not yet have fully developed their gross motor skills. We recommend that all Year R children complete Achieving Body Control (ABC) to develop the postural control needed for school activities. The programme can be readily incorporated into PE lessons (approximately over a six week period). Children with identified difficulties should also be given opportunities to practise the activities individually or in a small group. Implementing the ABC Training which supports implementing the ABC in school can be requested from the Children’s Therapy Service (see Training Section) Equipment required for each block Block A - PE mats PE bench Balls (football sized) Block B - As above, plus: Large hoops Bean bags Block C - As above, plus: Balloons Chiffon scarves Review Children’s responses will be monitored through observation of each session and then by completing the Individual Progress Sheets at the end of each block. NOTE: children with identified physical / learning difficulties who are known to children’s therapists should not be included prior to consultation with relevant therapist.


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ABC ACHIEVING BODY CONTROL

BLOCK A


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Children will need a mat Children should remove shoes and socks for these activities

1. Warm up beans

Beans on Toast

(Spread wide on the floor) Jumping Bean

(Jump on the spot)

Runner Bean (Running on the

spot)

Jelly Bean (Shake all over) Group jog between the mats and stop when instructed. Pretend to be specific ‘bean’. 2. Total flexion. As well as practising a

total body curl, listening skills can be worked on, as the children gain understanding and have fewer cues from group leader. Language of movement, position and body parts should be emphasised.


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3.

Total extension. Lying flat on their backs the children should attempt to be as straight and symmetrical as possible.

4.

Arm lift from static crawling. The children should attempt to lift one arm at a time. The forward movement should occur only at the shoulders shoulder and their backs should not twist. Once achieved it can be a paired activity.

5.

Table. Sitting on the mat the children should lean back onto straight arms then lift their hips off the floor to form a straight line from shoulders to knees. Ears should be clear of shoulders.

6. Bridge. Lying on their back with knees bent, the children should flatten their

backs to the mat to initiate hip lift, rather than lift by straightening their knees. This will prevent their feet sliding away. A straight line, stable, symmetrical posture should be attempted for a count of 10. Breath holding should be avoided.


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7. Roly Poly. This should be practised along a line of mats to encourage movement in a straight line, not an arc. Repeat in both directions.

8.

Sit kneeling to high kneeling. The children should initially place their hands on a bench if very unstable. Controlled lifting from pelvis is required.

9.

Side Sitting. The children should attempt side sitting to either side with their hands off the floor if possible.

10.

Half kneeling. The children should attempt half kneeling without sitting back on their heels. Practise with alternate knees forward.


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11.

One leg balance. Initially a group of children can stand with one leg forward on a bench. Their shoulders should remain relaxed. They should attempt to look around, bend and reach. They can try lifting or tapping the foot on the bench to increase their balance time. Progression: control one leg balance without a bench.

12.

Jumping. The children should jump on their ‘home’ mat lightly with knees bending.

13. Ball skills. Ball skills are an ideal way to acquire hand-eye coordination, a skill which is required for

every day life and for many classroom activities. Judgement of speed and movement are necessary for many activities including road safety.

Many children are fearful of balls coming towards them. They gain confidence by practising non-threatening activities in which the ball is not travelling directly towards them. Initial ball skills should be two dimensional rolling activities with the child remaining still so that the child can begin to understand the balls’ movement without needing to balance simultaneously. Movement can then be added as a progression. When learning to catch, emphasis should be placed on trapping the item in the children’s hands (not against their bodies), and on aiming and control when learning to throw.


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Suggested activities a. Sitting on floor, hands on top of a

large ball, rock ball forward and backwards and side to side keeping whole hands in contact with the ball. Progress to rolling from hand to hand under knees.

b. Kneeling on floor – roll ball against upturned P.E. bench or wall. Trap rebound

in hands.

c. A group of 3 children – sit in a circle on the floor, feet touching. Roll ball to

named person and then trap ball in hands.

d. Roll a ball along a track formed by 2 P.E. benches – run to far end and let ball drop into hands.


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GROSS MOTOR ACTIVITIES Individual Progress Sheet

Block A

Child’s Name …………………………………………….

Activity Date achieved

2) Total flexion

3) Total extension on back

5) Table sitting, forming a straight line from shoulders to knees

7) Rolling in a straight line

10) Half kneeling. Practise with alternate knees forward

11) One leg balance on a bench. Shoulders should remain relaxed.


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BLOCK B


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If possible each child should have an individual ‘home’ mat facing the group leader. All children should work in bare feet. All postures can initially be demonstrated or a child helped to achieve them. There may be some overlap from Block 1 in some activities. These activities should be persevered with as more advanced activities are reliant on them being secure. More of the activities consist of holding positions against gravity. The children should be encouraged to count out loud or say a rhyme to prevent them attempting to stabilise themselves by holding their breath. 1. Warm up activities as in Weeks 1 and 2. Try adding new ‘beans’ (String bean – stretch

up tall, Chilli Bean – shake arms and legs, French Bean – do the CanCan, Broad Bean – wide stretch).

2. Total flexion. Lying on the mat the children roll from side to side maintaining a curled position. They should attempt to balance midway on their backs. Avoid breath holding.

3.

Extension. Lying on fronts the children should lift their heads to look straight ahead. Their legs may also rise. Avoid breath holding.

4.

Happy Cat / Angry Cat. The children should adopt a crawling position on the mat: look up, hollow their backs and “purr”, then look through their arms, arch their backs and “hiss”.

5. Crab. Maintaining the ‘table’ position (see

Weeks 1 and 2) the children should initially attempt to move one leg or arm before progressing to moving along.


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6.

Bridge. Several children adopt a bridge position side by side and attempt to maintain it as a ball is rolled underneath the bridge.

7. Roly Poly. Place 2 mats an increasing distance apart. The children should attempt to roll from one to the other in a straight line.

8.

Kneel walking. The children should practise kneel walking on mats without sitting back. Follow the leader.

9.

Side sitting. From side sitting on the mat the children should swing their feet round so as to side sit the other way, without using their hands for balance.

10. Half kneeling and turning. From a half

kneeling position the children should turn their heads to watch the group leader walking around their mats. Change legs.


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11. Hopping. Hop on alternate legs for those who have achieved standing on one leg.

12.

Jumping. Jumping towards a target area (lightly, bending knees).

13. Ball skills. a. Roll ball a short distance – run past it – turn to face it and gather it into hands. b. Aim a bean bag onto a marked area. c. Dribble ball with hand around inside of hoop – progress to using a bat and moving along a marked

course.


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Block B

Child’s Name …………………………………………….


2) Total flexion, maintaining curled position

3) Extension. Lying on front, child should lift head to look straight ahead. (Legs may also rise).

5) Maintaining a table position: crab

7) Half kneeling and turning. Child should be able to turn to watch leader walking around the group.

10) Hopping, first on one leg and then on the other.


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BLOCK C


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1.

Warm up activities as in Blocks A and B.

2. Total flexion. Lying on their backs, the children should actively curl, rather then hang on their knees. Avoid holding breath.

3.

Total extension. Lying on their front the children should look forward lifting their heads and reaching lifted arms forward with straight elbows. Once achieved it can be a paired activity.

4.

Crab. Maintaining the ‘table’ position, the children should attempt to move along, dribbling a bean bag with their feet. This can be developed into a group activity.

5. Bottom lifts. Sitting on the mat with straight legs and hands beside upper thighs, the children should push their hands into the mat to lift their bottom up and balance. They should not bump down.

6.

Bottom walking. Sitting on the mat with straight legs and hands off the floor, the children should attempt to ‘walk’ forward with the movement coming from their trunk.


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7.

Crossing midline. Sitting on a P.E. bench the children should touch opposite knee to elbow attempting to keep up a rhythm.

8.

Kneel walking backwards. While kneel walking along a course of mats, the children should remain vertical, not sitting back on their heels.

9.

Alternate side sitting. From side sitting (preferably with hands off the mat) the children should move up into high kneeling, then go down into side sitting on the other side in a controlled way.

10.

Half kneeling and turning. Half kneeling in a line the children pass a bean bag down the line. Repeat with the other leg forward. Progress from being beside each other to behind each other.

11.

Hopping / skipping. Skipping on alternate legs for those children who have achieved hopping on either leg.


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12.

Jumping over a line. Use painted lines on the floor (or chalk). The children should jump over the line with two feet simultaneously. Progress to a series of lines.

13.

Ball skills.

a. Repeat dribbling a bean bag as Weeks 2 and 3 and then progress to a ball.

b. Balance on one leg and roll a ball to partner.

c. Catching should first be attempted with slow moving items such as chiffon scarves or balloons. It is easier to catch knotted socks with plenty of ends to grab. Later, progress to bean bag and gradually smaller balls.


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Block C

Child’s Name …………………………………………….


2) Lying on their backs, children should actively curl rather than hold onto their knees

3) Total extension: children should lie on front and look forward lifting their hands and arms off the floor and reaching arms forward with straight elbows.

5) Bottom lift. Sitting on the mat with straight legs and hands beside upper thighs, children push bottom up and balance.

10) Half kneeling in a line, (one behind the other) the children turn to pass the bean bag back down the line.

11) Skipping i.e. hop/ step on alternate legs (for children who have already mastered hopping)


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CLEVER BODIES PROGRAMME


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CLEVER BODIES PROGRAMME

This programme consists of activities which build on Achieving Body Control (ABC) to further develop balance, motor planning, coordination and ball skills.. The activities are suitable for individual or small

group practice, although some could be included in whole class warm-ups or PE lessons.

Note: as before, children with identified physical or learning disabilities who are known to paediatric therapists should not be included prior to consultation with the relevant therapist.

Balance Level 1 Page 67 Level 2 Page 70 Level 3 Page 74

Motor Planning and Coordination

Level 1 Page 78 Level 2 Page 82 Level 3 Page 86 Ball Skills Level 1 Page 90 Level 2 Page 93 Level 3 Page 96

Fizzy Training Games (adapted and used with permission) Paediatric Occupational Therapy Service,

East Kent Community NHS Trust


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CLEVER BODIES

Balance

(Level 1)


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Fizzy Training Games

Balance Level 1 (page 1)

Activity Description Target

Stand with your foot on a box and throw and catch a ball or beanbag with your partner.

Can you do 20 catches at 1 metre 2 metres 3 metres

Play statues Keep very still while your partner gently tries to move you. Try these positions. Starting position

Hands and knees

Walk along a 5 metre, then a 10 metre line, marked on the floor.

Can you keep your feet on the line?


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Throw and catch a ball with your partner from a half kneeling position. Try 10 throws without dropping them, then try 20 throws.

Can you do it from 1 metre 2 metres 3 metres

Stepping stones Walk along a route placing your feet onto coloured shapes or into hoops or quoits. Vary the distances and directions of the stepping targets.

Step into, onto or over different types of PE equipment. Use any of these to make up a small obstacle course.

Balance on one leg How long can you do it for? 5 seconds 10 seconds What is your record?

Child needs to be competent at all tasks before moving on to the next level.


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CLEVER BODIES

Balance

(Level 2)


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Stand with one foot on a small soft ball and try to throw and catch a ball with your partner.

How many can you do in a row 10 20 2 metres 10 metres

Try to stop a rolling ball coming towards you by placing your foot on the top.

How many can you do 5 10 15

Keep very still while your partner gently tries to move you. Try these positions

Balance on different parts of your body. Start with kneeling and then try raising one arm and the opposite leg.

How many seconds can you hold it Kneeling Arm and leg Raised


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Reach for a beanbag in a kneeling position. Gradually increase the distance. Then try half kneeling

Walk along a bench Can you do it Forwards Backwards Sideways

Walk along a bench balancing a beanbag on a bat

How far can you get Half the bench All the bench


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Try walking along with a beanbag on your head

How far can you walk 4 metres 6 metres 8 metres

Walk in a line, as straight as possible, heel to toe – eyes closed, or wear a blindfold

How many steps 3 7 10

Hop on either leg How many hops can you do? Left leg Right leg 3 3 5 5 8 8



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CLEVER BODIES

Balance

(Level 3)


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Statues Stand very still on one leg while your partner gently pushes you

How many seconds can you keep still for? 3 5 10

Walk toe to heel backwards in a line as straight as possible.

How many steps can you take 5 7 10

Walk backwards toe to heel in a straight line without looking behind you. Then try with a beanbag on your head.


Walk backwards on a bench


Stand on one leg with your arms folded

How long can you stay up for Left leg Right leg


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Now close your eyes or use a blindfold

Now try on a squashy mat

Hop into 5 squares marked out on the floor

How many squares can you hop into? Left leg Right leg 2 2 3 3 5 5

Now try hop and stop, hop and stop. Keep going for as long as you can.

Hopping How far can you hop? Metres Forwards Backwards Sideways


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Now try hopping in different directions called out by your partner

How long can you hop for Seconds Left leg Right leg

Play Twister How long can you play for before you fall over Minutes Seconds

Play Hopscotch What number can you reach?

Forward

Left …


78

CLEVER BODIES


Level 1


79

Fizzy Training Games Body Awareness and Coordination Level 1 (Page 1)


Lie on stomach on a bench – pull yourself forward to the end using both hands, and then push back again. This is counted as one movement pattern.

How many can you do?

Draw shapes in the air using a pole with a ribbon tied on the end. Use both hands. Draw shapes in the air without using the pole

Can you do Shapes Letters Your name Can you do it holding on with 2 hands 1 hand

Bounce on a trampette holding hands with an adult


Jump along the floor keeping both feet together.



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Body Awareness and Coordination Level 1 (Page 2)


Jump off a low box or bench holding hands with an adult. Keep feet together

Can you do it holding on to 2 hands 1 hand no hands

Throw and catch a beanbag with an adult. Then try a large ball.

How far can you do it from?

Throw a beanbag into a box or hoop

How far can you do it from?

Turn Turtle Lie down on your stomach and try to stop someone turning you over

How long can you stay still for?

Log Rolling Lie down with your arms stretched above your head. Roll over and over. Start with an adult holding your hands, then try holding a ball


81

Body Awareness and Coordination Level 1 (page 3)


Sit on a large ball with feet on floor: Throw and catch beanbags or balls, from 1 metre

Can you do 5 catches 10 catches

Hold paper in one hand and cut with other. Draw around your hand, with your fingers spread



82

CLEVER BODIES


(Level 2)


83


Body Awareness and Coordination Level 2 (Page 1)


Lie on your stomach on an inclined bench. Pull yourself along using both hands Remember, don’t use your feet.


Bounce on a trampette without holding on. Can you jump off onto a mat, with feet together without falling over?

How many jumps can you do?

Lift your head up

Lie on your stomach and lift your arms above your head. Throw a large ball at some skittles, 2 metres away


Keeping both feet together, jump into hoops on the floor.

Do bunny jumps over a line keeping your hands placed on the floor.



84



Throw a beanbag into a box or hoop


Holding a bat with both hands, hit a ball thrown by an adult


Star Jumps From a standing position, jump into star shapes


Sticky Toffee Crawl along the floor while someone gently holds you back by holding on to your hips or pushing on your shoulders

How far can you crawl?

Statues While kneeling or half-kneeling, try not to be moved by someone else


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Log Rolling Lie down with your arms stretched above your head holding a ball. Roll over and over to the right and then the left. Try to keep in a straight line.


Sit on a large ball with feet on floor. Throw and catch a ball from varying distances.

Play Dough Using play dough can you Roll out a sausage Make a long sausage Make a pot

Simon-Says In a sitting or standing position, copy ‘Simon’s’ actions

How many can you copy? 1 arm 2 arms 1 leg and 1 arm 3 limbs



86

CLEVER BODIES


(Level 3)


87


Motor Planning and Coordination Level 3 (page 1)


Statues While standing with your eyes closed, try not to be moved by someone else

How long can you keep still?

Resisted Pushing Walk with your arms outstretched while someone gently holds you back by pushing on the palms

How far can you push? 2 metres 3 metres 5 metres

Jumping Jacks Jump from a crouched position up into a star position


Log Rolling Lie down with arms stretched above head and holding a ball. Roll over and over with changes in direction trying to keep in a straight line


Sit on a large ball with feet on floor. Throw and catch balls of various sizes from varying distances and directions.

How many catches can you do?


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Keeping both feet together, jump forwards, backwards and sideways in a given sequence.

How many jumps can you remember?

Bounce and catch a large ball.

Can you do 10 bounces in a row with Both hands Left hand Right hand Alternate hands

Hold a bat with both hands and hit a ball thrown from a long distance.

How many can you hit?

Make a paper or card shape such as a paper-plane or an origami object.

Can you Copy someone else Follow someone’s instructions Read the instructions

Bunny Jumps With your hands on the bench, jump your feet from one side to the other over the bench.


89



Skipping With your feet together, jump over a slowly moving rope.


Can you jump over the rope after it has been turned over your head?



90

CLEVER BODIES

Ball Skills

(Level 1)


91

Fizzy Training Games Ball Skills Level 1 (page 1)


Can you throw a bean bag into a box or hoop placed 1 metre away?

How many can you do in a row?

Can you roll a ball between goal posts placed half a metre apart, from a distance of 2 metres?

How many goals can you score?

Can you throw beanbags into 2 hoops placed to the right and left in front of you, 2 metres away?

How many can you do without missing the hoops?

Can you kick a ball between 2 goal posts, placed 1 metre apart, 2 metres away?

How many goals can you score?

Throw and catch with your partner. Stand 1 metre apart. Use a ball or beanbag.

How many catches can you do in a row?


92

Ball Skills Level 1 (page 2)


Throw and catch from 2 metres using a ball or beanbag

How many catches can you do without dropping?

Stand in a circle with a few other people 1 metre apart and throw a ball to the person next to you. Try throwing the ball in different directions. Can you bounce the ball to the person next to you?

Can you use a ball? a beanbag?



93

CLEVER BODIES

Ball Skills

(Level 2)


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Throw and catch a ball between 2 people. Start at 2.5 metres, then try 3 metres

How many catches can you do?

Stand close to your partner. Throw and catch between you. Take a small step backwards each time you catch the ball.

How far can you go back? What is your record? Can you beat your record?

With a partner, bounce a ball between you. Start at 1 metre, then try 2 metres. Can you do 3 metres?

How many times can you do this?

Practice throwing balls over-head to your partner. Can you judge how hard to throw the ball?

How far can you throw?


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By yourself, practice bouncing and catching a large, bouncy ball with both hands.

How many bounces and catches can you do?

Stand in a circle with a few other people. Throw 2 balls around the circle. Try throwing in both directions around the circle. Vary the size of the circle.

How big a circle can you make without dropping the ball?

Kick a ball between you and your partner or around a large circle. Can you stop the ball with your foot? Kick carefully back to your partner.

How far apart can you stand?

Kick a ball between you and your partner or around a large circle.

Can you stop the ball with your foot?



96

CLEVER BODIES

Ball Skills

(Level 3)


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Throw and catch a tennis ball between you and your partner.

How many catches can you do without dropping the ball?

Throw and catch a bouncy football off a wall. Let the ball bounce once on the floor. Then try catching the ball before it bounces.

How many catches can you do with a bounce? without a bounce?

Throw and catch a tennis ball off the wall

How many catches can you do with a bounce? without a bounce?


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Throw and catch a tennis ball between you and your partner. Walk slowly opposite each other, 2 metres apart, in the same direction

Throw and catch a tennis ball with your partner while one of you moves around slowly. Now speed up!

How many catches can you do in a row?

Stand in a circle with a few others, throw a beanbag, ball and quoit around the circle in the same direction. Then try throwing in the opposite direction


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Throw a ball, beanbag and quoit around a circle. This time when the leader calls “change”, start throwing in the opposite direction.

Kick a ball between you and your partner while one of you moves around slowly. Now speed up.

How many kicks can you return?


100

Section 3b

FINE

MOTOR

FUNCTION


101

Contents

Page

Correct sitting posture 102

Possible causes of difficulties identified in 103 Preliminary Checklist

General activities to improve hand function/ hand-eye 104 coordination

Reception pupils programme 105

Hand function programme: CLEVER HANDS 116


102

FINE MOTOR SKILLS Introduction Fine motor skills include movements made by all the smaller muscles of the body. They include:-

eye fixation and tracking

chewing and speaking

hand / finger strength and coordination Hand Function Hand function is particularly relevant for classroom learning. Once gross motor core stability is established, small movements become more precise: children are able to coordinate both hands, using one to lead and the other to support in two-handed activities (although complete dominance may not develop for some time). They also develop the ability to hold objects steady while adjusting fine movements for tasks such as cutting out and handwriting. Most hand activities also require hand / eye coordination. The possible causes of difficulties highlighted by the Preliminary Checklist are tabled overleaf. The development of these skills can be helped by the General activities to improve hand function and eye/hand coordination, page 104, the FMS programme, page 105, and the Clever Hands programme, page 116. These activities are also suitable for giving to parents. Check correct sitting posture


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Possible causes of difficulties identified in Preliminary Checklist Difficulty Possible Causes Unable to pick up objects using a pincer grasp

Poor hand-eye coordination

Poor hand strength

Poor tactile awareness

Difficulty using blocks, beads, puzzle pieces to complete an activity


Poor manipulation skills

Difficulty using both hands together

Unable to turn pages of a book singly Poor tactile awareness


Difficulty handing out sheets from a stack of paper



Difficulty using both hands together (undecided preferred hand)

Difficulty using tools (scissors, pencils etc)



Limited hand strength


Unable to cut, draw, trace with precision and accuracy



Difficulty with buttons and zips Difficulty using both hands together (undecided preferred hand)


NB Many of these difficulties may also be associated with visual perception difficulties.


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General activities to improve hand function and hand/eye coordination

Typical problems Activities

Poor hand strength, weak grasp

Activities which require squeezing, pulling, pushing. Construction toys, crumpling paper, wringing out cloths, clothes pegs. For more ideas see activities in ‘Clever Hands’

Poor dexterity and manipulation skills

Gather a strip of material into the palm of the hand using fingers. Using one hand collect counters or marbles one at a time into the palm of the hand and then using thumb bring them out to post into container one at a time. For more ideas see activities in ‘Clever Hands’


Grade the difficulty of tasks presented e.g. use large pegs and board before moving on to small ones: start with activities where one part of the activity is stable e.g. placing stickers onto circles on paper masking taped to table. Move on to activities where both parts are moving e.g. threading beads, hitting a moving ball with racquet. For more ideas see activities in ‘Clever Hands’

Difficulty coordinating use of both hands together (bilateral coordination)

Always encourage the child to use non-dominant hand to support paper, puzzle board etc. Practise threading beads, using large beads and firm lace, gradually working towards small beads and thin lace; wind wool onto cards; tear paper. For more ideas see activities in ‘Clever Hands’

Hand preference not decided

Lots of practice at two-handed activities as above. Encourage crossing mid-line of body when painting on easel, using white board, playing trains or drawing on large paper on the floor etc..


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Fine Motor Programme for Reception Pupils.

Many children entering school will not yet have fully developed their fine motor skills. We recommend that all Year R children complete Fine Motor Skills Programme (FMS) in addition to the Achieving Body Control (ABC) Programme. This will develop the postural control and then develop fine motor control needed for school activities. The programme can be readily incorporated into lessons (over an approximate six week period). Children with identified difficulties should also be given opportunities to practice the activities individually or in a small group. Implementing the FMS Training which supports implementing the FMS in school can be requested from the Children’s Therapy Service (see Training Section) Equipment Weeks 1/2 - Chalk board or large pieces of paper on the wall

Chalk, markers Weeks 3/4 - Play-dough, newspaper, card, pegs, tweezers, cottonwool, Weeks 5/6 - Play-dough, beads, paper clips, rubberbands Review Children’s responses are monitored through observation and the FMS Individual Progress Sheets can be completed after each Block NOTE: children with identified physical / learning difficulties who are known to children’s therapists should not be included prior to consultation with relevant therapist.


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107


108


109


110

WEEK 1


111

WEEK 2


112

WEEK 3


113

WEEK 4


114

WEEK 5


115

WEEK 6


116

CLEVER HANDS

Level 1 Page 117

Level 2 Page 122

Level 3 Page 126


117

Fizzy Training Games Clever Hands Level 1

PLAYDOUGH Skill: hand strength, use of two hands together, applying appropriate pressure

Can you roll out a sausage? Make sure you use two hands. Now can you turn your sausage into a dinosaur by using your thumb and first finger to pinch along the top to make spines?

Roll it flat and make shapes using cutters.

Roll a sausage again, can you cut it into pieces with a play knife?

Try to keep your first finger on the top of the knife and your thumb and the other fingers either side. Hold your playdough still with your other hand.

Can you roll it flat again and make a face out of the playdough?

PEGS Skill: hand strength (For “graded” pegs see Resource List) Look at the picture, hold the peg this way.

Peg pegs onto the edge of a box

Peg pegs onto a rag doll / teddy

Peg pegs onto a T-shirt on a teddy


118

Clever Hands Level 1

TONGS Skill: hand strength, applying appropriate pressure Use one hand on the tongs. You need to hold the tongs with your thumb on one side and your fingers on the other.

Snap the tongs like a crocodile

Can your crocodile bite the paper?

Tear and scrunch up paper and pick it up with your tongs

Pick up cotton wool balls

Now try little bricks

POSTING Skill: manipulation, hand-eye coordination, use of two hands together, hand dominance

Pick up and post coins into a money box

Post dried peas / pasta / sugar decorations into a bottle and screw up the lid.

NOTE If you are working with a child who still puts objects into his / her mouth use edible items, e.g. raisins, dried banana chips, ‘holey’ cereals etc.

PASTRY MAKING Skill: hand strength, applying appropriate pressure

Roll the pastry into a ball. Flatten it with your hands. Cut it into shapes using pastry cutters and shape cutters

DUPLO Skill: hand strength, applying appropriate pressure, using both hands together, developing preferred hand What can you make?


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HAMMERING Skill: hand-eye coordination, hand dominance, dissociate hand from forearm movement, applying appropriate pressure

Find toys with which you can use a hammer

THREADING Skill: hand-eye coordination using two hands together, fine manipulation

Thread large beads onto dowels / sticks

HAND AND FINGER RHYMES AND GAMES e.g.

Two Little Dicky Birds

Twinkle, Twinkle Little Star

Tommy Thumb

Play games with finger puppets FEELY GAMES - Skill: tactile awareness

Hide everyday objects in a box of sand / rice / pasta / flour etc e.g. teaspoon, cotton wool balls, large beads, little bricks, toothbrush etc.

What can you find? Try this game again placing objects into a bag.

FEELY PICTURES Skill: fine manipulation

Tear up tissue paper.

Scrunch up the paper using your fingers (as in the picture) and glue onto the paper.

You can also use cotton wool, glitter, string, sand and oddments of different textures. What else can you use for your picture?


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Clever Hands Level 1 : more ideas to practise:- SLIME (see page 125 for recipe) Skill: tactile awareness, grasp and release Play and enjoy ! It is messy ! Keep clothes covered ! INSET PUZZLES Skill: hand dominance, manipulation Try large and easy to manipulate inset puzzles PUZZLES Skill: pincer grasp, use of two hands together, hand dominance

Wooden inset puzzles with chunky hand grips.

Wooden inset puzzles with small hand grips.

2 – 4 piece puzzle within a framed border. Large chunky 2 piece interlocking puzzles. MUSICAL INSTRUMENTS

Castanets / maracas

Toy trumpets / saxophone

Keyboards FINGER CYMBALS

Place a cymbal on each index finger and clap together

Now place a cymbal on your thumb and index finger of one hand. Play and enjoy! MORE IDEAS

Patting and tapping a balloon into the air You may need to use both hands:-

Squeeze a plastic bottle or bath toy in water to make bubbles

Blowing bubbles. Can you pop them with one finger?

Squeeze squeaky toys – see pictures below


121

S L I M E

1 cup Cornflour Add enough water to make a firm, yet pliable, slightly runny consistency Use food colouring or paint to add colour Shape into a ball then watch as the slime ‘melts’ and runs through your fingers!


122


PLAYDOUGH Skill - use of two hands together, hand strength, applying appropriate pressure

Can you make a snake? Make sure you use two hands when rolling out the playdough

Now can you roll it into a snail like the picture?

Can you make a hedgehog and give him lots of spines?

You can use wooden dowels or little sticks.

PEGS Skill: hand strength (For ‘graded’ pegs see resource list). Look at the picture. Hold the peg this way.

Peg flash cards onto the edge of a box.

Peg doll’s clothes or small clothes onto a washing line.

Peg pegs onto a paper plate to make a sunshine

TONGS Skill: hand strength, applying appropriate pressure Use one hand on the tongs. Hold them with your thumb on one side and your fingers on the other like the picture.


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Snap the tongs like a crocodile.

How many items can your crocodile collect?

Now pretend the tongs are a crane.

What can you pick up? e.g. polystyrene balls, little bricks, little cars

POSTING Skill: manipulation, hand-eye coordination, use of two hands together, hand dominance Pick up 2 large coins, one at a time and keep them in the palm of your hand.

Now try posting one while the other one remains in your hand. Now post the other one. Can you use your other hand? Now try with smaller coins.

PASTRY MAKING / SALTDOUGH Skill:– hand strength, applying appropriate pressure

Roll the pastry / dough into a ball.

Flatten it with your hands.

Cut it into shapes using pastry cutters and shape cutters. STICKLE BRICKS What can you make?


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Clever Hands Level 2 HAMMERING

Can you find games with which you can use a hammer.

THREADING

Thread ‘holey’ cereal / sweets onto pipe cleaners / straws.

Thread medium beads / pasta pieces onto a sturdy tipped lace.

Try lacing cards / boards HAND AND FINGER RHYMES e.g. ‘Here’s the church; here’s the steeple’. Can you think of any more? FINGER CYMBALS Place a cymbal on your thumb and index finger

Change the fingers they are used on.

Try using your other hand. FEELY GAMES Skill: tactile awareness

Hide medium items in a box of sand / rice / pasta / flour etc e.g. 10p, 50p, 2p, 20p coins, medium sized bricks / beads / toys / cars / dolls furniture etc. Have a duplicate set ready on a tray.

Now close your eyes. What can you find? Describe them. NO PEEPING!

Now can you point to the same object on the tray? Try this game again, placing objects into a bag instead.


125



Make a picture sticking pasta, lentils, sand, tissue paper.

How tightly can you scrunch the paper? Make sure you use your fingertips as in the picture.

SLIME (see page 124 for recipe) Play and enjoy ! It is messy ! Keep clothes covered ! PUZZLES

4 – 8 piece puzzle within a framed border.

Large chunky 2 – 6 piece interlocking puzzle. What other puzzles can you do? MUSICAL INSTRUMENTS

Toy trumpets / saxophone / flute

Keyboards / toy piano

Drums. Try with and without sticks.

Xylophone. Castanets / maracas (one in each hand).

Play and enjoy!

MORE IDEAS

Squeeze a plastic bottle with one hand only to make bubbles in water.

Using a spray bottle to spray water onto plants; or try to hit a target.

Squeeze squeaky toys – see pictures below.


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Clever Hands Level 3 PLAYDOUGH Skill: use of two hands together, hand strength, applying appropriate pressure

Make a nest and some little eggs to go in it.

Roll out the playdough into a long sausage shape and then coil it round to make a nest. Pinch off some more playdough and roll it between your fingers to make the eggs.

Here’s how to make it.

How many eggs can you make?

Now try an Easter basket! I’m hungry, can you make me a pizza?

Think of all the things you have done. Can you make a pot?

PEGS Skill: hand strength (For ‘graded’ pegs see Resource List). Look at the picture. Hold the peg this way.

Start with the easier pegs. See how fast you can peg 10 pegs onto a box.

Can you beat your own time?

Now try this again using your other hand.

Try one peg in each hand and alternate. Ready for a challenge? What can you find to pick up using the peg.


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TONGS Skill: hand strength, applying appropriate pressure Use one hand on the tongs. Hold them with your thumb on one side and your fingers on the other like the picture.

How many things can you find to pick up with tongs? Did you find anything difficult? Why do you think that was?

Try different tongs. Which tongs were the most difficult to use? Why?

Can you try picking up raisons / plastic buttons with tweezers?

Try this again now putting them into a bottle.

POSTING Skill: manipulation, hand-eye coordination, use of two hands together, hand dominance

Pick up 5 large coins one at a time; keep them in your palm. Post them one at a time.

Can you use your other hand?

Now try using smaller coins. Now post the coins with your right hand, then your left hand alternately.

How easy is this game when using 2 boxes?

Can you pick up a coin in each hand and post them into each box at the same time?


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Clever Hands Level 3 PASTRY MAKING / SALTDOUGH Skill: hand strength, applying appropriate pressure

Roll the pastry using a rolling pin and cut it out using pastry cutters or shape cutters or with a play knife.

What else can you make? LEGO

Can you build a tower of 10 Lego bricks one brick at a time? How fast can you do this? Can you pull them apart one at a time?

What can you make?

HAMMERING

Which toys can you use a hammer with?

THREADING

Thread small beads and / or small pasta pieces onto a lace.

Try lacing cards / boards.

Cut up straws and thread these onto a lace. HAND AND FINGER RHYMES e.g. ‘Here’s the church; here’s the steeple. ‘Incy Wincy Spider’. Can you think of any more? FINGER CYMBALS Place a cymbal on your thumb and index finger.

Change the fingers they are used on.

Try using your other hand.

Now put a set on each hand. What rhythms can you make?


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Clever Hands Level 3 FEELY GAMES Skill: tactile awareness

Hide small items in a box of sand / rice / pasta / flour etc e.g. 1p and 5p coins, paper clips, small beads / marbles / cubes, miniature cars / toys / dolls furniture etc.

Have a duplicate set ready. Now close your eyes. What can you find? Describe the items. NO PEEPING!

Now can you point to the same item on the tray? Try this game again placing the items in a bag instead.


Make a picture sticking pasta, lentils, sand, tissue paper.

How tightly can you scrunch the paper? Make sure you use your fingertips as in the picture.

SLIME (see page 124 for recipe) Play and enjoy! Warning: It is messy! Keep clothes covered! PUZZLES

2 – 6 medium piece puzzles.

6 – 12 medium piece puzzles.

4 – 12 smaller piece puzzles. What other puzzles can you do? MUSICAL INSTRUMENTS

Toy trumpets / saxophone / flute.

Keyboards / toy piano.

Drums. Use two sticks and alternate left and right tapping.

Castanets. Use in both hands, alternate left and right clicks.

Recorder. How many different notes can you play?

Section 4 – Speech, Language and Communication

Section 4

Speech, Language and

Communication


131

CONTENTS

1 Listening and Attention

1.1 Strategies – Listening and Attention 133

1.2 Activities – Listening and Attention 135

2 Understanding Language

2.1 Strategies – Understanding Language 140

2.2 Activities – Understanding Language 142

2.3 Complex Structures 148

3 Auditory Memory

3.1 Strategies – Auditory Memory 152

3.2 Activities – Auditory Memory 156

4 Descriptive Language Skills and Vocabulary

4.1 Strategies – Accessing Vocabulary from Memory 162

4.2 Activities – Expressive Language 163

Activities – “Odd One Out” Games 169

Activities – DIY Semantic Links 170

5 Grammar

5.1 Strategies – Grammar 188

5.2 Activities – Verbs 189

Activities – Working With Sentences 191

Activities – Tenses 193

Activities – Auxiliaries 201

Activities – Questions 202

Activities – Plurals 217

Activities – Plurals – Cats – Master Card – Page 433

Activities – Plurals – Cats – Small Cards – Page 434

Activities – Pronouns 220


132

6 Concepts

6.1 Strategies – Acquiring Vocabulary or Concepts 225

6.2 Activities – Concepts 226

7 Sequencing

7.1 Strategies – Sequencing 244

7.2 Activities – Sequencing, Retelling and Explaining 246

8 Process of Hypothesis

8.1 Strategies – The Process of Hypothesis 253

8.2 Activities – The Process of Hypothesis 257

9 Pragmatic Skills

9.1 Strategies – Pragmatic Skills 266

9.2 Activities – Pragmatic Skills 271

10 Stammering

10.1 Strategies – Stammering 297

11 Voice 11.1 300

12 Phonological Awareness/Working on Speech Sounds

12.1 Sounds Work 301

12.2 Auditory Discrimination Programme 303

12.3 Working with Sounds 305

12.4 Games for Sound Work 306

12.5 Speech and Language Tasks – Advice for Parents 308

12.6 Consonant Clusters 310

12.7 Picture Sheets for Consonants 312

13 Developmental Verbal Dyspraxia 313


133

LISTENING AND ATTENTION

1.1 Strategies:

1. Gain the child’s attention

Use his name or “cue” words, e.g., “Look”, “Listen”.

2. Gain eye contact

Get down to the child’s level, so you can get eye contact.

Say the child’s name.

You may need to refocus the child’s attention on many occasions.

You may need to stop the child from what he is doing to ensure full listening and attention.

3. Break down the instructions into small steps

Children with language difficulties often cannot remember or process more than one item of information at a time.

4. Use visual clues

Whenever possible, use visual clues to assist the child’s understanding and recall. This is particularly important because the child’s memory and sequencing skills may well be impaired.

Clues might include demonstration, gesture, pictures, symbols and writing.

It is often useful to display any visual clues where pupils can refer back to it as necessary.

5. Check Understanding

Check if the child has understood your question | instruction.

Encourage him to indicate to you when he has not understood. Think about why he might have failed to understand, for example :

Sentence too long or grammatically complex

New vocabulary

Words used have more than one meaning

Too many concepts in one sentence


134

6. Highlight important words for the child to listen for

Reduce the amount of redundant language you use

Ask the child to run errands with a short message to remember

Encourage the child to repeat an instruction to a peer

7. Use flowcharts

Flowcharts help the child remember each part of an instruction and therefore complete tasks more independently

8. Moderate your own Speaking

Be aware of the speed of your own speech – rapid speech is harder to process

9. Seating

Think about where the child is sitting in relation to you when you are talking. His attention will be better if he can see and hear you easily.

Think about who the child is sitting with - are they going to be distracted by that person?

Have the right size of chair for the child is sitting on – physical restlessness can affect the ability to attend

10. Eliminate Distractions

Remove distracting materials which may be cluttering the child’s table

11. Placing

Ensure consistent placing for keeping classroom resources, using clear labels (symbols, pictures or words).

12. Encourage, praise and reward the child’s efforts


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1.2 Activities:

Following Instructions

1. Traffic Lights Let the children run around freely. When you shout :

“red” the children must stop,

“amber” they must sit down,

“green” they must resume their running.

2. “Who Can Go?” At the “dismissal” times of the day, the children must listen to an instruction and be able to fit the requirement before acting. For example, the children are lined up, waiting to get their coats for playtime and the teacher says :

“Anyone wearing blue may put their coat on”.

3. “I Spy …”

Play “I Spy …” using descriptions of objects, instead of first sounds of the word. For example :

“I spy with my little eye, something that we sit on.” “I spy with my little eye, something that is under the window.”

This can concentrate on different aspects of language on different occasions or depending on the children’s needs, for example : verbs, adjectives, prepositions, functions, etc.

4. “Simon Says …” Play this game, firstly so that the children respond to all your commands, but, later, so they have to discriminate between responding to :

“Simon says touch your toes.”

and not responding when you say :

“Touch your toes.”

5. Listening Story Ask the children to draw a “listening story”, so that they listen to your instructions to complete a drawing : for example :

“Draw a big circle in the middle of your page. … Colour it pink.”

6. “Who Am I?” Think of a person/character you and the children all know and describe him or her, with one piece of information at a time. Let the children guess who it is, for example :


136

“I’m thinking of an animal … He has very big, floppy ears … He is grey, with a bit of pink … He can use his ears to fly …” (Dumbo)

7. Riddles Make up some riddles for the children to solve, for example :

“I gallop, I trot, my hooves go clip, clop. … Who am I?”

“I am green. I grow in gardens and parks. … You cut me with a lawnmower … What am I?”

8. Story Noises When reading a story, ask the children to make some response every time they hear a character name.

9. Sil ly Sentences Start a sentence, for example :

“I saw a cow sitting …”

Ask the children to take it in turns to finish the sentence :

“… in the middle of our kitchen. She was eating … a piece of apple pie.”

The children can later be encouraged to repeat the first part of the story before adding their own contribution.

10. Nursery Rhymes

One child starts off and another finishes a well-known nursery rhyme.

11. Nursery Rhymes

Read or recite nursery rhymes to the children. When they are familiar with one, recite it again, but miss out the last rhyming word of a line and encourage the children to help you fill in the missing word.

Later you can miss out several words at the end of a rhyming line, and then try missing a word from a non-rhyming line.

Eventually, when reading a well-known story, replace a word with its opposite and see if the children can correct you. (Most children find “mistakes” quite hilarious, and are very proud of their ability to catch you out!)


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12. How do we look Seat the group in a circle. The leader describes a situation and asks members to adopt an appropriate posture to sit – listening to music, cheering football, etc.

Classroom discussion can then take place around posture, facial expression and gesture.

13. Draw a Picture

Give the child an outline of a picture to colour in. Give him simple instructions such as to colour in the nose, hair, etc. He is only allowed to colour in one part at a time. Get him used to words such as “wait” and “go”.

You could make this into a barrier game where you have a picture with different parts coloured in.

Give the child instructions on what to colour in, for example :

“Colour the hat red”

When he has completed each stage, let him check his work against your drawing.

14. Draw A House

Work in pairs. One member instructs his partner to draw a house. The person drawing should do exactly what his partner says.

Classroom discussion can focus on giving and receiving verbal instructions.

15. “What am I thinking of?” Gradually build up a verbal picture of an object. Start with three clues. Can the child guess after two clues, three clues, etc. For example :

a) “four feet, fur” discuss that it could be any furry animal,

b) “whiskers” cat / lion

c) “drinks milk and is a pet” cat.

16. The Microphone The group sits in a circle. Members discuss a topic, e.g. TV, pets, holidays. You can only talk if you are holding the magic microphone.

Discuss turn taking with the group.


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17. Listen and Jump

In a group, the child has to listen for his name. When he hears it he has to jump into the circle.

The leader then prompts :

“What was Fiona’s favourite [ food | pet | …]?”

18. Favourites Everyone says their favourite for a list of items, e.g. food, pet, TV programme, etc.

19. Shakers Fill shakers (using “Pringles” packets, cardboard boxes or jars) with different sound makers (such as beads, dried peas, Ping-Pong ball, keys, etc).

Shake two that are the same, letting the child listen. Then shake two that are different. See if he can tell you whether the sounds he hears are the same or different. If he is having difficulty telling you, try introducing symbols or signs for “same” and “different” and encouraging him to point to the appropriate one.

You could have three shakers at a time, with two the same, see if the child can identify the two that sound the same.

Similarly you could shake one and give the child two to shake. See if he can show you which one sounds the same as yours.

20. Other Activities

Build simple “junk models”. Provide the child with objects of different size, shape and colour. Tell the child what to do step by step. For example :

“Pick up four toilet rolls and stick them on the red box.”

Give instructions by oral direction for activities that can be done with pencil and paper. For example :

“Write your name on the back of the paper. Put a cross in one corner of the paper. …”

This can be made increasingly difficult by introducing different colours, etc.

Negatives A game for the whole class - for example :

“Please, Mr Crocodile, may we cross your river?”

“Only those not wearing a [ dress | shoes | … etc ].”

Variations of “Simon says” - for example :

“Simon says ‘don’t touch your nose”


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It is good to help a child to be as independent as possible by giving them strategies for informing the speaker why they didn’t follow a question or instruction. Have a set of [ instructions | statements ] that are :

too long

“Go and get your reading book out of the yellow bag in the library. It’s next to the little desk by the window. Then can you go and see Mr ____ and tell him “_____””

too complex

“Have you hurt your patella (knee)?”

too jumbled

“Erm, … can you get me the red car? No, erm, I’ve changed my mind – can you get me the blue car?”

too short

“Can you get me the blue one.”

…etc.

Can the child tell what was wrong with each sentence?


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UNDERSTANDING LANGUAGE

2.1 Strategies:

1. Gain eye contact by saying the child’s name. You may need to refocus the child’s attention on many occasions. You may need to stop the child from what he is doing to ensure full listening and attention.

2. Break down the instructions into small steps Children with language difficulties often cannot remember or process more than one item of information at a time.

3. Use visual clues to assist the child’s understanding and recall This is particularly important because the child’s memory and sequencing skills may well be impaired. Clues might include demonstration, gesture, pictures, symbols and writing. It is often useful to display any visual clues which pupils can refer back to as necessary.

4. Check if the child has understood your question | instruction. Encourage him to indicate to you when he has not understood. Think about why he might have failed to understand, for example :

Sentence too long or grammatically complex

New vocabulary

Words used have more than one meaning

Too many concepts in one sentence

5. Create opportunities Reinforce [ learning | language ] in everyday classroom activities. It is essential that new language is generalised to lots of different situations and doesn’t just remain in the [ taught | learnt ] context.

6. Be repetitive in your teaching of new [ concepts | vocabulary ].

7. Be prepared to simplify your own language.

8. Use Pauses to help the child to process your language to him.

9. Be aware of the speed of your own speech. Rapid speech is harder to process.


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10. Give choice to the child For example, if working on his understanding of “behind” you might ask him :

“Is the car behind or on top of the lorry”.

11. Encourage, praise and reward the child for his efforts


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2.2 Activities:

In the following pages you will find activities for working with children who have difficulties following

instructions / understanding certain language structures.

Acknowledgement The following information is based on aspects of the

Derbyshire Language Scheme

What Is An Information-carrying Word?

Information-carrying words (ICW’s) are the words which have to be understood in order for the child to :

… follow a conversation

… follow an instruction

… answer a question

… understand a story

For example : “Put teddy on the table”

This is a one information-carrying word phrase if the child has a choice of a teddy and a rabbit with a table; or a teddy with a table and a bed.

This is a two information-carrying word phrase if the child has a choice of a teddy and a rabbit with a table and a bed.

This is a three information-carrying word phrase if the child has a choice of a teddy and a rabbit with a table and a bed knowing that he can put it on or under.

An ICW, therefore, has important information (not a little word like “the”, “put”, “a”, etc).

You need to be aware that children are often very good at working out what you are saying from the

context as well as from the language. For example, if you are putting on your coat ready for playtime and

say :

“Go and get your coat, we’re going out to play”

the child has probably already followed and anticipated the command from the situation. In order to

teach language, bear in mind the need to take away clues so the child has to understand the language.


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Develop Understanding at a Two ICW Level

Two Nouns Together

A. Toys : baby, teddy, chair, table

Ask : “Put baby on the chair”, “put bear on the table”, … etc.

B. Toys : baby, teddy, some objects (for example, spoon, car, brick)

Ask : “Give the brick to baby”, “give the car to Teddy”, … etc.

C. Toys : Po (Teletubby), dolly, sponge

Ask : “Wash Po’s hair”, “wash dolly’s nose”, … etc.

D. Toys : Baby, Teddy, toothbrush, hairbrush

Ask : “Brush baby’s teeth”, “brush teddy’s hair”, … etc.

E. Toys : Po with his cup and plate, baby with her cup and plate.

Ask : “Where’s Po’s cup?”, “Where’s baby’s plate?” …etc.

F. Toys : Picture of a man, lady, teddy, dolly or dog

Ask : “Where’s the dogs ears?”, “Where’s the man’s foot?” …etc.

G. Toys : animals, shed “box” and field

Ask : “Put the cow in the field”, “the horse in the box” … etc.

H. Toys : dolly, teddy, clothes for each

Ask : “Where are dolly’s socks?”, “Where’s teddy’s jumper?” …etc.

Noun and Action Word Together

A. Toys : Po and baby

Ask : “Make Po run”, “make baby sleep”, … etc”

B. Toys : dolly, teddy, “doing” objects, for example, comb, pen, flannel, book

Ask :

or :

“Make dolly read”, “make teddy draw”, … etc.

“comb teddy”, “wash dolly”, … etc.

C. Toys : dolly, table, chair

Ask : “Make dolly jump on the chair”, “Make dolly sit on the table”, … etc.


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Negative and a Noun

There are several stages a child goes through in learning the negative.

First he learns the meaning of “no” and later “not” before he will understand “don’t” or “can’t”

A. Toys : Draw pictures of trees - one with apples and another with no apples.

Ask : “Show me the tree with no apples”

Try with other pictures at the one word level, for example :

“Show me the face with no nose” … etc.

B. Toys : Draw pictures of faces - one complete, others with things missing, for

example, “nose”

Now you can move to two words together.

Ask : Who has no nose?” “Who has no eyes?” … etc.

C. Toys : Pictures of cars, one complete and another one with no wheels, etc.

Ask : “Show me the car with no wheels.” … etc.

D. Toys : Baby, Po, some objects. Give different objects to the toys.

Ask : “Who has no spoon?”, “Who has no plate?” … etc.

E. Toys : Pictures of houses, one complete, others with an item missing, for

example, a door, a window, … etc.

Ask : “Show me the house with no door.” … etc.

Size

Once a child is fairly confident at a two word level, start on concepts, beginning with the size concepts

“big” and “little”.

A. Toys : Bricks in two different sizes.

The first stage is to make sure that your child can size match.

Sort the bricks into two piles, the big ones in one pile and the small ones

into another.

Give a brick to your child and see if he can put the brick in the right pile.

If this is difficult, spend some more time doing this with other toys and

objects, for example, big and little animals, Teletubbies, spoons, cars,

… etc.

When he is confident at this, see if he can sort all the bricks into two piles

by himself.


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B. Toys : A big brick and a little brick.

Now you can move on to teaching your child the size words “big” and

“little”.

Ask : “Where’s the big brick?”

You can do this with any big and little toys or objects, for example,

Teletubbies, animals, … etc.

The next stage is to move on to two words together - use any big and little

toys | objects. Don’t forget to use a bridging activity (that is, give a

“clue”) if he finds it hard.

Ask : “Where’s the big Tinky Winky?”, “Where’s the little baby?” … etc.

Prepositions

Now you can move on to the place concepts : “in”, “on” “under”.

A. Toys : a large cardboard box.

First see if the child can go where you say.

Ask : “Go on the box”, “go under the box.” … etc.

You can also do this with a table or chair, … etc.

B. Toys : baby doll, box

Now see if your child can put the baby in the correct place.

Ask : “Put dolly on the box.” “Put Teddy under the box.” … etc.

You can do this with different toys and use a bridging activity if necessary.


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Develop Understanding at a Three ICW Level

These activities are the same as for two information-carrying words but this time the child has to choose

between three sets of items rather than two.

Prepositions

1. Use a doll and a teddy and ask the child to put them in, on or under the table or the bag. Make this into a game so that one animal might be hiding from another; for example :

“Let’s hide [ teddy under the bag | rabbit in the box ].”

2. “Put the [ pencil | car ] [ under | on ] the [ books | desk ], Put the [ book | apple ] in [ teddy’s | dog’s ] [ bag | box ].”

Big / Little

1. “Find the [ big car | little spoon ] and post them down a tube.”

2. When tidying-up ask the child to – “put teddy or dolly in the [ big | little ] box”.

3. “Colour in the [ big house | little door, etc ].”

4. Dressing up

“Put on the [ big | little ] [ gloves | hat, etc ].”

Actions

1. Make up an obstacle course “Make [ teddy | dolly | rabbit ] [ jump | hop | walk ] to the [ table | box ].”


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Develop Understanding at a Four ICW Level

1. Shopping game – “I would like a … … and a ……”

2. “Give me the … … and the … … - post them [down a tube | in a box | … etc ]” Have identical sets of objects / pictures. Take turns to choose two objects / pictures, looking

at them secretively and hiding them behind a screen. Ask the other person to find them and

when they have chosen two objects take the screen away – have you got the same?

3. You can use colours, words like “big” and “little”, “one” and “two” to extend the number of words that the child has to understand. An example at this level would be : “Put the [ apple | orange ] in [ big | little ] [ teddy’s | rabbit’s ] [ box | bag ].”

“Put one sock in teddy’s box.”

Remember that for every word in bold there must be a second choice, so in the second

example, there must be :

at least two socks

at least two of something other than socks

at least one other cuddly toy

at least one container as well as the box.


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2.3 Complex Structures

Why Do Children Have Ongoing Difficulties Following Instructions With Complex Structures?

Children with language difficulties have trouble making sense of “passages of speech”. These require an

understanding of a series of linked sentences and how they are related, for example :

“If you have finished drinking your milk you can go and play in the Wendy House or go in the sandpit.

In a few minutes it will be time for television. Before that we have to tidy up the classroom; so hurry

up or you won’t have time to choose.”

In order to understand the example above, children first need to remember all the pieces of information

given. Children with a short memory may find this particularly hard.

Spoken language often contains a lot of information that is not essential. Part of effective listening

involves knowing what is important and what is “extra”. The most important part of the above example

is the first sentence. Often in school explanations are given to a large group of children. Children must

pick out which parts are relevant to them. Children with language problems are often unable to do this.

Understanding linked sentences involves interpreting each part of the message in relation to the other

parts for example :

“Jessica has won her 25 metre swimming badge.

She is going to collect it at assembly tomorrow.

We will all go there to clap her.”

In order to understand the second and third sentences children must realise what the words “she”, “it”,

“her” and “there” refer to.

All these aspects of understanding interact. For example, auditory memory affects children’s ability to

select information that is important and word order and grammatical understanding are interrelated.


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Children with language difficulties may fail to understand or misunderstand what is said to them for a

number of reasons. They may have difficulties with :

1. Complex grammar

2. Understanding several linked sentences

remembering all the information

picking out the important parts

references within a paragraph | conversation

3. Auditory memory

4. Understanding the subtleties of language especially when the meaning goes beyond what is actually said. For example :

“Those sweets look nice” meaning “Please may I have one?”

“I’m feeling down” meaning “I feel unhappy”

5. Non-explicit and non-literal language.

Note: Some children’s understanding will be significantly affected by a difficulty in coping with fast

speech.

Grammatical Words and Word-Endings

Some children with severe language difficulties have problems understanding certain grammatical words

and word endings, for example :

Negatives – “hasn’t” “isn’t” … etc.

Word endings conveying different meanings – plural “s” possessive “s”

Past or future tense

Possessive pronouns – “yours” “mine” “theirs” … etc.

Children who usually do understand these may “miss” them on occasions if they are concentrating hard on

something else.


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Word Order

Children can be confused by sentences that have unusual or unexpected word order; for example :

“The boy was smacked by the girls.”

“The pencil on my table is broken.”

“The man who was sitting on the bench was old.”

All these could be misinterpreted because children are influenced by the word order they expect. For

example, in the second sentence they might interpret this as “my table is broken”.

Links Between Sentences

Words such as :

“but”, “if”, “so”, “because”, … etc.

all convey slightly different meanings. These are particularly difficult for children with language problems;

for example :

“John was cross so Mary was upset.”

“John was cross because Mary was upset.”

The differences in meaning here may not be very apparent to children with language difficulties.

Later Developing Grammatical Words

Many grammatical words that we use in conversation with older children have very specific and

sometimes subtle meanings. Language disordered children are late to develop an understanding of

these and this can put them at a disadvantage in conversation, for example, in the classroom.

Examples of these are :

“unless”, “although”, “however”, “therefore”,

“except”, “not only”, “but also”, “neither | nor”


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Difficulties With Complex Instructions / Language Structures

Follow this progression for longer instructions containing two parts :

a) one similar element – use one verb “Close the book and the box.”

b) two related commands “Put the pencil in the box and close it.”

c) two unrelated commands “Put the bear on the chair and give me the apple.”

d) two unrelated commands that contain more information “Put the dog and the bear on the bed and point to the door.”

To make these type of instructions easier :

point to where you want things to go

give the child one of the objects

repeat the second half of the instruction as the child completes the first part


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AUDITORY MEMORY

3.1 Strategies:

When a child has difficulty with auditory memory, the problem is often deep rooted and slow to change.

It is often, therefore, useful to consider slight adaptations to classroom activities and environment, to

allow the child to succeed. Some examples are :

a) Consider the use of visual information –

i. to explain new learning tasks

ii. to give additional clues to the spoken words being used

iii. to help recall past events

iv. to help word retrieval

Visual aids may include :

Books, pictures, photographs, souvenirs, gestures and signs, everyday symbols.

Written materials where appropriate, for example : daily diaries, instructions, home /

school books, calendar.

b) Consider the child sitting in the classroom. The teacher and the child need to have a good view of each other in order for his attention to be maintained.

The process of memory can be divided into :

ACQUISITION How you take the information in e.g. paying attention, senses

RETENTION What you do with the information to remember it, i.e. processing

RETRIEVAL Recalling the information

Difficulties can occur at any or all of the above.


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Child’s Strategies

The child will need to be taught and encouraged to use these in different situations :

1. Acquisition

Teach the child to :

Be aware of distractions and take responsibility for these, e.g. noise in/out of the classroom

Look at the person talking

Admit when he has not listened (teaching staff need to try not to react negatively!)

Ask for repetition – (teaching staff need to try not to react negatively!)

2. Retention


Check back after he has been asked to do something “So you mean I have to …”

Rehearse, i.e. say instruction to himself

Visualise, i.e. convert spoken words into pictures in his head. He can even draw simple pictures to help him.

Remember as the teacher is talking

Ask for time to think when needed, e.g. say “I’m just thinking …”

Ask when he does not understand or needs someone to speak louder or more slowly

3. Retrieval


Remember word finding strategies, i.e. when he cannot remember the name of something, think about :

a) meaning – what group does it belong to or what does it go with? Think of another word for it or what is it like?

Where do you find it or what do you do with it?

b) sound structure – “what does it begin with? How many syllables has it got?

What does it rhyme with?

If he still cannot remember it – can he draw it?


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Teacher Strategies

1. Acquisition

Gain the child’s attention before giving an instruction, e.g. say name, make eye contact, touch

Sustain attention : give clear expectations to the child so he knows the aim, e.g. framework on board

Refocus attention on the most important information

Use a variety of input modes, e.g. visual (pictures, posters, cartoons, key words, colour coding, gesture); kinaesthetic (movement, role play), smell, taste (when possible!), rhythm, music

Use flowcharts to help the child remember each part of an instruction and therefore complete tasks more independently

We remember bizarre or outstanding things – try to think how you could use this when teaching (e.g. dress up!)

Encourage the child to repeat an instruction to a peer

Motivation : reward at the end of the session; keep reminding during the session, e.g. Game/Quiz at end

2. Retention

Modify your language :

repeat important phrases, information, words

“chunk” language, i.e. short phrases with gaps

speak slowly

avoid unnecessarily complex sentences

avoid idiomatic language and sarcasm. If you use these explain what you really mean (e.g. “Hold your horses!”)

Introduce new words/concepts gradually, check understanding before putting in a teaching context

Revise and recall after each “break”, e.g. What was liked/disliked, summarising, word definition (quiz) especially at the beginning of lessons

Focus on key words : check and explain meaning by giving the “group” it belongs to and a simple example, e.g. ‘frustrated’ – it’s a feeling, a bit like cross, when you can’t do something – like “I felt frustrated when I couldn’t play football.”

Also focus on the sound structure of a new word, i.e. what sound it begins with, how many syllables, rhyming words

Primacy/Recency effect : we remember things taught first and last most easily, therefore have exciting / outstanding feature of the lesson in the middle of the lesson and have learning breaks

Organise information given to the child in a hierarchy, i.e. start with easy and familiar then progress to difficult and unfamiliar


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3. Retrieval

If the child cannot retrieve specific words try to accept his explanation which demonstrates understanding

Use a variety of recall modes : spoken, written, pictures

Allow time for the child to use his strategies (count to 10 before expecting a response)

Encourage the child to use his strategies (see previous)


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3.2 Activities:

Auditory Memory is the ability to recognise, store and recall information. The efficiency and span of auditory memory varies from child to child. Children with language difficulties very often experience problems with different aspects of auditory

memory. For example :

a) slow processing of spoken language

b) difficulty storing information

c) difficulty in organising information in their mind

d) slow or poor recall of information

Recognising Auditory Memory Problems The child may :

1) have difficulty in concentrating on what is said in class

2) simply follow what others are doing

3) carry out an instruction slightly later than others in the class

4) often carry out only part of a spoken instruction

5) not be able to re-tell a past experience that he recently heard in class

6) find it hard to recall specific words even though he knows what he wants to say have difficulty overall learning new ideas


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Activities

1 Copying Sounds You will need two sets of objects that make a sound, for example, rice in an empty margarine tub,

two spoons to bang together, a wooden spoon to bang in a saucepan, two empty crisp bags to

rustle together, … etc.

Note If the child has musical instruments, use these instead.

Give the child one set of sound makers and keep the other for yourself. Position your sound makers

so that the child can’t see them, for example, behind a cardboard box.

Play one of your sound makers and see if the child can find his same one and make the sound. If the

child can’t find it, play yours again and give him a clue.

If the child finds this very easy, make two sounds, one after the other. Can the child find both of

the sound makers and play them back to you in the correct order?

Gradually build up the number of sounds you make.

2 Actions This is a “Simon Says …” type of game. It is a good idea to make a list of actions that the child can

do, as it is sometimes difficult to keep thinking of new things while you are playing the game; for

example :

“close your eyes”

“clap your hands”

“stand up”

“stamp your feet”

“wave your hand”

“sit down”

“… etc.”

Begin by asking the child to do one thing. If he can, then ask him to do two things; for example :

“wave your hand and close your eyes”

Stress that he must do one then the other, and in the order that you said them.

Increase the number of instructions when the child is ready for more.


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3 Shopping (1)

Pictures of food or real food items can be used for this game. It will be more fun if you also have a

shopping bag, purse and some money.

Ask the child to fetch you something from the “shop”. Just ask for one item to begin with.

Once he has the idea of the game, ask for two food items; for example : “cake and bread.”

If the child can remember two items, ask him to give you them in the correct order; for example :

“bread then cake.”

If the child is successful, then ask for three items, and so on.

4 Shopping (2) This game encourages the child to listen, remember and repeat what you have said (without any

toys or objects to remind him).

Introduce the game by saying :

“I went shopping and bought … … …”

and say the name of something, for example : “eggs”.

The child then has to remember what you bought and add something of his own, for example :

“eggs and milk”

You then repeat the items and add one of your own; for example : “eggs, milk and meat”, and so

on.

5 I went to … This is a similar game to the second shopping activity. Begin by stating the name of the place you

have been to, for example :

“I went to the zoo and saw …”

Say an animal and then gradually increase the number; for example :

“I went to the zoo and saw an elephant”

“… … … … … … and saw an elephant and a lion.”

“… … … … … … and saw an elephant, a lion and a tiger.”

“… etc.”

Other ideas of places to go are :

nursery / school

the farm


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on holiday

Try to use a place that the child is familiar with.

6 Find the Toys Choose a selection of toys and place them, within sight, around the room; for example :

“ball, car, teddy, doll, book, … etc.”

Ask the child to fetch one of these toys for you. If he can do this, gradually increase the number of

toys that the child has to remember.

7 Drawing Game You will need to divide a table in half with a screen (books or a cardboard box).

Seat the child on one side of the screen with yourself on the other, each having to hand paper and

crayons or pencils.

Take it in turns to tell each other what to draw; for example :

“Draw a house”

“Put a red door on it”

“Draw three windows”

“… etc.”

Gradually increase the length of the instruction that you give to the child.

8 Grandmother’s Steps This is an activity for a group of children to play.

One person is “grandmother” (it is usually a good idea if you take this role the first time the game is

played.)

The children stand in a line around and at the same distance away from “grandmother” and take it in

turns to ask “her” if they can move closer. “Grandmother” replies by giving instructions such as :

“Take one big step and two tiny steps”

“Take three steps forward and one back”

The children must remember the instructions they have been given and carry them out carefully.

The winner is the first child to be able to touch “grandmother”.


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9 Colour Towers

You will need two sets of five different coloured bricks, one set for you and the other for the child.

Use a large book or cardboard box as a screen so that neither can see the other’s bricks.

Tell the child what colour bricks you are using as you make a tower on your side of the screen; for

example :

“red, blue, yellow, blue, … etc.”

The child has to listen to and remember your instructions so that he can build a tower to match

yours, remembering the colours in the correct order as the tower is built.

Once the child has built the tower, take the screen away and compare the two towers.

Note Another way to play this game is to use cardboard tubes standing on the table.

Say the colours of the bricks as you post them down the tube and then let the child do the

same.

When the child has finished, lift the tube and compare the result.

10 “I went to market …”, type of games Play games such as “I went to market and I bought …”.

Make the game more complex by adding in details, for example :

“1 dozen brown eggs, 2 litre bottles of coke”

Either take it in turns to draw what was said or let the child draw them.

Once drawn, turn the card over. When recalling what is said, point to the card but only turn it over

if the child can’t remember what is on it. At the end, can you go through them all without turning

them over?

Talk about the strategies the child used to remember and encourage the use of them in other games.


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11 Making signposts

For example, saying how much information, or how many items must be remembered, for

example :

“I want you to go upstairs and get three things …, … and …”

Ask the child to repeat them to you and then go and get them.

You can practise this in :

• Taking messages

• Getting items

• Recalling what other people have done, for example, at meal time everyone say three

things they have done, then get another person to say what they have just said.

As the child gets good at this increase the number of items.

12 Messages Play in a small group.

Teacher and one child stay in the classroom, the others wait outside (with an assistant if necessary).

The teacher gives the child a message, for example :

“Please buy 3 currant buns, 2 doughnuts and a pint of milk.”

The child calls in one other child and relays the message.

The second child calls in the next and relays the message, and so on.

The last child relays the message to the first, who says whether it has been changed.

Skills Listening

Auditory memory

Sequencing

Giving accurate information

12.1 Variation on “Messages” Mime a message or everyday scene, for example, washing up. The last person guesses what the message

was and checks with the first person whether he was correct.


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DESCRIPTIVE LANGUAGE SKILLS AND VOCABULARY

4.1 Strategies

Accessing Vocabulary from Memory

1. General Organisation Help the child :

Teach him routines

Encourage tidying up in set places This helps him to understand that things belong in sets and is crucial for learning new words and storing them.

2. Reinforcing Learning | Language Create opportunities for reinforcing learning | language in everyday classroom activities. It is essential that new language is generalised to lots of different situations and doesn’t just remain in the taught | learnt context.

3. Use Repetition Be repetitive in your teaching of new concepts | vocabulary.

Try to l ink new vocabulary / concepts with what the child already knows.

4. Plan, Do and Review Help the child with a task | activity by encouraging him :

Plan - talk about what you are going to do, your aims, the resources you need, … etc.

Do - whilst carrying out the activity, name the resource and describe what the child is doing, going to do next, … etc., in short sentences.

Review - after the activity is completed, encourage the child to think and talk about what he has done. Help him to structure this by using words like “first …”, “then …”, “last …”.

5. Encourage, praise and reward the child for his eff orts


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4.2 Activities:

(Activity Set A):

Expressive Language

The following activities can be used for a number of different aims :

Increasing vocabulary development

Strengthening word retrieval abilities (when a child has difficulty accessing the right word at the right time)

Strengthening descriptive language skills

Strengthening reasoning skills

Strengthening categorising abilities Look through them to determine which activities suit the child you are working with best. Ask your

Speech and Language Therapist for advice.


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Expressive Language – Description, Explanation, Reasoning and Sequencing Skills

These activities will help children with a wide range of difficulties. Use them to target giving accurate

descriptions, strengthening vocabulary knowledge (and therefore word retrieval), giving explanations,

strengthening reasoning skills and improving sequencing skills.

1. Can the child tell a brief story from several pictures or from one composite picture? If this is very difficult can they recall a story using pictures to help them?

2. Using a series of pictures that tell a story, see if the child can place them in the correct order and relate the story.

3. See if the child can select either an object or picture after hearing its description.

a) You can give the description in single words, phrases or sentences; for example, a ball can be described as “black, round, bouncy” or “It’s made of rubber, and you play sports with it.”

b) Play “What am I thinking of?” Gradually build up a verbal picture of an object.

Start with three clues. Can the child guess after two clues, or three, etc. For example :

i. “it has four feet and fur”,

ii. “… whiskers”,

iii. “… drinks milk” … a cat.

c) Play a “Guessing Game” Each player has some pictures of objects.

Take it in turns to turn one over and describe it.

Try not to guess the right answer unless the description is very accurate – make some other

guesses.

d) A game similar to this, which requires the child to select key information (i.e. the most important information to relay) is “Chicken feed”. Place a set of topic related pictures on a table. Ask a group of children to sit around the table

with their little fingers on the edge of the table. One pupil silently selects a picture and tells

the group the two most important features about it and then says, “go”.

The other pupils place their little finger on the picture they think it is. The first child with their

finger on the correct picture is “it” next time.

Note The activity can be made harder by providing pictures that have close semantic links,

for example, all drinks.


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4. Try and describe the functions of a familiar object; for example, pencil, vacuum, brush.

5. Describe a familiar object according to its shape, location and size; for example, a chair in a room.

6. Describe an item after it has been removed from sight, therefore combining visual memory with oral language.

7. Identify an item from touch – describing as you feel the object.

8. Sort out a group of objects or pictures according to use, size, shape, colour or what they are made of.

Activities 3 through 8 all involve giving accurate and relevant descriptions of objects/pictures. If this is

particularly difficult for the child you may find the following table useful as a memory aid for the child – it

will give them a structure from which to base their descriptions.

Describing Objects

When we describe something, we can use different features. Try using these headings to describe :

a ball a fork a cup

an apple a hat a cooker

Collect together some common objects. Ask the child to choose one and see how much you can say about

that one object, for example :

shape size colour texture weight

“It is used for …”

“It is made from …”

“You can can buy it from …”

“It is stored in …”

“You can find one at …”

“It is used by …”

“The category it belongs to is …”


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Object = sock Object

Category Clothing

Its function or use Wear it

What it looks like Has a hole at one end

What it does Keeps us warm

Where you find it Wear it on our feet

Keep it in a drawer

What it is made of Wool

Some features will have more than one idea beside them.

Which features describe the item best?

Which features are not relevant? When the person you are working with is good at this, progress to the games where you describe an

object for each other to guess which are listed above, or “20 questions” type games – ask the child to

select an object. Take turns to ask specific questions in order to find out what it is; for example :

“What colour is it?”

“What shape is it?”

“What size is it?”

“What is it made of?”

“What is it used for?”

“Where would you find it?”

… etc.


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9. Using a spoken or written list of objects, select an odd one out and explain the reason for your choice. If this is proving too hard, use actual objects or pictures of objects.

To make this even easier when introducing the activity, use the pictures/objects, e.g. an ice-lolly,

an ice cream and a sausage and talk about what the child might know about the first one. For

example, you might begin with “You eat it!”. Decide if you can eat the other two. Move on to

another attribute – “Is it sweet?” or “Is it hot?”

Given this information, decide which is the odd one out.

For ideas, refer to the “Odd One Out” list (page 169).

10. Describe the similarities and differences between two objects; for example : a bird and an aeroplane

an apple and an orange

honey and glue

1p and 10p

a cricket ball and orange

a river and the ocean

a pen and pencil

… etc.

See also the “DIY Semantic Links Sheets” enclosed.

11. Describe an emotion after hearing a story. Encourage more than just “happy” and “sad”.

12. Describe the emotion portrayed in a picture and suggest a cause; for example, a child crying beside a broken toy.

13. Describe how the child feels about an imaginary situation; for example, watching a peer hurt an animal. This is also aimed at increasing social awareness.


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14. Identify statements or pictures as fact or fantasy; for example, “a tree can shout.” A game that you can play is the “Silly – Sensible board game”. Provide a board such as that for

“snakes and ladders”.

Develop topic related cue cards such as :

“When you want to talk to the teacher in class you shout.”

“When you want to send a message to another country you can use a fax machine.”

Make sure some of the statements are silly and some sensible.

Play in a small group with one adult or able leader.

When a child lands on a snake or ladder he takes a cue card and says whether the cue is silly or

sensible. The whole group discusses whether they think he is correct and why and if they can think

of any alternatives.

If the child is correct he goes up the snake or ladder, if not, he goes down.

15. Silly Sentences

“The man ate the shoe.”

“Why is it silly – can you make it not silly?”

16. Complete a statement relating to the child’s wishes and find out the reasons for the child’s choice; for example :

“If I could go anywhere, I would go to…”


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“Odd One Out” Games

You will need to be selective and choose items suitable for the age, interests and experience of the child.

Make up similar ones of your own, if they find certain ones hard. Can they make up ones for you?

Easier choices

bus

bee

car

bus

ticket

car

bird

dog

ice cream

plane

helicopter

star

chair

worm

snail

grass

giraffe

lion

book

ladybird

caterpillar

sheep

swan

duck

whisper

biscuit

talk

jump

run

ball

radio

fridge

TV

chips

ice cream

burger

happy

scared

day

star

rain

snow

cup

tree

glass

mountain

hill

sea

10p

pound

bike

skipping rope

shoes

skates

kite

bus

taxi

3

8

TV

sun

flower

moon

clapping

jumper

waving

nose

eyebrow

shoe

seaside

playground

bathroom

jumper

train

car

big

tiny

small

orange

tea

coffee

tulip

sun

rose

Weetabix

sausages

rice crispies

pig

fish

cow

apple

coffee

banana

freezer

sandwich

bread

dog

cat

fire

fridge

coat

cooker

read

write

boat

Tuesday

October

Monday

jumper

house

sock

coat

scarf

pyjamas


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DIY Semantic Links Sheets

Take it in turns to make one up for each other. Draw the item or write the word. See the enclosed sheet.

The item in the big circle should go with an item in one of the small circles.

Talk about what they are :

“Which goes with the one in the big circle?”

“Why do they go together?”

“What else would go with them?”

“How are they similar?”

“How are they different?”

“What else goes with the one/ones in the other circle?”

DIY Semantic Links - Sep-2000


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Activity Set B:

Word Retrieval Difficulties

To communicate effectively through speaking and writing, objects, people, actions, events and ideas need to

be labelled by words.

In order to build a system of words (vocabulary) a child must be able to associate words with things from the

environment.

Young children first learn words related to things that are important to them. Words associated with

immediate and concrete events and ideas are easier to understand and use.

A person’s vocabulary continues to expand throughout life. It is individual to each person and reflects

personal experiences.

Words are stored in an organised way within memory. Words that represent closely related objects and ideas

are grouped together. For example, “table” and “chair”, “soft” and “hard”. Properties in words themselves

may lead to them being stored together according to, for example, their first sound or the fact that they

rhyme.

The organisation of words within memory means that they can be retrieved as needed.

Children with language difficulties may have problems in storing, organising or retrieving words, as they want

to. They may :

1. Pause and appear to be searching for the right word.

2. Say a word that is similar in sound or related in meaning, which may appear inappropriate.

Some children may :

1. Have a general problem in learning new words, and need constant repetition to build on other vocabulary.

2. Use “empty” words or phrases like “that one” and “there”.

3. Use phrases like “you know the one”, “like that one” … etc. in order to replace the words they are unable to find.

4. Use gestures like finger clicking and hand waving to help them in their search for the target word.

5. Use meaningful signs to replace the missing word. Techniques for pupils with word-finding difficulties are based on giving children a number of pegs on which to

hang a word. A good analogy is that of a magnetic fishing game – the more paper clips on the fish the easier

it is to catch it.


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Different strategies help children who have word finding difficulties recall words. You could try the following

and see which work best for your child.

Create different situations in which pupils can hear and use vocabulary, for example : real life; acting, (for example, role-play); technology (for example, model making); discussion.

Highlight the flexibility of language, for example, the same word can have different meanings, as in :

“park the car”

“play in the park”

“car park”.

Different words can have the same meaning, for example : far, distant.

Discuss the real meaning of ‘colourful’ phrases such as :

“Hit the roof”

“You drive me up the wall”

For pupils with word-finding difficulties :

a) For a known word :

give the initial sound

give a sentence to complete (e.g. “shoes and …”)

give its function

provide a closely associated word

use a sign | gesture

Talk about the structure of a word –

how many syllables it has

what it rhymes with b) For an unknown word ask :

“What kind of thing is it?”

“Can you think of a word that goes with it?”

“Show me one with your hands.”

“What do you do with it?”

“Can you put it into a sentence?”


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When teaching new vocabulary :

talk about the word structure, (syllables, initial sound, rhymes)

draw the word

talk about what it means

make up sentences using it


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As well as working on any of the activities listed in Activity Set A, if you have a child with a specific word

retrieval difficulty you may also like to draw on the following activities for further ideas.

1. Using tapes of environmental sounds, for example, animal noises, clocks, noises around the home, etc, play them and ask the child to name the object / person / animal that goes with the sound. If the child finds this difficult, you can provide pictures to give visual clues.

2. Using objects and pictures, ask the child to think of as many actions that can be done with that object; for example :

Spoon Stir with it

wash it

scoop with it

… etc.

3. Place a collection of objects in a bag. Ask the child to choose one item. The child must then describe it without naming it. This can be done as a group activity – timing how long it takes the children to guess the object.

4. Choose words that all begin with a particular sound, for example, “b”. One child is told the mystery word. He gives the other children a clue to what the word is –

preferably using one word, for example :

“animal”

“brown”

“hairy”

Other children guess the word described – “BEAR”.

The classroom can be divided into teams to make it more interesting.

You may have to take the first turn at providing the clues to give the children a good model.


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5. Collect together some objects and keep these out of sight of the children. In a small group nominate one person to leave the room.

While he is gone, show one of the objects to the other children. Each child has to think of

something different to say about the object. The object is then removed from sight.

The other child returns and each child gives their clue, so he has to guess what the object is.

6. A simple lotto can be adapted to encourage your child to think around the objects. Instead of naming the picture that is chosen, describe it without letting anyone see the picture. As in an ordinary lotto game, take it in turns to choose the pictures.

7. Make a list of adjectives, such as :

tiny cool slippery

funny round … etc.

Tell the child that each word can be used to describe something. Ask them to think of something

that goes with each word. You may have to define some of the adjectives in order to prompt a

response.

8. Make word games out of vocabulary, for example, word searches and simple crosswords.

9. Carry out sentence completion tasks or making sentences around the core vocabulary.


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10. Classification games

Vocabulary can be sorted into different groups, for example :

Places

inside outside

buildings park river …

shoppingliving in… etc

picnickingplaying… etc

swimmingboatingfishing… etc

… etc.

or, alternatively, the same vocabulary could be sorted, for example :

Places

urban rural

public private public private

shoplibrary… etc.

houseflat

footpath… etc.

farm… etc.


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Activity Set C:

Categorisation Difficulties

Categorisation is the ability to group and classify different words or objects according to their distinctive

features, concepts or qualities, for example, animals, opposites, initial letter/sound and rhyme.

It is the way that basic vocabulary is organised and stored for recall and use at a later point in time. Thus

some words may belong to several different categories or be classified in more than one way.

Initially children organise their vocabulary store using the more concrete or obvious features, for example,

visual similarities, use, etc.

As children develop they use their increasing knowledge of the world to classify objects by means of more

abstract properties. It is at this level that children with language problems may have significant

difficulties.

The child in the classroom may :

1. have problems choosing or carrying out simple instructions, for example, “Go and find me all the soft balls.”

2. substitute a word with one that has a similar meaning.

3. have difficulties using verbal reasoning.

4. be rigid in his learning, show little flexibility and a poor ability to generalise.

5. find it difficult to sort out by more than one category at a time. This may have implications for working in maths sets.


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Categorisation

When working with categories use ones with which the child is already familiar and/or categories that tie in with the class topic.

Let the child experience categories by visiting places; for example : the playground, the hall, a shop, etc. Talk about different things that you have seen. When you get back to the classroom or to home, draw or write a list of what you can both remember. At a later date, can the child recall what was seen or can they predict what they might see when they go somewhere. You can use similar strategies whilst looking at different topic books.

1. Collect together pictures of objects belonging to categories such as :

food furniture buildings transport toys plants clothes animals

It would also be useful to have pictures that are grouped together in less obvious ways, for example :

things that you cut with

things that are made out of wood

things you clean with

things found in the kitchen

things found at the seaside

a) Choose four pictures from three of the categories you have collected (so that you have twelve pictures in all) and mix them up. See if the child can sort the pictures into three category piles, and label the category of each pile.

They may need prompts, such as :

“which ones go together?” “What do you do with it?” Or “Is there another one you do that with?”

b) Choose three pictures from one pile and one from another. Mix the pictures up and see if your child can tell you which one is the odd one out and why.


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c) This can be made difficult by subdividing a category further (i.e. finer categories), for example,

things we wear on our hands / feet

things we wear inside / outside

things we wear when it’s hot / cold

things boys / girls wear

Other categories might include :

farm and zoo animals hot and cold food summer and winter clothes birds that can fly and birds that can’t fly … etc.

d) These types of activity can be extended for older children to include; for example :

opposite relationships

far and near slow and fast up and down cry and laugh borrow and lend before and after success and failure rough and smooth cruel and kind

spatial relationships

far and near car and garage before and after connected and joined ahead and front beside and below away and distant

temporal relationships

seed and tree before and after seconds and minutes smoke and fire sleep and night early and morning

Write down the words on pieces of paper and see if the child can pair them up. Make it easier/more difficult by altering the number of alternatives for them to choose from, e.g. you could put out three words and ask him to find the two that go together/that are linked.

2. Make a dice from a square box, but instead of numbers put a category on each side, for example : food / transport / clothes.

Play in a small group and take it in turns to throw the dice. When the dice lands whose ever turn it is needs to name one, two or three items (depending upon their age and ability) from the category that is shown by the dice.

3. Give the child an outline drawing and see how many appropriate items they can draw on it and name.

The outline could be a toy shop, a fruit shop, the zoo, a park, a farm, a hospital, a kitchen or any other location that has specific items associated with it.


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4. Place several cards of different categories on a table. Give the child an object or picture card and ask him to choose which of the cards on the table it belongs to. This game can also be played using the written word.

5. Give the child a magazine containing a variety of pictures. Have the child search for items of a given category, for example, food, clothing, and furniture.

6. Give the child a category heading, for example, “things rhyming with ‘PAN’”. How many items can the child name or write down?

7. Play a word-chain association game. Think of a word, the next person must say a word which is associated in some way with the previous one; for example :

up down town city traffic car (opposite) (rhyming) (hierarchy) (world knowledge) (hierarchy)

8. Give the child two objects that have some characteristics in common and some that are different; for example : Lego Blocks or Lego People. The child must state as many differences and similarities as possible. It will probably help initially to talk with the child about the things the objects have in common and to note them down in a simple way. Go on to talk about the differences in the same way. For example, an orange and a grape : “Both are round, fruit, juicy, edible. However the orange is bigger, has a thicker skin; you must peel the skin before you can eat it and it is a different colour.”

9. Ask the child to generate rules of association by saying :

“Glove is to hand as sock is to …”

Give probable and improbable alternatives for the child to select from, for example : television, scarf, foot, and ankle.

10. Category Bingo

Provide each child with a bingo card on which you have placed pictures or words from certain categories. Present a category heading out loud.

The child is allowed to place a counter / marker on any item that is a member of that category.

When a diagonal or horizontal line is filled, the game is over.

11. They belong together

Ask the pupils to collect one object each. Display the objects clearly. The pupils take turns to choose 2 things that go together according to their own criteria. The other pupils guess why the objects were paired.

General discussion can take place about each pupil’s reasons for pairing the selected objects.


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12. Scrapbooks

Put related pictures on the same page. Link to new vocabulary being learnt in class.

13. Comparing word pairs.

Make a list of word pairs and ask the child :

“Which of these are the [ same | different ] ?” e.g. pillow and cushion, insect and fly Sunday and week sweet and sour push and pull unlock and open … etc.

“Which of these is softer?” e.g. apple or grape bed or pillow gravel or snow … etc.

“Which of these is thicker?” e.g. rope or string

“Which of these is smaller?” … etc.

14. “I went shopping and I bought … “

You can use lots of variations of this game, for example :

“I went to the seaside and I saw …”

“I went out to dinner and I ate …”, etc.


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Category List

15. Naming Categories

Write some of the following words onto separate sheets. Take it in turns to choose a word and then take it

in turns to name items in that category.

You will need to be selective and choose categories suitable for the age, interests and experience of the

child.

Animals Clothes

Birds Cars

Insects Plants

Places Vegetables

Buildings Songs

Games Transport

Sports Weather

Countries Boys names

Food Tools

Drink Lessons

Colours Actions – clapping, jumping

Flowers Towns

Fruit Work people do

Parts of the body TV programmes

Football players Farm animals

Furniture Wild animals

Girls names Time

Names of books Famous people

Toys Footwear


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Resources

Bigland and Speake (19) Semantic Links

“Where’s Wally?” book / poster of a scene, for example : sport, seaside, park, etc. to discuss items that are linked in meaning. You can get fun “Where’s Wally” posters of different scenes to work with the child.

Practical Language Activities (1992) JoAnn Jeffries and Roger Jeffries ECL Publications


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GRAMMAR

5.1 Strategies:

Using Appropriate Grammatical Forms

1. Plan, Do and Review Help the child with a task | activity by encouraging him to :

Talk about what you are going to do, your aims, the resources you need, … etc.

Whilst carrying out the activity, name the resource and describe what the child is doing, going to do next, … etc., in short sentences.

After the activity is completed, encourage the child to think and talk about what he has done. Help him to structure this by using words like “first …”, “then …”, “last …”.

2. Expand utterances the child uses For example :

Child : “Look – fire engine.”

Teacher : “Yes, it’s a fire engine – a big, noisy fire engine.”

3. Model and Extend the child’s language When a pupil uses incorrect grammatical structures provide the correct one for him and, where possible,

extend his response.

Child : “I water it and it grewed.”

Teacher : “Yes, you watered it and it grew. Now its taller than mine.”


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5.2 Activities

Verbs

1 . V e r b L o t t o

This can be used to encourage varying lengths of sentence; for example :

“brushing”

“brushing hair”

“boy brushing hair”

“boy is brushing hair”

“boy is brushing his hair”

“the boy is brushing his hair”

If the child uses, for example, two-word sentences, then try to encourage three-word sentences.

Play the game as for normal lotto, but as either you or the child picks up a card, say the appropriate

sentence (at the chosen level, for example, three-word). Match the picture to the board.

If you colour the pictures on the board and the matching cards, so that they are same, you can

extend some of the sentences further; for example :

“The yellow duck is sleeping.”

“The little boy is crying.”

“The brown teddy is jumping over the wall.”


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2 . O t h e r A c t i v i t i e s

You can also use verb pictures either to play games of “snap”, “pairs”, or for the child to colour the

one you say.

Ask the child to act out the verbs on teddy/dolly, for example :

“make teddy hop”.

Take turns to pick up a verb picture and act it out for each other to guess. Make it easier by giving the child a choice of two pictures and ask :

“Which one am I doing?”

Use the verbs in lots of different contexts, e.g. washing face, washing clothes, washing car.

“Hide” pictures around the room and ask the child to find “cutting”, etc.

Gather together some objects that you can wrap, kick, throw, drive, eat, drink, etc. and ask :

“which one do you cuddle?”

Reverse the task by asking :

“what do I do with a ball?”

“What do I do with a pencil?”

“What does a fish do?”

“What does a bird do?”

… etc.


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Working With Sentences

Sometimes children will forget to include important parts of a sentence. These might be :

the subject of the sentence – who is involved

the verb – the action

or the object – what is involved.

For example, in a sentence such as :

“The lady is looking at the dog”

then :

“The lady” is the subject,

“is looking” is the verb and

“the dog” is the object.

The following activities can be carried out when the child is omitting the subject of the sentence.


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1 . U s i n g P i c t u r e P a i r s

Use picture pairs where the same event is pictured but different people are carrying it out; for example, use a picture of a man washing a car and a picture of a woman washing a car. Instruct the child to listen to what you say and point to the correct picture.

Say “washing the car” – then, whichever picture they point to, tell them that you have made a

mistake because you wanted them to point to the other picture. Tell them that you have

forgotten to say something and talk about what you would need to say to specify which picture

you really meant.

Repeat this activity with different pictures encouraging the child to help you with what to say to specify who is carrying out an action. Use pictures such as :

The [ man | lady ] is walking the dog.

The [ boy | girl ] is climbing the tree.

The [ cat | dog ] is eating.

The [ boy | girl ] is kicking a ball.

The [ man | boy ] is eating.

The [ girl | boy ] is sleeping.

The [ cat | boy ] is sitting on a chair

… etc.

2 . U s i n g a B a r r i e r G a m e

You can make this into a barrier game where you each have the same pair of pictures.

Take it in turns to choose one of the pair in front of you and tell the other one which you have

chosen. They then have to look at their pictures and choose the correct one.

You can see whether you have got it right by comparing pictures to see if they match. This also

provides a form of visual feedback for the child so that they can see how they are getting on.

Make sure the child has a go both at:

listening to what you say and

telling you which picture they have chosen.


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Tenses

Regular Past Tense:

Read a story to the children.

Ask them to recall what happened. This should result in the past tense being used, but if the

present tense is used, or an incorrect form of the past tense, repeat the sentence for the child,

using the correct form and expanding the sentence a little. For example :

Teacher : “Do you remember what happened at the beginning of the story?”

Child : “The three pigs leaved their mummy.”

Teacher : “Yes, that’s right – the three little pigs left their mummy. They went to build their

own houses. What happened next?”

At a time when all the children are gathered together, ask them what you all did together (and in their groups) yesterday (or earlier in the day, if this is done at the end of a session).

Again, this should encourage the use of the past tense. Make sure the child hears the correct form,

by repeating the child’s sentence correctly (and expanded), as described above.

“Simon Says …” game

If possible this needs to be played in a group. Choose an action from the list below and encourage

the children in the group to do the actions. For example :

“Simon says ‘hop’!”

You can then ask :

“What did you do?”

You are aiming to elicit, “I hopped!”

Actions : jumped, walked, opened the door, closed the door, laughed, hopped, kicked the ball,

clapped.

Look at some simple action pictures using some of the actions described above.

Turn the pictures over when your child has looked at it and say :

“What happened?”

encouraging use of the past tense. For example :

“The man laughed”

“The girl opened the door”


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Play charades with another child, miming an activity, for example, brushing hair. The child must guess what you did when you have finished, for example :

“You brushed your hair”. Use pictures of actions to help with this activity.

Other examples may include :

“You cleaned your teeth” cleaning teeth

“You washed your face” washing face

“You cried” crying

Talk about the first picture, for example :

“Look, here’s a boy - let’s see what he did yesterday”

The child lifts the flap. You are aiming to elicit :

“The boy kicked the ball”


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Irregular Past Tense:

As certain past tense verbs do not follow the normal rules of putting “ed” on the end, activities involving

use of irregular past tense may have to be repeated many times for the child to learn these verbs.

Role-play activities for working on “ate”, “drank” and “bought” are fun.

Set up a restaurant scene - the child could be a customer choosing various items from the menu with

you being the waiter / waitress. When the child has finished the pretend meal, he can be asked :

“What did you eat?” (to elicit “I ate …”)

“What did you drink?” (to elicit “I drank …”)

Shopping - the child has to buy various food items from a pretend shop, (empty food packets could

be used). Afterwards ask the child what he has bought, for example :

“What did you buy?” (to elicit “I bought …”).

You and the child can instruct each other to draw a picture. For example, you say :

“Draw a house!”

then you say :

“What did you draw?” aiming to elicit “I drew …”

Robber Game

This is a role-play activity that can be played in a small group with the children taking it in turns to be

a robber and a policeman.

The robber takes some objects from a shop, (for example, watch, toys, etc.).

The policeman tries to catch the robber.

At the end, the robber is asked to reveal what he took, for example :

“I took a watch”.

“What’s Gone?”

This can be played in either a small group or with you and the child on your own.

Four or five objects are placed on the table.

Ask the child to look at the objects for a few minutes. Then, when the child’s eyes are closed,

something is taken from the table. The child has to guess what’s gone, saying “you took …”


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More on Regular and Irregular Past Tense:

Tell Stories

Puppets can be used. Act out a sequence using the puppets and encourage the child to re-tell the story in

the past tense.

Look at a story with your child and encourage him to re-tell the story, perhaps after just a few pages.

Collect a few noise-making instruments behind a screen, for example, a drum, a trumpet, a bell.

(Homemade instruments can be made from dried peas, etc., in yoghurt cartons.) One child

disappears behind the screen and plays an instrument. The other members of the group have to guess

what he did; for example :

“He rang the bell.”

“She banged the drum.” etc.

Place a few objects in front of your child, for example, a purse, a pencil, a box, paper, scissors.

While the child watches, perform an activity, for example, put the pencil in the box. The child must

tell you what you did :

“You put the pencil in the box.”

Open the purse “You opened the purse!”

Close the box “You closed the box!”

Talk about :

“going to do things”

“doing something”

“done it”

Sorting stories

“Will it happen?”

“Is it happening?”

“Did it happen?”

Use words like :

“now”

“yesterday”


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“tomorrow”

“late”

to help, give a clue as well as the tense.

If you have a “days of the week wheel” then have “past, now, will happen” section on the outside which

can be moved around - “yesterday, today, tomorrow”

Sort time words into :

“Happened”, “is happening”, “will happen”

for example :

“yesterday”, “now”, “tomorrow”, “last week”, “next week”

Using words, do “odd one out” activities; for example :

Monday Tuesday slowly

next week tomorrow yesterday

April Monday Wednesday

night evening morning

Which is the odd one out and why?

Draw pictures of a sentence or make toys do what you say, for example :

“he is jumping”

“he will eat his dinner”

“he ate his dinner”

Which sentence is correct?

“Yesterday I will go to school”

“Yesterday I went to school”


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Passive Tense:

Say a sentence using the passive tense, for example :

“The horse was pushed by the man.”

Talk about what it means. Ask the child to act it out using toys.

When they can carry this out consistently, mix up active and passive tense structures and ask them either

to act out what they mean or to draw them.

Passive Tense Structures

The horse was pushed by the man.

The man was pushed by the horse.

The cat was pushed by the dog.

The dog was pushed by the cat.

The cow was followed by the dog.

The horse was watched by the man.

The sheep was chased by the cow. Active Sentences

The man pushed the horse.

The horse pushed the man.

The dog pushed the cat.

The cat pushed the dog.

The dog followed the cow.

The man watched the horse.

The cow chased the sheep.


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Resources

Rippon (1996) Worksheets on Past Tense and Irregular Past Tense Black Sheep Press

Semel and Wiig (1990) Clinical Language Intervention Program Syntax Worksheets The Psychological Corporation Harcourt Brace Jovanovich Inc.

Semel and Wiig (1990) Clinical Language Intervention Program Morphology Worksheets The Psychological Corporation Harcourt Brace Jovanovich Inc.


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Auxiliaries

Some children have difficulty remembering to use “is”, “am” and “are” before a verb - for example, using

“it raining” instead of “it is raining”.

The difficulty may be because in everyday speech we frequently use a shortened form, for example, “It’s

raining”, which is harder to hear. Try to emphasise the sound (for example, “’s”) in your speech to help

the child hear it.

The games are easy to play, and you may know some of them already. Choose the ones that you think

the child will like best and have fun playing them together. (You do not need to do every activity

suggested.)

Try to set aside a short amount of time each day to play the games. If the child finds them difficult to

begin with, don’t give them up - it can take time to learn how to develop the use of auxiliaries.

1. Miming

This is suited to group activities. The children take it in turns to mime an action suggested by an

adult. One member of the group at a time guesses. For example :

“He’s eating.”

If they are correct, the child miming is then encouraged to say “I am eating” by asking him “What

are you doing?”.

More than one child could mime at the same time to provide practice for “They’re eating” and

“We’re eating”.

2. Descriptions

Using pictures, such as the ones provided, encourage the child to describe the pictures, for

example :

“The baby’s sleeping.”

Give the child a “reward” if they describe the picture well, for example, a Lego brick towards

building a toy, a sticker for a picture, etc. You could also describe what people are wearing as a

guessing game, for example :

“He’s wearing trousers.”

3. Emphasis in an Argument

Puppet stories can be set up where arguments take place along the lines of Punch and Judy, for

example :

“The baby’s crying.” “Oh no, he isn’t.” “Oh yes, he is.”


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Questions

There are many types of questions and there is a normal developmental order in which children learn to

understand and answer them.

Generally, young children first learn to respond to questions about their immediate environment. These

usually require simple short answers. Examples include :

“What is it?”

“Who is that?”

“Is it mummy?”

Later, children are able to deal with simple questions – things outside their immediate situation, like

those related to past events, for example :

“Did you go to the park?”

“Where have you been?”

“What did daddy give you?”

As children’s’ memory, vocabulary, reasoning skills and knowledge of the world develop so does their

ability to deal with questions that draw on these skills. For example :

“Why did you do that?”

“Where do we go to see…”

“What is the opposite of hot?”

“First hand” experience will always make the question easier to answer.

Overall, questions beginning with “How…” are the most difficult to answer. This is because they require

both reasoning and explanatory skills.


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Children also learn to reply to routine type questions such as :

“How old are you?”

“Where do you live?”

“When is your birthday?”

This is because they hear them repeatedly and they learn how to reply.


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Recognising Difficult ies in Responding to Questions

Children with language difficulties may have problems in both understanding and responding to questions.

Their development of these skills may not follow the usual pattern. However they are likely to find it

easier to deal with simple questions related to immediate events and concrete ideas.

The child may :

1. need questions to be rephrased before he can answer them;

2. find choice difficult, for example : “Do you want to go on the computer or finish the maths?”

3. not respond appropriately in conversation even though the answer may be predictable;

4. repeat the question or respond by opting out and saying : “I don’t know”

5. Confuse the type of question asked, for example : give a “who” response to a “where…” question or tell “how” instead of “why”?

6. Take a greater than average time to understand and reply to questions generally (this becoming more obvious as the questions and required responses become harder).

Children have to answer many questions throughout their day. It is important that they learn to cope with

the hard questions as well as the easy ones.


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Question types can be broken into four groups moving from easy, concrete types to more difficult abstract

ones :

Level 1 Questions Involving naming and recalling; for example: “What’s that?” “What did you see?”

Level 2 Questions Requiring more information from the child; for example: “What’s he doing” “Where is the dog?” “Who’s got the book?” “Which one is an animal?” “Which one is big and blue?”

Level 3 Questions Involving even more thinking; for example: “What could we use?” “How are these different?” “Which one is not a cup?”

Level 4 Questions Requiring prediction, formulating solutions, explaining problem solving; for example: “Why is he crying?” “What would happen if…”


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Activities for Level 2 Questions

Ask about things that you really want to know; for example :

“What-doing” Dad is working outside, so say : “What’s dad doing?” to which the child might respond : “He’s working on the …”

“Where?” When tidying away, say : “Where will I put the pens?” to which the child’s response might be : “in the drawer”. (If the response is just “There”, you could say something like : “Where? On the floor?”)

“Who?” You are at the child’s table and say : “Who’s got the glue?” and the child would say : “Me” or “Sarah” … etc.

Remember, if you ask the child a question and he does not respond, simplify the task so he experiences

some success and doesn’t become frustrated. Work through the following simplification techniques until

the child can respond; for example : when asking the question :

“What is he doing?”

1. Wait Give the child time to process the question and respond.

2. Gain the child’s attention If the child is not concentrating on the task, say : “Look!” and gain his attention.

3. Repeat the question

4. Wait

5. Give an alternative choice For example : “Is he watching television or sleeping?”

6. Give a model For example : “Oh! He’s sleeping”


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Remember that children will be more likely to answer questions if you really need to know the answers,

so :

Do ask questions about people or things that are not in the room. For example :

“What’s Mr.. doing?”

“Where are my scissors?”

Ask questions when you know the answers will have an effect; for example : “Where will I put the pictures?”.

Say absurd things to get a response; for example : “Where will I put the pictures?”

“On the floor?”

Don’t ask redundant questions. For example :

“What am I doing?”

or “Where’s my shoe?”

when it is perfectly obvious that you know. However, do ask :

“What will I do?”

and “Where will I put it?”

as long as the items you are talking about are actually there.

You need to create interest within the child in order to get the most out of him. Here is a list of further

games and everyday activities you may like to use :


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Puzzles and Barrier Games

You are doing a puzzle and need to find all the pieces (“set in” puzzles are best). Put a barrier between you and the other players. Split the puzzle pieces between other players and say, for example :

“Who’s got the dog?”

The child must tell you, for example :

“I’ve got it.”

or “Charlie’s got it”.

Have pairs of action pictures, for example : someone running, someone jumping, … etc. Give one of the

pictures to each player (a maximum of two pictures given to any individual).

You have to find the picture the child is looking at (you might get another person to help). You ask :

“What’s he doing?”

The child tells you, for example :

“Running.”

You hold up the picture and see if it’s the same one.

Cutting and Gluing

Make paper hats, collages, and picture scrapbooks. Ask the child to give you directions, for example :

“I’ve got the scissors. What will I do?”

or “Where will I put the glue?”

Before you start you put the things you need in different places and ask the child, for example :

“Where are the scissors?” … etc.


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Outdoor Games / PE

Have turns telling the other person what you will do together. You say :

“Let’s run!”

and both of you run.

Ask the child :

“What will we do now?”

The child could say :

“[ Jump | skip | hop | throw | … etc ]”

Remember, if the child does not respond, to give alternative choices initially, for example :

“Shall we run or jump?”

Reading Books

You can read books with the child and ask questions intermittently, for example :

“What’s the boy doing?”

“Where’s the dog?”

“Who’s got the dog now?”

Don’t ask too many questions, though, as it may become boring. Remember to comment yourself about

the pictures as well, for example :

“Look! He’s pushing the car!”.

Tidying Away Activities

Ask for instructions; for example :

“What will I do?”

“Where’s the …?”

“Where will I put it?”

Comment about dirty hands, dirty tables, etc., saying :

“What will we do?”.


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Cooking

Make easy things (for example : sandwiches, coloured drinks, popcorn, pancakes, iced biscuits, etc.,

asking questions such as :

“What am I doing?”

“What will I do?” (when you have the spoon in the glass,

ready to stir.)

“Where will I put the … ?” (you have finished the cooking and are looking for a place to put

it.)

Guess Who

“Who has blue eyes and blonde hair?”

Where’s the Spider?

“Hunt the spider”


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Moving on to Other Level 2 Question Types

These include :

Identifying By Function “Which one can run?”, “What can I cut with?”

Activities

Barrier games – using pictures or objects; for example :

“Who’s got one you cut with?”

“Who’s got one you sit on?”

Cooking

“What can I stir with?”

“Which one can I eat?”

Identifying Two Attributes “Who’s got something big and blue?”

Activities

Barrier games

“Who’s got something big and blue?”

You need big and little things in various colours so that the child has to make a choice.

Cooking

Have everything you need lined up on a worktop. Say :

“I need something round and green” (for example : apple)

Reading books

Look at the pictures and ask questions and saying, for example :

“What has four legs and horns?”

Identifying Parts of Objects “Which one has wheels?”

Activities

Cooking – “Show me the handle of the cup”

Books – Look at the pictures saying, for example : “Which one has got legs?”, “Where’s the lid?”

Dolls and toys – Ask where parts of dolls and toys are, for example : Where’s teddy’s tummy?”

Level 3 and 4 type questions are covered in the “Process of Hypothesis” Resource.


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Asking questions is a vital way of obtaining information. The skills involved vary according to the type of

question asked. They include :

1. An ability to use the rise in intonation at the end of a sentence or word

2. The ability to use question words

3. The ability to change the order of the subject and verb so that a statement becomes a question. For example :

“That hat is mine.”

“Is that hat mine?”

Having the underlying motivation to ask questions is a very important part of communication. It relies on

the ability to recognise that there is a gap in our knowledge and knowing how and where to seek out the

relevant information.

R e c o g n i s i n g D i f f i c u l t i e s i n A s k i n g Q u e s t i o n s Children with language difficulties often do not appreciate the function of questions. They may therefore :

1. not seek information

2. not ask for help

3. ask the same question repeatedly (even though the answer has been given) as a younger child might

4. use a question form without a real intent to seek an answer; not waiting for, or listening to, the reply

5. ask questions which are inappropriate to a topic of conversation


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Asking Questions

It is important that the child asks questions so that he is able to find out about things that he does not

know or things that he is interested in.

a) “What doing” for example : “What is he doing?”

b) “Who?” for example : “Who’s got the ball?” “Who’s running?”

c) “Where?” for example : “Where is the book?”

It is important that your child really needs to ask the questions. Some games and activities that will

encourage question asking are :

1. Puzzles / Barrier Games

1) Use “set in” puzzles. Set up barriers so that no one can see what pieces of the puzzles the other places have. Give the puzzle board to your child. They must ask “Who’s got the … ?” (so it is really important that the child can’t see who’s got

it!). An adult may have to sit with the child and model the questions at first.

Don’t pressure the child to ask the question absolutely correctly. These are hard and take time

to master, so keep giving clear models.

2) Barrier games. Two players sit opposite each other with a barrier between them. One player selects a picture and the other player asks questions to find the same picture on their own side of the barrier. Use pairs of pictures of people doing things :

a) The child picks a picture.

b) You say “What’s she doing?”

c) The child says, for example “She’s sitting on chair”.

d) You find that picture.

e) You pick a picture.

f) The child says “What’s she doing?”

g) You say “She’s eating an apple.”

h) The child finds the picture. Again, someone may need to sit with the child to model the question for him.

2. Shopping Put all the groceries in different places, for example : in the fridge, in a cupboard, on a shelf, …

etc. The child must ask, for example :

“Where’s the butter?”

Take turns at being the shopper and the shopkeeper.


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3. Puppets Have a puppet show (puppets can easily be made from socks). Have conversations with the child

pretending that the puppets are talking. Say, for example :

“What’s your name?”

“What are you doing today?”

“Where’s your mummy?”

“Have you got any friends?”

“Who are they?”

Then encourage the child to get his puppet to ask questions about yours. Say “You ask me

something.”

You could get the people in the family to play and model two-way conversations with the puppets.

Remember – asking questions is difficult for the child, so :

a) Do lots of modelling and provide support, for example : have someone to help during the barrier games.

b) Make sure the child really needs to ask a question, that is, make effective barriers :

ask questions about people who are not in the room.

get the child to ask things of other people.

Be patient. If the child is having difficulty – don’t push, accept a good attempt and model the correct question.


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Further Activities

1. Twenty Questions

Put an object or a picture unseen into a large envelope / bag. Working round a small group of

children, each child must ask questions to find out what the object may be.

The teacher models this first by allowing someone else to choose the object.

Encourage questions that proceed according to a hierarchy, that is, that become specific, for

example :

a) is it something to eat?

b) is it a fruit?

c) is it an apple?

2. Exploring Interesting Objects Encourage the children to bring in unusual objects or photographs. Be a good model by asking

questions about them yourself.

Bring in an object that the children have never seen before, for example : a souvenir from a

holiday, something from a hobby, … etc.

Discuss the object – where it was bought, how it was made, … etc. Next time encourage the

children to ask questions.

3. Guess Who? A popular game available commercially.

4. Happy Families. A popular game available commercially.

5. Bingo Make a bingo game with shapes of different colours and sizes. Each child has a board. As the caller,

you have a set of corresponding cards. As you turn over the cards, ask each child, for example :

“Have you got a red square?”

Each child in the group should then have a turn to be the caller.


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6. Make a Man. Cut out from sticky paper, circles for heads, rectangles for legs and arms, squares for bodies. Have

enough for each child to make three different men, each a different colour, for example : red,

yellow and blue.

Also cut 24 cards and colour the centres (using felt tip pens) such that there are eight cards of each

colour.

Shuffle the cards and place them face down on the table. Each child is given a large piece of paper

and then turns over a card and asks for a part of the body in that colour.

The game proceeds round the group with the idea being to make three men. When the first child

has his next turn, if a red card is turned again, he asks for a red body, but if a green card is turned

he begins a new man asking for a green head – each man must have the same colour body parts.

7. Beetle Drives This can be played in the same way as above but using body parts for a beetle.

8. Jigsaws The teacher or another child holds the pieces of the jigsaw. The child must ask for the next piece he

needs.

9. Interviews The children work in pairs. They ask questions to find out information about each other. Give the

children a topic to help them, for example :

“Find out about each others’ families.”

and if necessary give them some written vocabulary to help them, for example :

“sister”, “cousins”, “uncle”

Make a topic of the interviews. You could try producing a newssheet or articles for a newspaper.


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Plurals To start with, use real objects or pictures which have regular plural endings, for example :

brick(s)

book(s)

car(s)

truck(s)

square(s)

doll(s)

key(s)

bead(s)

shoe(s)

sock(s)

At story-time, in the home corner, working on shapes or colours all offer opportunities to let the children hear the plural form of a noun. For example, after sorting shapes in a small group situation, encourage each child to count how many of a

particular shape he has :

Teacher : “John, how many big circles do you have?”

Child : “One … …” (he pauses as he thinks).

Teacher : “One, two, three … .. you’ve got three big circles, haven’t you?”

Later, start to introduce nouns which sound an “-es” at the end, for example : horse(s)

match(es)

badge(s)

box(es)

dress(es)

nose(s)

Later still, introduce nouns with irregular plural endings, for example : child(ren)

foot (feet)

sheep (sheep)

goose (geese)

man (men)

woman (women)


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However, don’t worry if you use all of these types in the course of your day’s natural conversation with the children. The exposure to different vocabulary will also be beneficial. To start with, use real objects or pictures which have regular plural endings, for example :

brick(s)

book(s)

car(s)

truck(s)

square(s)

doll(s)

key(s)

bead(s)

shoe(s)

sock(s)

At story-time, in the home corner, working on shapes or colours all offer opportunities to let the children hear the plural form of a noun.

For example, after sorting shapes in a small group situation, encourage each child to count how many of a

particular shape he has :

Teacher : “John, how many big circles do you have?”

Child : “One … …” (he pauses as he thinks).

Teacher : “One, two, three … .. you’ve got three big circles, haven’t you?”

Later, start to introduce nouns which sound an “-es” at the end, for example : horse(s)

match(es)

badge(s)

box(es)

dress(es)

nose(s)

Later still, introduce nouns with irregular plural endings, for example :

child(ren) sheep (seep) man (men)

foot (feet) goose (geese) woman (women)

However, don’t worry if you use all of these types in the course of your day’s natural conversation with the

children. The exposure to different vocabulary will also be beneficial.


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Understanding “a” and plural “s”

Some children find it hard understanding that “a” means “one” and an “s” at the end means “more than one”. Usually these children require this to be taught in a structured way.

1 Listening Game Place the large card (See Appendix page 433) depicting a single cat in one half and many cats in the other

half in front of the child.

Count the cats on the card with the child. Explain to the child that when we say “a” before a word it means there is just one item, and when we say “s” at the end of the word it means there are more than one of the item. Have the smaller separate cards of “A Cat” and “The Cats” cut out and shuffled (so that they are in random

order) and placed in a pile, face down in front of the adult.

The adult takes the top card from the deck and names it (e.g. “A Cat” or “The Cats”). Encourage the child

to point to the correct side of the large card.

Show the card to the child so that he has visual feedback of the correct answer.

Encourage and reward the child by showing you are pleased if he was right.

1.1 Variations on the Game Use the large card showing “A Cat” and “The Cats” again, as a visual feedback for the correct answer. Use a variety of toys or objects on the table and ask the child to :

Pick up a particular toy using “a …”, or a set of toys using “the …s”

Post a particular toy using “a …”, or a set of toys using “the …s” down a tube

Stamp “a stamp” or “the stamps” on a sheet

Point to “a …”, or a set of “the …s” in a complex picture, or in a book

Play “Simon says …” type listening games (e.g. “point to the windows” or “point to a door”)


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Developing the Use of Pronouns The following activities will give you some ideas for helping your child to developing the child’s the use of pronouns, for example :

“he”, “she”, “they”, “his”, “him”, “her”

The games are easy to play, and you may know some of them already.

Choose the ones that you think your child will like best, and have fun playing them together. (You do not

need to do every activity suggested.)

Try to set aside a short amount of time each day to play the games. If the child finds them difficult to begin with, don’t give them up. It can take time to learn to listen and remember.


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Using “He and “She”:

1. Place the enclosed oval pictures of a girl and boy (See Appendix page 422) on the table and place action pictures involving boys and girls face down in a pile. Encourage the child to turn over a picture and say whether it is a boy or a girl. If it is a boy say :

“We say he for a boy.”

and encourage him to put it in the right oval and then the child can tell you about the picture, for

example :

“He is swimming.”

Repeat with the remaining pictures, taking it in turns to turn one of the cards over.

2. Look at action pictures of people doing different things, for example :

“She is running.”

“He is jumping.” … etc.

This activity can be made more fun by turning the pictures face-down in a pile. The child must turn

the first picture over and describe what’s happening, using the correct pronoun. If he is correct,

reward him with a turn in a game, for example, snakes and ladders.

3. Within a group, a child is given an action picture and must mime what is happening, for example, a picture of a girl swimming. The other children must guess what is happening, for example :

“She is swimming.”

This game can be played in a group at school, or at home with brothers and sisters, etc.

4. Pick out a boy and a girl from a group. A third child must look at them and try to remember what they are wearing. The teacher makes the third child turn his back on the children and then says, for example :

“Who’s wearing a red jumper?”

Encourage the use of pronouns; if the child says, for example :

“John is wearing a red jumper.”

say “Yes, so we say he is wearing a red jumper.”

The game can be adapted for hair colour, eye colour, … etc.


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5. Draw two blank faces. Explain to the child that one will be a girl and one will be a boy. Give the picture of the girl some hair and then say :

“Now he needs some hair!”

“She needs a nose.”

… etc.

Encourage the child to join in.

This game can also be adapted using cut out pictures to represent monster-type facial features.

6. Discuss pictures of well-known people with the child, for example, a member of the royal family, a well known pop-star, etc. Talk about what they do, for example :

“She sometimes entertains important people” … etc.


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Using “His”, “Him” and “Her”:

1. Using a picture of a girl and a boy, encourage your child to colour parts of one of the pictures, or to

add certain features, using sentences such as :

“Let’s give him black trousers”

“Let’s give her a big nose”, … etc.

2. This next activity needs to be played in a group. Choose a boy and girl from the group and give each a shopping bag.

Make up a story about a naughty baby brother who goes shopping with them and keeps taking things

from the shop and putting toys, etc, in their bags. This can be acted out.

The remaining children have to guess where the missing toys are :

“It’s in her bag”

“It’s in his bag”

etc. …

3. Place a girl doll against a drawing of a house with a garden; do the same with a boy doll. You could also use a selection of farm animals which have “escaped from a nearby field”. Say :

“Put the boy in his garden.”

“Put the horse in her field.”

… etc.

Reverse the roles.

4. Play lotto games, etc. in a small group with another boy and girl. The child can be encouraged to say whose turn it is; for example :

“It’s his go.”

“It’s her go.”


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Using “They”:

1. Within a group, a couple of children are given an action picture and must mime what is happening,

for example, a picture of a girl swimming. The other children must guess what is happening, for example :

“They are swimming.”

This game can be played in a group at school, or at home with brothers and sisters, etc.

2. The child is given two boy manikins and sets of clothes. Say :

“He’s going to wear shoes.”

The child gives shoes to one of the manikins only. Then say :

“They are going to wear jumpers.”

The child gives jumpers to both of the manikins.

Give the child a turn in telling you what to do.

3. Use enclosed oval pictures of a boy, a girl and a group of people as well as action pictures which include some with two or more people doing actions to elicit “they” (are running, … etc.) Place the pictures on the table face down in a pile.

Encourage the child to turn over a picture and say whether it is a boy or a girl or (a group of) people.

When it is a group say :

“We say they for more than one person.”

and encourage him to put it in the right oval and then the child can tell you about the picture, for

example :

“They are swimming.”

Repeat with the remaining pictures, taking it in turns to turn one of the cards over


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CONCEPTS 6.1 Strategies:

Acquiring Vocabulary or Concepts

1. General Organisation Help the child :

Teach him routines

Encourage tidying up in set places This helps him to understand that things belong in sets and is crucial for learning new words and

storing them.

2. Reinforcing Learning | Language Create opportunities for reinforcing [ learning | language ] in everyday classroom activities.

It is essential that new language is generalised to lots of different situations and doesn’t just remain

in the [ taught | learnt ] context.

3. Use Repetition Be repetitive in your teaching of new [ concepts | vocabulary ].

4. Plan, Do and Review Help the child with a [ task | activity ] by encouraging him :

Plan - talk about what you are going to do, your aims, the resources you need, … etc.

Do - whilst carrying out the activity, name the resource and describe what the child is doing, going to do next, … etc., in short sentences.

Review - after the activity is completed, encourage the child to think and talk about what he has done. Help him to structure this by using words like “first …”, “then …”, “last …”.



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6.2 Activities:

Concepts

Note These activities are not ordered in a developmental progression.

Work on one concept at a time

When teaching concepts ensure that the child is given plenty of opportunities to learn them in lots of different situations. Make them as concrete as possible so that they are more easily remembered. While you are working on a particular concept try and bring the words into what you are doing in everyday situations, for example :

“We’re going to the shops first” “Can you get me either the red socks or the blue ones” … etc.

Work on each concept should be carried out in stages :

1) Experiencing the word

2) Isolating the word / phrase and working on it in a structured game

3) Adding more information

4) Generalising the understanding to different situations.

Work with objects first, moving to understanding in pictures.

Specific Examples

In the following pages are some activities to develop understanding of some commonly used concepts in the classroom.

In / On / Under

Big / Little

Behind / In front

Or, or vs and

Not

And then

Long / Short

Next to

First / Last / Middle

Before / After

Some

When I – you

Except

Other concepts you might choose to work on in similar ways include :

Full / Empty

Wet / Dry

Slow / Fast

Few / Many

Up / Down

Happy / Sad


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1. “ In” , “On” and “Under”

Check whether the child understands the meanings of “in”, “on” and “under”.

Put a bag on the table and ask him to put an object in different positions in relation to the bag.

For example, give him a toy car and tell him you want him to listen carefully and do what you ask.

Ask the child to put the car in the bag. It is quite natural to put things into bags so you can’t be

absolutely sure that he has understood the meaning of the word “in”. However, if you now ask

him to put the car on the bag and he is able to, you know he understands both “in” and “on”.

If he succeeds with both “in” and “on”, you can check that he understands “under”, by asking

him to put the car under the bag.

If the child understands “in”, “on” and “under”, give him some more practice with all three prepositions, making a game of putting different things in different positions, pointing out where objects are in pictures (for example, the cat is under the table, etc.).

If the child does not understand all of the prepositions, teach the one he doesn’t understand by giving him lots of examples of the meaning in everyday situations.

For example, if he doesn’t understand “under”, make lots of opportunities throughout the day to

point out things which are under other things (for example, you can’t find his socks, because they

are under his jumper).

Or, for example, engineer the putting of objects under other objects (for example, “please put

my bag under the chair”), or point out the position when looking in books (for example, “Look at

Spot, he’s under the tree”).

If the child doesn’t understand any of the prepositions, work on one at a time (as described above)

When you are confident that he understands one of them, introduce another one.

When he has had lots of exposure to the preposition you are working on, you can begin to play games with him where he has to understand only the one key-word, i.e. “in”, “on” or “under”; for example :

“Put it on”, “Put it under”


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Once the child can consistently follow instructions at this level move on to two key-words in an instruction.

Have two items that objects can be placed in / on / under. Give the child an object and ask him to

:

“Put it [ on the chair | under the chair | on the table | under the table ]”

The next step is understanding at a three key-word level.

Have a selection of small toys and dolls house chair, table and bed. Give instructions such as :

“Put the shoe on the chair”

“Put the brush under the bed”

It is often helpful to have some pictures that match the objects you are using, e.g. a picture of a [

mouse, spider and snake ] on or under a [ bed, chair or table ]. You can then look at the picture

secretively, saying, for example “Put the mouse under the table”. Once the child has carried out

the command, show him the picture – cheer if it’s correct!


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Choose from the following set of activities whilst taking into account the child’s level of ability.

Make an obstacle course for some teddies (or the child) round the room (going under or on chairs, tables, etc).

If several children are playing, they can take turns to be the leader and call out.

Play a “hide and seek” game where the child leaves the room while you hide a favourite toy in, on or under something. When he returns, tell him where the toy is (for example, “it’s under the table”) and the child finds it.

Draw a picture with the child and suggest putting things in, on or under other things, for example, “a cup on the table”, “a teddy under a car, with just his head poking out”.

Put out some coloured bricks and give the child a collection of farm animals – “Put the cow on the red brick”

Make up clues for a treasure hunt and then hide them round the room.

Make sure the clues follow one another logically so that if Clue 1 says “Look under the table”,

Clue 2 must be hidden under the table.

Put a small prize in the last hiding place.

“Simon says – Put your hands on your head”, “… sit under the table”

Hunt the thimble / using toys to hide – “where’s teddy hiding?”

Looking at books – for example : “Where’s Spot?”


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2. “Big” / “Little”

To begin with, it is important to check that a child can recognise the physical difference between “big” and “little”, before learning the label for it. So, give lots of practice in sorting big and little samples of the same objects - big and little [ bricks | spoons | pencils | toy cars | etc ].

The next stage is to help the child choose between a big and a little object.

Start with just two objects (for example, a big and a little cup) ask your child to give you either

the big one or the little one. The child has to understand the words “big” and “little” only.

Slowly add more big and little pairs of objects so the child has to choose between “big and

little” and “teddy and duck” for example.

Gradually make the request even more difficult. So, you might ask him to “Give the big cup to

the dolly” or the “Give the little cup to the teddy”, or alternatively, “Put the big teddy in the

car”, etc.

At the same time, use big and little in your everyday conversation with the child. Expand what he says, if appropriate, with a word that describes what he is talking about. For example, if he says :

“bus”

when looking at a picture, you could say to him :

“Yes, it’s a big bus, isn’t it!”

When looking at books with the child you can also point out big and little things.

Other activities to choose from :

One-word level

Find a range of toys, for example : one big cup and one little cup, one big plate and one little plate, or spoon, or car, etc.

Ask the child :

“Find the big car.”

“Find the little spoon.”

and then post them in a cardboard box.


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Two word level

Move on to teaching two key-words together, using any big and little toys or objects, but making sure

that the child now has to understand two words to carry out requests.

Find a big and a little doll, a big and a little teddy. Ask :

“Where’s big teddy?”

“Where’s little dolly?” … etc.

If it is too hard, give a “clue”; for example, if he points to big dolly instead of little dolly, pick

up big dolly, saying :

“This is big dolly – where’s little dolly?”

using your free hand to point out the remaining toys.

Find two cardboard boxes for holding toys of the same shape but different sizes. When tidying up toys, ask the child, for example :

“Put teddy in the big box.”

“Put the car in the little box.”

Draw a big house and a little house. Then ask the child to colour in the big window or the little door. You can do the same with big and little faces, for example :

“Colour in the big nose.”

“Colour the little ear.”

Play a dressing-up game with different sized articles of clothing. Comment on what the child is wearing; for example :

“Look at the big hat.”

“Try on the little T-shirt.”

Then try giving the child instructions :

“Put on the big shoes”

Ask him what he is wearing.


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Three word level

Resources : a big and a little dolly a big and a little teddy a chair a table

Ask : “Put the big dolly on the chair.”

“Put the little teddy on the table.”

… etc.

Resources : a big and a little dolly a big and a little teddy

Ask : “Make the big teddy jump.”

“Make the little dolly sit.”

… etc.

Resources : a big and a little dolly a big and a little teddy objects

Ask : “Give the brick to little teddy.”

“Give the spoon to the big dolly.”

… etc.

Resources : dolly teddy a big and a little chair a big and a little table

Ask : “Put teddy on the little chair.”

“Put dolly on the big table.”

… etc.

Resources : teddy a big and a little chair a big and a little table

Ask : “Make teddy stand on the little chair.”

“Make teddy jump on the big table.”

… etc.

Resources : dolly teddy big and little bricks big and little spoons

Ask : “Give the little brick to dolly.”

“Give the big spoon to teddy.”

… etc.

Resources : big and little cups big and little plates a spoon a fork

Ask : “Put the spoon in the little cup.”

“Put the fork on the big plate.”

… etc.


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3. “Behind” / “ in front”

Once a child can understand the basic prepositions “in”, “on” and “under” you might like to start

working on other position words such as “behind” and “in front”.

As well as adapting the activities listed above you could also try the following :

Play “follow my leader” type activities – stress that “… … must stay behind … … …”

Roll the ball behind you.

Number all the children. Then call out a number and everyone has to run and line up behind that person.

If there are a lot of children (i.e. too high memory load) ask the children to put their hands up

if their number is called so that everyone knows who to line up behind.

For younger children, set out chairs to make a pretend bus and saying, for example :

“John, you sit behind Kate.

Matthew sit behind … … and … …,”

… etc.

Then ask :

“Where’s John?”

“He’s behind … …”

Use farm animals or Playmobil.

“Put the car behind the bus”

“Put the cow behind the hedge”

… etc

Look at pictures in books and ask :

“Who is behind the chair?

Where is the baby?”

… etc.

Drawing to instructions. For example :

“Draw a ball behind the chair”.

Once the child consistently understands “behind”, you can introduce similar activities to work on “in

front”.


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4. “Or” - “Give me the red one or the green one”

1. Experiencing the word in everyday situations. In as many situations as possible offer choices, for example, at breakfast time :

“Do you want Weetabix or Shreddies?”

“Do you want to watch x or y video?”

“Shall we read x or y book?”

When you offer a choice emphasise the word “or”. It may be helpful if you hold the two

choices for him.

2. Isolating the word / phrase and working on it in a structured game – explain that “or” means we have to choose one.

3. Adding more information

4. Generalising the understanding to different situations.

Activities

Putting items away

Posting items down a tube

Pointing to pictures in a book

Once the child understands the concept individually you can begin to work on contrasting it.


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5. “Or” vs “and”

Explain that “or” means we have to choose one, “and” means we can do both.

The following worksheet might be useful.

Understanding “or” vs “and”

“Or” means we have to choose one, “and” means we can have more than one.

Work through the examples with the child. Ask him to identify how many items are offered in

each example below. Circle the right answers.

1. Tim can have an apple or an orange 1 2

2. Ben can have a chocolate biscuit and a plain one 1 2

3. Ann has a cat and a dog 1 2

4. Andy can have a biscuit or a drink 1 2

5. Tom’s going to draw a house or a man 1 2

6. Bob drew a plane and a train 1 2

7. Mum is going to have a sandwich or a cup of tea 1 2

8. Dad is going to have an apple and some crisps 1 2

9. Joe is going to have coke or orange 1 2

10. Holly is going to go on the train and the bus 1 2

11. Robert will go by car or by bus 1 2

Make up some ideas of your own.

Listening game – Use “and” or “or” in instructions for the child to follow.

Putting away game – “Put away a brick or pencil”, “Put away a book and a rubber”

Building towers – “Use a red and blue brick”, “Use a big or little brick”

Colouring in – “Colour in a tree or a house”, “Colour in the trousers and the jumper”

Stamping shapes – “Stamp a bus and a car”, “Stamp a man or a dog”

Simon says … – “Touch your nose and your chin”, “Touch your ears or your cheeks”


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6. “Not” - “Point to a dog but not the one that is eating”

1. Experiencing the word

You will probably have to set up situations to allow the child to experience “not”; for example :

“Why is the tape recorder not working?” – It has no batteries in.

“Why is the drink not coming out?” - The cap is still on.

“Who has not got a book?”

2. Isolating the word / phrase and working on it in a structured game

Talk about what “not” means. Work through pictures. Draw two faces but miss a part on one,

for example, the eyes. Then ask :

“Which one has not got eyes?”

The child can then draw on the eyes. This activity works with faces, houses and stick people

holding items (such as balloons and ice creams). You can extend it to colouring in clothes on

people; for example :

“Who has not got red trousers?”

Children usually enjoy this activity and learn “not” in this situation quite quickly. It then needs

to be generalised to other situations.


4. Generalising the understanding to different situations

Emphasise “not” by adding additional cues, e.g. shaking your head.

Activities

Use toys

Have two toys and two sets of items for them, e.g. two cups, two plates, two spoons, etc. Put

the toys on the table.

Let the child have one set of items in a bag, take them out and give them to the toy of their

choice. You can then use the other set and say :

“Who has not got a [ cup | plate | spoon ]?”

Similar games can be played when drawing or colouring pictures, putting clothes on toys, etc.

Using reasoning skills


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At small group time you can talk about different items that the children

have or do not have, for example :

“Who has not got blue shoes?”

It can be made fun by the child needing to do actions :

“Stand up if you have not got long hair.”

At first, use body language clues and emphasise the “not”, then decrease the additional clues,

encouraging the children to listen carefully so as not to be caught out.

7. “And then” - “Point to the cat and then to the bird”

Talk about the order the actions need to be done in.

Activities

Body parts “Touch your nose and then your elbow”

Putting away game “Put away the cars and then put away the man”

Building game “Find the red bricks and then the blue ones”

Looking at pictures “Touch the tree and then the dog”

8. “Long” and “Short”

Begin by collecting pairs of objects, differing only in their size, for example, a long and a short sock, a long and a short pencil, etc.

Put the pairs of items next to one another (for example, the two socks).

Talk about them to the child, saying :

“Here’s a long sock, here’s a short sock.”

Encourage the child to sort the long items into one pile and the short ones into another pile,

talking about it as it is done, for example :

“Let’s put this short pencil with this short sock.”

Other Resources : Long and short strands of wool

ribbons scarves

elastic rulers

… etc.

During constructional or creative play, talk about what the child has made. For example, if a train has been made out of Lego, you can say :


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“That’s a long train! I’m going to make one too.”

(Make your train shorter.)

Draw the child’s attention to the two trains :

“Look, yours is a long train, mine is a short train.”

Draw some long and short snakes (or trains, etc.) for the child to colour in, for example :

“Colour the long snake.”

Draw two faces and cut some long and short strands of wool for hair. Using glue, stick a strand of wool to one of the faces, saying :

“Look, she’s got long hair!”

Stick a short strand onto the other face, commenting as it is done :

“This one’s got short hair!”

Lay out the different sizes of wool in front of the child, asking him :

“Find a long piece”

and helping to stick it onto the face.

Give the requests in random order so that the child cannot predict what he is going to be asked

to do.

Use musical instruments, such as whistles or recorders for playing long and short notes with lots of examples.

After giving examples, ask the child to play :

“a long note”

“a short note”

at random.

Long and short roads

You need a selection of cars, vehicles, etc.

Draw a long road and a short road. With your finger, show the child the long and short road,

labelling them as you do so.

Ask the child to take the cars along the roads in random order so that he cannot guess what

you are going to ask next.


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9. “Next to” - “Point to the elephant next to the giraffe”

Activities

Animal Game

Line up a selection of farm animals and Playmobil characters.

Get one of the children to shout instructions such as :

“the man next to the pig go into the box”

“the cow next to the dog go into the box”

etc.

Looking at pictures

Ask the child to point to people or objects that are next to things.


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10. “First” / “Last” / “Middle”

“Point to the first elephant in line”

“Point to the last bird”

“Point to the animal in the middle”

Work on one at a time. When understanding of one is established move to the next. Children usually develop understanding of “first” before “last”.

1. Experiencing the word – Bring the words into what you are doing in everyday situations, e.g. at “lining up” time, choose who should line up by saying :

“Who can be first to touch their toes?”

“Who can be first to put their hands on their heads”

… etc.

As the children are lined up, talk about “the first” in line and “the last” in line.

2. Isolating the word / phrase and working on it in a structured game – Talk about what “first” and “last” mean.



You can use similar activities to those detailed for “before” and “after”. You may also like to use some of the following :

During PE, spend a few minutes playing a game where the last person to reach one side of the room is “out”.

Play “Simon Says” games where the last person to act correctly is out. Use the games to use the words “first” and “last”.

Point out the first word on a new page to be read aloud. Ask the child to point to the first word and the last word on the page.

In picture storybooks, point out the “first” and “last” in any pictures of “line ups”, for example, at a race finish (“The Hare and the Tortoise”).

Line up toys and ask who is first, last, in the middle?

Putting away game

“Put away the horse first.

Put away the one in the middle”


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11. “Before” / “After”

These concepts are hard because the order we need to do things in is affected by the sentence structure

we use. For example in the sentence :

“point to the cat before you point to the fish” (Type 1)

the child is expected to point to the items in the order said. However, in the sentence :

“before you point to the fish, point to the cat” (Type 2)

you still have to point to the cat first – i.e. not in the order in which the items were said.

When a child doesn’t understand the concepts “before” and “after”, he will usually follow an instruction in

the order in which it is given. (So, given the direction :

“Before you sit down, give me the egg”

a child will ignore the meaning of “before”, and carry out the commands in the order given, i.e., “sit

down”, then “give the egg”.)

Use this to advantage by working on the Type 1 sentences first, so that the child is carrying out an activity

in the right order, before he is completely aware that order is an important part of the direction.

For example, ask the child to :

“Point to the cup, before you point to the spoon.”

Later, when the child is happy with instructions like these, progress to the second type of structure. Explain that he will have to listen hard and change the order of “before” in the sentence, for example :

“Before you point to the cup, point to the spoon.”

When he understands these consistently give him instructions using both sentence types 1 and 2.

Following this pattern, teach “before” first, moving on to “after” when understanding of “before” is consistent at every level.

As with “before” it is important to take care with how you teach “after”. First use instructions which begin

with “after”; for example :

“After you point to the pencil, point to the rubber.”

Later, place “after” in the middle of the instruction; for example :

“Point to the doll after you point to the teddy.”

When the child is understanding all the sentence types outlined, mix up “before” and “after”.

Following the structure for teaching concepts detailed previously you might like to use some of the following activities in working with the child.


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1. Experiencing the word

Bring the words into what you are doing in everyday situations,, for example :

“we’re going to the shops before we go to the park”

“we’re going to feed the ducks after we’ve posted the letters”.

2. Isolating the word / phrase and working on it in a structured game Talk about what “before” / “after” mean.



You can work on “before” and “after” when :

Playing instruction games

Giving instructions to build a Lego model

Pointing to pictures

Tidying away

For example,

Put out rows of items, this could be linked to a particular topic or subject that you are working on in class. For example, during science with an older child, put out science equipment or chemicals you might be using in a particular class. After the experiment has been completed / equipment used you could ask :

“Which item did you use before the …?”

and “Which did you use after the … ?”.

Similarly in English, talk about what came before the body of the text (i.e. an introduction)

and what came after (i.e. conclusion), etc.

When lined up, talk about who is “before” / “after” particular children.

During discussion of [ historical | geographical events | stories ], talk about :

“what happened before …”

“what next …”

“what happened after …”

Anything that grows or develops can be used to discuss “before” and “after”, e.g. plants, life of a frog, child-adulthood.

Use sequences to talk about what happens “before” and “after”, e.g. recipes - what do you need to do before you put the flour in? Planting a bulb, decorating your bedroom, making tea, etc.

Events in the day –Does breakfast come before lunch? Do you go to school after breakfast?

Touching parts of the body – Touch your nose before you touch your elbow

Putting away game – put away the cars before you put away the man

Building game – Build a tower with the yellow bricks before you build with the green ones

Looking at pictures – Touch the tree before you touch the dog


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12. “Some” - “Give me some of the bricks”

Discuss what this means, i.e. when we ask for “some” we mean “more than one but less than all of

the items”.

Practice understanding of this on its own, i.e. only use instructions containing “some”. When the

child is confident at this level, add other concepts. Choose between the following words – “a”,

“all”, “a few”, “most”, “one of”, “two of”, etc. explaining what each one means, and then use

them randomly. For example :

“Put away a blue brick” – meaning just one item

“Put away all the red bricks”

“Put away some of the yellow bricks”

“Put away one of the green bricks”

Activities

Putting away items

Posting items down a tube

Colouring in pictures

Putting stickers on a picture

Pointing to pictures in a book

13. “When I …, you …” - “When I point to the elephant you point to the giraffe”

Activities

Putting away game “When I say go, put a brick in the box”

“When I clap my hands put a red one away”

“When I put away a car you put away a man”

Looking at pictures “When I touch a tree you touch a flower”

Dressing up “When I put on the hat you take off the shoes”

14. “Except” - “Touch all the animals except the bird”

Activities

Putting away game “Put away all the cars except the blue ones”

Farm game “Put all the cows in the field except the black ones”


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SEQUENCING 7.1 Strategies:

Sequencing Language

1. Plan, Do and Review Help the child with a task | activity by encouraging him to :

Talk about what you are going to do, your aims, the resources you need, … etc.

Whilst carrying out the activity, name the resource and describe what the child is doing, going to do next, … etc., in short sentences.

After the activity is completed, encourage the child to think and talk about what he has done. Help him to structure this by using words like “first …”, “then …”, “last …”.

2. Spidergrams (Mind maps) Spidergrams are a useful method for planning a story, experiment, and essay and for reviewing and

summarising work.

It is useful for a child with language difficulties because it encourages the child to plan more visually.

Memory recall is assisted, sequential organisation is supported and maintenance of a topic is made easier.

Example - A Story Plan The story title must be in the body of the spider and referred to constantly. Each leg represents a paragraph or section of the story. Key words, pictures, symbols should be noted on the legs, in order, during the child’s brainstorming. The use of different colours is also helpful. As the story is transferred to paper, computer, … etc, the legs can be cut off, crossed out, … etc.

Introduction

Conclusion

Idea 1 Idea 2 Idea 3

Idea 4


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3. Mind Maps

The same principle can be used to give an overview or summary of things taught, for example, a review of a topic covered over the week. This method is called a mind map (Tony Buzan).

Example

Sequencing

Word-finding

Difficulties

Social Skills, etc.

Normal

Developmen

Language

Disorder


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7.2 Activities

Sequencing, Retelling and Explaining

Early Stage

The first stage is being able to order pictures into a story by being shown the pictures one at a time, and

being able to predict what will happen next.

Cut story strips up into individual pictures. Talk about each picture and ask what might happen next. If

the child doesn’t know or says something that is unusual or unexpected; for example :

a boy peeling a banana – what will happen next? “play football”

give him some alternatives, e.g. “Will he eat the banana or throw it away?”

You can also encourage these skills when reading a story and talking about what will happen next.

Talk about what you are going to do next during everyday routines. Sometimes you could draw a story of something that you have done during the day – see if the child can put the pictures in the right order and tell you what happened.


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Retelling and explaining are important features of human communication. They enable us to share

experience and pass on information when removed from the actual event.

At their highest level, these tasks are dependent upon :

a) Remembering the episode

b) Thinking of ideas

c) Being aware of the listener’s prior state of knowledge

d) Having an adequate vocabulary and ability to recall words

e) Being able to put words into sentences

f) Sequencing sentences and ideas to form a logical structure (that is, beginning, middle and end)

g) Being precise

h) Adjusting your language to suit the listener

i) Checking your listener is understanding

j) Having the ability to keep the interest of your audience (using, for example, facial expression, gesture, body language, different voices and accents).

k) Acknowledging the value of environmental props.


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Retelling 1. Recalling and retelling of events that happened earlier in the day, or the day before, for example,

outings, visits, special assemblies, … etc.

The use of photographs to help recall past outings, plays, … etc. is useful. The children can be

helped by someone asking questions.

2. Watching a video and retelling the story.

You could try stopping the action on a second run through and asking the child to tell you what

happened just before.

3. Use of classroom story books.

Short stories that are read by individuals could then be retold to the other members of the group.

The child could use the pictures in the book to help recall the story.

4. Picture sequencing.

Either published material (LDA, … etc.) can be used, or you can draw a story sequence with the

child, as you tell the story. Cut it up for him to order and retell the story.

Make the language simple at first and then go on to use longer utterances and more detailed

descriptions of the picture. Eventually use language that is imaginative and also abstract to link the

pictures.

5. Using a “Magnetic Way to Language” act out a story telling it as you move the people, … etc. around the board.

Encourage the child to :

tell your story to another adult or child who has not heard it before.

using the board to make up a story and have the child act out the story for you.

6. Use sound lotto stories.

Listen to the story and link the sounds heard to the pictures.

When the story is over, use the picture boards to help recall what has happened.

Listen to the story again to check if the answer was right. Make mistakes occasionally.

Can the child you are working with spot errors and tell you the correct sequence?


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7. “Chinese story”.

Make up a story and use a tape recorder to record it.

Play it to one child who then has to make his own tape retelling the original story.

The next child listens to the first child’s story and retells it.

Continue until everyone in the group has had a turn.

Listen to the stories from the beginning.

The children can talk about what they missed out or got wrong on their retelling.


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Explaining

In all of these activities, it would be useful for you to demonstrate how to explain things first.

1. The child can behave as a teacher explaining to the class | group how to do something he has done before, for example, laying a table.

2. The child has a picture of a model which he keeps secret. He explains to another child or a small group how to make it using the materials available.

At the end of the session, the children compare the picture and model and discuss where they have

gone wrong (or got it right!).

3. As above using Lego or other building bricks.

4. Working behind a screen, the child explains to another child how to make or draw something that is in front of him.

5. The child can explain to someone else how to carry out a simple daily task, for example, making a cup of tea.

He can be helped by using resources (including a teapot, cups and saucers,… etc.) as suggested to

him by you.

6. The child can be asked to explain how to do something, for example, how to get to the hall, to a younger child.

7. Using science activities (for example: cooking, broad bean growth, … etc.) the child can explain to others how to do an activity or what happened after it is completed.

8. Using a large scale map, the child can explain how to get to a specified place; for example :

“We are outside the library - tell me how to get to the cinema.”


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Extending Sequencing Activities

Use a set of pictures for the following activities that make up a story sequence. You can use as many

pictures as you feel the child is able to cope with. Preferably start with three picture sequences, gradually

building up the demands of the task.

The pictures can depict any story you like, e.g. a boy getting up, having his breakfast and then going to

school, or a balloon slowly being blown up and then popping, etc.

Mix up the pictures and ask the child to put them in the right order to tell the story. Note the order the child puts the pictures in and whether they are using left-right orientation.

Ask the child to tell the story, noting vocabulary used along with the grammatical structures employed.

Ask what might happen next – this targets prediction skills.

Ask the child “wh” questions, for example: who / what / where / why.

Ask the child how they know something, for example : “How do you know he is scared?”

Similarly ask how they would feel in that situation – this targets the child’s ability to recognise

and understand emotions and to empathise.

Ask the child to demonstrate understanding of language concepts, for example: first / last, before / after.

Ask the child to give a title for the story.

This shows an understanding of the “big picture”.


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Resources

Helen Rippon (1996) Black Sheep Press Sequencing Pictures, Tel 01507 358 669


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PROCESS OF HYPOTHESIS 8.1 Strategies

Prediction and Reasoning

Just as some children have problems in early language development so others experience difficulties with

higher language development. In some cases the problem is an extension of an earlier one; in other

cases the child has no history of early language problems but begins to struggle, as language becomes

more complex. Higher Level Language problems present a barrier to learning.

In English we often use words and phrases that have a meaning other than the literal one. Speakers also

sometimes express their meaning by implication rather than explicitly. For example we might say :

“Those look like new shoes.” meaning “Have you just bought them?”

“Those sweets look nice.” meaning “Please may I have one?”

“Your bedroom looks like a pigsty.” meaning “Tidy it up!”

Some children have to put so much effort into interpreting words that they find it difficult to use other

information such as context (for example, the speaker’s tone of voice, … etc.) in order to interpret what

is said.

Some children with language difficulties have a poor appreciation of the speaker’s point of view and may,

for this reason, miss the real meaning.

There are many metaphors and non-literal words and phrases in English; for example :

“Pull your socks up!”

“It’s raining cats and dogs.”

“You’re so sharp you’ll cut yourself.”

“You’re a bright spark.”

It is at around seven years of age that children begin to understand this sort of sentence, but children with

language difficulties will be much slower to do so, and may interpret such things literally in their teens.


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Problem Solving Skil ls

Problem solving is another essential higher-level language skill for learning in the infant and junior

classroom. It is required throughout the curriculum. For example, in number work, the child is required

to “make predictions based on experience” and in PE the child must use rules and know how to apply these

in a team game.

Problem solving is a skill used not only in the classroom but in all areas of the child’s life. The child who

knows from past experience that the boxes on top of the wardrobe contain his Christmas presents and gets

the chair from his room to climb up and reach them has used the skill of problem solving.

Problem solving is a complex skill which involves :

selecting the relevant information

organising and sequencing

making inferences

and predicting outcomes

The child uses verbal reasoning to carry out these different processes. He may talk through these either

audibly or using internal language. At a later stage he may use written language.

Selecting Relevant Information

To begin to think through a problem, the child needs to select the information relevant to the task from

the general information available.

Some children with language problems find selecting the appropriate information difficult; since they

cannot make this selection the whole situation can be overwhelming.


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Organising and Sequencing Information

Having selected the relevant information, the child must organise this material, and then sequence it

appropriately.

Sequencing and organisation can break down at every level in a child with a language problem. You may

notice this in his physical ability with difficulties in dressing and, in general, in activities involving gross and

fine motor skills.

Number work may also be affected.

In language work, he may find it hard to organise ideas and sentences; words and phrases within a

sentence may also be ordered incorrectly.

Making Inferences

After organising and sequencing the information, the child will need to draw conclusions from the evidence

he has collected. This will involve memory to recall past information.

In order to do this, the child needs to be able to classify and categorise and then make links between these

categories.

Predicting

This is closely linked with making inferences and again involves cross-referencing. The child needs to know

that he can predict the outcome of one situation because of his knowledge of similar, related situations.

In order to predict the child will also need the ability to plan ahead.


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Problem Solving

1. Visual Presentation Modelling For example, demonstrate a science “experiment”.

Encourage pupils to ask questions and make predictions about the experiment using language forms such as :

“What happened when …?”

“What do you think will happen …?”

“What if …?”

“How …?”

“Why …?”

“Which will be the best …?”

2. Visual Representation of Results Record on a chart or clear table what happened, use symbols rather than written material.

3. Hands-on Experience Allow pupils to repeat the “experiment” themselves or set up a similar experimental situation.

Encourage them to ask the questions and fill in a similar chart.

Examples of “experiments” :

a) Demonstrate what happens to pastry :

at room temperature

in the freezer

in a hot oven Pupils could repeat the experiment with ice cream and frozen fruit.

b) Supermarket test comparing different washing-up liquids on dirty plates – grade from worst to best.



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8.2 Activities

Problem Solving 1. Organisation

1. Any sorting activity will be helpful. The child will need to sort according to concrete properties, for example, weight, wet | dry, and more abstract properties, for example, things that roll.

2. “Odd One Out”

Use pictures or objects to decide which belong together and which are the odd ones out.

3. Cross categorising, to show that any one object is a member of a variety of different categories.

4. Collecting things up for the teacher at the end of the lesson, for example, all the scissors.

2. Sequencing

1. Let the child copy a sequence of shapes set out by the teacher.

2. The teacher sits behind a screen, makes a pattern, tells the child what the pattern is and he makes it. Remove the screen and compare the patterns.

3. Help the child to talk through a familiar sequence, for example, dressing, going to school, dinnertime at school, by drawing each stage. Make a personalised set of cards or a book.

4. Cooking is a very useful way to help develop the child’s sequencing skills. Talk about what you need to collect before you begin. Ask the child “What are we going to do next?” … etc.

5. Make up simple stories.

6. Act out well known stories, or the stories in the reading scheme.

7. Songs and rhymes. Sing the first line – can the child sing the next?

8. Let the child be a joint leader of a small group where the activity involves organising other members of the group, for example, in P.E.

9. Take the opportunity during festive times to let the child organise parts of the decorations, for example, where to put the Christmas tree.


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3. Making Inferences and Predictions

1. Ask the child to anticipate what may happen next at key points during the day, for example, just before P.E can he say what will happen, for example : “… get PE bag, change, go into the hall …”. Draw picture sequence stories of these activities.

2. Answer a quiz; for example :

“… the children have their P.E bags; they’re wearing shorts. What will happen next?”

Children are lining up with their full lunch boxes :

“what are they going to do?”

The children are lining up with empty lunch boxes, coats and reading folders :

“what is happening?”

Similarly, find some pictures of people in different clothing or situations, for example, in a

swimsuit, or with a suitcase. See if the child can tell you where they are going or what they

are going to do.

3. Sequence picture cards and say what may occur next.

4. Predict what may occur next in a story.

5. Ask the child to give you instructions in a familiar daily routine, for example : washing hands. Carry this out for real.

Only do what the child says, for example, if he says “dry hands” without saying “turn the taps off” first – don’t turn the taps off. Help the child to see the omissions

6. Make “prediction” pairs of cards with cause and effect, for example :

a house on fire and a fire engine

a boy climbing a tree and a boy eating apples

a man running and a bus about to drive away

The child must find the things that go together. Ask questions to prompt the child to think

about cause-effect relationships, for example :

“Why is the man running?” “Because his bus is leaving”

“How did the boy get those apples?” “by climbing the tree”

7. Using weather pictures and pictures of people in different clothes, see if the child can match the person with a weather picture (for example, shorts summer, umbrella rain).

8. If you make a calendar in the classroom, see if the child can select the appropriate weather picture for the day.

Use this opportunity to make predictions, for example, if it is raining what will happen at

playtime (that is, indoor play).


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9. Using sequence cards, see if the child can tell you what would have happened before the sequence begins and what will happen after the sequence ends.

10. For older children only – use a story that is currently in the news and see if the child can predict the outcome based on the information they have been given.

For example, there has been an earthquake – what are the consequences? Talk about people

being homeless. Ask the child :

“What will they need?” … etc.

11. Science experiment

Encourage pupils to ask questions and make predictions about the experiment using language

forms such as :

“What happened when …?”

“What do you think will happen …?”

“What if …?”

“How …?”

“Why …?”

“Which will be the best …?”

Use pictures of “problems” to consolidate all the above skills. For example :

a girl in bed, blowing her nose, with a box of tissues next to her

a scene of a kitchen with mum looking cross and some muddy footprints all over the floor

… etc.

You could give verbal descriptions of “problems” if the child is at a higher level, rather than use pictures,

for example :

“A little girl is in the playground at the end of the day and he isn’t very happy because all the other

children have gone home and he is still there”


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Note The following activities are drawn from “Think It Say It”

Inferential Reasoning

Can the child tell you what the problem is? – for example, the kitchen floor is all muddy and mum is cross because he has just mopped it.

Can he then tell you how he made that inference? – for example, there is a mop bucket pictured and mum looks angry.

Problem Solving

Can the child determine a solution via visual analysis or auditory? – What can the boy do to make his mum happy again? – mop the floor, say sorry

Can the child suggest how the problem could have been prevented? – the boy could have taken his shoes off.

Determining Causality

Why did something happen? – the boy had been playing football and came in the house without taking off his shoes.

Generalising

What will … do next? (lower level)

What will happen next? (higher level)

What was …. doing before …. (lower level)

What was happening before …? (higher level)

Assuming A Role

What will .. say to ….?

Applying General Knowledge

How can you tell … is in a kitchen?

What will the boy use to clean the floor?

Relating Personal Experiences

Do you have to mop the floor in your kitchen?

Where is it kept?


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Verbal Reasoning Skills

4. Describing items by their use (Function of items)

Discussion Of The Use Of Objects

During the day talk about what you are about to do and what you will need :

It’s time to get dressed – we need our …… (clothes)

It’s time to eat lunch – we need our ……(lunch box)

It’s time to do reading – we need our …..(books)

Describing Items

Have a pile of object pictures and a pile of description cards

Keep the description cards in this order.

What do we do with it?

What is it? (category)

Where do we find it?

What does it look like? (key feature)

Turn over the top description card and take it in turns to turn over an object picture and say what we do

with it. Only accept the main function, for example, bed – “sleep in it” not “put duvets on it”.

This can be reinforced in description games like “I Spy …” and action rhymes like “Here we go round the mulberry brush” – use an array of pictures or items in a box. Turn over one at a time or take one out of a feely bag and sing the appropriate verse.


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Describing Objects

To describe something we can use different features of the object. Try using these headings to describe:

a ball a fork a cup

an apple a cooker a hat

Object = sock Object

Category Clothing

Its function or use Wear it

What it looks like Has a hole at one end

What it does Keeps us warm

Where you find it Wear it on our feet

Keep it in a drawer

What it is made of Wool

Some features will have more than one idea beside them.

Which feature describes the item best?

Which features are relevant?

When the person you are working with is good at this, progress to games where you describe an object for each other to guess, or “20 Questions” type of games.


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Language Choices

These ideas are best carried out in a small group.

Explain that you are going to work on activities that will help the children to talk about their ideas more

easily. Encourage them to think about times when they have had problems getting their ideas out (e.g.

explaining to a friend about how to use a computer game).

Choice

You will need to think up some choice (i.e. a definite “yes”) and no-choice (i.e. a definite “no”) scenarios

to read aloud to the group in turn. They then decide if there is a choice or not. The others can agree or

disagree. For example :

Your teacher says “The whole class has a detention” – No choice

Your parent(s) say(s) “We need to think about our next holiday” – Choice

Collect pictures (for example : from magazines or catalogues) to make categories, for example, food,

holidays, hairstyles, fashion clothes. For each category show a selection of examples and ask the

students to choose one they like, emphasising they are making choices.

Link the concept of choice to language choices – explain that you have been thinking about choices and

that you also have to choose words to use when you talk. Write on a board or piece of paper “HAPPY” and

ask the students to think of all the words you might use to tell someone you feel “happy” (Repeat with

other examples, for example, “getting around”, “friend”.)

Importance

The students need to become aware of this to help them to be more relevant in their communication.

Write out multiple choice questions on card with the answer covered or on the back. Explain that you

have talked about choices but you can’t choose everything, you have to think about the best choices, i.e.

the most important things. Read out the multiple-choice examples and ask each student which choice

they think is the most important and discuss why. For example :

“When you eat a meal the most important thing to have would be …”

a) knife and fork

b) Plate

c) Food (Answer!)


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Silly Sentences

You will need to be selective and choose items suitable for the age, interests and experience of the child. Make up similar ones of your own, if they find certain ones hard. Can they make up ones for you? “What’s Wrong” cards can also be used.

Which sentences are silly? Can the child make them sensible?

The man sat on the TV

They made sandcastles at the seaside

The boy had long hair

They fed the lion at the farm

The snail sandwich was delicious

The cooker was in the kitchen

The hot drink had ice in it

He cooked his tea in the fridge

The coffee was hot

The man took his coat off because he was cold

You wear pyjamas when you go swimming

The bus had two people on it

The dog paid for the ticket

The cat slept in the garden

The duck swam in the bathroom

The boy cried because he was happy

Trains go on the road

The orange had lots of pips

He bought three blue bananas

Chocolate is pink

A fireman works in a hospital

We speak with our mouth

We use our ears to see


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Resources

Ideas for much of this area of work are taken from :

Dr. Wendy Rinaldi “Language Choices – Selecting and Organising Ideas for Communication” published by Wendy Rinaldi 18 Dorking Road Chilworth Surrey GU4 8NR

Practical Language Activities

Martin (1990) “Think It - Say it : Improving Reasoning and Organisation Skills” Communication Skill Builders, The Psychological Corporation


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PRAGMATIC SKILLS

9.1 Strategies

Acknowledgement The information in sections marked “*” has been taken from the NAS website.

1. Only Use Necessary Words * Try to remove any language that is not providing key information. For example :

Don’t say … “Would you mind coming over here and sitting down there on the chair?”

Do say… “John, sit here”

(and indicate with your arm which chair you mean)

2. Provide As Much Information As You Can * Although the child may be distressed by change, he will cope better if told in advance so he can anticipate

and prepare for it. For example :

Don’t … neglect to tell the child that his normal teacher is away.

Don’t let him find out when he walks into the classroom and sees that another teacher is

there when he is expecting his normal form teacher. This may seem like an easy option,

and you may feel that by doing this you are minimising his stress by delaying the bad

news. However, it is better to manage things before they happen, rather than waiting

for the (unpredictable) response. It is sometimes only when routines are broken that we

see how much children rely on them.

Do … prepare him.

“John, tomorrow, when you come to school, Mrs White will not be there. She is …

Mr Simon usually teaches you maths. Tomorrow Mr Simon will be your form teacher for

the day.”

Provide as much information as you feel the child needs. Be prepared to answer questions. Be honest, if you are not sure the teacher will be back the next day, say that. Explain what will happen in that eventuality. As long as the child is informed, he will feel more secure. Monitor any changes in the child’s behaviour – if he is more aggressive or obsessional, it may be that he needs you to reassure him about the change in routine and how it will affect him


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3. Be Positive * Don’t just tell the child what he shouldn’t be doing, tell him what he should be doing. For example :

Don’t say … “I don’t want you to throw the books all over the floor”

Do say … “John, pick the books off the floor. Put them into the library shelves”

4. Avoid Sarcasm * The child may have a very literal understanding of language. If you indicate that you want the child to do

something, use a direct style. For example :

Don’t say … “My, what a tidy desk you have!”

(in a sarcastic tone of voice, which you use to indicate that the desk is a real mess.)

The child may well take your words genuinely. This may seem infuriating – as though the child is being

cheeky, or perhaps even using sarcasm back. However, this reaction is almost always because of a

misunderstanding by the child. Sarcasm is a complex form of language, which some children with

social communication difficulties cannot understand, or use themselves.

Do say … “What a mess. Put these books in the library.”

5. Use Concrete Terms Wherever Possible * The child will have a better understanding of this sort of language. This point also ties in with providing

enough information to reassure the child. For example :

Don’t say … “We can’t do that now, we’ll do it later.”

Do say … “John, I know you want to go to lunch. We will have our lunch at one o’clock.”

If more questions are asked, try to respond (within reason). Obviously a balance needs to be drawn

between being informative and concise :

“We can’t go to lunch now. We still have some work to do. The ladies who put the tables and chairs out aren’t here yet. When the tables and chairs have been put out and when we have finished our work, we’ll go for lunch”.


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6. Tell The Child Why You Are Pleased With Him * Provide enough information when you are praising the child – so it is clear to him why you are happy with

his behaviour. This will encourage him to repeat this behaviour in the future. For example :

Rather than say … “Good boy”.

Say instead … “You’ve tidied the home area, that’s brilliant!”

7. Provide Extra Thinking Time * The child may need slightly longer to process the information you give him. Acknowledge this. If

necessary, come back to him a few minutes later for the answer to a question. If you know he has

understood the first time, try not to repeat yourself. This can be frustrating to a child who is trying to

respond but needs more time to formulate his reply.

8. Use A Home-School Book For a few children with more severe communication difficulties, it can be helpful to discuss the idea of a

home-school book with the parents. In this book messages can be written, pictures can be drawn and

interesting events described.

Knowledge of things said or done during the day at school or home :

gives parents and teachers topics for conversation,

helps a child talk about what they have done and

makes it easier for adults to identify what a child might be saying when speech is of poor intelligibility.

9. Encourage the Maintenance of a Topic of Conversation If the child tends to talk “off topic”, acknowledge what he is saying but tell him you will talk about it later,

for example :

“That’s nice - but we were talking about this story weren’t we?

We’ll talk about your birthday later.”

10. Encourage Turn-Taking In Conversation


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11. Encourage The Child To Be An Active Listener Play games where you either give him information that is too long, too jumbled, too hard, too sparse (on

information). For example, information that is too long might be :

“Before you pick up the large blue pencil, move it towards the box.”

Jumbled information might be :

“Put them all on the shelf by the sink.”

while you rustle paper as you talk.

Information that is too hard might be :

“The herbivores were walking into the field.”

Sparse information might be :

“Point to the small blue one.”

when there are several small blue items.

By playing these games it is hoped that the child will learn to identify listening problems and request

further help / information. Discuss what was difficult about each instruction. Pictures or symbols of

potential problem areas (i.e. symbols for “too long”, “too jumbled”, too hard” “too sparse”) may help

him to identify the problem - for example :

“It was too long.”

“You didn’t tell me enough.”

etc.

12. Check That You Have Understood The Child’s Meaning Don’t assume that you have understood, particularly if you have received an unusual or unexpected

answer. For example :

Teacher : “What did you do last night?”

Child : “Trains”

Teacher : “What did you do? Did you play with your train set?”


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13. Use Star Charts as a Self -Monitoring and Reward System Choose the headings to be worked on, for example :

Good Looking

Good Listening

Good Turn Taking At the end of each session, talk to the child about how he has done with each one. Encourage him to

monitor his own performance :

How does he feel he has done?

Where should he get a star?

What should he concentrate on tomorrow / next week? You may need to help him judge his evaluation more accurately. In the next session remind him of all the

“rules” and the one he really has to try hard with for the current session. Decide when he will get a

reward, for example, after 10 stars for a particular heading, and let him know this is what you are

working towards.

14. Encourage, Praise And Reward the child’s efforts


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9.2 Activities

Social Communication Disorder, Pragmatic Difficulties/Disorder, Difficulties With The Social Use of

Language

“Social Communication Disorder”, “Pragmatic Difficulties / Disorder” and “Difficulties with the Social Use

of Language” are all terms used to describe the difficulties some people experience with pragmatic skills

These pragmatic skills help us to get on with one another. In terms of communication, these are the rules

of interaction which allow is to achieve our desired outcome in an acceptable way. They are appropriate

to our background and culture.

For most children, these skills continue to develop certainly beyond five years of age.

Some children with pragmatic difficulties may have problems in knowing how and when to start and finish

a conversation and how to react when spoken to. Some fail to appreciate the subtle and mixed messages

shown by facial expression, body language and tone of voice and may therefore take things said to them

literally. They could also be unable to use these forms of communication successfully. Children with this

difficulty may “hog” the conversation or launch in at the wrong moment.

These children often use inappropriate language because of a lack of awareness of other peoples’ feelings.

As a two-way exchange of information, conversation is important for learning. Some children have

difficulty in initiating and maintaining conversation at an appropriate level for their age. This may be

because they have problems in organising their thoughts, finding the right words or putting words

together to make sentences. They sometimes wrongly assume you share the same background of

information and may strike up a conversation or make a comment accordingly. They may not know what

language to use to greet somebody or to make a request.

These children often have difficulty in developing a topic. In a group they will frequently copy somebody else’s sentence structure or use closely associated ideas. On the other hand they may go off at a tangent talking about something completely different. They may talk a lot without giving much information.

Children with these difficulties sometimes find maintaining a conversation easier if they’ve chosen the

topic themselves, and if the ideas are concrete rather than abstract. They benefit from contextual

support (for example, objects, pictures, … etc.).

As proficient users of language, we understand that different situations call for different codes of conduct.

For example, a formal approach is necessary when attending a job interview but when talking about work

with friends a formal approach would be very peculiar.


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Further, when we speak and listen, we allow our conversational partners to contribute and influence our

responses. Often we do so assuming that what is being said is relevant and true, using inference and a

shared base of knowledge to maintain interest and add a certain richness, and using only enough words to

convey our meaning adequately.

Using such skills we negotiate our way through conversation and verbal exchanges. These are pragmatic

skills, for we use language in a range of contexts, which vary in terms of people, places and functions as a

tool for communication.

A child is said to have a pragmatic disorder when he is unable to use appropriate pragmatic skills.


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Behaviours Displayed By Children With A Pragmatic Disorder

There are three main groups of inappropriate behaviour :

1. When responding, the child may …

change the topic completely, or pick up on an insignificant piece of information and elaborate upon it.

respond with an answer that the person could assume, for example, the child may give superfluous information :

Question “Where do you live?”

Answer “61 High Street, Bletchley. It’s a house with a red door and it’s next to

John’s house that has a red door and … … etc.”

Or they may give too little information, assuming that the listener has the same knowledge as

they do on a particular topic.

2. During conversation the child may …

interrupt by introducing an unrelated topic.

not understand the implications of what has been said, for example, the topic may have been about how wet it is outside because it is raining so heavily and then the child asks if he can go out and play.

3. The message is not conveyed as the child may …

overuse pronouns with the result that the listener is confused as to who or what the child is talking about.

have a mismatch in the understanding of the meaning of some words, for example, “listening” vs “understanding”.

use incorrect words where the child has selected the correct group of words but has chosen the wrong one, for example, he correctly selects prepositions but uses “on” instead of “under”.

Children with pragmatic difficulties may have difficulties in making friends, and coping with peer group interactions. Their problems may be overlooked because the symptoms are common in everyday conversation and defined as confusions or simple misunderstandings. The important factor is the number of times the behaviours are observed and the degree of confusion that follows, for often the listener will try to make sense of the conversation but will get even more confused as the child may be inconsistent.


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Helping Children with a Pragmatic Disorder

1. Don’t be side-tracked in conversation if the child changes the subject inappropriately, instead say : “we’ll talk about that next but just now we are talking about … …”

2. Don’t over apply your skill as a good communicator by struggling to make sense of the child’s communication, instead say :

“I don’t understand what you are saying.”

“Do you mean … … … or do you mean … … …?”

3. As far as possible, use only questions meaningfully ; do not ask questions that the child knows you already know the answer to.

4. Encourage the child to monitor his understanding, so that he can identify when he hasn’t understood and what he can do about it. Encourage him to be an active listener. Play games where you either give him information that is

too long, too jumbled, too hard, too little (information). For example :

too long “Before you pick up the large blue pencil move it towards the box”

too jumbled “Put them all on the shelf by the sink” (make a noise, e.g. rustle paper as you talk)

too hard “The herbivores were walking into the field.”

too little “Point to the small blue one” (when there are several small blue items).

By playing these games it is hoped that the child will learn to identify listening problems and request

further help / information. Discuss what was difficult about each instruction.

Visual pictures / symbols of too [ long | jumbled | hard | … etc. ] may help the child to identify the

problem, for example :

“It was too long, You didn’t tell me enough, I didn’t understand the word …”

During naturally occurring situations, the child can be set up so that he has to make some sort of request based upon context, for example, the child is asked to draw a picture but given blunt pencils.

5. Use procedures such as barrier games, for example, where the child has to give information to the listener to enable the listener to make an identical picture. Then swap roles so that the child becomes the listener and has to follow the instructions.

6. Give him feedback about the adequacy of the message conveyed. For example : “You didn’t tell me where this happened”.

“I came to the zoo yesterday so I know we went on the coach.”


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7. Role-play and video record to encourage monitoring, for example, the adult models rules of interaction and then discusses these rules explicitly.

8. Explore emotion and discuss how these are expressed, for example, using stories.

9. Set out clear group rules (and possibly use a star chart) with a social skills group, with targets such as “Good sitting”, “Good looking” and “Good listening”. Encourage the children to monitor themselves, i.e. ask them during or at the end of a group :

“[ Are you doing | Did you do ] good listening?”

… etc.

It may be useful to model [ poor | good ] [ looking | listening ] skills with another adult.

For example, one can talk whilst the other looks at the ceiling, floor, their watch, etc. Ask the

children what was wrong. Ask the speaker how they felt, for example : cross, upset. See if the

children can identify when you are doing it well and when you aren’t.

In discussion with the class, develop a list of

“Things we should do when listening”

For example : “be quiet” “sit still” “use our ears” “think”

and “Things we should do when we want to speak”,

for example : “put up our hand”

“wait for our turn”

“wait until someone has finished speaking”

“wait until someone has finished what they are doing”

“say ‘excuse me’”

… etc.

Note Many of the ideas for the games in this section come from Dr Wendy Rinaldi’s “Social Use of

Language Programme”.


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Working on Pragmatic Skills

Role reversal and barrier games are useful for working on pragmatic skills, particularly for focussing on

topic maintenance and repair strategies.

Role Reversal

There are many types of these games. The aim of the game is for the child or children and adults to take it

in turns to be the teacher.

Some games lend themselves to this readily; for example :

Shops, Schools, Doctors and Nurses, etc.

Also :

“Simon Says …” games

Directing how to set up an obstacle course and then which way to go round.

Directing a car or person around a road or town map.

Having two identical pictures and telling each other how to colour them in, which part and what colour.

Telling each other which stickers to put on a picture - you could have identical ones.

Making identical pictures or patterns using shapes, etc.

Arranging rooms in a house.

Arranging animals in a farm or zoo.

Helping someone through a maze.

How to play a particular game on the computer.

Barrier Games

These are similar to role-reversal games. Each person has an identical set of resources with a barrier in

between them and takes it in turn to place the items in a set place and tell the other person how to do the

same. The complexity can be increased by changing the resources. For example :

Putting items in set places “Put the cup on the plate”.

Making a person do an action “Make the man stand on the chair” “Make the boy sit on the table” Resources : Choice of people and furniture.

Adding prepositions : “Put the brick under the book”

“Put the dog on the table”


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Resources : Choice of items and places.

Two part instructions : “Open the book and put the pen on it” “Turn the cup over and put the brick under it” Resources : Choice of items and places.

If the child doesn’t do as you direct, do tell him how to do it correctly.

When you have to follow what the child says, do exactly what he says. For example, if the child says “put

it in the cup” meaning “put the bear in the cup”, either ask “what should go in the cup?”, or put the wrong

thing in.

Barrier games can be useful for teaching a child strategies to “repair” a conversation. We use these

strategies when we don’t know what to do in different situations; for example, we can’t remember or

don’t understand. These are very important for the classroom. A child with language disorders often fails

to comment if he hasn’t understood. For example :

Absence Have a piece missing when you give the instruction.

Target, for example : “I haven’t got the …”

Volume Say part of the instruction in a whisper.

Target, for example : “what did I do? I didn’t hear”

Incomplete information

Sneeze or cough when giving an important part of the instruction.

Target, for example : “What do I do?”

Vocabulary Use a word that you know he would not understand, for example,

perambulator.

Target : “What is it? I don’t understand.”

Too much information

Give a too long list.

Target : “I can’t remember. What do I have to do?” … etc.

The following sheets can be used to target different pragmatic skills. Some of the activities can be used on a one-to-one basis with the child; others are better used in a small group situation.


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Eye Contact/Looking

Talk about eye contact – we use it to :

find out what a person is feeling

show we are listening

show we are interested

When we are looking at someone it is all right to look away at times

Wink “Go” playing “Ready, … steady, … go!” games

When you say “go”, wink or blink at the same time.

Gradually take away the verbal prompt so you are saying “Ready … steady … (wink)” – so the child

has to look at you to know when they can go.

Magic Box

A chair is set aside. When the adult makes eye contact, the child comes to sit in the chair and is

shown something inside a secret magic box. Each child has a turn (later, children can be in charge of

the magic box).

Copy Me

Children watch the leader and follow their actions.

Chinese Gestures

The group sits in a circle. Members close their eyes. The leader initiates a [ gesture | mime | facial ]

expression, for example : cleaning your teeth. They tap the member to the right of them who then

observes the gesture being made and passes it on.

Skills involved observation eye contact gelling

posture facial expression proximity

touch memory co-operation

turn taking.


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Observations

Get into pairs, making two lines facing your partner.

Line A holds a posture for 30 seconds and line B observes.

Line B must now turn away.

Line A change one thing to do with posture, one to do with clothing and one to do with facial

expression (to make this simpler, change only one aspect). Line B then turns back and identifies the

changes.

Classroom discussion can focus around observation and what it is like / how it feels to be observed or

to be the observer.

Skills involved gelling observation eye contact

gesture facial expression posture

proximity memory turn taking

social perception problem solving

Eye Swap Chairs

Sit in a half-circle with one member left standing in the middle.

All those seated silently seek eye contact with another member. Once established, the two must

swap places. The person in the centre has to try and reach an empty chair.

Skills involved eye contact observation gelling

proximity touch co-operation

Tangle

Two members of the group leave the room. The rest stand in a circle and hold hands.

The group is then instructed to get into a tangle by going over and under arches formed. They must

not break contact with one another.

The two members of the group are then asked back in and told to untangle people using verbal and

physical means – but they must not break the links.

Skills involved observation gelling posture

proximity touch co-operation

problem solving


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Discussions

Talk about looking to show we’re ready for the next instruction. Practice it in a task – for example :

- answering quiz questions

- carrying out instructions

- playing “Simon Says …”

Talk about sending messages with our eyes – sometimes we don’t use someone’s name when giving them an instruction, but we look at them instead.

Practice this in these games :

Throw a pretend ball to someone in a circle

Look at someone to [ stand up | go first | go next ]

Who can sit down and which chair should they sit on

Hidden letters Have an array of envelopes, only one has the magic letter in (or treasure map). By your facial expression, can the children find out which one it is? Let them take turns to send the messages.

Surprise presents Take it in turns to open a pretend present and mime what it is.


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Listening and Attention

Note Use this resource in conjunction with that on “Listening and Attention” skills found elsewhere

in this resource pack.

Draw A House

Work in pairs. One member instructs his partner to draw a house. The person drawing should do exactly

what his partner says.

Classroom discussion can focus on giving and receiving verbal instructions.

Skills involved gelling eye contact gesture

proximity listening volume

memory asking questions listening

responding co operating turn taking

problem solving self-instruction self-monitoring

negotiating

“Who Is This?”

The group is seated in a circle. The leader gives a physical description of a group member, for example :

“brown hair, wearing a red jumper”. The group has to guess who it is.

Skills involved gelling observation eye contact

gesture facial expression posture

proximity presentation listening

memory turn taking social perception

problem solving self-monitoring assertion

“What Am I Thinking Of?”

Gradually build up a verbal picture of an object. Start with three clues. Can Christy guess after two clues,

three clues, etc. For example :

a) 4 feet, fur – discuss that it could be any furry animal

b) whiskers – discuss that it could be a [ cat | lion ]

c) drinks milk

d) and is a pet – therefore it is a cat.


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Play Sound Lotto or Ordinary Lotto

The child must listen carefully to instructions individually or as part of a small group (i.e. two or three

children). He must wait his turn and match items appropriately.

Give the child an outline of a picture to colour in. Give him simple instructions to colour in the nose, hair, etc. He is only allowed to colour in

one part at a time.

Get him used to words such as ‘wait’ and ‘go’.

Keep these activities short (no longer than five minutes at first). If this is too long try one

minute, then this can be slowly increased.

You could make this into a barrier game so that you have a picture with different parts

coloured in. Give the child instructions on what to colour in, for example : “Colour the hat

red.”

When they have completed each stage, let them check their work against your drawing.

Construction could be built in to the tasks, so the child could listen for the correct item in a lotto game and cover it up with a brick or build a brick tower beside each item every time he hears it. Similarly he could listen out for a target word in a story and build a tower every time he hears it.

Listen And Jump

In a group, the child has to listen for his name. When he hears it he has to jump into the circle.

Favourite Things

Everyone says his favourite food, pet, TV programme and then the leader prompts : “What was Fiona’s

favourite pet?”

Same and Different

Fill shakers, for example : Pringles packets or jars with different sound makers, for example : beads,

dried peas, Ping-Pong ball, keys, etc.

Shake two that are the same. Allow the child to listen and then introduce the vocabulary – “they’re the

same”. Then shake two that are different – “they’re different”.

See if he can tell you whether the sounds he hears are the same or different. If he is having difficulty

telling you, try introducing symbols or signs for same and different and encouraging him to point to the

appropriate one.

You could have three shakers at a time, with two the same, see if the child can identify the two that

sound the same. Similarly you could shake one and give him two to shake. See if he can show you which

one sounds the same as yours


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Turn-Taking Traffic

It is first explained to the children that they will pretend to be cars but they will stay sitting down. In turn,

each child must say “Brm!” as the car moves along. This is practised once around the circle, so that

everyone has one go at saying “Brm!” The teacher then explains that each car is allowed to stop once, and

to do this it must say “screech” (or “stop”). When this happens, the “Brm” sequence must change

direction.

It is important that only one child is talking at one time and that the children get used to the idea of turn

taking.

If the game fails, because someone has a go out of turn, talk about why the game failed (someone didn’t

remember to take turns) and start again.

The Wave

The teacher begins the “wave” by making a non-verbal gesture, for example, clapping hands, stretching

arms, raising one thumb in a “thumbs up” sign, putting a hand on one knee etc. The group has to repeat

the action, in turn, so that the gesture moves like a wave round the circle. The teacher then changes the

gesture on the second turn and the cycle starts again with the new action.

Sound Wave

This is played like the Wave above, but a sound or a word is repeated. Examples include animal sounds,

noises of household objects, words in a category (for example, food).

Story Share

The first and last lines of a story (a well known fairy story is good) are written up on the board and read aloud. The teacher explains that she will begin the story with the first sentence and that the last member will end the story with the last sentence. The rest of the group must “share” the story, by saying just enough to allow the last person to say the last sentence.


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The Microphone

The group sits in a circle. Members discuss a topic, for example : TV, pets, holidays.

You can only talk if you are holding the magic microphone.

Discuss turn taking with the group. Skills involved eye contact facial expression gesture

proximity listening volume

memory initiation responding

turn taking answering questions

co-operation topic maintenance / repair

Other Games

Use a ball of wool while children are talking. Unravel it and give the thread to the child who is talking, who must keep hold.

Continue until the discussion has come to an end.

Discuss with the class who has [ most | no ] wool and why this has happened.

Use any game to talk about taking turns.


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Emotions

What emotions can children think of? Ask questions like :

“What feelings do you have?”

Talk about how you all feel when a particular thing happens, for example :

a) When you’re told off.

b) When someone gives you a present.

c) When you are invited to a party.

d) When you argue with your friends.

e) When somebody gets a prize and you don’t.

f) When somebody pushes in front of you in a queue.

g) When somebody doesn’t understand you.

h) When you go on an outing unexpectedly.

i) When you’ve got a part in an assembly | play.

j) When you see somebody you haven’t seen for a long time.

k) When you’ve won | lost a race.

Talk about what makes you happy, sad, upset, frightened, … etc.

Make facial expressions and body postures. The other members of the group have to guess what emotion you’re showing.

Give everybody in the group a turn.

Take photographs of the group members making different facial expressions. Try to match up the emotions, for example, find two people who look happy.

Facial expressions plaques and body language cards from E. J. Arnold may be useful.


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Expressing Emotions / Working Together

Play a game called “Who feels the same?” Write different emotions on cards – happy, sad, tired, bored, angry (use pictures, if you like,

to support the written word). Each emotion is written on two cards.

The cards are shuffled and then given to the children in the group. They must then move

around the room miming the emotion that they have on their card. The aim is to find the

other person miming the same emotion.

Classroom discussion can then focus on non-verbal ways of expressing emotions.

Skills involved group gelling observation eye contact

posture facial expression gesture

proximity touch co operation

turn taking problem solving self-monitoring

identification of own and others’ feelings

assertion

“How do we look” Seat the group in a circle. The leader describes a situation and asks members to adopt an

appropriate posture to sit – listening to music, cheering football, etc. Classroom discussion of

posture, facial expression, gesture.

Skills involved posture observation facial expression

gesture listening proximity

identification of feelings


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Emotional nursery rhymes Use the emotion cards described earlier – happy, sad, bored, etc. Sit in pairs. Each takes a

turn to say a nursery rhyme in a manner that depicts the emotion written on their card – use

facial expression, intonation. Their partner has to guess the emotion.

This can be made as easy or as hard as you feel appropriate; for example : you could just have

happy vs sad cards.

Classroom discussion could focus on how emotions are shown both verbally and non-verbally.

With younger age groups, the adult can read out a story / nursery rhyme for the children to

guess how they felt – [ happy | sad ].

Skills involved eye contact observation proximity

posture facial expression listening

gesture volume memory

prosody turn taking self-perception

self-monitoring responding co-operation

identification of feelings

Reading Facial Expression Talk about how our faces can give messages and show how we are feeling.

Play the “Surprise Present” game. Put out pictures or objects that would be :

- something nasty to have, e.g. a snake

- something really nice to have, e.g. a new bike

- something that would be alright to have, e.g. a plain rubber

- something that would be disappointing to have, e.g. a broken car

Have an identical set of pictures or objects for you to pick. Secretly open a present / envelope. Can the children guess what it is from the look on your face?


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Emotions (Younger Child)

Expressing Emotions / Working Together

Play a game called “Who feels the same?”

Draw different emotions on cards – happy, sad, tired, bored, angry.

Sit the children in groups of three or have one child and two adults with younger age groups.

Each emotion should be drawn twice to make a pair. Take a pair of cards and pick one other card. Deal

one of the pair to one member (A) of the group, and then give the other two members the remaining

cards without showing member A. The two group members (B and C) must then mime the emotion that

they have on their card.

The aim is for member A to find which person is miming the matching emotion to the one that they have [

written down | drawn ].

Classroom discussion can then focus on non-verbal ways of expressing emotions. Member A could also be

asked to mime their emotion.

You could use a mirror to demonstrate how their mime looks compared to the other two.

Skills involved group gelling observation eye contact

posture facial expression gesture

proximity touch co operation

turn taking problem solving self-monitoring

identification of own and others’ feelings

assertion


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Awareness of Self/Others

Try to work through these ideas in turn. It is helpful (sometimes necessary) to carry out the work in a

group setting. It could be part of an English lesson.

The Concept of “Same” and “Different”

Start by focussing the children’s awareness on the basic notion that people have some things the same and

some things different.

This can be done by asking the children to observe one another to see what is the same (for example, two

eyes, two legs, one nose, etc.) and what is different (for example, hair length and colour, eye colour,

etc.).

This can also be done around the topic of interests, so that the children think about the things they like to

do; those that are shared and those that are different.

Matching Games

Ask the children to match aspects of themselves to stimuli presented by the teacher. For example,

around the topic of physical appearance, children can match their hair type (wavy, straight, curly) with

strips of paper cut into the appropriate shapes, their hair or eye colour to colour cards, etc.

Jumping Game

The teacher calls out an appropriate attribute (for example, hair / eye colour, an interest, etc) and all the

children who have that attribute or interest jump into the middle of the circle. The teacher or a second

member of staff gives feedback to the children on the accuracy of their self-awareness.

Self-Portraits

The children are asked to make a self-portrait of themselves. They can be supplied with a ready made

black and white picture of a face, or they can draw their own. They may be encouraged to think about

specific attributes for example, shape of face, colour of eyes, colour, length, type of hair, etc. Around

the topic of “Hobbies / Interests” they could write or draw a favourite animal, food, sport and TV

programme. The children are then asked to describe their self-portraits and explain (if they can) why they

have included particular items.

Right or Wrong?

The teacher makes a statement about each member of the group. After hearing each statement, the

children decide whether it is right or wrong. For example, around the topic of appearance, the teacher

might say “Jane, you have blond hair”. Jane would then say “Right” or “Wrong” (or “Yes” or “No”).

Around the topic of interests, the teacher might say “John, your favourite sport is football”.


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Throwing Game

The first stage of this game is to throw a beanbag or ball amongst the group. As each member receives

the beanbag/ball, they share with the group one piece of information about their appearance or their

interests, depending on which topic is being covered.

The second part of the activity is to remember one piece of information and identify who said it.

A Pat on the Back

We deserve a “pat on the back” if we do something we don’t want to do, or find hard. Different people

like different things or find different things hard.

In the examples below, which ones should get “a pat on the back”?

You tidied your bedroom without being told to.

Mum said you couldn’t go out till your room was tidy and you moaned.

You helped your little [ brother | sister ] get dressed.

You ignored your little [ brother | sister ].

You did your homework before being nagged.

Mum told you 5 times to do your homework.

You waited for mum to finish talking to her friend even though you were bored.

You moaned while mum was talking to her friend.

You let your little [ brother | sister ] watch Teletubbies even though you wanted to watch “The Simpsons”.

You made your little [ brother | sister ] cry because you wouldn’t let them watch Teletubbies.

Think about something your [ mum | dad | brother | sister | friend ] doesn’t like doing or finds hard :

“My … … … … … finds … … … … … … … … … … … … hard”

“My … … … … … doesn’t like … … … … … … … … … … … “

When could you give them a pat on the back?

What do you not like doing?

What do you find hard?


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Think of a situation where you would deserve a pat on the back.

Which ones of the following deserve a “pat on the back”

You helped wash up when you didn’t want to.

You did your homework without being reminded.

You helped Grandad.

You helped your little [ brother’s | sister’s ] homework.

You would not give your friend a crisp.

You shared your crisps.

You let someone have the last biscuit even though you wanted it.

You helped tidy up without being asked.

You helped make tea.

You helped put away the shopping.

You did something you didn’t want to.

You let your [ brother | sister ] choose where to go.

You let your [ brother | sister ] choose the video to watch.

You lent your friend your football boots.

You waited till [ Mum | Dad ] was ready without moaning.

You did not tidy your bedroom even though mum asked.

You sent your friend a birthday card.

You would not help your Mum.

You did not help Mum to put away the shopping.

You watched your programme when you knew your friend wanted to watch a different one.

You ate the biscuit you knew your [ brother | sister ] wanted.

You sat in the front of the car even though your friend wanted to. How could you change the ones that didn’t deserve a “pat on the back” so they could get one?

Talk about why the “pat on the back” examples got a “pat on the back”. What special thing was done?


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When to say “sorry”, When to say “it’s alright”

Somebody bumped into you accidentally.

Someone said they would meet you at 6 but they were 15 minutes late.

You said you would ring but you forgot.

You knocked over someone’s coke can and spilt it.

Somebody nudged you on his way past and made you spill your drink.

You picked up someone else’s book thinking it was yours and wrote in it.

Someone tripped and bumped into you.

You told someone they could have the last cake – but it got eaten.

You said you would buy a pen for someone at the shops but you forgot.

You accuse someone of having your rubber (they haven’t – yours fell on the floor).

Someone lent you his or her ruler but you snapped it hitting a fly.

Someone accidentally tripped you up.

You borrowed someone’s boots and got them muddy.

You said you would help someone but you had to do something else.

You promised someone you would take his books back to the library – but you forgot.

Someone accidentally tore your work.

Your dog chewed a book someone lent you.

You ripped a top someone lent you. Think of two different occasions when you should say “sorry”.

Think of two different occasions when you should say “it’s alright”.


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About Me

We are all good at different things.

Where would you rate yourself?

1 2 3 4 5 6 7

I’m last at sport I’m good at sport

I find reading hard I’m a good reader

I find maths hard I’m good at maths

I find spelling hard I’m a good speller

My writing is untidy My writing is neat

I can’t swim I’m good at swimming

I can’t sew I’m good at sewing

My drawings are poor I’m good at drawing

I can’t play music I’m good at music

I don’t like helping I’m good at helping

I’m not good at I’m good at

We are good at some things, we find some things hard and we are OK at other things.

Sometimes we’d like to be better at something, for example, spelling; other things we don’t want to

change.

Mark the ones you’d like to change.


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Opinions

The following games are devised to encourage children to recognise the difference between fact and

opinion and to begin to recognise and acknowledge that other people may hold differing opinions but that

this is acceptable.

The games should be worked through in order.

Fact versus Opinion

Ensure the children understand the meanings of the words “fact” and “opinion”.

Prepare a number of statements and read them one by one to a small group of children. Let the children

decide whether the statement is fact or opinion. This will lead to discussion which can be used to make

the point that some things are indisputable, whereas other statement’s truth depends on a person’s

viewpoint. It is also important at this stage to emphasise that this is normal and inevitable.

Agreeing versus Disagreeing

Leading on from the first discussion, the children should be introduced to the idea of agreeing and

disagreeing. Play a game where an opinion is read out (for example, “Manchester United is the best

football team in the world”) and each child moves in one direction if he agrees and in the other direction if

he disagrees. Alternatively, children can give a “Thumbs up” or “Thumbs down” sign, depending on their

view.

Follow this with discussion about the disparate views of the group and the importance of accepting

different opinions.

“I Think” and “What do you Think?”

Allow the children a turn each at giving their opinions (on an unrestricted subject or a specific area) by

starting a sentence with “I think..”

When the first child has given one sentence, move the game on by asking that child to ask his neighbour

“What do you think?”

Review this exercise with the group by asking them to remember in turn each opinion as stated earlier in the game.


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Missing Person

Allow each child to express two or three things which they enjoy doing. Explain what will happen next.

Ask one child to leave the room for a few minutes and, while he is absent, take it in turns to suggest one

possible treat for the absent person (vary this later with, for example, birthday treats, best meal, best

toy or book to buy etc). Write the ideas down.

Allow the chosen child to return to the room and share with him the ideas suggested. Let the chosen child

give feedback on how much or how little he would have liked that treat and how good it feels to have

people valuing your feelings.

Children often find it difficult to suggest a treat that they personally would not enjoy, although the absent person would. This is a helpful lesson in learning to value others’ opinions.


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Resources

Semel and Wiig (1990) Clinical Language Intervention Program Pragmatic Worksheets The Psychological

Corporation, Harcourt Brace and Company


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STAMMERING

10.1 Strategies

Making It Worse?

Things that make stammering worse are closely related to the demands being made on a child and include

the following examples :

1. Speaking to adults who speak very quickly.

2. Speaking when having to look high up into someone’s face.

3. Speaking when you think you will be interrupted.

4. Speaking to someone who is not listening (or not looking at you).

5. Speaking when you are frightened that what you say will make someone angry.

6. Being told to speak when you do not want to.

7. Being told to speak when you have nothing to say.

8. Speaking when tired, unwell, excited.

9. Speaking when you have a complicated idea to express.


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Strategies

1. Be encouraging. Stammering can undermine children’s confidence so that they don’t notice their achivements.

2. Do anything that makes talking and listening enjoyable.

3. If the child seems aware of the stammer, then talk to him gently about it.

4. Try to be consistent in your handling of all the children – being clear about rules helps children to feel secure.

5. Ensure the child has the opportunity to join in conversations, particularly if he finds it difficult to interrupt more fluent peers.

6. Listen attentively : look at the child and get your face on the same level.

7. Speak in language that can be easily understood.

8. Talk about what is going on now and about things that can be seen.

9. Reduce the number of questions you ask – allow the child to choose when to tell you something.

10. Slow down your own speech and allow him time to answer.

11. Help him to feel valued by replying uncritically and kindly.

12. If he goes through a period of greater dysfluency, then reduce the demands made on speech.

13. Find time when the child can do things that do not require much talking and where the activity is more important than speaking. Spontaneous, easy talking may occur as a result of this shared experience.

14. Help others to understand the child. Avoid encouraging the child from using tricks, that is, things one does not normally do in relaxed

conversation, but which may improve fluency for a short while; for example : taking a deep breath,

shutting eyes, or speaking with an accent.

15. If something helps, then continue. If not, then stop and think again. For example, you may find that telling the child to slow down has no effect at all, whereas slowing your own rate of speech helps.


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16. Do not correct mispronunciations or grammar – just say the correct version for the child to hear. So, for example, if he says :

“I rided on my bike today”

you can respond with :

“You rode your bike did you? Where did you go?”

Resource

For further information look at www.stammering.org

http://www.stammering.org/


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VOICE

11.1

What are voice disorders?

A voice disorder is when the quality of a person’s voice is significantly different from what you would

expect given their age and gender. Poor voice quality may affect communication with others and a child’s

self esteem.

If you have ongoing concerns about a child’s voice, you should speak to your link speech and language

therapist.

Children with voice problems may:

Have a hoarse, breathy, rough or croaky voice

Temporarily lose their voice, especially at the beginning or end of the day or after specific events e.g. sports day

Have instances of their voice ‘cutting out’ for a second

Speak in an effortful or strained way.

How to help:

Encourage the child to drink plenty of water throughout the day (drinks such as fruit juices can dry out the throat)

If the child coughs a lot encourage them to have a sip of water or to swallow the irritation away rather than coughing.

Discourage shouting or loud talking in the playground or classroom and encourage children to speak to people when they are next to them.

Encourage quiet talking rather than whispering.

Provide opportunities for the child to ‘rest’ their voice e.g. encourage times of quiet play (puzzles, looking at books)

Try to reduce background noise where possible so that the child doesn’t have to raise their voice talk over it.


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PHONOLOGICAL AWARENESS/WORKING ON SPEECH SOUNDS

12.1 Sounds Work:

The following are some ideas for work with your child that will help with improving sounds.

1. Play “I Spy …” with your child. Make sure you use the sound at the beginning of the word, and not the letter. Beware of words like “photograph” where the clue will be /f/ not /p/.

2. Collect objects with your child from around the house, which begin with the same sound. Lay them out onto a tray or table and leave them there for a few days. Go through them each day with your child. Tell him that they all begin with the same sound, tell

him what that sound is, and then name all the objects for him.

See if he can find some other things, which begin with that sound.

Don’t expect your child to repeat the words correctly, but if he wants to have a go, praise him for

his efforts (even if not entirely accurate).

After a few days, try a different sound.

3. Make a snake out of a circle of paper. Draw a spiral of circles within the circle and then cut it out. Draw 2 eyes and a tongue where the lines end, in the middle of the circle. Draw a pointy tail where the lines end at the edge of the circle. You can now hold the “head” of the snake and lift it up. Practise saying /s/ as you pretend to make the snake say “hello” to your child. Let him have a go.

4. Link other sounds with objects to encourage practising the sounds in a playful, non-threatening way. For example, try the following :

/v/ for the noise of the hoover

/n/ for the noise of an aeroplane

/t/ for a dripping tap

/g/ for water going down the plug


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5. Recite nursery rhymes and action rhymes to your child. These are very important for language development and also help your child’s reading skills. Say a line and then pause before the last word and see if your child will fill in the space.

6. Make up rhymes with your child. Supply him with a word and see if he can think of a rhyming word. This will probably need some

patient work on your part, as this often doesn’t come easily to children with delayed speech

development.

Help by providing the words yourself to begin with and letting him “play” with the sounds of them,

repeating them after you.


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12.2 Auditory Discrimination Programme:

This programme is to help the child listen more carefully to some of the sounds we use in speech. Listening and hearing the difference in sounds will help the child to develop his own speech.

1. Understanding the Concepts “Same” and “Different”

Use pictures of the same fruits (e.g. two bananas) and different fruits (one banana and one

apple).Talk about same and different.

Write two words which are visually very different (in length and shape), for example, crocodile, pig,

and two words which are the same.

Ensure the child understands the concepts same and different before moving on.

2. Minimal Pairs

A minimal pair is two words that sound very similar – with only one sound different between them, for example :

key, tea ; paw, four ; bee, bead ; car, cart

Before a child will say words differently he needs to hear the difference between them – the

following games are to develop these discrimination skills.

It is important that this work consists of you doing the speaking and the child doing the listening. He

should not be expected to say the words himself.

Make the games fun and make up your own as well – spend five minutes a day doing them.


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3. Games

You will need to prepare sets of minimal pairs written on separate pieces of paper, or use pictures. Your Therapist will advise you on suitable words to use.

If, during these games, the child tries to say the word himself, accept his version uncritically.

Using the words (or pictures), put them in front of the child and see if he can point to the one you say or place a counter on it.

Alternatively, he can run and touch the right picture on the back of the door or jump on the right picture on the floor.

Make a “hungry man” by drawing a face on a shoebox and cutting the mouth out. See if the child can “feed” the picture you say to the man.

Photocopy several copies of some minimal pairs. See if the child can colour in the picture that you say.

Take one of the pictures and see if the child can tell if you are saying it right or wrongly, for example, for the key picture, ask :

“Is it a tea?” “Is it a key?” “Is it a sea?” … etc.

Say two of the words together and see if the child can hear if they are the same or different, for example :

“key – key” “key – tea” “key – sea” … etc.

Instead of just saying the word, put it in a sentence and see if the child can still point to the right picture, for example :

“I like my tea” “I like my key” … etc.

When you have carried out these games and the child is successful at discriminating the correct sounds, you can swap roles, so that the child is “the teacher”.

Listen carefully to the word he says and respond to that word, even though you may think he meant the other word. Give him feedback about his mistake, for example :

“That sounded like bee to me.

This one says bee and this one says bead”.


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12.3 Working with Sounds:

Always work in the following set order :

Repeating the sound on its own

Repeating the sound and a single vowel sound (e.g. see, sew, sow)

Repeating the sound in a word

Saying the sound in a word when someone points to a picture

Saying the sound in a word in a short phrase

Saying the word in a longer sentence

All these stages need to be worked through before the child will use them correctly in his speech.

Note Work only on a single consonant, followed by a vowel (e.g. “sack”)

Blends (two consonants together) develop later (e.g. “ski”).

Generally, work begins on sounds at the beginnings of words first, then with the sound at the

end and then in the middle of the word.

Do’s and Don’ts

Practise for a short time (3 to 5 minutes), and often

Try practising before school homework time

Make practice time fun

Praise correct attempts

Ignore any incorrect sounds which are not the target sound (e.g. if working on /s/, do not correct the child when his attempt at “chair” sounds like “care”)

Have a treat after practice time

Repeat a word back to the child, when this sound has been pronounced incorrectly, emphasising the correct pronunciation

Don’t tell the child “that’s wrong”. Rather, tell the child what sound you heard the child make and tell him how you say the sound

Be imaginative and use opportunities as they occur. With practice, you can add extra practice sessions on the way to school, waiting for a bus, etc.


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12.4 Games for Sound Work:

1. Use a “reward” game where the child carries out an activity every time the word is said. For example, have a piece of an inset puzzle or a bead to thread onto a necklace, take a turn to play with “hopping frogs” or to throw a dart at a dartboard, colour in the picture, or add another brick to a tower.

2. Place dots (from one to six) on the backs of target pictures. Take it in turns to throw a die and turn over the corresponding picture.

3. Make a dice game, using pictures of the words. When you land on a square, name the picture. At the sentence level, the child can repeat or make up a sentence.

4. Using two copies of target pictures, make up a “pairs game”. Take it in turns to turn over two pictures to find a matching pair.

5. Make a rod with a magnet and some string, put paper clips on the target pictures and play a “fishing game”. Take it in turns to catch a “fish”.

6. Place the pictures on the floor and say the one stepped on in a “stepping stones” or hopscotch game.

7. Play “Kim’s game” with 4-5 pictures or objects with the target sound. Take it in turns to close your eyes while the other person takes away one away. Name the one, which is missing.

8. Take it in turns to hide something around the room for the other person to find. You could use a treasure hunt clue; for example :

“Its under something we read” The searcher then has to say what they have found.

9. Take it in turns to describe something with the target sound in it for the other person to guess. For example, if working on the sound /k/, the clues could be :

“It goes on the road, has 4 wheels and you drive it.”

10. Play a “treasure game” by hiding pretend coins under the target pictures. Take it in turns to turn over a picture, say the word and collect the treasure.


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Games for Saying Words in Sentences

Make up a story, with the child “reading” the pictures of the target words. For example, if working on /k/, use pictures of a car and a cat and a cake. The story might be :

“I went in the car”

“I saw a cat”

“It ate a cake”

Have some pictures or objects with the target sound in and take it in turns to give each other instructions and carry them out. For example, when working on /s/, the instructions might be :

“Put the sock under your chair”

“Hide the sun under the book”

Make up tongue twisters. Can the child remember them to tell Mum or Dad

and then bring a new one to school to tell you?


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12.5 Speech and Language Tasks – Advice for Parents:

Practising the Games

Only correct the sound or structure that is being worked on at the moment – trying to correct everything at once only leads to confusion and slows down progress.

When working on sounds at the beginning of words, use words that have a consonant followed by a vowel (e.g. cat). Words that begin with two consonants (blends, or consonant clusters, e.g. crate) develop at a later stage.

Avoid a time of day when the child wants to do something else (like watch a favourite television programme – this applies equally well to you!)

Work in a room with as few distractions as possible (e.g. no television, radio, other people).

Children cannot concentrate for very long periods, so try to practice the tasks little and often.

Stop playing the game while it is still being enjoyed – that way you will both come back to the game with good memories.

The Programme

When working on speech sounds, work in a set order. This order can be used when working on sounds at

the beginning of words, in the middle of words and at the end of words. When working on sounds at the

ends of words you may not need to work on stages 1 or 2.

The examples given below are for the production of /k/ at the beginning of words.

Stage 1 – Repeating the sound on its own

Use any tips the Speech and Language Therapist has shown you. For example, for /k/, open your

mouth very wide. When the child can make the sound easily, move on to the next stage.

Stage 2 – Repeating the Sound with a vowel

For the example of /k/, practise the production of “kee”, “kah”, “koo”, “kor”. To begin with, it

may be helpful to say the /k/ sound, pause and then say the vowel sound. As the child becomes

more able, reduce the pause. Move on to the next stage when the child can say the consonant and

vowel without a pause.

Stage 3 – Repeating the Sound in a Word

To begin with, choose words with one syllable (e.g. comb, can, cat, cave). When these words are

pronounced successfully, move on to longer words (e.g. caravan, castle, kangaroo).


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Stage 4 – Saying the Sound in a Word

Up until now the child has repeated the sound after an adult. This next stage is for the child to

remember to say the sounds correctly without this adult model. Use the pictures on the worksheets

for the child to name.

Stage 5 – Saying the Sound in a Phrase

When the child is able to name the target words accurately, help him to repeat the sound in short

phrases. For example, a key, a fat cat, Kim’s hopping. At first it will be easier for the child to say

the target sound correctly when the word containing that sound is the first word of the sentence. As

he becomes more able, you can use more than one word with the target sound (e.g. king cat, a key

for the castle).

Stage 6 – Saying the Target Sound in a Sentence

When the child is able to say short phrases accurately, make up longer sentences for him to copy.

Take turns, so the child makes up sentences that you copy. You can make up nonsense or silly

sentences with lots of words containing the target sound.

If you have any queries about this programme, please contact your local Speech and Language

Therapist.


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12.6 Consonant Clusters:

Carry out this work for five minutes, 3 to 4 times a week.

Concentrate on one blend (for example, /sm/, /sp/, /br/, /pl/, /dr/, or /kl/) to begin with

When the child is using that blend correctly in his conversational speech, move on to another

blend.

Draw representations of the main part of the word, e.g. rain, pot, or lay in a column down the middle of the page, 4 or 5 times.

Tell the child what the word says and ask him to name it.

Then write the blending consonant in front of this word. For example :

rain could become brain (if working on /br/ clusters)

pot could become spot (if working on /sp/ clusters)

lay could become play (if working on /pl/ clusters)

Help the child to say the new word by saying the first sound, pausing and then saying the main part of the word.

Now spend some time reducing the pause until the two parts become one smooth word without a pause.

Try to make it fun (for example, colour the sheet, tick the words and play games such as skittles, pairs, lotto, fishing game, hiding the pictures).

The child will need to say the target word before each turn at the game.

When the child is able to pronounce the words correctly, encourage the use of the words in short phrases.

Again, make it fun with games.

When the child is successful in using the sound in short phrases, you need to encourage the remembering of the use of the new sound in real life. Warn the child that you :

are going to “Practise your Sounds” and

want the child to think about their sounds

Spend 5 minutes in conversation and remind the child of any instances where the sound

worked on is pronounced incorrectly.

Do not correct any other errors.

Do this exercise every day until the sound has been integrated into the child’s sound system.


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Word Lists

/r/ blends

red becomes Fred, bread, tread

rain brain, train, drain, crane, grain

ray grey, pray, tray, bray

/l/ blends

Lou becomes blue, clue, glue lay becomes play, clay

love glove lane plane

litter glitter lad glad

law floor lie fly

lock flock, block, clock low blow

last blast loud cloud

lap flap, clap lime climb

late plate

/s/ blends

pot becomes spot paid becomes spade

tear stair tar star

mile smile no snow

wheat sweet low slow

leave sleeve ledge sledge

lip slip Kate skate


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12.7 Picture Sheets for Consonants:

Pictures for working on sounds can be downloaded from the following websites: www.mommyspeechtherapy.com www.speech-language-therapy.com www.speechlink.co.uk www.speechteach.co.uk

http://www.mommyspeechtherapy.com/

http://www.speech-language-therapy.com/

http://www.speechlink.co.uk/

http://www.speechteach.co.uk/


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DEVELOPMENTAL VERBAL DYSPRAXIA

Information for schools Developmental Verbal Dyspraxia, DVD, is a speech disorder which affects voluntary movements of the mouth. Children with this, have specific difficulty speaking clearly as they find it hard (in some cases making, and ) sequencing sounds accurately and swiftly to make words. Some children will have difficulty in copying mouth movements. Children with DVD often have difficulties with sounds which are only subtly different e.g. p and b (one is whispered and the other has voice). They may also find it difficult to use final consonants so that ‘bee’ and ‘beat’ will both be said as ‘bee’. Systems such as Jolly Phonics are very helpful as the children can cue themselves into the sound they want by using the appropriate action. Children with DVD usually have poor phonological awareness skills, which of course impacts on literacy development. Those of you who have Literacy Hour will need to be extra vigilant during this aspect of literacy work, and aware that these children will need extra help. Those of you who work differently will still need to work on phonological awareness. As with a lot of problems DVD is different for different children. Different children will have different levels of severity. How they cope with it will depend on their personality and their experiences. It is therefore important to build up the child’s confidence. There are almost more unanswered questions than answered about DVD. At present we do not know a cause. Some children may have an associated difficulty with all motor movements, and would benefit from the advice of an Occupational Therapist.

Some facts about DVD

This affects speech only, the child can understand as well as their peers.

It is helped by a programme being implemented for 5 minutes a day

Being able to say a sound or word clearly one moment and then being unable to repeat it is part of DVD. The child is not being lazy

Children may be helped by being given an alternative method of communicating e.g. gesture or signing. [provided that they do not have associated difficulties with general motor skills]

How may it affect a child ?

Children may be able to say words correctly one day and not on another, or even in the next sentence.

Some children may have difficulty regulating the volume of their voice, and may seem very loud.

A child with a DVD needs to use more effort in speaking clearly so his/her speech may be less clear when

they are excited, tired or unwell.


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Most children will be very aware of their difficulties and reluctant to repeat

words, or depending on their personality, speak.

If they have phonological awareness difficulties these will impact on how easy they find it to learn to read

and spell.

Some children will develop expressive language with no difficulty, others will go on to have difficulties with

expressive language. The later the child is in developing clear speech and awareness the more likely he is

to have word finding difficulties later on.

Some children may be clearer when they are reading, this is because they will do this more slowly and have

the letters to clue them in to how to say a word. They will not be able to speak this clearly in conversation

and should not be expected to.

How can school help?

Be aware that a child with a DVD may have difficulty with phonological awareness skills and monitor these

carefully during the literacy hour.

Approaches which involve different senses such as the Jolly Phonics approach are useful.

It is important that the child develops the correct letter sound links. If a child cannot make a sound tasks

may need to be subtly adjusted to prevent this. Ways of doing this could be

The adult saying a sound and letting the child select the appropriate letter.

Saying a sound and letting the child choose the object that begins with that sound.

What should we do?

Refer to the Speech and Language Therapist. He/she will assess the child and implement a programme of

activities. Children will differ in the rate they progress through the programme. It is not possible to predict

how quickly they will move through the programme, or which stages they will find more difficult. As with

developing other skills a child tends to learn then have a time when the skills are being consolidated a

plateau. It is important that the child with DVD does not practice incorrect letter sounds, so if you are in

doubt if the sound is correct do not practice it.


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Developmental Verbal Dyspraxia Programme

Some children have difficulty sequencing speech sounds accurately. This programme has been devised to help this difficulty. Sounds that the child can make are included as well as sounds that he/she finds difficult. It is important that all sounds are practised. Children will progress at different rates. It is important that the programme that the therapist has written is followed exactly. The child will be moved onto later stages of the programme when the therapist feels s/he is confident with these stages. Sometimes the child will be working at different stages at the same time.

Practice must:-

Take place for about 5 minutes daily. Making it part of the every day routine is helpful e.g. at the same time as doing reading for school can work well.

Be in the order listed. Do not be tempted to do more.

Be fun. Praise your child’s attempts and have a small treat afterwards.

It is important how you say the letter sound, do not add a vowel to the sound. Saying the consonants s, t, p

should be very quiet. This is important when you go on to blending the consonants. An easy way to tell if

you are doing it correctly is to try this, add p to pie, if it sounds like pipe you were right, if it sounds more

like piper you were probably adding the vowel so check with someone!

STAGE 1: Maintaining the production of the sound

The first stage is being able to maintain the production of a sound, this is achieved by practising the sheets

where the consonant is written down 8 times (By 8 sheets). Younger children may need to start with only 4

and then build up to the 8.

To begin with label the sheet as you hand it to them, e.g. “this is the “t” sheet”. The aim is for the child to

be able to say the sound when they see the letter. (As they become familiar with the sheets do not label it

first.) Either you or the child should point to each letter as s/he makes the appropriate sound.

If the child has difficulty producing the sound when s/he points to the letter, try

1. Letting the child grope for the sound 2. Cue him/her, e.g. “The letter P (pee) says…….” 3. Model the sound for the child to copy. Use 3 as a last resort as the aim is for the child to be able to say the sound on their own.

If the child cannot produce a sound even when repeating it STOP. It is not helpful to practice saying the

wrong sound.


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STAGE 2: Sequencing sounds

The next stage is to practice alternating consonants, e.g. pb, td. Place one sheet on top of the other so the

child says one sound then the other sound 4 times, e.g. pbpbpbpb. When they are good at this try the

other way round as well, e.g. bpbpbpbp.

You or the child should point to the sounds in order. (As they get confident you can change the speed of

your point.)

If the child has difficulty changing the sound, try:

1. Letting the child grope for the sound 2. Model the sound for the child to copy, the aim is to reduce the help you give them. 3. Using the different order.

STAGE 3: Saying sounds randomly

Sounds are organized in a different order to make different words. This stage helps the child to say sounds in an unpredictable pattern. You will need separate cards of the letters for this stage. It is fun and allows the child to have an element of control. Have up to 4 cards of each of the sounds. Choose a sound pair as directed in the programme. Take it in turns to make a pattern for the child to say, e.g. bbpbppbp. (You may find that the child realizes that it is easier if the sounds are in a predictable order, e.g. bpbpbpbp, you then have the opportunity to make a random pattern). This task can be made easier by giving them fewer cards to sequence. When the child is good at this you can progress to patterns with 3 sounds. If the child has difficulty. Try

Reducing the number of cards.

Letting the child grope for the sound.

Say the sound for them (use this as a last resort). Later stages The stages of

maintaining the sounds

contrasting them

saying them randomly will be worked through for all the stages. As the child progresses through the stages he/she may need to spend little time on the maintaining stage and more time on the other stages. For different sounds the child may be working at different stages. For all the stages the principals of leaving a sound if the child can’t make it accurately and giving him/her prompts and praise apply. Consonant Vowel Pairs CV and VC Once the child can say target consonants randomly the next stage is to progress to consonant vowel, CV pairs. The child learns to blend a consonant with a vowel. In the early stages some children find it easier to start with the vowel and blend the consonant finally (VC), others are happier with CV. Start with which ever the child finds easier. Consonant Vowel Consonant Words CVC The next stage is to blend a consonant to form CVC words. Initially this can be done by either keeping the CV constant and adding a final C, or keeping the VC constant and adding an initial C. The consonants that are added will change. Words and non-words can be used.


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The majority of children will need to work through the stages outlined above. Some children will also need to work through the stages below. Combining two CV pairs to form a word e.g. bay + bee = baby, pea + ping =peeping Multi syllabic words, e.g. peeping, barbecue, caterpillar Combining words into phrases, e.g. baby peeping, puppy eating paper, Consonant Consonant Blends, e.g. s + top = stop or lamb +p = lamp. If in doubt contact the Speech and Language Therapist

Section 5 – Skills for Living and Learning

Section 5

Skills for Living and Learning


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Section 5a

SENSORY

PROCESSING


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Introduction Children may respond to sensations (sensory information) in different ways. Information is registered through the different senses: -

sight

hearing

touch

taste

smell

position in space (proprioception)

balance (vestibular sense).

The child needs to be able to process this information in order to respond appropriately. The nervous system operates through a system of ‘excitation’ and ‘inhibition’. Excitation results in an active response while inhibition lessens or blocks a response. When a balance between the two is achieved, it can be described as ‘modulation’ and it is this regulation which enables children to respond appropriately to their environment. It allows children to get used to regular, everyday sensory inputs, so they can get on with activities. Some children who have difficulties with modulation may appear to over-react to sensory stimuli which other children can usually ignore e.g. loud sounds, bright lights, the touch of clothing, particular tastes and smells. Other children may seem unaware of ordinary sensory inputs and appear to under-react and be unresponsive. A range of strategies can be tried to help children respond more appropriately to sensory inputs in the school environment. Strategies to help with Sensory Processing Children who over-react:-

Children who have difficulty processing sensory information are more likely to become overloaded by some environments or circumstances. When this overload occurs, children benefit from a change in sensory environment. It may help to gradually grade exposure to more challenging situations.

Consider placement of the child within the classroom e.g. do not seat him/her in areas with lots of ‘traffic’ (which may provide too much visual or tactile stimulation, causing discomfort and interrupting concentration).

It is important to acknowledge the feelings of children who react aggressively to touch (e.g. lashing out when standing in line). It may help to place them at the end of the line. Ensure that time in crowded areas is minimised e.g. consider how to help them deal with coming through a doorway with the rest of the school after play time.


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Provide ‘time out’ opportunities.

If an older child appears to overreact to a situation e.g. is upset or buries head when the fire alarm goes off, it may help to review the event subsequently with them and discuss that it is normal to experience strong emotions, possibly by sharing some of your own experiences. Encourage them to think through different ways of responding.

Children who under-react:- For children who have difficulty ‘tuning in’:

Place them at the front of the class, close to the teacher to improve focus.

Provide clear visual contrasts e.g. place white paper for drawing/writing on a larger piece of dark paper

Reinforce verbal instructions with visual demonstration

Provide movement breaks to improve arousal (see Attention Section).

Be aware that a child who has a fear of movement or heights may find it hard to carry out activities such as climbing on apparatus off the ground, particularly in a busy, overwhelming environment. Encourage him/her to take small steps towards e.g. climbing the wall bars, perhaps choosing own goal:

- Side stepping, hand held if needed, along the narrow side of a gym bench

- Forward stepping, hand held if needed, along the narrow side of a gym bench

- Walking up a gym bench that has one end hooked onto chosen rung of the wall-bars

… and so on.


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Section 5b

VISUAL

PERCEPTUAL

FUNCTION


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Check for correct sitting posture

(see Handwriting Section for detailed description)


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VISUAL PERCEPTION

Introduction Visual perception enables a child to recognise and understand a visual stimulus e.g. a shape or colour; it gives meaning to what is seen. It therefore forms a link between sensory processing (see Section 4 ) and aspects of cognitive skills. This can be thought of in three stages, for example:-

sight (good visual acuity) visual perception reading

Visual perception can be broken down into a number of skills which are important in the classroom but also in everyday life:-

ability to spot details in a complex background (figure-ground skill) helps to pick out the right number in a number square but also to spot the ‘green man’ lit up at the crossing

recognising which way round a figure is placed (position in space) helps avoid letter reversals but also to follow direction signs

being able to relate figures to each other (spatial relations) helps learn about shapes and patterns but also to move around without bumping into things

All visual perceptual skills rely on visual acuity and to some extent on motor skills (whether postural control, eye fixation/tracking or hand/eye coordination). It is therefore helpful to consider whether underlying difficulties may be contributing to problems with visual perception. (Refer to other Sections as appropriate). Activities to improve visual perception for the younger child (see also Pre-writing Activities in Handwriting Section (5d, page 163):-

Copying games (Follow my Leader, Simon Says)

Inset puzzles, simple jig-saws and construction

Identify objects/shapes by feel as well as sight

Match and sort objects, colours, shapes

Join the dots to make an object/shape

Looking games : I-Spy, ‘Find one that’s the same/different’

Copy simple shapes/patterns

Follow simple mazes

For learning to recognise and copy shapes, letters and numbers, use a multi-sensory approach: combine looking, movement, touch, speech and music (singing)


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For the older child, strategies for visual perception link to different aspects of learning:- Reading, writing

Make sure the child sits facing the board

Enlarge worksheets, thereby enlarging print

Colour or highlight key information on the board or on a page

Use a ruler or finger to highlight text (see Resource List for ‘line tracker’)

Exclude unnecessary detail on worksheets

Provide partially completed worksheets

Provide a paper copy of work that is on the board

Trace shapes, numbers and letters with a finger before drawing

Use lined paper for writing (try raised lines – see Resource List) Spatial organisation and copying

Use a grid method to copy drawings (place an acetate grid over the drawing to be copied)

Provide pre-drawn tables, graphs and pie charts to fill in

Reinforce spatial concepts e.g. under, over, in front, behind, left, right,

Colour margins: green for ‘start’ and red for ‘stop’

Use stickers to indicate where to start on the paper

Trial spacers between words: index finger, penny, ice lolly stick

Provide a cue sheet with sample layout

Plan picture content before drawing

Use stencils to draw shapes


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Construction

Help child recognise the relationship between 2D and 3D by placing an actual cube with a picture of a cube

Show child a completed sample to demonstrate finished object and use as model

Provide partially completed object for completion

Work in ‘parallel’ with LSA / teacher / a buddy when constructing object

Practise following simple visual/verbal instructions to make an object

Use tick list for steps in process Numeracy

Use graph paper for setting out maths calculations

Use coloured columns for tens/ones(units)

Fold paper to indicate columns

Provide a cue sheet with example of calculation required

Use concrete examples to demonstrate length, depth, height etc.

Continue to use visual / concrete representation to teach concepts e.g. fractions


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Section 5c

ATTENTION

AND

ORGANISATION


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ATTENTION and ORGANISATION

Children who find concentration difficult may be either very active or more passive and unresponsive. It may be because a child has had limited opportunities to develop sustained attention or finds school activities more challenging than peers. Attention deficits may result in a child appearing not to listen, impulsivity and poor organisational skills. It is helpful check whether such behaviours happen in all settings - in school, at home and during other play activities. However, there is now increasing awareness that some children have underdeveloped or inefficient ways of organising sensory inputs. They can be over or under-responsive to inputs such as touch, visual stimuli and sound; they may find it hard to sustain upright postures and may seek out or be readily distracted by body movements. They may find it hard to integrate sensory information so as to respond in an organised way. See also Sensory Processing Section. It seems that by providing the right amount and type of sensory input, children can be helped to function at a more optimal arousal level and this can often make them feel more comfortable and begin to learn strategies which help to regulate attention. This approach can be thought of as helping an engine to run at the right speed, not too fast and not too slowly. ‘How does your engine run?’ training may be available from the Children’s Therapy Service (see Training, section 9). ‘The Out-of-Sync Child: Recognising and Coping with Sensory Integrative Dysfunction’ is another helpful information source (see Resource List, Section 7). The following general strategies can be tried before referral to Occupational Therapy or while awaiting Occupational Therapy assessment:-


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ATTENTION

Strategies

Provide opportunities for movement e.g. cleaning the whiteboard, running errands, giving out equipment to peers, collecting equipment after an activity has finished etc

Provide a movement breaks outside the classroom e.g. walking or running around the playground, jumping up to touch a high point on the wall. (Do not take away outdoor play opportunities as a sanction).

Do a whole class ‘wake up stretch’. Demonstrate stretching the body and tensing the muscles, followed by relaxing and ‘flopping’; letting out a big sigh may also help) - exaggerate the movement!

Child helps the teacher to move large pieces of gym equipment e.g. gym benches and mats (be mindful of correct lifting procedure)

May help to place the child at the front of the class, directly in front of the board if possible or in line with the teacher when floor sitting

Use a carpet square on the floor to create a defined space for circle time

If child has poor postural control on the floor, encourage stable sitting position (e.g. cross-legged) or leaning against back support

Try using a move ‘n’ sit cushion – see details in Resource List

Consider if the child has had breakfast. Would a small, healthy snack (e.g. banana) put them back on track?

Allow frequent access to water bottle, kept on the desk or readily accessible

Remove all materials that are not required for completion of a task from the child’s desk

Try timers which allow the child to see how long he/she needs to concentrate on a task and set targets

Give the child a ‘fidget toy’ to use when you want him / her to listen for any length of time

Use frequent, positive encouragement e.g. “That was good, now let’s see if we can …”

Encourage effort rather than performance.

Grade activities to guarantee initial success

Have a calming (low distraction) area of the classroom (with e.g. bean bag to sit on).


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LISTENING

Think about the classroom environment

Position children with attention difficulties close to the teacher

Be aware of any competing sounds and visual distractions, which may make it harder for children to know what they should be attending to e.g. shut the classroom door

Sit children with attention difficulties away from distractions

Provide short breaks between activities to allow time to refocus

Use visual support

Use visual rules as reminders to sit well, look and listen

Give specific praise to encourage active listening e.g. “good looking!”, “good listening!”, and “good sitting!”

Use visual clues e.g. pictures, gestures, objects, writing alongside spoken language

Use timers to provide visual cues about the length of an activity which can help maintain attention

Use verbal cues and support

Make sure that you have the child’s attention before giving an instruction. Say the child’s name and make sure that they are looking at you.

Focus the children by telling them ‘It’s time to listen’

Highlight what you want them to listen out for, e.g. “At the end I want you to tell me three things about elephants” or “I want you to touch your nose every time I say ‘Goldilocks’”.

Encourage the pupil to repeat the instruction back to you before they start a task


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ORGANISATIONAL SKILLS

Children need to be able to establish a degree of concentration, sequencing, memory and self-awareness in order to be able to develop their organisational skills. The following strategies may useful:-

Strategies Working Space

Help child to work in an uncluttered area.

Use a clear plastic pencil case to aid easy location of pens / pencils etc

Get child into the habit of having a place for everything: after an item is used, make sure the child puts it back where it belongs so that s/he knows where to find it next time.

Schoolwork With younger children:-

Reinforce regular routines, prompt child to tell you what’s next

Use a simple, visual timetable; colour code days or activities (this can be replicated at home)

Put pictures on school books to indicate the subject. For easy location, pictures could also be put on the trays/drawers where the books are kept (if all in one place).

Consider a ‘home/school’ book to help keep track of child’s activities With older children:- Especially in preparation for secondary school, the child should be involved in deciding what strategies may be helpful. A useful source of further strategies is ‘Occupational Therapy Approaches for Secondary Special Needs’ (see Resource List).

Use a different coloured exercise book for each class and coloured folders to match the exercise books. Keep all papers and homework for a class in the matching folder, so that the child always knows where it is.

Where tools/apparatus are kept out of sight, mark cupboards/drawers with labels.

If using just one notebook / ring binder file, use tabbed dividers for each class/subject with a different colour for each.


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Keep pens, pencils, pencil grips, erasers, a small ruler and other things needed for each class in separate(colour-coded) zipped, plastic pockets

Keep a supply of post-it notes in each file to write brief notes and stick on to provide cues for follow-up work.

Keep a memo book to write down important things.

Encourage making lists to help remember things and keep track of what needs to be done (cross off list when completed).

The same technique could be applied to completing a task / project i.e. tick off each step as it is achieved.

Try mind mapping approaches.

Put a copy of the school timetable in the notebook / ring binder file for reference (can be colour coded to match subject lessons).

Homework and preparing for school

Make a ‘master’ timetable that shows the usual weekly schedule, e.g. lessons, homework, after school activities.

Put the timetable in a plastic wallet to keep it clean, or get it laminated.

Provide a wall calendar with large blank spaces on which child can write important dates or events e.g. exams, when projects are due in. Use a pencil in case need to make changes. (Check dates with school).

Use a ‘plan’ book to keep track of daily homework assignments.

The plan book will also help with tracking assignments that are due later in the week or month.

If child has trouble writing down homework assignments, check to make sure that what is written is accurate (can also ask a classmate to do this):-

Date:

Subject Is there homework? What is it? When is it due?

Numeracy Yes / No

Literacy Yes / No

Science Yes / No

History Yes / No

Teachers and parents discuss a routine to prevent child losing things and rushing e.g. place all school items in the same place every day - perhaps a large box by the front door at home


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Written tasks

Keep printed/ written alphabet and number lines nearby and refer to them if s/he forgets how to write a letter or a number.

When copying information from another book or sheet of paper use a ruler or blank sheet of paper under each line of print (or line-tracker - see Resource List).

Get child into the habit of making a brief outline before writing (e.g. list key words) to help prompt what s/he wants to write. Could try a dictaphone/tape recorder if writing is difficult.

Keep a diary of words the child has trouble spelling so that it can be referred to easily when writing.

Try saying written work out loud; this may help child notice and correct mistakes.

Seek advice from Teacher Adviser for Information Technology regarding equipment available for alternative methods of recording.


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Techniques to try in the Classroom Refer also to section on ‘Attention’ (page 2) If the child has difficulty:- Listening

Position the child in front of the teacher

Work individually or in small group

Provide a quieter environment Following instructions

Repeat instructions

Give one instruction at a time

Use key words, short phrases, concrete language

Break the task down into small steps - work on one step at a time

Ask the child to demonstrate and review how to play a game before starting.

Tick off tasks as they are completed

Provide examples (use visual, auditory and tactile prompts)

Ask the child to repeat and explain the instructions before beginning

Team up with a peer in the class who understands the task instructions and can help Starting an activity

Explain the purpose of the assignment and make sure the child understands the expectations

Present work in small amounts

Give a signal to begin working

Give immediate feedback and encouragement

Use a digital timer and help the child estimate how long the work will take

Discourage rushing

Provide individual attention to support routine


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Staying on task

Seat child away from window/door and/or in front of teacher

Place a child next to a peer who provides a good model and can help immediately

Consider which time of day is better for demanding tasks so the child will be at his/her ‘best’

Start the child on short tasks which require concentration - gradually increase this

Provide frequent reinforcement - lots of praise!

Ask questions to help prompt child focus on next step

Use a timer to indicate when the task is to be finished Working independently

Provide activities appropriate for the child’s development level

Alternate short, independent tasks with those which require some assistance. Grade tasks so that the child is gradually required to increase the amount of independent work

Coping with change

Provide structure and routine; visual timetable may help.

Encourage flexibility and acceptance of change using a symbol for change or surprise (? or !), introducing change into the timetable from time to time


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Section 5d

HANDWRITING


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HANDWRITING

The expectation of the National Literacy Strategy is that most children will write consistently with neat, legible, joined handwriting by the end of Year 4. However, handwriting is a complex task which relies on many underlying motor and perceptual skills including:-

Balance and postural control

Ability to move rhythmically

Eye-motor control

Arm/hand stability and finger dexterity

Body/spatial awareness and directionality

Visual attention and listening

Combining spatial and language concepts (‘up’, ‘down’, ‘round’)

Bilateral coordination (both sides of the body working together)

Individual finger awareness

Hand dominance

Linking letter sounds and shapes

Visual discrimination and recognition

Motor planning Children need to develop the mechanical skills of writing before they can start to concentrate on factual or imaginative content and achieve the later stages of writing in the Foundation Stage Profile. It is important to focus on quality before quantity and for children to have fun with developing such a complex skill! Your school will have a handwriting policy; some handwriting schemes are more helpful particularly for children who find writing difficult - you may wish to discuss this with the occupational therapist. Readiness for Writing With early school entry now in place in the United Kingdom for over a decade, reports suggest that that many children coming into reception classes exhibit variations in maturity and have not fully developed the foundation skills for more formal learning. Pilot occupational therapy/education research in a Hampshire infant school (2006) identified that during their first term, over two thirds of reception children were not developmentally ‘ready to write’. When children come to school, experience of letter shapes and writing varies. Some may know how to hold a pencil and form certain letters; others may have been encouraged to write before they are ready. Most children will benefit from practicing the foundation skills needed for writing. Foundation skills can be improved through the programmes provided in this Schools Pack, particularly Achieving Body Control, Clever Bodies, FMS, Clever Hands and the activities in the Visual Perception Section. You may also want to draw on approaches such as Write Dance, hand gym etc. which promote movement, rhythm and coordination. (see resource section)


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Developing pre-writing skills The following are examples of the type of activities which could be included in a pre-writing programme and why they are useful:- Balance and postural control

Lie on tummy and pull along with forearms - move like a seal with appropriate noises! - extension posture, shoulder stability, strengthening arm muscles

Kneel up tall, roll ball to named child in circle - eye tracking, balance

Actions to Grand Old Duke of York, Hickory Dickory Dock - coordination, body and spatial awareness, rhythm

Hand function

Hold onto large piece of Lycra, lift up and down keeping ball/bean bag on surface - eye tracking, shoulder stability, hand grasp

On all fours, rub chalk/chunky wax crayon to cover large sheet of paper with colour - shoulder and arm stability, developing pencil grasp

Motor planning/sequencing, visual perception

Make (anti-clockwise) wheels in the air (tractor, bus, bicycle) in time to music - movement, rhythm and letter shape

As children begin to consolidate foundation skills, other factors need to be considered Guidance on sitting position (stable, upright posture)

child sits on chair with hips, knees, ankles at right angles

feet are supported e.g. flat on the floor or a foot rest

seat depth allows child to be well supported by back of chair (without front edge of seat pressing into back of legs)

chair is pulled into the table/desk, providing good forearm support on table

table height is at level of child’s bent elbow (when sitting upright) or 2-3cms below


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Check for correct sitting posture

Good posture when writing (or for other table top activities and using a computer) Hips, knees and ankles at 90º, feet flat on the floor, good back support, chair well pulled in Table at resting elbow height or just below

Strategies for Pre-writers

Practise making shapes and patterns in the air with big arm movements to reinforce motor memory, then with smaller hand or finger movements (in sand, playdough, finger paint etc.)

Repeat the above with letters/numbers.

Encourage good posture for writing: it is important to reinforce this early, so children do not have to unlearn habits later on.

Pencil grasp Observe children’s grasps on crayons and paint brushes. Practise correct pencil grasp as soon as children are developmentally ready, for drawing and patterns. (You may wish to divide the class into groups, working on this as children are ready). Normal development of pencil grasp:

whole hand (cylindrical grasp)

pencil pointing downwards in direction of finger tips

pencil held between thumb and several finger tips (rounded web space between thumb and index finger developing)

tripod grasp between thumb and index finger, resting against middle finger


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To develop pencil grasp:

Colour on sugar paper with very short, chunky wax crayon

Identify thumb/fingers needed: place writing hand palm down on table. Lift named finger in turn: Tommy Thumb (1), Peter Pointer (2), Toby Tall (3), then tap each separately on table

Pick up pencil and practise where the fingers go

Reinforce with rhyme/song (tune as in ‘Here we go round the mulberry bush’ or ‘Twinkle, twinkle’ - repeat last two lines)

On my pencil, can you see?

Thumb and fingers, one two three Hold your pencil just like me

Thumb and fingers, one two three

Children with extra stretch in finger joints may hold a pencil with an excessive dip in fingers (usually index), see also ‘Pressure’, below.

A suitable pencil grip can reduce this dip Letter formation

Practise letter sounds and names (e.g. point to alphabet cards, naming ‘t’ for teddy)

Sing alphabet to reinforce sequence

Check school’s handwriting scheme: encourage correct letter formation from the start - check frequently and reinforce; practise for short period every day

Think of writing a letter as a sequence of movement, emphasising correct starting point

Use multi-sensory techniques for learning shapes, letters, and numbers e.g. talk through sequences (‘I go round, up and down’) and illustrations (‘b’ is ‘big stick down and circle away from body’).

Letters can be practised in similar ‘families’ but they may be easier to learn in alphabet sequence (easily reinforced by singing) where each succeeding letter has a contrasting shape

Share information on how pencil grasp and letter formation are being taught with parents so they can reinforce in play activities at home


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Strategies for Early Writers

Warm up exercises

These can be done as a class or individually

Rub hands together - fronts and backs

Hands flat on table, tap thumbs and fingers in sequence.

Tap specific fingers, e.g. “tap your index finger (Peter Pointer) twice”.

Press palms, fingers and thumbs together, keeping fingers straight.

Touch thumb to each fingertip in sequence, both hands at the same time, then right hand, then left. Try and do it without looking at hands.

‘Flash lights’ (fingers opening and closing quickly); again specify both hands, then left, then right. Then

Stand up, stay on the spot and wriggle your whole body.

Stamp your feet on the spot.

Stretch arms up above your head, let arms flop down. ‘Now you are ready to sit down and write’!

Print or cursive? Most children find single (i.e. printed) letters an easier motor and perceptual task to start with (but always include exit stroke/flick on appropriate letters to prepare for later joining).


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Materials/equipment

Provide suitable pencil grips for children who need more help with correct pencil grasp (see Resource List)

Provide a selection of pencils (pens), so children can choose what feels comfortable

Children can experiment on blank paper but then move on to lined paper (wide space between single lines)

Raised line paper is available (see Resource List)

As letter formation develops, double (tram) lines often help (set at width approximating to child’s average mid-zone letter size when written freely)

Use exercise books rather than loose paper

Try large graph paper for sums to keep columns and rows organised. Consistent, preferred hand for writing? Some children may not have developed a leading hand or clear hand dominance by the time they start school. (Even those who always hold a pencil in the same hand may alternate the leading hand in two-handed activities). Picking up a pencil alternately with either hand can sometimes be linked to coordination problems or difficulty crossing the mid-line of the body and/or directional confusion. Strategy/review

Give child time to experiment

Does child generally use both hands together efficiently (or tend to ignore one?)

Check whether there are immediate left-handers in the family (especially mother) which may suggest a left preference

Observe whether one hand is preferred for throwing a ball, pointing, picking up food, threading a lace into a bead etc.

Where there is no reason to predict left-handedness and child appears to function at the same level of skill with either hand, encourage using pencil in right hand (in liaison with parents)

Note : a child could be genuinely ambidextrous i.e. equally skilled with either hand but this is rare.

Paper position The position of the paper can affect the fluency and speed of writing. - right-handed children should angle the paper to the left - left-handed children should angle the paper to the right


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Younger children will need guidance; older children can check for themselves: - sit straight at the table - clasp hands together in line with both head and midline of the body, place forearms on table to make

a triangle - place paper inside the triangle, parallel to writing arm

Left and Right Hand Paper Position

Advice for left handers

In order to see text as they write and prevent smudging, they should hold the pen/pencil further from the point. The preferred position can be marked with a small elastic band or by using a pencil grip or pen with an integral grip. Left-handed children have to push the pen/pencil across the paper which can be more tiring. Ballpoint, Berol or fibre tip pens create less friction and left-handed nibs are available from commercial stationers. Position left-handers at the end of a table (not next to a right-hander) to provide adequate space for forearm support.

Correct grasp for left-handed child


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A hooked grasp may result in: - restricted arm and finger movements - having to move the whole arm when writing letters, which

becomes tiring

- continual re-adjustment of hand position with jerky movements which reduce fluency and speed - ache in wrist and fingers with extended periods of writing

- smudging of work and difficulty achieving neat writing and presentation

Hooked grasp

Strategies to avoid a hooked grasp

- practise drawing /writing on vertical or sloping board to develop wrist

extension - check paper position - angled correctly for left-hander - try an angled surface on table - experiment with softer pencils or alternative pens - use relaxation techniques regularly (see below)

Useful resources for left handers The following resources are available from Anything Left-Handed (see Resource List): - Writing Left Handed - Helping Left Handed Children to Enjoy - Left Handed Children - A Guide for Teachers and Parents - The Left Hander’s Handbook


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Relaxation techniques for the writing hand Most children will tire at some stage when writing and exercises can be incorporated into classroom activities:-

Position hands under thighs, flat on chair seat, palms down, rock from side to side

Place hands palms down, grasp edge of chair seat, straighten elbows, push down through hands to lift bottom off chair.

Place palms together and interlock fingers, turn fingers towards body and push away with elbows straight.

With arms down by sides, make a tight fist in both hands and then straighten and spread fingers

Place palms of hands together in ‘praying’ position with fingers stretched then lower forearms onto table, keeping fingers pointing upwards and wrists extended.

Shake arms and hands down by sides. Pressure Children may press either too hard or too lightly. Contributory factors may be - poor shoulder stability (and attempt to compensate by tightening muscles in the arm or hand)

- weak arm or hand muscles - poor sensory feedback - extra stretch (hyper-extension) of thumb/finger joints (where children try to achieve a more stable

position by using position of maximum stretch, causing an excessively dipped appearance)

Tripod grasp with hyper-extension of index finger


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Heavy pressure may result in:

- increased tension (aching) in forearm and wrist

- loss of fluency - difficulty writing for a sustained length of time

- indentations or holes made in paper Strategies - check sitting posture (see page 321 )

- see hand relaxation techniques (see above) - implement Clever Bodies – Motor Planning and Coordination and (Section 3a page 66) and Clever

Hands (Section 3b page 117)

- practice writing on sheet(s) of paper over carbon paper to provide visual feedback on degree of pressure

- write in exercise book rather than on a single sheet of paper on desk - place card under the paper to prevent imprint of text onto the next page - try an angled surface (see Resource List)

- use larger diameter pencil/pen to reduce strain on finger joints - use commercially available pens with cushioned grip incorporated into the barrel, which may reduce

tension - try pen (nib) with easier ink flow on paper e.g., fibre tip, roller ball, fountain pen Light pressure may result in:

- inability to make consistent marks on paper

- poor pencil control - illegible, spidery script


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Strategies - check sitting posture (see page 321)

- implement ‘Clever Hands’ (Section 3b page 117)

- try angled surface (see Resource List) - try different pencils /pens which require less pressure e.g. soft pencils, fibre tip, roller ball - a weighted pen can help dampen a tremor (shakiness); a light weight

pen can help children with muscle weakness (see Resource List)

Strategies for Older Children For older children, specific programmes may be helpful:-

‘Write from the Start’ Books 1&2 (Teodorescu, Addy ) : perceptuo-motor approach

‘Speed-up’ (Addy) : kinaesthetic approach (from 8 years) See Resource List To type or not to type? Writing continues to be important to schools and employers; word processing is not an automatic alternative to handwriting since it also requires fine motor and perceptual skills. However, for some children, typing becomes a useful adjunct or occasionally the sole recording method. In these cases, it is particularly important to introduce a useful method from the start (preferably touch-typing), usually not until about 7 years old. Various children’s programmes are available for keyboard familiarisation (e.g. Speedy Keys) and typing (e.g. BBC Dance-Mat, see Resource List). Daily practice with adult support is strongly recommended. Even if word processing is introduced early, try to maintain limited handwriting e.g. confidence in signing name. Encourage practice and praise effort - becoming a good writer can take time!


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Strategies for children approaching or attending secondary school - Allow extra time for writing assignments. - Begin writing assignments creatively with drawing, or speaking ideas into a dictaphone writing down

key words. - Vary focus of writing assignments - clear requirement for grammar, neatness and spelling or for

organisation of ideas. - Explicitly teach different styles of writing (provide templates) - personal essays, short stories, letters,

poems, etc. - Do not judge timed assessments on neatness and spelling. - Get students to proof-read work after a delay - easier to see mistakes after a break. - Help students create a checklist for editing work - spelling, neatness, grammar, syntax, clear

progression of ideas, etc. - Encourage use of a computer spell checker (or speaking spell checkers which can be used for hand

written work). - Reduce amount of copying; focus on writing original answers and ideas and use prepared

worksheets where possible - Consider alternative ways of assessing knowledge, such as oral reports or visual projects. - Encourage practice through less pressured opportunities for writing such as letters, diary, making

household lists or keeping track of sports teams.


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Section 5e

SELF-CARE


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SELF-CARE

Introduction

Self-care includes those skills children require for meeting their personal needs with an increasing degree of independence:-

Drinking and eating

Washing

Dressing

Managing the toilet For older children, self-care includes tasks such as shopping and using local community facilities. The development of self-care skills is a part of children’s learning where partnership between home and school is particularly important. Consistent approaches shared with parents are more effective and they often appreciate support to improve their child’s independence. Although self-care may appear task-focused, a combination of underlying skills is needed for success e.g.

Immature balance may make it difficult to sustain steady postures for dressing

A child who leaves face and hands messy after eating may have poor tactile awareness

Putting clothes on back to front or in the wrong order may result from reduced spatial awareness or planning

Working on motor and perceptual skills may therefore also help to improve self-care.

However, this Section includes strategies for the different aspects of self-care, together with some specific techniques e.g. for dressing and doing up shoe laces.


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Strategies for drinking and eating Drinking Tends to cough when swallowing or spills drink:-

Sit at table, with both elbows supported, hold cup/bottle with both hands, encourage to drink slowly

Eating

Check sitting posture and chair/table height (see Handwriting, Section 5d)

If cannot hold and use knife and fork (encourage using spoon and fork for the time being), practise grasps as below; try cutting playdough/plasticene first in classroom activities (simple cooking activities provide further practice)

Use ‘hand over hand’ help to cut up food at start of meal or to open lunch boxes and containers (sit slightly behind or beside child)

Identify dinner lady to supervise particular children

Prompt child to check (in mirror if possible ) when face/hands are messy (and wash/wipe)

To encourage children who are reluctant to try eating/drinking in school, provide a range tastes, smells, cooking experiences etc. in classroom activities

(See also Sensory Strategies, Section 5a)

For the child who lacks confidence or gets lost easily in a busy environment, use a buddy system to encourage.

Packed lunches may be easier to manage but school dinners (with adult support) can provide useful practice.

For packed lunches, consider

- can the child open packets? If not, putting the food in a zip lock plastic bag may help.

- can the child manage drinks cartons independently? If not, a sports bottle is an alternative. Steps involved in using a knife and fork

Stab with fork

Hold food still with fork, cut with sawing motion with knife

Stab food or use knife to guide food onto fork


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Encourage child not to grasp cutlery too tightly (keep arms relaxed)

Practise first with softer foods (potatoes, fish fingers, sausages, well cooked vegetables)


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Strategies for washing Opportunities for washing occur mainly after using the toilet or clearing up after messy activities. Check Can child

reach sink, taps, soap, towels? - provide step (can be a hazard in communal toilet area, providing lower sink, towels etc. may be

an option)

turn taps on/off? - practise hand function

reach and use soap? - practise hand function

Does he/she remember to wash hands after using toilet and before meals?

- give prompts (a picture sequence on the wall beside the basin may help)

Practice sequence: turn tap on, rinse hands, apply soap, rinse, turn tap off, dry hands

Reinforce verbal prompts with ‘hand over hand’ support as necessary

Reinforce with action songs: ‘This is the way we wash our hands…’


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Strategies for dressing Children coming into school may still rely on adult help with dressing:-

Provide extra time specifically for dressing/undressing and treat as a skill some children need to learn (by practising, watching others, learning specific methods) - encourage parents to reinforce (especially in the evening or at week-ends when there’s more time)

Prompt child to do as much as possible e.g. fetch coat from peg, put one arm into sleeve, then provide ‘hand over hand’ support as required e.g. standing behind, help child slot zip into place and pull up

If slow dressing/undressing for PE:-

- Is child easily distracted? Take to a quieter area of the room.

- If making the first move to get dressed / undressed is difficult, give clear verbal (and/or visual) prompt to start and try a timer

- If child has difficulty putting on clothes in the correct order help child to lay them out in the

sequence required and/or make a picture card sequence for child to follow (see ‘do 2 learn’, Resource List)

- If child seems to have immature balance and coordination, improve postural stability by sitting

on floor to dress, e.g. leaning against back support to put on socks If a child continues to have difficulty, consider more intensive adult support. A useful approach is ‘backward chaining’ where the child initially completes only the last step (thus gaining success and praise) and then gradually achieves each preceding step:- Putting on socks This example specifies the adult help required (helps to sit on floor behind or next to child - encourage child to use both hands) Step 1 Adult puts child’s socks on up to just below the ankle, child pulls socks up. Step 2 Adult puts child’s socks on, the top of the sock just over the heel of the foot, child pulls

socks up from the heel of the foot. Step 3 Adult places child’s socks just below the heel, child pulls socks up. Step 4 Adult places child’s sock on toes, child pulls socks up. Step 5 Child puts toes into socks and puts on independently. In the following examples, adult provides ‘hand over hand’ help as required:-


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Putting on trousers (elasticated waist) Start all steps sitting on a chair unless child has sufficient balance to do in standing (see balance activities earlier on in the programme) Step 1 Child stands up and pulls trousers up from thighs to waist with both

hands, adult having assisted with first part Step 2 Child pulls trousers up to thighs from ankles and then up around waist having been assisted

by adult to place both feet into the correct trouser legs Step 3 Whilst adult holds trousers child is guided to place one foot at a time into correct trouser leg Step 4 Repeat step 3 with child holding trousers Step 5 Child manages to place both feet through correct trouser leg and pull up round waist with

verbal prompting from adult Step 6 Child puts trousers on independently Putting on a T-shirt Step 1 Child pushes one arm through sleeve (other arm and head are already through T-shirt) Step 2 Child pushes both arms through sleeves (head already through T-shirt) Step 3 Adult positions T-shirt head hole on head and child pulls T-shirt down over head Step 4 Child places T-shirt on head and pulls down over head with both hands with verbal

prompting from adult Step 4 Child puts on T-shirt independently.


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Fastenings Buttons, hooks and zips can be the main difficulty when dressing. The following strategies may help:- Buttons

Play games that involve pincer grip (thumb and index finger tips) e.g. “Pick up Sticks”, Lego, squeezy toys, water pistols, sand play, making shapes with pipe cleaners, also use games that increase sensory awareness of thumb and index fingers e.g. finger puppets, finger painting, using playdough.

Try first with a shirt on child’s lap so he/she can easily see what to do, then practise with the shirt on. When he can do buttons with the shirt on, practice with eyes shut. Do the same with trouser buttons, hooks/ clasps, i.e. first practise first with them off, then with them on.

Use bigger buttons in a different colour to the fabric. Plain coloured fabric is easier than checks or stripes which can be tiring for the eyes and make buttonholes difficult to see. Patterns can be re-introduced when the child is able to do up buttons.

To avoid confusion, take off any spare buttons on the inside of shirts.

Encourage the child to start buttoning from the bottom of the shirt so he can see what he is doing. To do top buttons, help him check in a mirror (at the right level) in the changing area.

To ensure that buttons do not come off easily, put some nail polish on the thread at the back of the button to secure it for longer.

To ensure that the button can fit through the buttonhole easily, try snipping the edges of the hole to make it slightly bigger. To ensure buttonholes do not fray and to provide a little sensory feedback and stability, you can use clear nail polish to seal the ends (it will feel like the end of sealed rope).

Use shirts that are slightly bigger but resist the temptation to use Dad’s shirts (except for fun!) as they are often too big, with long sleeves and make it difficult to see.

http://www.mjtrim.com/catalog/product.aspx?product=22049&variant=--1025-28L









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Normal method for doing up buttons (practise yourself before helping child who may need to follow sequence a step at a time) 1. Line up the correct buttonhole and corresponding button. 2. Helps to put index finger through the buttonhole so that it is sticking through on the underside of the

material. This hand is then in the right place to grasp the button and pull it through. Keep that hand there!

3. With the other hand grasp the button with the thumb and index finger (usually index finger on the

top flat surface of the button and the thumb underneath - keeping free the edge of the button going into the hole .

4. Push the button through the hole. As the button gets halfway through, the index finger and thumb

of the other hand grasps the button and pulls it through. 5. The other hand will be pushing it through with the thumb while the index finger pulls the material

over the button. Adapted from guidance devised by Clare Reabow and Mary Hodson Paediatric Occupational Therapy service Swindon Primary Care Trust


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Zips

Make sure that you are practising with a zip that is easy to do up.

First make sure child can pull up zips that are already engaged, for example trouser zips.

‘Hand-over-hand’ support can help child to feel the movement that is needed.

Make sure that your child can see what s/he is doing Practise with the garment laid flat on a stable surface first – it may be easier than looking down to fasten it Bigger zips are usually easier to see and grip initially. Zips without flaps of material around them are easier as they do not get in the way. Practice with an old zip can be useful. You could also colour one side of an old zip with nail polish for clarity. Attaching a small loop of string or metal ring to the zip can help to make grasping and pulling the zip easier

Replace zip with Velcro


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Method for coats etc. Practise first with the garment off. Once child can do this easily, practise zipping up with the garment on – the method will be the same – just seen from the other side. 1. Lay out the garment so that it is flat and you can see which sides need to be put together. 2. Make sure that the zipper is right at the bottom. 3. The end of the zipper should be flush with the metal / plastic end (on the same side). Where there’s

a tab or overlapping fabric, move it away and out of the way and hold it back with the thumb of the hand on the same side. Do not let this side go.

4. With the other hand, take the flat metal / plastic side (that slips into the zipper) and hold it about

1cm away from the edge between the tip of the thumb and index finger. 5. Now slip the flat side into the groove of the zipper. It is really important that the other hand is still

holding tightly onto the zipper. 6. Slide the flat side down to the very edge of the garment. (Sometimes you can hear a soft click when

it slots into the bottom properly). TIP: help child pause here – children tend to get excited when they have reached this step, rush and undo all their hard work. 7. Make sure that one hand is holding both sides of the fabric AND the slotted base of the zip VERY

tightly. 8. Keep holding on and pull up zipper with thumb and fingers of the other hand.


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Tying Shoelaces Younger children usually have shoes fastened with Velcro but older child may need laces for football boots and other shoes. The following method simplifies the tying process. If this still proves difficult, alternatives to standard laces are available (see Resource List).

Right Handed Method (the positions can be reversed for a left-hander)

In each hand, hold up one end of the lace so that there is roughly 10cm sticking out.

The hands should be in a position so that thumbs are uppermost.

Cross the ends of the lace, but still with an end in each hand.

Put the left end over and then under, the right end. (It may help to draw L and R on the child’s thumbs). Now pull the end to make the knot tight.


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Tip: by doing this twice the knot will be more secure.

Make a loop or ‘bunny ear’ with the right lace and ensure that there is a ‘tail’. The loop should be flush with the knot made in the previous step. This loop should be

held tightly at the base (so that the ‘bunny doesn’t escape’).

Keep holding this loop with the right hand. Now, with your left hand, make a loop as

in the previous step.

Cross the loops over, right loop on top of left loop, but keep holding the loops

tightly. Ask your child to STOP and tell you which hole the loop / ‘bunny ear’ needs to come through.


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Now push the top loop / ‘bunny ear’ over the other loop and through the hole – catch hold of this loop whilst still holding onto the other loop.

Pull both loops slowly to tighten, making sure that the ‘tails’ do not slip through!

Congratulations !


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Strategies for managing the toilet Younger children are sometimes just delayed in establishing independent toileting. This seems more common in children with lower muscle tone - it may be that their sensory feedback is less pronounced and they are not so aware of urgency. (If difficulties persist, discuss with parents whether there is a need for medical referral to exclude any other cause). Such children may need help to reinforce toileting skills in school (in conjunction with similar approaches at home):-

Emphasise expectation for whole class of going to the toilet routinely (social motivation)

Specifically prompt child to go to the toilet regularly e.g. at the beginning of break time

Check whether child seems anxious about going to the toilet or whether any aspect is physically difficult (e.g. does small child feel secure on the toilet?)

Provide adult supervision to reinforce sequence e.g. may need ‘hand over hand’ help with managing clothing, reaching toilet paper, flushing toilet, washing hands

Provide ‘big wipes’ which can be easier than toilet paper

Check ability to shift weight onto one side, balance and reach: play games on floor and chair e.g. passing bean bag under each thigh in turn

Parents to supply change of clothes to be kept in school (and may reassure child to be aware of this)

If incontinent, treat as not a problem but involve child as appropriate in washing/changing (helping to manage)

Keep a record of times when wet or soiled - is there a pattern? Use Toileting Record Sheet (page 16)

If there seems to be a behavioural element, consider child going to toilet prior to a rewarding activity / alongside other children (peer reinforcement) or on his/her own (with adult support) if needs less busy environment

Lots of praise for success can be reinforced with specific rewards or star charts. Children with complex needs may benefit from a very structured approach such as that devised within the TEACCH approach (see Resource List).


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Toileting Record Sheet

Name:- Date:-

Time Drinks Wet/Dry/Soiled Used WC?

8.00am

8.30am

9.00am

9.30am

10.00am

10.30am

11.00am

11.30am

12 noon

12.30pm

1.00pm

1.30pm

2.00pm

2.30 pm

3.00pm

3.30 pm

4.00pm

4.30 pm

5.00pm

Section 6 – Glossary

Section 6

Glossary


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Glossary of Terms

Speech, Language and Communication definitions

Articulation

difficulty

A sound is made differently to normal, sometimes due to a structural deficit. An

articulation difficulty can cause unintelligible speech, or may not cause any loss in

clarity. A lisp (tongue touching teeth when producing ‘s’ and ‘z’ sounds) is a typical

example.

Cleft Lip and/or

Palate

A cleft lip and/or palate occurs when the two sides of the lip, soft palate or hard

palate, do not join and fuse during development in the womb. A cleft lip can occur

with or without a cleft palate, and likewise a cleft palate can occur with or without a

cleft lip, and may involve the soft palate, hard palate or both. A cleft lip and palate

can result in speech and feeding difficulties.

Dysarthria An impairment of movement and coordination of the muscles required for speech,

due to abnormal muscle tone. Muscles do not move as far, as accurately or as quickly

as normal, similar to the slurring that occurs when someone is drunk or following a

stroke, head injury or neurological disease. In children, it is usually associated with a

condition such as cerebral palsy or muscular dystrophy.

Language delay The child’s language skills are developing according to normal patterns but slowly, so

that they are at the level of a younger child. A child with a language delay is likely to

continue to develop language skills naturally with general support within his normal

communicative environment.

Language

disorder

The child’s language skills are not developing according to normal patterns, e.g. they

may be able to use more complicated language than they can understand; have

difficulty in learning new words; make word-order errors; or have word-finding

difficulties. Alternatively, different components of the child’s language abilities may

be developing unevenly or his language may be developing at a significantly slower

rate than his non-verbal abilities. A child with a language disorder is unlikely to

develop new language skills without specific support.


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Oral Dyspraxia This is a motor speech disorder that can be either oral – affecting all movements of

the muscles of the mouth – or verbal – only affecting these muscles when the child is

speaking, but not when eating, whistling, or using facial expressions, etc. It consists of

difficulties in organising and sequencing the rapid oral movements required, despite

the intention to make the correct sound. Production of sounds may, therefore, be

inconsistent and become worse when the child is tired or unwell.

Phonological

delay

The child’s system/organisation of speech sounds is developing according to normal

patterns, but slowly so that it is at the level of a younger child. A child with a

phonological delay may catch up without specialist help.

Phonological

disorder

The child’s system/organisation of speech sounds is not developing according to

normal patterns. They may be able to use harder, later developing sounds, but not

simpler, early developing ones; they may replace sounds they cannot yet say by

unusual, or even non-English sounds, and may distort vowel sounds. A child with a

phonological disorder may require specialist support to develop their speech.

Selective Mutism Selective Mutism (formally known as Elective Mutism) is a disorder that usually

occurs during childhood. It is when the child chooses not to speak in at least one

social setting; however, the child can speak in other situations. Selective Mutism

typically occurs before a child is 5 years old and is usually first noticed when the child

starts nursery, pre-school or school.

Specific Language

Impairment (SLI)

A language disorder that is not associated with any other learning difficulty.

Word-finding

difficulties

Difficulty in retrieving specific vocabulary from memory even though the word is

known. This is similar to the ‘tip of the tongue’ phenomenon. Children may use non-

specific words, such as ‘thing’/’doing’; pauses or fillers, such as ‘um’/’er’; related

words, e.g. ‘apple’ for ‘orange’; neologisms; or circumlocution.


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Physical skills, Posture and Movement

Abduction Movement of a limb away from the midline of the body.

Active Movement When a person moves a body part on his own without any help or support.

Active Assisted

Movement

A movement of a body part assisted either by the physiotherapist,

or by the patient using another limb to assist the weaker limb.

Activities of Daily

Living

Refers to daily self care activities we need and want to do, such as bathing, dressing,

toileting, feeding and meal preparation. Also includes tasks such as school work,

home work and leisure.

Adaptive

Response

An action that is appropriate and successful in meeting some environmental demand.

Adaptive responses demonstrate adequate sensory integration and drive all learning

and social interactions.

Asymmetrical

When one side of the body does not reflect the other eg. It may appear unequal.

Ataxia

A term used to describe quality of movement; it is poorly timed, graded and directed.

Resulting in poor balance and coordination, with jerky and unsteady movements.

Atrophy

Wasting of muscles or nerve cells.

Bilateral

Coordination

The ability to use both sides of the body together in a smooth, simultaneous, and

coordinated manner.

Bilateral

Integration

The neurological process of integrating sensations from both body sides; the

foundation for bilateral coordination.

Body Awareness

The mental picture of one’s own body parts, where they are, how they interrelate,

and how they move.


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Clonus Shaking movements caused by spastic muscles (tight muscles) after they have been

suddenly stretched.

Co-ordination The joint working of several muscles or muscle groups in the execution of

complicated movements eg. for posture, balance and limb movements

Contracture Permanently tight muscles and joints, occurring when a joint loses motion due to

structural changes in the muscle, ligaments or tendons.

Core stability

This refers to muscles whose strength is the base of support for efficient and effective

limb movements through the maintenance of good posture, balance etc. Most

commonly this refers to the pelvic floor, deep abdominals and deep spinal muscles.

Depth Perception The ability to see objects in three dimensions and to judge relative distances between

objects, or between oneself and objects.

Deformities Body or limb fixed in an abnormal position.

Diplegia A type of Cerebral Palsy where the legs are most affected, but often with some

involvement of the arms.

Dorsiflexion Movement at the ankle of pulling the toes up towards the body.

Dynamic Balance

The ability to anticipate and react to changes in balance as the body moves through

space.

Dyskinesia

A term used to describe impaired movement. An impairment in the ability to control

movements, characterized by spasmodic or repetitive motions with a lack of

coordination.

Dyspraxia

A partial loss of the ability to perform skilled, coordinated movements caused by

deficient motor planning that is often related to a decrease in sensory processing.


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Eversion Movement at the ankle of turning the foot out.

Extension

A straightening action of a joint (neck, back, arms, legs).

Eye-Hand

Coordination

The efficient teamwork of the eyes and hands, necessary for activities such as playing

with toys, dressing, and writing.

Facilitation Assistance given to the child to move the limb.

Fine Motor Skills

The skilled use of one’s hands. It is the ability to move the hands and fingers in a

smooth, precise and controlled manner. Fine motor control is essential for efficient

handling of classroom tools and materials. It may also be referred to as manual

dexterity.

Flexion

A bending action of a joint or a pulling in of a body part.

Form Constancy Recognition of a shape regardless of its size, position, or texture.

Gait

Manner of walking, characterized by rhythm, cadence, step length, stride length, and

velocity.

Gross Motor

Skills

Coordinated body movements involving the large muscle groups to make large motor

patterns eg. running, walking, hopping, climbing, throwing and jumping

Hand Preference Right – or left handedness, which becomes established in a child as lateralization of

the cerebral hemispheres develops.

Hemiplegia A type of Cerebral Palsy in which only one side of the body is affected


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Hydrotherapy Rehabilitation exercises performed in a appropriately designed heated pool.

Hyperextension Active or passive force which takes the joint into extension past the ‘normal’

accepted range.

Hypermobility

An increase in the normal range of joint movement. This may lead to instability and is

caused by lax ligaments and tendons.

Hypersensitivity Over sensitivity to sensory stimuli, characterized by a tendency to be either fearful

and cautious, or negative and defiant.

Hypertonia

Increased muscle tone causing stiffness and potentially decreased range of

movement at a joint. Also called spasticity.

Hyposensitivity Under sensitivity to sensory stimuli, characterized by a tendency either to crave

intense sensations or to withdraw and be difficult to engage.

Hypotonia

The lack of supportive muscle tone, usually with increased mobility at the joints,

causing the limb to appear loose and floppy.

Integration The combination of many parts into a unified, harmonious whole.

Inversion Movement at the ankle of pulling the ankle in towards the body

Intoeing

Term used to describe gait when a child walks/stands with the toes pointing inward.

Kinaesthesia The conscious awareness of joint position and body movement in space eg. knowing

where to place one’s feet when climbing stairs without visual cues.

Kyphosis Exaggerated posterior curvature of the spine to cause a ‘hump back’ appearance.


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Lordosis Exaggerated forward curvature of the spine, whereby there is hollowing.

Midline A median line dividing the two halves of the body. Crossing the midline is the ability

to use one side or part of the body (hand, foot, or eye) in the space of the other side

or part. i/e crossing the right hand to the left knee and vice versa.

Mobilisation Passive movement technique performed on a child to move a joint.

OR

To describe walking.

Modulation

The brain's ability to regulate its own activity.

Motor Control The ability to regulate and monitor the motions of one’s muscle group to work

together to perform movements.

Motor Planning The ability to organize, sequence, and carry out an unfamiliar and complex body

movement in a coordinated manner.

Muscle Tone The degree of tension within muscles at rest and during movement. This is regulated

sub-consciously.

Myopathy

A condition used to describe the musculoskeletal system characterized by muscle

wasting, weakness, and histological changes.

Orthosis Splints and appliance to maintain/improve/facilitate function and joint position.

Paresis

Partial paralysis of voluntary and involuntary muscles.

Passive

Movement

Movement performed for a child, which they are usually able to do themselves.


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Perception

The meaning the brain puts to internal and external sensory stimuli.

Plasticity The ability of the brain to change as a result of repetitive activity or stimuli.

Planter Flexion Movement at the ankle of pointing the toes away from the body.

Position in Space Awareness of the spatial orientation of letters, words, numbers, or drawings on a

page, or of an object in the environment.

Postural Stability Being able to maintain one's body in a position to efficiently complete a task or

demand, using large muscle groups at the shoulders and hips.

Praxis

The ability to interact successfully with the physical environment; to plan, organize,

and carry out a sequence of unfamiliar actions; and to do what one needs and wants

to do.

Often referred to as motor planning.

Pronation

The act of assuming the prone position eg. if applied to the hand this is turning the

palm backward (posterior) or downward.

Prone A horizontal position of the body where the face is positioned downward.

Proprioception

The unconscious awareness from the sensory feedback of the child’s joints, muscles,

tendons, and ligaments. Allowing the body to be aware of where it is in space.

Quadriplegia A type of Cerebral Palsy where the whole body is affected eg. all 4 limbs, head and

trunk.

Reflexes Movement in response to stimuli not consciously controlled.


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Rigidity Inflexibility and stiffness in a joint or muscle.

Scoliosis An abnormal curvature of the spinal column causing an ‘s’ or ‘c’ shape.

Self-Help Skills Competence in taking care of one's personal needs and activities of daily living, such

as bathing, dressing, eating, grooming, and studying.

Self-Regulation The ability to control one’s activity level and state of alertness, as well as one’s

emotional, mental or physical responses to senses; self-organisation.

Sensorimotor Pertaining to the brain-behaviour of taking in sensory messages and reacting with a

physical response.

Sensory Diet The multisensory experiences that one normally seeks on a daily basis to satisfy one’s

sensory appetite; a planned and scheduled activity program that an occupational

therapist develops to help a person become more self-regulated.

Sensory Input The constant flow of information from sensory receptors in the body to the brain and

spinal cord.

Sensory

Integration

The normal neurological process taking in information from one’s body and

environment through the senses, of organizing and unifying this information, and

using it to plan and execute adaptive responses to different challenges in order to

learn and function smoothly in daily life.

Sensory

Modulation

Increasing or reducing neural activity to keep that activity in harmony with all other

functions of the nervous system. Maintenance of the arousal state to generate

emotional responses, sustain attention, develop appropriate activity level and move

skilfully.


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Sensory

Processing Skills

The ability to receive and process information from one’s sensory systems including

touch (tactile), visual, auditory (hearing), proprioceptive (body position) and

vestibular (balance). Behaviour, attention and peer interactions are greatly influenced

by the child’s ability to process sensory stimuli.

Spasm Sudden tightening of muscles.

Spasticity Stiffness due to increased muscle tone.

Spatial

Awareness

The perception of a child’s proximity to, or distance from, an object, as well as the

perception of the relationship of one's body parts.

Static Balance

The body's ability to maintain stable and upright whilst still.

Supination

The act of assuming the supine position eg. if applied to the hand this is turning the

palm forward (anterior) or upward.

Supine

A horizontal body position where the face is positioned upward.

Tactile Refers to the sense of touch and various qualities attributed to touch: to include

detecting pressure, temperature, light touch, pain, discriminative touch.

Tracking

Following a moving object or a line of print with the eyes.

Vestibular

Refers to our sense of movement and the pull of gravity, related to our body.

Visual

Discrimination

Differentiating among symbols and forms, such as matching or separating colours,

shapes, numbers, letters, and words.

Visual Motor

Integration

The ability to control hand movement guided by vision. A child who is challenged in

this area has difficulty coordinating body movements in response to what he/she is

seeing.


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Visual Motor

Skills

The ability to visually take in information, process it and be able to coordinate your

physical movement in relation to what has been viewed. It involves the combination

of visual perception and motor coordination.

Difficulty with visual motor skills can result in inaccurate reaching, pointing and

grasping of objects, as well as difficulty with copying, drawing, tracing and cutting.

Visual Perceptual

Skills

These skills are needed to understand, interpret and analyze what we see for reading

and writing. It is the ability to interpret and use what is seen in the environment.

Difficulties in this area can interfere with a child’s ability to learn self-help skills like

tying shoelaces and academic tasks like copying from the blackboard or finding items

in a busy background.


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Assessment Terms

Age-equivalent This is the age for which the raw score achieved is average for a child who is

developing in the expected manner.

Chronological age The child’s age in years and months since birth at the time of the assessment.

Developmental

level

The level of development that the child has achieved in general, e.g. motor skills,

learning and language. If the child has other learning difficulties or general

developmental delay, we would expect all elements to be be similarly delayed.

Percentile This relates to how many children out of 100 of the same age as the pupil would have

achieved the same or a lower score.

Raw score This is the number of correct responses achieved by the child on the assessment.

Standard or

Scaled score

This compares the pupil’s raw score with other children of the same age. The

average/normal range will depend on the particular test, e.g. average may be 10,

with 7-13 considered to be within normal limits, or average could be 100, with scores

85-115 being considered to represent the normal range.

Within normal

limits/within the

age-appropriate

range

The child has achieved a standard/scaled or percentile score within the expected

average range for their chronological age.


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Conditions or diagnoses

Cerebral Palsy

(CP)

www.nhs.uk/conditions/Cerebral-palsy/Pages/Introduction.aspx

www.scope.org.uk

Developmental

Coordination

Disorder (DCD) /

Motor Dyspraxia

www.nhs.co.uk/conditions/Dyspraxia-(childhood)/Pages/Introduction.aspx

www.dyspraxiafoundation.org.uk

Muscular

Dystrophy

www.nhs.co.uk/conditions/Muscular-dystrophy/Pages/Introduction.aspx

www.dfsg.org.uk

Autistic Spectrum

Conditions (ASC)

www.nhs.uk/conditions/Autistic-spectrum-disorder/Pages/Introduction.aspx

www.autism.org.uk

Chromosomal

Abnormalities

www.genome.gov/11508982

Down’s

Syndrome

www.nhs.uk/conditions/Downs-syndrome/Pages/Introduction.aspx

www.downs-syndrome.org.uk

Sensory

Processing

Difficulties

www.sensoryintegration.org.uk

www.sinetwork.org

Parental Support www.cafamily.org.uk

www.parentpartnership.org.uk

http://www.nhs.uk/conditions/Cerebral-palsy/Pages/Introduction.aspx

http://www.nhs.co.uk/conditions/Dyspraxia-(childhood)/Pages/Introduction.aspx

http://www.nhs.co.uk/conditions/Muscular-dystrophy/Pages/Introduction.aspx

http://www.nhs.uk/conditions/Autistic-spectrum-disorder/Pages/Introduction.aspx

http://www.genome.gov/11508982

http://www.nhs.uk/conditions/Downs-syndrome/Pages/Introduction.aspx

http://www.sensoryintegration.org.uk/

http://www.sinetwork.org/

http://www.cafamily.org.uk/

http://www.parentpartnership.org.uk/

Section 7 – Equipment and Resources

Section 7

Equipment and Resources


380

Resources

Language

Colorcards (pictures)

E.g. “What’s wrong?” Emotions

What’s different? Sequences, Verb tenses

LDA Winslow Press

Yesterday’s Verbs Winslow Press

And then? / And then? 2

(sequencing cards)

LDA

Semantic Links Winslow Press

Emotions and Facial Expressions Black Sheep Press

Speaking and Listening Through Narrative Black Sheep Press

Story Starters Black Sheep Press

Fun with Narrative Black Sheep Press

Understanding and Using Spoken Language (7-9

years)

LDA Speechmark

Speaking, Listening and Understanding LDA Speechmark

Rhodes to Language (7-16 years) STASS/Winslow Press

Listening

Following Auditory Directions Winslow Press

Auditory Memory Black Sheep Press

Lip and Tongue Exercises

Oral motor Fun and Games Winslow Press

Mighty Mouth Game Winslow Press

Phonology

Phonological Awareness Procedure (for 6+ years

STASS

The Big Book of Blends and Diagraghs Winslow Press

Consonant Worksheets Black Sheep Press

The Late Eight (th, s, z, l, r, sh, ch) Plural Publishing

Activities for Developing Phonological Awareness

Winslow Press


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Verbal Reasoning

Practical Language Activities Winslow Press

Think it – Say it Winslow Press

Why?Because Black Sheep Press

Speech Bubbles Black Sheep Press

Talk About series

Talk About school

Talk About friends

Talk About Secondary School

Winslow Press

120 Idioms at Your Fingertips Winslow Press

Social Skills (Group Work)

Talkabout Speechmark

Talkabout Activities Speechmark

Talkabout Relationships Speechmark

Skills for Daily Living – Social Behaviour Winslow Press

101 Games for Self-Esteem Winslow Press

Socially Speaking Winslow Press

Social Use of Language Programme Wendy Rinaldi

Classroom Support

Social Communication Difficulties Resource Pack

Speechmark

Visual Cue Cards Black Sheep Press

Writing and Developing Social Stories Speechmark

Teaching Children with Autism to Mind-Read Winslow Press

Boardmaker for Windows Winslow Press

Makaton Resources Winslow Press

Handwriting

Handwriting without Tears by Janice Z. Olsen Handwriting without Tears

Write from the Start by Ion Teodorescu and Lois Addy

www.LDAlearning.com :0115 907 4001

Loops and other groups by Mary D Benbow Pro-Ed

Write Dance by Ragnhild Oussoren Sage Publications

Speed Up! By Lois Addy www.LDAlearning.com :0115 907 4001

Roll ‘n’ Write www.LDAlearning.com :0115 907 4001

http://www.ldalearning.com/




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Recommended equipment Suppliers

Cutlery

Junior Caring Cutlery

Caring Cutlery

Ultra-light cutlery

Weighted cutlery

Easigrip cutlery

Angled cutlery

www.benefitsnowshop.co.uk

0845 459 6006

www.nrs-uk.co.uk

0845 120 4522

Scissors

Easi-grip (mini and standard)

Long loop Easi-grip

Long loop

Self- opening

Dual control training scissors

Self-opening Long Loop Scissors

www.peta-uk.com

01376 573476

www.specialdirect.com

0800 318 686

Pencil grips

Ultra Pencil Grip

Ultra Pencil Grip Large

Cross-guard Ultra Pencil Grip

Comfort

Stubbi

Air grip

Jumbo (triangular for pens)

Grotto

www.taskmasteronline.co.uk

0116 270 4286

www.tts-shopping.com

0800 318 686


0800 318 686

http://www.benefitsnowshop.co.uk/

http://www.nrs-uk.co.uk/

http://www.peta-uk.com/

http://www.specialdirect.com/

http://www.taskmasteronline.co.uk/

http://www.tts-shopping.com/



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Therapeutic putty

Yellow (soft)

Red (medium soft)

Green (medium)

Blue- (Firm)

www.oneclickpharmacy.co.uk

0844 44 11 800

or

www.homecraft-rolyan.com

08444 124 330

Other

Posture pack

Movinsit- junior (JPM code- ECCMSJ)

Movinsit- senior (JPM code-ECCMS)

Wobble cushion

Writing slopes

Teenage writing slope

Writing slant-wooden (JPM code-JPMCCWS)

Privacy board

Weighted lap cushion

Neoprene wrap/waistcoat

Southpaw Bear Hug

www.backinaction.co.uk

01494 434343

www.fledglings.org.uk

0845 458 1124

www.jpmproducts.co.uk

01920 468 380


0800 318 686

www.jpmproducts.co.uk

www.ldalearning.com

0845 120 4776

www.rompa.com

01246 211 777

http://www.oneclickpharmacy.co.uk/

http://www.homecraft-rolyan.com/

http://www.backinaction.co.uk/

http://www.fledglings.org.uk/

http://www.jpmproducts.co.uk/


http://www.jpmproducts.co.uk/


http://www.rompa.com/


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Specialist Seating which may be used at school.

This equipment will be assessed, prescribed, advised, arranged and reviewed by the individual child’s therapist/s. The equipment is to be used only by the child it is prescribed for. Please contact your therapist immediately if you have any concerns about safety. Leckey Chairs such as the Easy Seat and the Everyday Activity Chair. All equipment can be viewed online at - http://www.leckey.com/

Jenx Chairs such as Jenx Junior or Jenx Bee. All chairs and equipment can be viewed online at - http://www.jenx.com/

http://www.leckey.com/

http://www.jenx.com/


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Smirthwaite Chairs such as the Heathfield, Brookfield and Samba. Tables such as activity tables and study table. Full range of equipment can be viewed online at - http://www.smirthwaite.co.uk/

Joncare Most commonly provided is the Teezi Breezi and Breezi chairs. Full range of equipment can be viewed online at - http://www.joncare.co.uk/

http://www.smirthwaite.co.uk/

http://www.joncare.co.uk/

http://www.smirthwaite.co.uk/images/detailed/Samba-chair.jpg

http://www.smirthwaite.co.uk/images/detailed/Heathfield-Table.jpg

Section 8 – Training

Section 8

Training


387

Introduction The Solent Children’s Therapy service has highly trained therapists who are able to provide a variety of training programmes to suit your needs. Our core offer to you is a free one day, all staff training package. We are then able to offer targeted workshops and resource sessions to enable you to be confident that you have a trained and confident workforce able to meet children’s needs. Please contact the Single Point of Access (SPA) to book training or receive a copy of the latest training catalogue. Essential A1 Whole school one day integrated training Designed to complement this schools pack, this training day fits into a school inset day. It is presented by the therapists working in your school and enables you to ask questions about how to support the children in your school. This training is free and is the essential training provided by the service. Objectives

Understand how children develop and use speech, language and communication Recognise how children develop and use fine and gross motor skills Understand the links between language, motor skills and learning, behaviour and social/ emotional

development Will recognise what features to look out for to help identify whether a child is having difficulties

with their development Be able to use positive approaches and strategies to support development of speech, language,

communication and motor skills Will be able to use the schools pack and programmes to support children’s development Be able to access specialist services appropriately

When you book the Children’s Therapy Service Integrated Therapies Universal Inset training full day package, you will receive a number of documents, including the power point presentations and a Self Evaluation Audit. We ask that PRIOR to your inset day,

ALL staff complete the self evaluation audit (which is based on national level universal competencies), as honestly as possible, thinking carefully about the evidence they provide to support how confident they feel about specific topics.

Completed audits should be handed to the SENCo in school – hopefully it will be possible to collate the results (in percentages) and this information shared with the therapy team.

The Power point presentations are printed and circulated to your staff.


388

DURING your inset day

The Universal level Integrated Therapies package will be delivered by 3 members of the Children’s Therapies team: a Speech & Language Therapist, an Occupational Therapist and a Physiotherapist. It is anticipated that 1 of these 3 will be your school link therapist, as identified in your School Pack.

You will be asked to complete a training evaluation form to help us to continue to develop our training packages.

AFTER the inset day (at the end of the academic year; either the year in which the training was delivered or the following year)

The Self Evaluation audit should be completed AGAIN by all members of staff allowing time for aspects of change to embed. This will enable both the senior management team in school and the Integrated Therapies trainers to evaluate the outcomes of the training package on staff practice; it would also enable the SENCo to identify ongoing training needs within the staff group.

Targeted Workshops These workshops can be run either within your school for a group of staff or at an external site which you can send staff to. Please contact the Children’s Therapy Service to discuss your requirements. The costs will be based on duration of the training and the support that you are able to provide for running the session. The team at the SPA will be able to give further details. Below is a selection of targeted workshops which we have delivered or we can tailor a session to your needs specifically. T22 Development of Gross Motor Skills Aim To develop an understanding of how gross motor skills develop and activities/strategies to help gain and improve these skills. Objectives a) Identify different stages of gross motor development b) Empathise with children who have gross motor difficulties c) Gain knowledge of strategies that can be used to improve gross motor skills T 14 Development of Fine Motor Skills Aim To develop an understanding of how fine motor skills develop and activities/ strategies to help gain and improve these skills.


389

Objectives a) Identify different stages of fine motor development b) Empathise with children who have fine motor difficulties c) Gain knowledge of strategies that can be used to improve fine motor skills An extension of essential training with more practical activities. (OT) T 18 Development of Writing Skills Aim To gain an understanding of difficulties that children can experience when learning to read and write and strategies to encourage them to gain the necessary skills. Objectives a) Begin to identify areas that could be causing difficulty b) Empathise with children who have difficulty with writing c) Gain knowledge of activities and strategies that can be used to improve these skills A 22 Development of Organisational Skills Aim To gain an understanding of how organisational skills develop and strategies to help gain and improve these skills Objectives a) To understand the essential components of organisation b) To gain knowledge of how a lack of organisational skills can have an impact on daily living c) To identify strategies that can be used to improve organisation T1 Supporting young people in Key Stage 3 setting (SLT/PT/OT) T2 Supporting Children with attention and listening difficulties in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT) T3 Classroom strategies to support Quality First Teaching in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT) T4 Using visual support in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/OT) T5 Supporting Children with social communication difficulties (including Autistic Spectrum Conditions) in the Foundation stage, Key Stage 1 and Key Stage 2 within school setting (SLT/PT/OT)


390

T6 Supporting Children with sensory impairments in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT and Teacher Advisors) T7 Supporting Children who stammer in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT) T8 Supporting Children with speech sound difficulties in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT) T9 Developing Adult-Child Interaction Styles in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT) T10 How to provide Development Rich Environments in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT) T11 Supporting Children with Emotional and Behavioural difficulties in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (via MABS – Harbour School) T12 Supporting Children using the Derbyshire Language Scheme in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT) T13 Supporting the development of vocabulary in children in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT) T15 Supporting Children in Phonics, Literacy and Expressive Language (through Narrative Therapy) in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT in conjunction with INSPIRE) T16 Supporting Children who require Alternative and Augmentative Communication strategies (including PECS) in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT) T17 Supporting Postural Management for children with physical disabilities in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (PT/OT) T19 Developing Core Stability in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (PT/OT) T20 Supporting Children with Sensory Processing difficulties in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT) T21 Supporting Children develop through Makaton Signing in the Foundation stage, Key Stage 1 and Key Stage 2 within school settings (SLT/PT/OT)

Section 9 – How to refer

Section 9

How to refer


392

Introduction All referrals should be sent to the Children’s Therapy Service at the address below. All referrals will need to have the following:

Integrated referral form: The referral form can be found within this section and is available electronically from the website www.solent.nhs.uk/childrenstherapies.

For children with motor difficulties, please also send either the Early Years Motor Skills Checklist (Yr R) or DCDQ Checklist (Yr 1 onwards) : Found on following pages

For children with speech, language and communication difficulties please send the Referral Information Form on page 429.

Evidence of strategies used from the schools pack: see section 2, page 42 for suggested format All referrals must have parental consent. The letter on page 430 may be used (adapted according to which therapy the child needs) to request parental consent. The parental questionnaire on page 431 may be used to gain information on the child’s developmental history. Once completed the referral should be posted, faxed or emailed via a secure nhs.net account to the address below. Children’s Therapy Service Stoneham Centre Moorgreen Hospital Botley Road West End Hampshire, SO30 3JB Tel: 0300 300 2019 Fax: 023 8047 5378 Email: [email protected]

http://www.solent.nhs.uk/childrenstherapies


393

Early Years Motor Skills Checklist All Sections Must be Completed and accompany the integrated referral form Please attach copies of record of intervention form for Achieving Body Control (ABC) and Clever Hands / FMS programme. N.B. referrals will not be accepted until at least one block of both programmes have been completed

Motor Skills

Please provide examples of the child’s writing/drawing

Yes/No Comment

Reliably uses one hand as dominant

Colours within boundary lines

Can copy a (a) vertical cross Yes/No (b) oblique cross

Holds pencil/scissors using appropriate grasp

Can cut along a straight line with accuracy

Can draw a recognisable person

Picks up and uses small objects efficiently (blocks, beads)

Can fasten buttons

Able to catch a (a) large ball Yes/No (b) bean bag

Able to kick a stationary ball

Balances on one leg for 5 seconds

Can jump two feet together

Fluent movements when running

Moves around avoiding objects

(a) classroom Yes/No (b) playground

Please indicate whether the child is known to have a generalised learning difficulty □ and/or difficulty with attention/concentration □ speech and language □ literacy □ social skills □ self esteem □

Main Concerns: Form completed by: Name: Date: Designation:


394

For children in year one onwards please complete the DCDQ checklist for motor skill referrals and attach to the integrated referral form with evidence of strategies/programmes tried.


395


396


397

Children’s Therapy Service Referral Form Please return the completed form to: Children’s Therapy Service, Stoneham Centre, Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB. Email: [email protected], ensuring the referral form is sent from an nhs.net email account. Fax: 023 8047 5378

Service referred to:

Speech & Language Therapy

Occupational Therapy

Physiotherapy

Client details: NHS No:

First Name Surname Previous names:

Date of birth:

Male / Female

Address: Postcode:

Name of parent/guardian

First name Surname

Daytime tel: Home tel: Mobile tel:

Ethnicity:

Languages spoken at home:

Interpreter/Signer required: Yes / No Language:

GP name:

Health Visitor/School Nurse Name:

Surgery:

Base address:

Tel:

Tel:

Preschool / School name:

Days/Times attended:

Address: Postcode:

Tel:

Transport difficulties: Yes / No Details:

mailto:[email protected]


398

Referral information (Please attach appropriate supporting evidence from Early Years Developmental Checklist, Schools pack, Feeding Questionnaire or Child Monitoring tool as well as any audiology or recent paediatrician reports)

Diagnosis (if known): Statemented: Yes / No Statement designation:

Are there any Safeguarding issues?

Is the child a Looked After Child? Yes / No

Social services involvement: Yes / No Social worker’s name: Contact number:

Are there any concerns about; hearing? Yes / No vision? Yes / No

Has hearing been tested? Yes / No Date:

Reasons for referral:

What is the functional impact? Give details:

What support has already been provided? Please attach supporting information

Has it made a difference? Yes / No

Other professionals/services currently involved (e.g. Paediatrician, Portage, Audiology, Educational Psychologist. Please provide names where known)


399

Referral and background information

Please complete as fully as possible at referral stage, to avoid the family having to repeat family history

Developmental and medical history information

Were there any complications in pregnancy or birth?

General health/Childhood illnesses

Are the child’s immunisations up to date? Yes / No

Does the child have any allergies? Yes / No

If ‘yes’ please state:

Is there any family history of medical diagnoses? (e.g. autism, specific learning difficulties, developmental delay)? Please give details:

Current treatment/Medication:

Has the child had any of the following (please circle)?:

Frequent colds

Frequent ear infections

Frequent chest infections

Tonsillitis Asthma

Has the child had any visits to hospital?

Yes / No

If ‘Yes’ please give details:


400

Hearing/Vision

Does anyone in the family have a hearing impairment/loss/deafness?

Yes / No

Has the child had middle ear infections/glue ear? Yes / No

Does anyone in the family have visual impairment? Yes / No

Feeding

Can the child eat foods that need chewing e.g. meat, sandwiches, raw fruit or vegetables?

Yes / No

Did the child have any problems weaning/taking lumps?

Yes / No

Do they use a bottle, beaker, inverted lid or open cup to drink?

Has the child ever had fluid or food escape through their nose?

Yes / No

Motor skills

Does the child (please also indicate from what age):

Roll Age: Crawl Age:

Sit Age: Walk Age:

Run Age:

Do you have any concerns about their movements? Yes / No

Does the child complain of pain? Yes / No

Do you have concerns about the child’s hand skills? (e.g. Handwriting/scissors/using construction toys/throwing and catching a ball)

Yes / No Please describe

Personal care

Is the child toilet trained? Yes / No If yes, at what age?:

Can the child dress themselves? Manage buttons/shoelaces

Yes / No Yes / No

If no, please describe difficulties

Can they use a knife and fork?

Yes / No If no, please describe difficulties

Emotional

What time does the child…

Go to sleep: Wake up:

Does the child stay in their own bed?

Yes / No

Do they use a: (please circle any that apply)

Dummy Bottle Security blanket

Other comforter


401

Play and attention

What types of games/toys/activities does the child enjoy?

Does the child like to play with others (adults or children)?

Yes / No

Roughly how many hours of TV/DVD/Computer time a day does the child watch?

How would you describe the child’s attention span for:

- Activities of their own choice:

- Activities that the parent chooses:

Speech and Language

Is there a family history of speech and language difficulties? e.g. late talking, unclear talking, stammering (please give details of who and what)?

If the family uses more than one language at home, when is each language spoken and to whom?

Did the child babble as a baby? Yes / No

At what age did the child:

Say their 1st word:

Begin to put 2 words together:

Talk in sentences:

Does the child dribble excessively for their age? Yes / No

Does the child have any problems with their teeth? Yes / No

Does the child have any problems with their lip or tongue movements?

Yes / No

Referrer details: Date of referral:

Name of referrer (please print name):

Profession (e.g. Hospital/GP/HV/Preschool):

Would you like a copy of the appointment date? Yes / No

Address:

Tel: Signature:


402

Parent / Guardian consent

This referral has been discussed with me, and I agree to take my child to the clinic for assessment and ongoing therapy intervention as required, which may take place in school, clinic or nursery setting. I understand that if I do not attend the assessment, my child will be discharged and no further appointments will be offered. I am aware that for training purposes, a student may be present. I agree to the sharing of information with services relevant to my child’s treatment / care

Name of parent/guardian (PRINT NAME):

Signature: If unsigned, verbal consent given:

Date:

We constantly aim to improve our services and we value your feedback. Please tick box if you would be happy for us to contact you in the future

Therapist use only

Signature: Date:

Location:

Section 10 – References

Section 10

References


405

REFERENCES

Asher, A.V., (2006). Handwriting instruction in elementary schools. American Journal of Occupational

Therapy, (60) 461-471

Boyle J, McCartney E, Forbes J, O’Hare A (2007). An RCT and economic evaluation of direct versus indirect and individual versus group modes of speech and language therapy for children with primary language impairment. Health Technology Assessment 2007, 11 (25). [WWW Document] retrieved on 06/05/11 from http://www.hta.nhsweb.nhs.uk/fullmono/mon1125.pdf Case-Smith, J., Heaphy, T., Marr, D., et al (1998). Fine motor and functional performance outcomes in

preschool children. American Journal of Occupational Therapy (52) 788-796

Conti-Ramsden GM, Durkin K, Simkin Z, Knox E. (2009). Specific language impairment and school outcomes. I: identifying and explaining variability at the end of compulsory education. International Journal of Language and Communication Disorders, 44( 1), 15-35. Chu, S., (1997). Occupational therapy for children with handwriting difficulties: a framework for evaluation

and treatment. British Journal of Occupational Therapy 60 (12) 514-520

Department of Health, Department for Education and Skills (2004) National Service Framework for

Children, Young People and Maternity Services. The Stationary Office

Department for Education and Skills (2001) Special Educational Needs Code of Practice. The Stationary

Office

Dunn, W., Bennett, D., (2002). Patterns of sensory processing in children with attention deficit

hyperactivity disorder. Occupational Therapy Journal of Research (22) 1

Erhardt, R., (1989). Developmental Hand Dysfunction. Tucson: Therapy Skill Builders

http://www.hta.nhsweb.nhs.uk/fullmono/mon1125.pdf


406

Feder, K. P., Majnemer, A., (2007). Handwriting development, competency and intervention.

Developmental Medicine and Child Neurology (49) 312-317

Gascoigne M. (2006). Supporting children with speech, language and communication needs within

integrated children’s services. RCSLT Position Paper, RCSLT: London

Gross, J (2011). Speech, language and communication – issues, impacts and actions. Office of the

Communication Champion

Hartas, D (2004) Teacher and speech-language therapist collaboration: being equal and achieving a

common goal? Child Language Teaching and Therapy 20: 33 [WWW Document] retrieved on 30/04/10

from http://clt.sagepub.com/content/20/1/33.full.pdf

ICAN (2006). The cost to the nation of children’s poor communication. Talk Series 2. [WWW Document] retrieved on 26/08/13 from http://www.ican.org.uk/~/media/Ican2/Whats%20the%20Issue/Evidence/2%20The%20Cost%20to%20the%20Nation%20of%20Children%20s%20Poor%20Communication%20pdf.ashx

Jenkinson, J., Hyde, T., Ahmad, S., (2002). Occupational therapy approaches for secondary special needs:

practical classroom strategies. London: Whurr Publishers

Lindsay G, Desforges M, Dockrell J, Law J, Peacey N, Beecham J (2008). Effective and Efficient Use of

Resources in Services for Children and Young People with Speech, Language and Communication Needs.

Department for education, Research Report DCSF-RW053. [WWW Document] retrieved on 26/08/13 from

https://www.gov.uk/government/publications/effective-and-efficient-use-of-resources-in-services-for-

children-and-young-people-with-speech-language-and-communication-needs

Marr, D., Windsor, M., Cermak, S., (2001). Hand writing readiness: locatives and visuomotor skills in the

kindergarten year. Early Childhood Research and Practice 3 (1) 1-15

Moore, B., (2003). Providing occupational therapy input in mainstream schools for children with specific

developmental disorders. National Association of Paediatric Occupational Therapists Journal 7 (1) 10-13

http://clt.sagepub.com/content/20/1/33.full.pdf

http://www.ican.org.uk/~/media/Ican2/Whats%20the%20Issue/Evidence/2%20The%20Cost%20to%20the%20Nation%20of%20Children%20s%20Poor%20Communication%20pdf.ashx

http://www.ican.org.uk/~/media/Ican2/Whats%20the%20Issue/Evidence/2%20The%20Cost%20to%20the%20Nation%20of%20Children%20s%20Poor%20Communication%20pdf.ashx

https://www.gov.uk/government/publications/effective-and-efficient-use-of-resources-in-services-for-children-and-young-people-with-speech-language-and-communication-needs

https://www.gov.uk/government/publications/effective-and-efficient-use-of-resources-in-services-for-children-and-young-people-with-speech-language-and-communication-needs


407

Roulstone S, Wren Y, Bakapoulou I, Goodlad S and Lindsay G (2010). Exploring interventions for children

and young people with speech, language and communication needs: A study of practice. Department for

Education, Research Report DFE-RR247-BCRP13. [WWW Document] retrieved on 27/08/13 from

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/219627/DFE-RR247-

BCRP13.pdf

Royal College of Speech and Language Therapists (RCSLT) (2005). Clinical Guidelines. Speechmark

Publications.

Snowling M and Hulme C (2011). Evidence-based interventions for reading and language difficulties: Creating a virtuous circle. British Journal of Educational Psychology 81 (1) 1-23[WWW Document] retrieved on 06/05/11 from http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8279.2010.02014.x/abstract

Volman, M., van Schendel, B., Jongmans, M., (2006). Handwriting difficulties in primary school children: a

search for underlying mechanisms. American Journal of Occupational Therapy, (60) 451-560

Wright, H., Sugden., D., (1998). A School Based Intervention Programme for Children with Developmental

Coordination Disorder. European Journal of Physical Education (3) 35-50

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/219627/DFE-RR247-BCRP13.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/219627/DFE-RR247-BCRP13.pdf

http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8279.2010.02014.x/abstract

http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8279.2010.02014.x/abstract

Section 11 - Appendix

Section 11

Appendix


408

Speech and Language Therapy Action

and

Year R Screen

Children’s Therapy Service Stoneham Centre

Moorgreen Hospital Botley Road

West End Southampton

S030 3JB

Tel: 0300 300 2019 Fax: 023 80475378

www.solent.nhs.uk/childrenstherapies


409

Speech and Language Therapy Action

If staff express concerns regarding children’s speech and language development, please take the following steps to address their needs. Some children will have very obvious speech and language needs and should be referred to our Service. In that case, the following steps should be taken in the interval between referral and assessment. Listening and attention If the child’s listening and attention skills are poor relative to the other children of his or her age and it is difficult for him or her to focus in whole group setting, please follow the Letters and Sounds programme Phase 1 with the child in a 1:1 setting or in a small group. This focuses on eg: listening for sounds in the environment, matching and identifying musical instruments and thinking about loud and quiet sounds. Delayed language development If the child appears to be finding it difficult to follow instructions, has a poorly developed vocabulary or sentences tend to be short, it will be helpful to work with the child in a small group (of up to four children) using the YR Narrative programme. This should be delivered in a twice weekly session for half a term. Each child’s language should be tape recorded pre-group and then post-group to evaluate any changes that have taken place. The Narrative programmes are available from www.blacksheeppress.co.uk Delayed speech sound development Again, the child may benefit from working on the Letters and Sounds programme Phase 1 in a 1:1 or small group setting. Also, if staff can identify a sound that the child is finding difficult, it will be helpful to ask the child if s/he can imitate the sound after an adult. If so, it is appropriate to work on a programme for this sound in the same way as speech programmes have previously been delivered for other children in your setting. Also, please follow instructions for working on speech sounds contained in the Phonology Resource Pack for schools (all schools should have a copy). Please refer to attached developmental stages for speech sounds to ensure it is appropriate to focus on this sound, eg: if a child in YR says ‘t’ for ‘ch’, it is likely that he or she will develop the sound naturally, but it is expected that children should be at least beginning to develop ‘k’ and ‘g’ at this stage. Social interaction If the child is finding it difficult to interact, play and take turns with the other children, it will be helpful to begin working on the ‘Time to Talk’ programme in a small group with other children (no more than four in total). This should be delivered twice a week for half a term. There is a pre- and post-assessment in this programme together with forty lesson plans that are ready to be delivered. The ‘Time to Talk’ programme is in book form, written by Alison Schroeder and is inexpensive to buy. Next steps… If staff are still worried about the child’s speech and language development, please deliver the new YR Screen. The SENCo will then evaluate the outcome of this and refer to the Speech and Language Therapy Service as appropriate. If at any time staff are unsure how to proceed, please ask the SALT attached to the school for advice.


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Year R Screening Test (Revised 2012)

The purpose of this test is to support SENCos to decide if a child has a speech and language difficulty over and above an overall delay in developmental skills. This assessment should be viewed alongside information regarding progress gained through teacher assessment, FSP and P-levels. This assessment should be conducted by an adult who is familiar to the child in the Spring term or the term that s/he turns 5 years of age whichever is later. It should be conducted in a quiet environment that is familiar to the child. A referral should be made by the SENCo if the child does not achieve the scores expected in a typically developing YR child as detailed in the front page of the assessment pages. Contents The assessment comprises four sections: listening and understanding, vocabulary, sentence use and speech sounds at the beginning of words. Please print all forms and information and colour print the picture resources. It will be helpful to cut up the laminated pictures. Description Listening and understanding. A black and white picture is provided for your use and you should provide the child with coloured pencils, red, blue, green, yellow and orange. A question sheet with space for scoring is also provided This will give an indication of the quality of his/her listening skills and assess how accurately the child follows spoken instructions at the level expected for a child aged 5 years. The child should score a minimum of 8 out of 10. Vocabulary A set of colour pictures is provided as well as a scoring sheet. This assesses how well a child names a series of pictures. It is not an assessment of speech sound use so a word that is recognisable as the key word is scored as accurate. The child should score a minimum of 21 out of 24. Sentence use Three set of picture sequences are provided and a score sheet. The child is asked to describe a picture scene and the adult writes verbatim what the child has said. Please omit words that the child does not say and write grammatical errors as the child says them. Again, this does not assess speech sound use. Please refer to examples of typically developing children’s sentences provided, and compare your child’s sentences with these. Speech sounds A set of pictures is provided with a score form. This assesses how the child uses initial sounds only. The adult should write the initial sound of the word as the child says it if it is not accurate, if possible. If it is difficult to identify which sound the child has substituted, it should simply be marked as incorrect. The child should score a minimum of 10 out of 15. The last five sounds assessed are generally developed by the end of YR.


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Child’s name: Age: Date of Birth:

Year R Screening Test (revised 2012)

Score form

Test

Score

Comment

Listening and Understanding

/10

Vocabulary

/24

Sentences

Not scored, comments only required.

Initial sounds

/15

Summary: Meets criteria for referral: Yes / No (Please circle) The results of this screen should be signed and referral made, if appropriate, by the SENCo. Signed: (SENCo) Date:


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Child’s name: Age: Date:

Listening and Understanding Provide the picture and coloured pencils red, blue, yellow, green and orange for the child and ask him/her to look over the picture to become familiar with it. Read the instructions and ask the child to do as you have asked. Repeat the instruction if necessary and note that the repetition was given. The child should score a minimum of 8 out of 10.

Instruction

Correct √ / x

Repetition required? √ / x

1. Find the bear on the bed, colour him yellow.

2. Find the book on the bed, colour it red.

3. Find the doll, draw yellow flowers on her

dress.

4. Find the little chair, colour it blue.

5. Find the cat under the bed, colour it orange.

6. Find the teddy in the box, colour it yellow or

orange.

7. Draw a teddy on the big chair.

8. Find the ball in the box, colour it blue or

green.

9. Find the clock on the wall, colour it red and

yellow.

10. Draw a cartoon on the TV.

Comments: Score out of 10


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LS2 Barrier Game Worksheets - ©Black Sheep Press 2003, Helen Rippon It is permitted for the licensee to photocopy this sheet for use in their clinic / school. Black Sheep Press, 67, Middleton, Cowling, Keighley, W. Yorks. BD22 0DQ, England Tel. +44(0)1535 631346 Email: [email protected]; web www/backsleep-epress.com

mailto:[email protected]


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Vocabulary

Ask the child to name these pictures.

Mark correct if the child uses an appropriate word.

The word is considered correct if you know what the child is saying regardless of how it is said.

Write what the child says if an incorrect word is used or NR for ‘no response’ if the child does not know the word.

Picture number

Target Word Correct √ / x

Picture number

Target Word Correct √ / x

1. Tractor 13. Money

2. Slide 14. Arrow

3. King 15. Dragon

4. Fish 16. Shell

5. Elephant 17. Ladder

6. Bike 18. Fireman

7. Bag 19. Lion

8. Toothbrush 20. Dentist

9. Owl 21. Fridge

10. Tree 22. Motorbike

11. Flag 23. Octopus

12. Sink/basin 24. Drawers

Comments: Score: out of 24


415

Vocabulary Set


416

Vocabulary Set


417

Vocabulary Set


418

Vocabulary Set


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Sentence Use Show the child the first picture in the first sequence and say ‘What’s happening in the picture?’ Then show the second and ask again. Prompt by repeating what the child said with a rising intonation to indicate you would like him/her to say a little more. Another permissible prompt is ‘Well done, can you tell me some more, please?’ Repeat with the other two sequences. Please write verbatim what the child says. Examples of typical responses are given in italics. Sequence 1: ‘Football accident’ ‘A football. It smashed and it broke.’ ‘He was doing it very well and then he accidentally kicked it through the glass’. ‘A boy’s playing football in the house. It smash the window.’ Sequence 2: ‘The cake mishap’ ‘The Grandma put it on the table and he jumped on the table and he licked it for a little taste and she took it away.’ ‘The lady’s making a cake and the lady turning round and the dog eating a cake.’ ‘The lady make a cake and the dog licking it.’


420

Sequence 3: ‘The Park’ ‘He’s sliding down and a person walking through and he bumped into her.’ ‘He crashed into that little girl. She sad and she crying for her Mum.’ ‘That boy sliding down the slide and crashed into her.’ Please look at the sentences used with the examples of typically developing YR children. Make a judgement whether the child’s sentences stand out as less well developed than the examples given. Comments:


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Sequence 1: ‘Football accident’


422

Sequence 2: ‘The cake mishap’


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Sequence 3: ‘The Park’


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Initial Sounds

Ask the child to name the picture and note the initial sound used.

Write the sound the child says if incorrect if possible.

Say the word for the child if s/he cannot think of the word and ask him/her to say it after you. Note that the word was imitated and write what the child said if possible.

Mark as an error if the initial sound is incorrect but you are unsure what sound the child used.

The child should score 10 out of 15.

Picture number

Target Word

√ / x or initial sound used

Picture number

Target Word

√ / x or initial sound used

1. pig 9. sun

2. bus 10. sheep

3. teddy 11. chips

4. dog 12. giraffe

5. car 13. spider

6. girl 14. stop

7. football 15. lady

8. van

YR children generally acquire these sounds, which are set out in order of development, by the end of YR. Please see the summary form for referral guidance. Comments: Score: out of 15


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Initial Sounds


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Initial Sounds


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Initial Sounds


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Request for Speech and/or Language Assessment (to be sent with Solent Referral form) With the child’s Parent/Guardian’s permission to make this request, the school’s SENCo should complete this form. Name: DOB: Reasons for referral Please indicate with a tick the area/s of concern or give a brief description

Difficulty understanding instructions:

Difficulty speaking in sentences:

Poor vocabulary:

Difficulty using speech sounds accurately:

Difficulty using language to interact:

Any other comments:

In order to make an effective assessment, we require a copy of the following:

The child’s FSP, or NC levels.

The SLT Service’s YrR screening test score forms, if appropriate.

The child’s IEP.

Please attach any information from other professionals, e.g: Paediatrician, EP

Date: Signed: SENCo:


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Dear Parent/Guardian Your child’s teachers are concerned about his/her development of speech sounds, understanding or use of language, general communication skills, and would like him/her to be seen by a Speech and Language Therapist. This letter is requesting your permission for the referral to be made. With your permission the Speech and Language Therapist will visit your child in school to carry out an assessment. If your child needs some extra help the Therapist will write a programme which will be worked on by the school staff on an individual or small group basis and monitored and adjusted by the Therapist when needed. Any written report will be sent to you and those professionals involved in your child’s care, e.g. school, GP. Once your child has achieved most of the speech/language aims he/she will be discharged from the service and you will be notified of this. Please let us know if you change your address or GP. Please complete and sign the enclosed questionnaire, in doing so you are agreeing for your child to be seen. Please return the completed form to the Special Needs Co-ordinator at school or class teacher as soon as possible. If you would like further information or wish to discuss your child’s speech or language skills please contact us using the above details. Yours sincerely The Speech and Language Therapy Service

Please fill in the questionnaire and return to school.


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This sheet to be filled in and signed by Parent/Guardian and returned to school:

QUESTIONNAIRE

Name of Child:.............................. .............................. Date of Birth: .............................. .............................. School: .............................. .............................. 1. Are you concerned about your child’s speech and language skills? 2. If you feel there is a problem with his/her speech and language, what do you feel it is? 3. Is there a family history of slowness in speaking, learning difficulties requiring special help at school,

reading and writing problems, cleft palate, non-fluency (stammering), hearing problems, difficulty pronouncing sounds, any other relevant medical details you think we should know?

4. Did he/she have any problems at birth/during/after? 5. Has he/she had any major accidents, illness, periods of hospitalisation? 6. Has he/she had a hearing test recently? If yes, what was the result? I have received the enclosed information and permit my child to be assessed by the Speech and Language Therapist. I am happy/not happy for any reports to be sent to other professions involved with my child. (delete as appropriate) Parent/Guardian’s full name:……….……….……….……….……….………. Parent/Guardian’s signature:……….……….……….……….……….………. Date:……….……….……….


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Typical speech and language development in YR children Listening and attention Children develop integrated attention so are able to ‘listen and do’ at the same time. Understanding spoken language Children can increasingly understand:

instructions of four key words.

a range of prepositions such as ‘behind’, ‘in front’, between’, ‘next to’.

comparatives such as ‘bigger’ and superlatives such as ‘biggest’. Using spoken language Children can increasingly:

use longer sentences, linking ideas with ‘and’ and ‘because’.

apply features of grammar such as ‘the, is, a’.

recount a short story or event using the regular past tense.

Speech sounds

Children are increasingly clear and are understood by most people most of the time. Sounds still to develop may be:

‘s’ blends such as ‘sp, st, sc/k, sm’.

‘sh’, ‘ch’, ‘j’

‘l’, ‘th’, ‘r’. Social communication Children increasingly:

take turns to speak and listen.

play rules-led games, winning and losing with appropriate behaviours.

maintain topic in carpet-time discussions. Comment It is important to bear in mind that children with summer birthdays, or immature development or poor language models at home are likely to make progress with all aspects of speech and language development with exposure to the language-rich environment of the classroom.


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Section 4 Grammar - Activities

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