Pro-neurodiversity Speech Therapy

As a speech and language therapist I work with a lot of neurodivergent kids. So engaging in discussions about neurodiversity and learning how to be affirming of neurodiverse identities is really important to me.

Over recent years, there’s been increasing discussion and research highlighting how our traditional ways of working can be potentially harmful to neurodivergent kids. Traditional ‘social skills’ training can risk teaching children to mask their true nature, which can negatively impact their mental health and wellbeing.

In this video I give a brief rundown of the trouble with traditional views of social communication difficulties and some practical suggestions for being actively pro-neurodiversity in speech and language therapy sessions.

Pro-neurodiversity Speech Therapy: Why I don't teach social skills

Neurodiversity is a term used to explain the vast difference in brain types, which affects how individuals experience and interact with the world around them. It’s a term that includes things like autism, adhd or dyslexia to name a few.

If we view these types of neurology from the ‘medical model’ we might focus on the child as having a problem that needs to be fixed.  But, if we view the situation from the ‘social model’ of disability, then we can start to see how the environment can create the challenge.

For me, the core of pro-neurodiversity practice is about approaching my interactions with radical acceptance, genuine joy and curiosity in order to find out what each child needs and what we can do to accommodate that.

Here’s three practical suggestions for making this happen:

  1. Support self-awareness.  Help the child to understand their unique identity and be comfortable naming that: what they need, what helps them be successful, what helps them feel comfortable. This can’t be just about helping a child to understand themselves.  We also need to ensure that the environment is safe and supportive for them to practise doing so.
  2. Facilitate shared understanding.  Discussions of diversity need to involve everyone. The focus shouldn’t be on the minority group having to adjust or explain themselves to the majority, but instead for us to all have a better understanding of different neurotypes and different needs. I’d like us all to be able to talk about what we need and find a way to negotiate that within a group.
  3. Be clear about what you’re expecting and why.  We need to think carefully about who our goals are for and prioritise work that improves the child’s wellbeing and access in the environment.

What things have you been thinking about in your own practice or with your own child? What does pro-neurodiversity mean to you? Let us know in the comments below. We’re all learning together.

Want more?

Here’s an explanation of autism.

Thoughts on social justice.

How many words should a 2 year old know?

Wondering how many words your toddler should know? I’ll give you the short answer, the longer answer, and an alternative way of approaching this question.

How many words should a 2 year old know?

When we’re thinking about vocabulary knowledge, we need to consider whether a child understands the word and whether they can use the word themselves. Often children understand more words than they can use, which means that the ‘vocabulary comprehension’ number for a two year old is in the hundreds, whilst the ‘vocabulary use’ number is closer to 50 words.

Remember: there’s a whole lot more to communication than just word count. Your little one is busy figuring out lots of important skills, even if they aren’t yet using lots of spoken words. Find out more about all your child is learning and what to expect when in my free mini communication workshop.

If you’d like to dig into all the details of how we help kids learn to talk, then do check out Toddler Talk.

What to do if your two year old isn’t talking

If your two year old isn’t talking yet it can feel daunting knowing where to begin. There’s so much information out there, what do you pay attention to? This video was inspired by a question from a parent and includes some simple ideas to help you get started.

What to do if your toddler isn't talking

Firstly, spend time together! I know this seems obvious, but when kids aren’t talking it can be easy to think they’re happier playing by themselves. So, I encourage you to keep turning up for the play, without it having to look a particular way. As I’ve said before, it’s all play!

Allow for the quiet. It can feel awkward when noone is talking and very tempting for us to fill in all the silence. But, allowing that quiet thinking time is a valuable part of communication practice.

Practise presence. If you’re worried about your child’s communication development it can be easy to get stuck overthinking and catastrophising. And this pulls us away from the actual thing that’s happening right now. Paying attention isn’t easy, but it’s so worth it.

Look for how your child communicates. When we look at the variety of ways your child is already communicating, then we’re in a better position to teach them the words to match.

Celebrate the small wins. It can be a long road helping children learn to talk. Noticing and appreciating every tiny step along the way helps to keep us going.

Interested in more?

Check out my full YouTube playlist on helping toddlers to start talking.

Check out my Toddler Talk programme for parents.

My commitment to social justice

Below is an incomplete and imperfect statement on my own learning around matters of social justice.

This isn’t intended as an information source for others, more an act of accountability to myself and an exercise in open communication. I want to understand broader perspectives beyond the mainstream privilege that I hold as a white, able-bodied, cisgender, university-educated, middle-class westerner. I want to contribute to the ways we shift power and move towards equity for all.

There are many great educators out there providing essential information on the topics of antiracism, trauma-informed care, neurodiversity-affirming practice and more. Follow the threads of your own internet searchings, ask friends for recommendations, pay attention to what’s around you and who it’s written by. This is work we all need to do. I endeavour to keep going, especially when it feels uncomfortable.

Within our work we’re in a position to inform how people view a child, understand their needs and make choices about how to support them. This is no small position of power.

Speech and language therapy as a profession is majority white, able-bodied and middle-class (source), while the population we serve is vastly more diverse than this.

We work with many that are historically marginalised: people of colour, neurodivergent people, transgender people and those who are disabled.

With that in mind, it’s essential that we better understand the impact of intersecting forms of oppression, consider our own layers of privilege and reflect on how all of this influences our work.

The systems in place impact:

  • funding choices for research
  • data gathering and what becomes the ‘norm’
  • behaviours considered acceptable and from whom
  • the opinions and experiences that are prioritised
  • whose stories are told

I’m learning to be more aware of resources I use, the information I call on, who I listen to in my ongoing learning and what I choose to share.

I renew my commitment to the following values and principles within my own work: radical acceptance, joy and curiosity. I want to work within flat hierarchies, where everyone’s contributions are heard, everyone’s safety and wellbeing prioritised.

I want to keep having conversations about how we achieve this. What can we fix? What do we need to let go of, break down or change entirely?

Writing a statement on social justice isn’t enough. I hope it might lead to more discussion and an unfolding path of tiny steps we can take together.

What to do when your child won’t play with toys

I meet children with the most fantastically varied interests. Their delight in details has taught me a lot about play and exploration. I always aim to follow a child’s lead within speech and language therapy sessions, to find the thing that inspires a child to communicate. Over time, I’ve learned that this often means abandoning my own plans and my shiny new toys in favour of the door jam, the lid of a cardboard box and oh so much more.

So, when parents ask me ‘What toys shall I buy to build attention’ my response is always ‘What is your child interested in?’ Because supporting attention, communication and interaction isn’t about buying a prescribed set of toys. More often, it’s about putting down the toys and paying attention to the details of what your marvellous unique kiddo wants to explore with you.

PLAY & COMMUNICATION: It's not about the toys!

What surprising things does your child delight in exploring? For starters, there’s always the good ol’ cardboard box.

PS. I have put together a list of gift suggestions, if you’re looking for a few more ideas.

What does it mean to be child-led?

This strategy is my number one go-to piece of advice and approach to my therapy sessions. It sounds incredibly simple, so much that we often dismiss it. But when we really dig into the many ways that we can follow a child’s lead, tune in and build on their ideas, then we’re in a much better position to support their learning.

What does it mean to be CHILD-LED?

Simple right?! Maybe not. The trick is to notice when we’re trying to direct, advise or change the play. Often we have an existing picture in our head of how the train track should be laid down, or how the stacking cups should nest together. It can be quite hard to slow down and watch how a child discovers different ways of playing with what’s available.

Being child-led in your play together supports a child’s attention, their motivation to stay in the play and their ability to learn new words. And this is because you’re able to give them the words that are really relevant to what they’re interested in.

Here’s to embracing the unexpected and learning together from what children have to show us.

Here’s 3 important lessons I’ve learned from the children I work with.

Tips for tricky conversations

In the last couple weeks, prompted by the terrible murders of George Floyd, Breonna Taylor, Ahmaud Arbery and countless others, people across the world have been protesting and speaking up against ongoing racism and injustice.

As someone who walks through the world in a white body I know I can never understand what it’s like to experience everyday racism and the inequalities baked into our systems.

I’ve been spending a lot of time listening and reading. And I want to hear more, I want to understand better and continue the lifelong practice of being anti-racist.

One of the very small actions that I’ve been taking is to be braver in everyday conversations with the people around me. We need to be willing to dig into tricky conversations about race and privilege and the many emotions that go with that.

As a Speech and Language Therapist I’m always encouraging children to step outside their comfort zone and practice the communication skills that they find tricky. It feels a good time for us all to be practising the same.

I’d like to share with you some of the things that I bear in mind for any important conversation.

Tips for tricky conversations

1) Listen more than you speak. Approach the conversation with the aim to better understand, rather than to educate or convince.

2) Focus on ‘I’ sentences instead of ‘you’ sentences. This helps you communicate your ideas, without judgement or accusation.

3) Feel it in your body. When we attend to how our body is feeling, it helps us to formulate and articulate our own thoughts and feelings about a topic. When a conversation makes you feel uncomfortable that’s often a valuable clue that these are important topics worth grappling with.

3) Be patient. These are conversations we need to have for a long time. This isn’t about a quick correction, it’s an ongoing discussion.

4) Practice out loud and be willing to get in wrong. It’s easy to stay silent for fear of getting something wrong. But engaging in these conversations is too important to avoid.

I’m committed to having more conversations, so that I can learn and make a positive contribution. And I’d love to hear from you. If you’d like to share your perspective or signpost to other resources, please feel free to add to the comments below.

A response to coronavirus

Honestly, it feels a little strange to make any attempt at responding to the global situation right now. I say global because it’s that interconnected, shared experience that has most struck me about all of this. As we all talk about the changes in our everyday routines, I see how much we have in common. We share so many of the same fears, hopes, challenges and unexpected joys.

At home, our top window looks across to our small stretch of sea, the Solent. My dad, a keen sailor, commented recently how the sea reminds him of that connectedness across the globe. I feel particularly grateful to have this sea view in these days of sheltering in place.

As a Speech and Language Therapist, the changes to our everyday make me think about how we communicate. But it’s bigger than communication. It’s about how we respond to each other and care for our community.

If you subscribe to my monthly newsletter you’ll be familiar with the Communication Tree model. But, in this video I propose a different model of communication development; one that considers why we bother with all this stuff in the first place.

CARE and CONNECT // A Speech and Language Therapist's response to Coronavirus

You can download the Communication Tree model by subscribing below. Watch out for more posts in the weeks to come, as we learn to navigate the new rhythms of our days.

What children have taught me about communication

Baby playing with toys

Have you ever had one of those sore throats where you lose your voice almost entirely? Suddenly all the little comments and contributions you‘d normally make with ease become laden with effort. You tell yourself that the thing you wanted to say wasn’t that important after all and you quickly stop trying.

When I lost my voice last winter it really affected my confidence. After all, If I can’t join in, then why am I here? I found myself smiling all the wider, in an effort to show that I was present, despite my lack of contribution. Hey! It’s me here! I can’t possibly speak, but I’m still thinking about everything that’s going on and I want to be a part of it!

It brought to mind the many children I support as a Speech and Language Therapist. How much they want to contribute and be a part of things, how eager their smiles. For them, speaking up is hard. Perhaps harder than we can imagine. The communication chain can break down at any number of points, but there’s lots we can all do to help knit it back together.


Be curious

When we approach a situation with open curiosity, rather than holding on to our idea of the ‘right way’ we create more opportunities to explore and learn together. If a child creates a long line of train track, instead of a nice neat round loop, it’s tempting for us to dive in and ‘fix it’. But, if we hold back for a moment and think ‘I wonder what will happen next,’ some of the best problem-solving and conversations emerge.

Embrace the silence

Often the most important ideas need time before we’re brave enough to say them out loud. In my work we often describe this quiet as ‘busy thinking time’. When we embrace the awkward silence, we give room for these ideas to flourish. Communication is about so much more than talking. Allowing a little more quiet is a hugely powerful strategy we can use to give children time to form their ideas and figure out how to share them with us.

Give attention to gain attention

There’s a reason we call it ‘paying’ attention. It requires focus and effort, ignoring the many distractions all around us. How many of us can say that we give our full attention to every conversation? We fly a mile a minute and so much of modern-day life expects this from us. So the challenges that children have in paying attention is something we can surely relate to. In therapy sessions we focus on giving a child our best quality attention, being truly present. When we do this we create a space that really allows for the best attention from all of us.

I’m always on the lookout for lessons learned in unexpected places. So, it’s easy for me to say that my dog has also taught me a thing or two. Find out more in this honest post.