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.

Helping children to answer questions

Do you find yourself asking your child lots of questions and never quite getting a reply? Getting children to answer the question is a common conundrum. Here’s five suggestions to help children answer questions.

Asking kids QUESTIONS... getting them to REPLY!

Do you really need to ask the question? When kids aren’t talking very much, it’s easy for us to get into quiz mode. But, there are more helpful things we can do to support language development. Let’s remember to give, not quiz. When a question pops into your head, try flipping it to a comment. Instead of asking ‘What’s that?’ you might say ‘Oh, it’s car!’ Instead of ‘What you doing?’ you might say ‘Wow, you’re jumping!’

If you know the answer, don’t ask the question. There’s huge value in us modelling language, rather than testing to see if a child can say the word. You’re still helping them learn when you model instead of ask the question. This also means that you can save your questions for things that you are genuinely curious about.

Flag the question. Our children have so much to pay attention to when they’re learning new skills. So, it can be easy for them to miss a question we want to ask them. Try giving your child a cue, like raising your hand and saying “I have a question!”

Choose your question carefully. Some questions are much harder than others. ‘Why’ questions are the very hardest to answer. For more information, check out this post on understanding question levels.

Give visual clues. If you’re asking your child to make a choice, then holding up the items is a useful way to help them understand and respond. Here’s more ideas for making language visual.

Pick a focus question. In speech and language therapy sessions, we’ll often pick a focus question, such as ‘who’ or ‘where’. These are important questions for developing language (here’s more information on teaching important ‘wh’ questions). Having a focus can help cue your child in and help you to come up with relevant questions in the moment.

Finally, embrace the awkward silence! Give your child quiet thinking time to process your question and consider their response. Avoid the temptation to dive in and repeat or rephrase the question. Give it time, allow for the pause.

Did I miss anything? Let me know your ideas for using questions in the comments below.

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.

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.

Activity Ideas for Early Speech Development

Some of the very young children who come to me for Speech and Language Therapy need help to master the early building blocks of words. Some of their early speech sounds haven’t yet developed and so families and I work together to find fun, creative, playful ways to encourage a child to practise some of these early sounds.

In this video I share with you some of the toys and everyday activities we use to help children practise these early parts of speech.

Activity Ideas for Early Speech Development

Is your child learning to master the building blocks of speech? What sounds are you helping them learn?

If you’re interested in finding out more about the process behind Speech Therapy sessions, you can check out the stages of therapy in this blog post.

What is Speech and Language Therapy?

What is Speech and Language Therapy?

You know that classic moment, when someone turns to you and says “So, what do you do then?”

Sometimes I’m tempted to answer with something un-work-related, like “I climb trees” or “I read books” or “I sing songs”. (Perhaps working with children helps me appreciate that we are more than the work that we do.) But, of course I know that they really want to know about my vocation, so I reply “I’m a Speech and Language Therapist”.

Often I’m met with a delighted smile: “Oh, that must be fascinating work!” or “That must be so rewarding.” Yes and yes; it absolutely is!

Just occasionally I’m met with a bemused expression: “So, is that like helping people with autism?” (Sidenote: it’s a testament to the success of awareness-raising campaigns that this is now the common response rather than: “Oh, is that like elocution lessons?” which is what I used to be asked ten years ago.) I reply: “Yes and also so much more!”

So, inspired by many conversations and attempts to explain a profession that involves a huge variety of work, I put together this super-quick video rundown of Speech and Language Therapy: what it involves and who it helps.

What is Speech and Language Therapy?

I wonder: what would you add to this explanation? Let me know in the comments below.

P.S. Find out what to expect at a Speech and Language Therapy appointment.

What Makes Speech and Language Therapy Successful?

What Makes Speech and Language Therapy Successful?

When I was about nine years old I had piano lessons. I went to visit a lady in a lovely old house down a long gravel drive. She would greet me at the door and usher my mum to her cosy waiting room before then leading me through to her music room to play for half an hour on her grand piano.

I always had a nice time working through my big red ‘beginners’ book and my mum no doubt enjoyed the rare opportunity to sit in peace with a magazine and a cup of tea. After half an hour my teacher would bundle me and my mum out the door and we’d say cheerio until next week. It was all very lovely and truthfully not very effective. I never practised between my visits and I never really had a sense of learning or improving at anything.

When you seek Speech and Language Therapy for your child you may picture it looking a little bit like my old piano lessons: weekly 1:1 between therapist and child and a bit of peace and quiet for you. I am sorry to say that, whilst this can make some difference, it is absolutely not where the magic happens! Therapy that really makes a difference in a child’s life involves a lot more.

Shared goals

It’s important to talk together about your hopes for your child and the challenges you face. By agreeing together your goals for therapy, you can carry your practice beyond a weekly SaLT visit, spot everyday opportunities to practise together and notice when your child is trying out their new skill.

Shared conversations

No child is an island. Whether it’s mum or dad, the nursery key person or the class teacher, talking together ensures that we all can provide the right support in a cohesive way.

Shared work

An hour a week practising a new skill is simply not enough to make a lasting change. Yes, time is limited and our weeks run away from us. But if you can find regular time to practise between SaLT visits and to bake that into your weekly routine, you will enable your child to make much faster progress. Which leads me to my next point…

The right timing

Sometimes life is simply too busy. Sometimes there are other priorities or events going on that mean you’re not able to make the most of SaLT support. I want therapy to really make a difference for your family. So I often ask parents to think about the best time to begin a block of therapy sessions and make sure it complements the rest of your busy schedule.

Good fun

Far from a last minute extra, ensuring that sessions are fun is actually a crucial part of effective therapy. We learn and remember information best when it’s attached to good feelings. So, having some laughter in therapy sessions and being flexible in how we approach our targets can ensure more lasting change.

What I really want to tell you is that therapy is absolutely a team effort. Yes, you can ask a therapist to work 1:1 with your child and you can have that cup of tea in the waiting room. But, when you invest your time and attention, then you can really make the most of Speech and Language Therapy.