Archive: October 2021

The 22nd of October 2021 is International Stuttering Awareness Day. In light of this important date, we teamed up with Janet Stevens to bring you an informative article on Stuttering. Janet is an experienced speech and language therapist, independent practitioner and module leader on our Speech, Language and Communication Needs module. 

This article highlights the different terminology you may hear, important facts, risk factors, and much more. If you are interested in any of the information below, please do feel free to leave any questions or feedback for Janet in the comment section at the end of this article.

Raising awareness on International Stuttering Awareness Day

Firstly, it is important to understand the differences in terminology: the speech difficulty known as stuttering in the USA & Australia, is more commonly referred to as stammering in the UK. The charity that supports & provides guidance for families, education & health agencies that have contact with children & adults who stammer in the UK is known as STAMMA. All of these terms can equally be encompassed within the descriptor of dysfluency.

Stammering is a neurophysiological speech disorder that appears to affect neural pathways in the speech-linked areas of the brain; it can be described as being like ‘a glitch in the wiring’.

A current definition of stammering is:

A voluntary disruption to the smooth flow & timing of speech, characterised by prolongation or repetition of sounds, blocking or secondary features.

This is what we know about stammering:

• It affects 5% of children under 5 years of age
• It affects 1% of the adult population
• It usually first manifests between the ages of 2 and 5 years of age
• It is not linked in any way to intelligence (IQ)
• It can be intermittent & appear to disappear for periods of time
• Early identification & referral to a Speech-Language Therapist (SLT) is essential to monitor & assess risk factors

Main Risk factors

• Family history of stammering: hereditary factors particularly strong with male relatives, although females can stammer
• Recognised difficulties with early speech/language/communication development OR significantly advanced language skills
• Time since onset of stammer: the longer the period of time between onset & consultation with SLT, the greater the risk that the stammer will become established
• Pattern of change over time: if child stammers every day, the risk of more permanent stammering is increased
• Parental levels of concern: the more anxious & concerned parents are, the greater the potential risk that early mitigating factors will not be effective
• Child awareness/level of concern: the higher child levels of concern/anxiety, the greater the risk that the stammer will become established

Triggers for Stammering

Multiple factors can interact with these main risks to trigger a stammer at any time; the circumstances will vary for individual children; however, none of these factors will cause stammering by themselves; individual children will already have an underlying deficit or predisposition or a stammer.

The factors to consider are:

• Language factors
• Psychological factors
• Environmental factors
• Physical factors

There is a Framework for Stammering that is used by the majority of NHS SLT teams & alternative diagnostic agencies, to inform their thinking about the specific factors involved in the stammer of individual children

This is also known as the Multifactorial Model: as the graphic illustrates all 4 factors interlink & overlap. SLTs will use this information to generate a Profile of Risk for each child, which will then inform the focus of intervention & act as the evaluation framework for that intervention.

Features of Stammering

• Repetition of sounds [usually word initial]: e.g. m.m.m.mummy
• Prolongation of sounds [usually word initial]: e.g. sssssunshine
• Blocking of sounds: e.g. trying to speak but no sound comes out
• Secondary features: e.g. eye blinking, twitching, facial grimaces

This list is a broadly chronological pathway of the typical evolution of childhood stammering. In terms of identification, generally stage 1 is auto-resolvable, whereas once stages 2/3 are reached, the risks multiply & the likelihood of the stammer becoming established is significantly increased.

Prevalence

Of the 5% of affected children:

• 2 of the 5 will experience transient difficulties with dysfluency between the ages of 3-5, which will resolve with no external intervention
• 2 of the 5 will experience significant dysfluency as young children, which will be    resolvable via SLT intervention & guidance
• 1 of the 5 will become a chronic stammerer, through childhood into adulthood

Intervention Options

1. Indirect Intervention: this could include guidance/advice for the family & ‘watchful waiting’ by the SLT, who would over review appointments if the family requested them
2. Direct Intervention: the care pathways on offer across different NHS trusts in the UK will vary. In my own Trust, SLTs are trained to offer Parent Child Interaction sessions, Lidcombe Therapy sessions, Swindon Group Therapy sessions and referral to specialist intervention at The Michael Palin Centre in London. An individual child (& their family) will be guided onto one of these options initially, with the possibility of moving onto other options at a later date. This is not a sequential pathway, as each individual child & family are unique, so therapy packages will be uniquely designed around their needs.

Parent-Child Interaction

This intervention is based within the Hanen Approach: essentially it comprises short video clips of interactions involving a parent/significant adult & the child, which are then watched by the adult with discussions guided by the SLT to help identify areas of interaction ‘practice’, which could be ameliorated or changed, by the adult to minimise the child’s stammering behaviour [referring to the Profile of Risk].

Lidcombe Programme

This is a behavioural treatment mainly for children under 6 who stammer; there is no pressure within the treatment sessions on the child to consciously attempt to change any stammering behaviours. Parents are ‘trained’ to identify the number/severity of every stammered utterance [called ‘offering verbal contingencies’]; they do this in daily ‘treatment’ sessions AND in some ‘natural’ conversations. [https://www..lidcombeprogram.org]

Swindon Group Programmes

The SLT team in Swindon have devised, operated & trained other SLTs in a series of 3 different group therapy programmes. They combine intensive speech therapy in a group of peers with similar impairments with outdoor activities. These can be used sequentially & generally cover the ages from 6 up:

1. The Smoothies Pack (6-9 years)
2. The Blockbuster Pack (9-12 years)
3. The Teens Challenge Pack (13-17 years)

The Michael Palin Centre

As a centre of excellence in London, the team of highly skilled SLTs deliver intensive 2-week programmes for the families of the stammering child, as well as the child themselves. Group discussion, parent support and techniques to reduce stammering behaviour, combine in a challenging yet supportive environment to resolve often deep-seated family & personal issues, of which the stammer is frequently a manifestation.  These courses require referral & local GP/NHS funding, so it can require years of effort to secure a place.

Advice for Parents and Supporting Adults (e.g. teachers)

• Remain open to communication about the STAMMER
• Do not react to the STAMMER in a negative way
• Wait for the child to finish talking, don’t interrupt or finish their sentences for them
• Don’t ask the child to stop & start talking again
• Praise the child for things they are good at/do well, using specific praise
• Praise the child when they talk ‘fluently’ or ‘smoothly’
• Maintain eye contact when communicating with the child whenever they stammer
• Slow down your own rate of speech
• Use pauses to give the child time to think & process information
• Don’t ask too many questions; use comments instead

In conclusion, if, as a professional educator, parent or relative, you become aware of a child stammering, please refer or encourage parents to refer the child immediately. The closer to onset a child can be seen by an SLT, the better the long-term outcome will be.

This article provides information on how to apply for grant funding for the Real Training Senior Mental Health Leadership courses.

As we are sure you are aware by now, the Department for Education has announced new quality criteria for Senior Mental Health Leadership courses, and these criteria help define this important senior role in schools across England. Additionally, the announcement contained information on grant funding to all state-funded schools and colleges in England. In the current funding tranche (up to May 2022), this is expected to cover one-third of eligible schools, with further funds to be released after this.

Applications are now open to apply for this funding, and in this article, we guide you through the steps to complete the process. 

Step 1 – Read the guidance for grant funding to ensure eligibility

The DfE has published a comprehensive guide to applying for grant funding. Initially, we recommend you visit this page, which offers a useful overview of topics such as what the grant must be used for, eligibility criteria when to complete the submission and so on. It will also provide information regarding creating a ‘DfE Sign-in account’ which is necessary in order to access the form. Please note, it can take up to 10 days to create a DfE Sign-in account!

You can also visit this page which will offer more information on the conditions of the grant and application guidance. We highly recommend you read all of this information to avoid submission errors that could delay or invalidate your application unnecessarily.

Step 2 – Decide on the course you wish to apply for grant funding

At Real Training, we offer two DfE quality-assured Senior Mental Health Leadership courses. Click the links below to visit our course pages and learn more:

Senior Mental Health Leadership Certificate (SMHLC) – aimed at those who are new to a Senior Mental Health Leadership role or are aspiring to become a leader in this area.

Senior Mental Health Leadership – Advanced Award (SMHLAA) – aimed at those who have some experience in the role, and have some existing training in mental health leadership.

If you are unsure which of these is best for you, then please don’t hesitate to get in touch with one of our experienced course advisors who will be happy to help, either by email info@realgroup.co.uk or by phone on +44 (0)1273 35 80 80.

Step 3 – Collate information for your setting in preparation for application

It is important to ensure you have the relevant information to hand in and that certain conditions are met before commencing the application process. This includes, but is in no way limited to:

• Having a commitment from your setting’s senior leadership team to develop a whole school, college or centre approach to mental health and wellbeing
• Details of your senior mental health lead, who will receive the training in 2021 to 2022 financial year, to oversee your setting’s whole school, college or centre approach
• Authority to submit a claim for this training grant on behalf of your educational setting

Having this information readily available will enormously reduce the time it takes to apply and helps ensure correct information is provided first time.

Step 4 – Access the application form

Once you have all of the necessary information required, you can access the form here. At this point, you will need to log into your DfE account. You may be asked to specify the individual campus you would like to complete the form for if your account has more than one eligible campus. The next page will display the details of the organisation the DfE holds, related to your login. It is important to check these details, and complete this form if any of them are incorrect. You will be guided through the form, step-by-step.

Once complete, you will be asked to agree to the declarations as set out in the grant terms and conditions. You will then receive an email of confirmation, containing your claim reference.

Amendments and waiting lists

It isn’t possible to make amendments to the application form once submitted. However, if errors have been made or circumstances change, you can submit another application, the details of which will be used, and previous applications disregarded.

Since there is a limited amount of funding available for this financial year, you will be offered the chance to join a waiting list, in the event that a successful applicant withdraws.

The DfE has committed to offering senior mental health leadership training to all state schools and colleges by 2025, and further funding is expected to be announced in the spring of 2022.

Step 5 – Book your course!

Once you have received confirmation of your grant, you can visit our booking form to book your place on one of our Senior Mental Health Leadership courses.

Useful facts about the Real Training Senior Mental Health Leadership Advanced Award

• Although the cost of our Advanced Award (£1,300 + VAT) is more than that of the grant being offered (£1,200), you can still apply for the funding to cover the majority of the cost of this course, with the difference being covered by the school. This course provides additional benefits beyond the goals of the course content:
  • High-quality, masters level qualification written and delivered by experienced educational psychologists
  • We aim for this course to be validated by Middlesex University as part of our SEND Programme, so will be worth 30 masters-level credits
  • Flexible delivery that suits your circumstances and fits your other responsibilities.

In a non-state-funded or international setting?

This course is just as relevant to those working in non-state or international settings. Please visit this page to learn more.

with Dorthe Kronborg Allen, SEN Consultant

Earlier this year, Dorthe provided us with her top tips to discuss SEN with parents. Dorthe has completed a variety of courses with us at Real Training and you can read more about her time studying with us here. This article provides a really useful overview of effectively discussing SEN with parents. 

Teachers, parents and learners are a team. Together we cover all the essential contexts and bases for support that lead to a learner’s progress. We are all working toward the same goal, albeit with differences in our respective motivations and methods. Sometimes, the introduction of the ‘SEN variable’ into this team equation can be the cause of tension and stress, especially when an initial meeting is scheduled with parents to discuss observations that point toward the need for intervention. In fact, parents of children with special needs often report feeling overwhelmed by such meetings – even if it is not the first time they are attending one – and thus we need to proceed with care and professionalism.

To assist with the planning of meetings to discuss SEN with parents I created the following acronym, quite early in my career, to remind me of the five areas to be mindful of before, during and after the meeting:

Honesty 

Empathy 

Language 

Preparation

Support

Honesty. It is important to be direct and to tell parents the pertinent information about their child’s strengths and weaknesses – from both the academic and pastoral perspective – and to explain what this has meant for the child thus far in their learning journey. Sugarcoating the situation in the hope that parents will accept the information more readily only causes confusion and makes it sound as if the school doesn’t have a solid intervention plan for the child. For children who do not have a formal diagnosis, it is really important that you do not make any suggestion (or an informal diagnosis) about the particular special need category you suspect, and you should always avoid referring to a specific SEN condition even if you are certain you know what the diagnosis would be. I have often had parents offer their own ‘diagnosis’, asking me to confirm their suspicions about their child and this is the golden moment to indicate that an external assessment by a qualified professional would be useful. 

Empathy. Taking the time to explain the situation in detail to make sure parents understand the various needs of their child is vital for both cooperation and progress. It also means that you listen and give parents the opportunity to offer their own insights and reflections about their child’s behaviour at home and in other contexts. These ‘other contexts’ outside of the school environment present the part of the puzzle that we teachers don’t get to see and can provide useful insight to inform our intervention planning. Keep in mind also that the wonderful progress that we see our learners make on a daily basis is usually only communicated to parents at termly parent-teacher evenings, in hurried ten-minute slots consulting with a broad range of teachers, more often than not with a focus on the observed weaknesses in a certain subject, followed by simple instructions that “more needs to be done at home”.

Language. Avoid using language that is too technical, such as our daily SEN department jargon, as this might make parents feel alienated and even more confounded. This is not the time to showcase your own knowledge on the subject, it is not a job interview after all. Your objective is to work together with the people seated opposite you to make sure that their child is happy, motivated by their education and successful, and that everyone is on the same page about how to best achieve this outcome. Direct and honest language is the best policy, as mentioned earlier, but you also need to make sure you are not too clinical or harsh in your explanations. 

Prepare. You need to bring solid examples to show parents that demonstrate the need for the kind of support to be provided. Classroom or tutor teacher observations are really useful here as parents tend to trust their child’s main teacher. Make sure the observations are chronological so that they show the growth as well as the gaps in learning. If you have used any screeners and have the results then you need to bring those as well, making sure that you can actually interpret and explain them in clear language. Other documents such as observation questionnaires completed by TAs, and samples of work that demonstrate a gap or need should be brought along as well. You don’t need to show parents all of these examples, and indeed you shouldn’t aim to power through them all, but during the course of the meeting, you will be able to gauge which of these will be most relevant.

Support. This is the final and broadest term, and the one that is also the most thrilling, time-consuming, and tiring at the same time. Parents need your expert advice on how to work effectively with the school and they may also need some emotional support during the meeting with you. You must ensure that you explain clearly the types of intervention the school is able to offer, how that will pan out in the school environment and, should an IEP be planned, now would be a good time to introduce this document and speak with parents about the goals you would like to set for their child at school. Support at home should be discussed as well, with time spent explaining how the parents can help with everything from the right environment for study, to strategies that support their child cognitively and emotionally. You will no doubt also be asked to give advice on how to get them to clean their room and remember to bring all their books to school each day, which is a topic for another, much longer article!  

Take the time to listen well, speak candidly and advise with clarity. If you are an NQT or a less experienced teacher and are worried about the meeting then you can always call on your SENCo to attend with you for support. When parents leave an SEN meeting with the relieved feeling that the school listens and is aligned with them to ensure their child is successful then you have done an excellent job and you can confidently pat yourself on the back as you make a nice cup of tea, type up the mandatory meeting notes and send them to all those concerned.

If you have any questions for Dorthe on tips on how to effectively discuss SEN with parents please feel free to comment at the bottom of the article.

We are delighted to be attending The TES SEN Show 2021 in person next month. You can find us at Stand 135 from 8-9 October at the Business Design Centre London. 

Our team will be on hand to help, whether you would like to know more about our popular MEd SEND Programme or maybe it’s one of our brand new Senior Mental Health Lead Courses that caught your eye. You can read more about these below:

• Senior Mental Health Leadership Advanced Award
• Senior Mental Health Leadership Certificate

Not only will you find Real Training at the show, our sister company, Dyslexia Action Training, will also be attending. They will be located on Stand 163 accompanied by the Dyslexia Action Shop and The Dyslexia Guild. 

Dyslexia Action: A leading provider of accredited training specialising in Dyslexia and SpLD

The Dyslexia Action Shop: Online shop providing educational assessments and learning aids. Visit them at TES to receive your exclusive £10 off voucher!

The Dyslexia Guild: A network of professionals maintaining the support of those with Dyslexia and other literacy needs

Whether you’re currently studying with us, have in the past or just want to have a chat, it would be great to see you there. You can collect a free goody bag from both stands and there will be some insightful seminars taking place throughout the event, check out the TES schedule here.