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Outreach Team

For some children who need Speech and Language Therapy, the clinic is not the most appropriate place to meet their needs. The outreach team will work with children when ongoing clinic work is not suitable.

For families who meet the criteria for the outreach service, the main focus will be adapting the child’s environment to support and encourage their communication. The targets we set need to be embedded into the child’s daily life and routines to promote communication development. This involves joint working with parents, education staff, and other professionals involved in joint care. The outreach team work across a variety of settings including schools, nurseries, health settings and family homes.

Children seen by the outreach team often have complex needs and may have additional medical diagnoses that impact on their communication such as:

  • Autism Spectrum Disorder
  • Down Syndrome
  • Global Developmental Delay

These children might be known to other services, for example paediatricians, physiotherapists, or occupational therapists.

Communication

Communication refers to the way we convey information to each other. Talking is a part of this, but there are lots of others ways we communicate with one another. These can include:

  • Gesture
  • Facial expression
  • Pictures or visuals
  • Signing, such as Makaton signing

When we talk about children’s communication development, it is important that all types of communication are recognised and encouraged.

For a child to develop communication, they need lots of different skills and experiences. We can use the communication pyramid to help us visualise this (right):

A pyramid is a helpful way to think about this as the skills at the bottom typically come first and act as a foundation for the skills on top.

There are some ideas for helping develop these skills below and in the video at the bottom of this page.

children's SLT - communication pyramid
Attention and Listening

Attention means taking notice of the things around us and paying attention to particular things in our environment. Children need to be able to pay attention to what is happening around them to start to explore and understand what is going on and the language around them. One example of this is a child starting to notice that the sound of the water running means that bath time is coming

Children also need to share that attention with another person in order for that language to develop. If you are pointing out something of interest the child needs to be looking, they won't be able to attach your language to the object you are talking about.

Strategy: Ready, Steady, Go

Games that incorporate “ready steady go” are great to develop shared attention, anticipation & waiting and encourage some vocalisations / early words. You could play games such as blowing bubbles, rolling a ball, playing with a balloon.
Try to pause between each word to encourage your child to hold their attention for longer and help them to anticipate that something will happen when they hear the word “go”.

Play and Interaction

Play helps children to develop the skills that they need to be able to communicate well later on. This might be skills such as learning to take turns, develop social skills such as appropriate eye-gaze, how to copy other people’s actions but also learning and experiencing the word around them.
Children’s play may be re-enacting everyday life and copying parents by talking on the phone or making a cup of tea. We can help children learn language by encouraging them to copy our language in play.
But remember play doesn’t always mean playing with lots of toys, it might be playing people games (like singing songs or tickle games), exploring pots and pans (that might be stacking or making noises with them) or playing with water in the bath. You don’t need lots of toys to do this and often your child’s best toy is you.

Strategy: Turn-taking games

Taking turns is really important in communication and games that encourage this can be helpful in developing shared interaction. These could include rolling balls to one another, stacking items one at a time or building Lego towers, or pressing buttons on toys to make characters jump out. You can use these games to model language and vocabulary. For example, if you are making a Lego tower, you could say “my turn” “your turn” “more” “again” “bricks”.

Understanding language

Children usually understand words before they are able to use them. For example a young child might know the word “cup” and understand that it means the object they drink out of, but they might not be able to say the word yet. Children may also understand that a specific item represents a part of the everyday routine such a coat may mean that the child is going outside or pyjamas may mean the start of the bedtime routine.
Understanding doesn't always mean understanding spoken language. There are lots of different ways of understanding, for example understanding everyday routines, understanding visuals such as pictures and understanding gestures. These are all elements of understanding communication and we need to help our children them to make sense of the world around them.

Strategy: Reduce Your Language

When we talk about reducing our language, we mean making what we say simpler so it is easier for a child to understand. We can do this by using just the key words in a sentence eg. instead of “Jack, get your shoes we’re going to grandma's” You could say “Jack, shoes!” or “Jack, grandma’s!”. This reduces the amount of information your child has to process to understand what is happening or what is expected of them.

Using Language

Typically, single words develop first, then two words together, short phrases and then sentences.  But there are also lots of other means of conveying a message in addition to words e.g. gestures, vocalising, using objects and pictures. This may be your child giving you the TV remote to say he wants his favourite programme put on or leading you to the fridge to request a drink.
Children may also be able to say words such as colours or shapes but may need some help to use functional phrases to communicate their wants and needs with another person.

Strategy: Modelling and Extending Language

When you talk to your child remember to keep your sentences very short and simple and matched to their current level of language e.g. one word if your child is using one word etc. To help your child to learn the names of things around the house, tell them the names of objects when you are using them, or the names of toys when you are playing with them. When you are out and about, watching TV or looking at books, point out items to your child and name them or comment on what is happening e.g. “bird”, “dog barking”. If your child is using words and comments on the things around them, repeat what they have said and add another word e.g. if your child says “Mummy juice” you could model back “Mummy more juice” or your child says “bird” model back “bird flying” etc. We call this ‘match plus 1’ – match the language your child uses and add one element to it.

Speech

The final skill to develop is speech, or being able to use the correct sounds in words. This is the last thing to develop and children need to be using lots of language before they will be able to produce clear speech.

Strategy: Modelling Speech

Just like language, a child is more likely to develop speech if they have clear and consistent models of this from the adults in their life. If a child says a word using the wrong sounds, you can repeat it back to them with an emphasis on the sound they found tricky. So, for example, if a child says “Mummy, tat!” instead of ‘cat’, you can say “That’s right, it’s a cat” with an emphasis on the “c” sound.
This way, you are praising the child’s attempt while modelling the correct pronunciation. Always make sure you praise your child for what they are saying and not just how they are saying it.

For more ideas on developing speech sounds, see our Speech Sound Disorders page.

Getting Started With Communication