Teachers: Looking after your voice this winter

I lost my voice this week. Like, properly lost it. Ironic, if you consider that I used to specialise in voice disorders. 

Funny, if you're my kids. Not funny when your job relies on your voice. I didn't realise how exhausting it is not having your voice, never having lost it before.

Every year 60% teachers experience difficulties with their voice, according to the NUT, at a cost of £15m a year. 

You can't avoid getting viruses at this time of the year, especially when your job is based within sneezing distance of young children's faces. But, to recover your voice quickly? Well, you might want to pay attention to these tips below, because if you don't, you'll end up with longer-term voice difficulties. 

I know that it might seem that losing your voice is an occupational hazard when working with your voice (teachers, preachers and screechers) but if you are losing it on a recurrent basis (or for longer than 10 days in a row) then ask your GP for a referral to ENT to rule out anything untoward, like vocal nodules. They can then refer you onwards to SLT who can give your exercises to recover and maintain good vocal hygiene.

But if it's a one-off throat infection or virus like mine, then these tips will help you get your voice back again.

1) Don't push or force your voice. This includes whispering. This is really important. You may think that this is impossible, but if you force your vocal chords when they are swollen then you will sustain long-term damage. So, if you need to get the attention of your class, put something up on the board to say you won't be raising your voice today, agree with them the non-verbal way you are going to get their attention, enlist the help of the child least-likely to respond to a non-verbal means of getting attention to be your attention-getter (because they are often the noisiest, so give them that role!) 

voice amplifier

Consider using a voice amplifier. I know, it looks naff, but you're protecting your voice, so get over it. And plan to give the children more speaking roles in today's classes. Or cancel your class -  I had to do this this week, myself. It's actually very difficult to listen to someone with a husky voice so your teaching won't be as effective as your usual inspiring and energetic self.

2) Be well hydrated. Drink lots of water, and aim to sip water instead of coughing to clear your throat. If you can't help coughing that's one thing, but if you're constantly clearing your throat then stop. You can't clear swollen-ness and it makes your vocal folds more swollen.
Avoid alcohol (I know you don't sip from a hip flask in class, but that large glass of wine you use as a relaxant at the end of the day? R-E-S-I-S-T. It'll seriously aggravate your vocal folds. Drink water instead - preferably just cooler than boiling, and give the steam a whiff on the way down. Avoid caffeine and milk - dehydrating and mucous-inducing in that order. 

3) Keep your throat warm - use a scarf or polo-neck jumper. And try to breathe through your nose so you filter and warm the air you're breathing in.

4) Avoid pain-killers like throat lozenges. All they do is mask the strain you are putting on your voice and so you do more damage. 

5) Have voice rest. No Whitney Houston impressions in the shower or on your commute to work in the car, no yelling across the playground when some kid drops litter, no long conversations on the phone to your mother in the evening. Your vocal folds are swollen and need to rest. 

6) Don't be a martyr. Seriously. Your voice is your tool. You need it so that you can work well into your 60's (sorry to depress you there!) It's definitely in your head teacher's interest to be flexible when you have a sore throat (e.g. giving you non-contact time over teaching) for one week, than to risk you not being able to teach for much longer. I have seen teachers for voice therapy who had been off for 12 months, so in the grand scheme of things, a week doesn't seem so bad. 

NB These tips are for recovering your voice after a throat infection or virus, but please know that voice problems can be linked to stress or physical difficulties such as vocal nodules. So, if your voice is always the first thing to go when you are ill, then ask to be referred to ENT just to get things checked over. And, if you are looking for ideas as to how to project your voice on a regular basis, contact me and I'll see if I can help.

Ditching the dummy over Christmas: The Dummy Christmas Tree

When I'm asked how to encourage children to give up their dummies, I often advocate the giving it to Santa/Easter Bunny/Dummy Fairy *delete as appropriate. In fact, I've even been known to dress up as the dummy fairy a long time ago - I must have been the most-hated person in Jersey that night!

However, beyond the comfort that very young babies get from suckling and soothing, dummies can become the bane of a speech and language therapist's life. The dentists probably aren't that keen either, with prolonged dummy sucking leading to an open bite mal-aligned teeth, called an interior bite.

I know, I know, this can also be caused by thumb sucking, so safe to say, it's a lot easier to get rid of a dummy than it is your child's thumb, without taking drastic measures, that is.

So, I'm not a Dummy Nazi. I don't go around snatching dummies out of babies mouths as they cruise around the supermarket. But when a 6 year old walks into my clinic with significant speech sound difficulties, I really wish they had been encouraged to break the habit earlier so the speech problems weren't there in the first place. [and before I get any comments, yes sometimes SLTs recommend dummies for babies with a weak sucking reflex]

Typical speech difficulties caused by prolonged dummy use are using /k/ and /g/ for everything, e.g. saying "goggy" for doggy or "kak" for cat. Also, having a lateral /s/ otherwise known as slushy speech (as used by Sid the Sloth in Ice Age.) Or a lisp. All of which are quite difficult to 'undo.'

Babies need to babble - it's how they practise the sounds needed for speech. And dummies just get in the way. So, if you do use a dummy to soothe, then keep it for that - soothing - or bedtime and not just as a habit.

Most of my early years colleagues report that the children don't ask for their dummies all day, then as soon as the parent picks them up, they still don't ask for it, but they are given it. So, it is a habit and it is usually the parent's habit.

I'd love to see dummy use being reduced by about 12 months but definitely by 2 years and then it's simply a case of going cold turkey. Pick a time when you as parents are not using it as a prop to survive life.. Sleep deprivation is a form of torture, so there is definitely a time where needs must.

But if you are ready and feeling strong (!) talk about how Santa likes to collect dummies to give them to the little babies for Christmas. "Now you're a big boy/girl, and big boys/girls don't use dummies."

I love the idea of having a "Dummy Christmas Tree" at your local playgroup/nursery. Children can be encouraged to bring their dummies and make Christmas decorations out of them (cover them in glitter to they are not tempted to go in for a stealth suck on the sly!) Tie them on the tree with tinsel or ribbon and in return they get a gift of something like bubbles or a party blower - basically something they can do now they haven't got a dummy in their gob.

This is probably a better idea than giving them up to the real Santa on Christmas day as it might turn in to the night from hell - and it's hard enough to get them to sleep on Christmas eve!

Once they have given them up, there's no going back (unless they are really ill or something comes up that's needing lots of soothing.) But gentle reminders using positive language can help. "Ooh, remember you're a big boy and you were kind and gave them to Santa for the babies." or "you gave the dummy to Santa and he gave you a really lovely toy."

Remember, choose a time that is good for you. Know that dummy sucking IS a habit and children who continue to use dummies are more likely to have teeth and speech problems. And, yes, you'll hate me for one night - two nights tops - and then you'll thank me.

You're welcome!

*This blog is my own opinion and does not represent the views of all Speech and Language Therapists. Just the sensible ones.

Top Ten ideas for World Nursery Rhyme Week

OK, OK, I'm not going to win prizes any time soon, but I love rhymes and have even been know to have written a rhyming book about a haggis called Mac (make mental note, do something about it!!)

Rhyming is so so important for language and literacy development. When children hear you making up silly rhymes, they have a go at doing the same and have a phase at rhyming everything (particularly if it rhymes with poo.....or was that just my kids?!)

But we are losing the art of singing nursery rhymes to the allure of the iPad and YouTube. But there is NOTHING your little one wants more than to hear you sing to them. Remember to sing it slow enough so they can join in. Or leave off the last word of each line, for them to fill in the gaps. And repeat repeat repeat!!

Kids love hearing the good old fashioned rhymes and love them even more when there are visual prompts to help them, so here are my favourite ideas for encouraging rhymes at pre-school.

Baa baa bag

I visited an early learning setting this week and saw some fantastic drawstring bags with different nursery rhymes on them. The bags themselves come empty, but the kids had great fun telling the staff what should be in them (though there was a challenge as to how to put rain in the 'incy wincy spider' bag!!) Staff then send the bags such as this Baa baa black sheep bag home to the children.

Five Little Ducks Puppets

I love these little puppets to help cue the children into the right number for the five little Ducks rhyme.

Five Little Ducks Went swimming one day
Over the hills and far away
Mummy duck said quack quack quack quack 
But only 4 little ducks came back

Five little speckled frogs more puppets, but this time individual hand puppets. Children love a visual prompt when it comes to rhyming as it helps their understanding and their attention skills.

There was an Old Lady

There was an old lady- This was my favourite book when I was little - I loved the holes in the pages that got bigger and bigger! I like the idea of kids dressing up as each of the animals - these masks would be great for this!

Little Bo Peep Wall Art

One of the nurseries I visit has wall art like this all around the room - they are really colourful and attractive  - this one is for Little Bo Peep

Dingle Dangle Scarecrow

I love all of these books by Annie Kubler as they have the signs to accompany them. This one is Dingle dangle scarecrow

Wheels on the Bus CD

Thank goodness my kids have grown out of the obligatory nursery rhyme CD that went in the car every time we went anywhere! But if you're going to get one, this one has all the classics and it does make the car journey go quicker - for them, at least!









You don't have to just have song time at your nursery.

Humpty Dumpty Game

You can sing the song whilst playing this
Humpty Dumpty interactive game...

magnetic animals

I love these magnetic animals....OK so it's a bit dubious as to whether you'd find a tiger on Old Macdonald's farm but it's always good to stray from the original lyrics!!









And lastly, these puppets are a great visual prompt for children to choose the nursery rhyme they want to sing before they have the words, especially if they are non-verbal!

twinkle twinkle

10 top Christmas present ideas to help language development for under a tenner

Stuck for Christmas presents?

I’ve come up with a list of toys that are great to encourage language if your child is between 2 and 5 years old. Obviously you will have to adapt the rules according to their age.

All for under a tenner. And no batteries required!

There’s just one catch to these toys….

You’ve got to sit down and play with them with your child – shock, horror! The best Christmas present you can give your child is to pledge to spend 15 minutes a day uninterrupted play on the floor with them. No phones, no texting, checking facebook or watching telly whilst you’re doing it. Just pure play, you and them, uninterrupted, following their lead.

PS These games are gender neutral, because nothing pees me off than labelling toys for boys or girls.

So, in no particular order.....

#1 Red Dog Blue Dog
I had to have a big think about which Orchard toys game to include, because they are my absolute favourite to use in therapy sessions. They are great for encouraging turn-taking skills, sharing, following directions etc. I like to ask them which one they want, then give them the wrong one, just to see what they will say….

Red Dog Blue Dog

#2 Crazy Chefs
Another firm favourite of mine, because you can encourage pronouns with this one “she needs the prawns, he needs the pizza base.” “I’m giving the noodles to him, and the pineapple to her.”

Crazy Chefs

#3 Growing Pot of Fun
Growing plants from seeds is a great sensory experience and any activity like this helps the child sequence their language (“first we put soil in the pot, then we made a hole and put the seed in. Last of all, we watered the soil and waited for the plant to grow.”

Growing Pot of Fun

#4 Tea Set

You can’t beat a good tea set for encouraging language development. Children need to hear language repeated over and over and here’s only so many times you can make a real cup of tea for daddy. But with pretend play, you can make a cup of tea for daddy, mummy, monkey, dolly, dinosaur. You can “stir the tea” “add some milk” it can be “too hot” “too cold”

Tea Set

#5 Opposites Puzzle
Kids love interlocking puzzles and these are easy two piece ones for little fingers. After object and action words, children need describing words and this is a perfect starting place.

Opposites Puzzle

#6 PeppaPig Playdough

You can’t beat playdough – another great activity for introducing new vocabulary; “rolling, cutting, squeezing, flattening, molding”

Peppa Pig Playdough

#7 Tummy Ache
My all-time favourite game when I was growing up – yes it’s that old! I use this game as a reward for speech sound homework. They say a sound/word and they get a piece of food for their plate. They love shouting out “tummy ache” - which is great if you are working on ‘k’ or ‘t’!

Tummy Ache

#8Fuzzy felts
An oldie yet a goodie! This farm yard scene opens up a whole possibility of story-telling, or following instructions – can you put the cow next to the horse? Can you put the sheep in the barn?

Fuzzy Felts

#9Bubbles!!

Every speech and language therapist has a tube of bubbles in their bag – they are fun and so versatile in developing language. You can ask them if they are going to blow a bubble “up to the ceiling or down to the floor?” And for younger children “Big bubbles,” “tiny bubbles,” “lots of bubbles, “ “more bubbles “ “pop bubbles” “bubbles gone!” Only hold, on to the pot yourself because I guarantee you, the whole pot will end up on the floor! This one is a big refill, but use little pots for the same aforementioned reason!

Bubbles

#10 What's Up
Oops – this is 70p over a tenner, but it’s a great game to develop your child’s describing skills, though it’s better for older children, say 4 years and above if you’re going to play by the rules as younger children can’t help but blurt out what they see on the card! But you can adapt the game for younger children by just getting them to wear the band and you give them clues to see if they can guess who they are.

What's Up?

Supporting Language Using Lego

In my house, we're big fans of Lego. And I mean BIG! These days, there are more 'projects' than when I grew up in the 70s with just a big box of primary coloured bricks for us to unleash our creativity. 
Now, our Lego seems to be different shades of grey, as most of our kids' Lego revolves around Star Wars. Which is flippin expensive but has involved hours and hours of play over several years. Plus we lived on a boat for 3 years so it was - hands down - the best investment we made as it ticked all the boxes:

• waterproof (sometimes things got wet on board!)
• Kids loved playing together with it (especially my daughter who is a huge Star Wars fan!)
•  It was a good ice-breaker for meeting new children, even if English wasn't their first language.
• We could break it back down whilst we were on passage at sea and then get it all out again once back at anchor. (OK, so there was one down-side - it slipped off the table when we had the sails up!) 

But I digress! Therapy using Lego? Well this is getting big, especially for children with ASD (Autistic Spectrum Disorders)  but I've found it to be fantastic for all children with language and communication disorders too. This is how it works:

You have 3 people, ideally: the architect, the supplier and the builder.
The architect gives directions, the supplier has to listen and give the builder the pieces he needs and the builder must follow the instructions. It's as simple as that!

The instructions can be as complicated or as simple as you like. Older children might like the Lego architect like this Eiffel Tower or you could use more simple diagrams such as this one:

 Tips for getting started:

• Use visuals; either the instructions from the manual or a picture you've made yourself.
• Encourage eye contact, by holding the pieces closer to your face when handing them on.
• Support the children in negotiation when a breakdown in communication occurs.

Skills you are encouraging:
Joint attention
Listening to instructions
Turn taking
Sharing
Communicating ideas 

For a great 5 minute youtube video, watch Hannah Coles, an SLT explain how she uses Lego here.

Opinion: making language and communication everybody's business

I was excited to get day release from my NHS job this week to attend a conference in North Ayrshire  called 'making language and communication everybody's business.' I'm excited because this is right up my street - my passion is to get other people excited about speech, language and communication skills in children.

It's not literally right up my street, but this worked to my advantage as arriving an hour early due to not knowing about local traffic jams ( there weren't any) meant I got a bracing walk on the beach before the conference. I didn't realise how much I miss the sea!

All in all, a great conference. The NHS team were really inspiring and have created a fantastic programme of early prevention programmes - albeit because their SLT budget was completely slashed - but it definitely fits in with avoiding the wait-until-they're-bad-enough-to-be-seen current model of SLT care. "Yes, I know your child has speech sound difficulties, but they're not really bad enough for us to see - come back when they are really struggling with literacy in a couple of years time." In our (Scottish) government's latest policy for SLTs, we should have "a desire to see a shift from intervening only when there is a crisis happens, to prevention and early intervention."*

It was good to see that some of the programmes are already well on their way in the department I am working in. But how do we move on from it being a year's funded project to being embedded in policy? Answers on a postcard!

My take-aways from this inspiring workshop are these:

• a great P7 buddy project. In many schools the youngest primary kids are 'buddied' by the eldest ones. The SLT offer an hour's lesson to the P7s on how to communicate better with their buddies. These future parents were reporting how much easier it was to talk to their buddies after the session!
• When we make language and communication everybody's business, we can be proactive rather than reactive. (I knew that already, but I took it away as being a message I needed to share more!)
•  I'm not the only weirdo who loves their job, but that there is a direct correlation between happiness levels of SLTs working in early prevention and SLTs firefighting the waiting lists on decreasing budgets using the older model of provision. It looks like this:

 

So thank you @weepeoplechat for a fabulous conference!


 *Ready to Act A transformational plan for children and young people,their parents, carers and families who require  support from allied health professionals (AHPs)