Online Learning

A Speech and Language Therapist reports from a changing world

Following on from Melanie Cross’ brilliant blog at the end of March, I wanted to write about how Speech and Language Therapists (SLTs) all across the country, indeed the world, are adapting to change.

My hat goes off to my NHS colleagues who are struggling to get the right PPE to deliver their therapy, other therapists’ jobs are being changed drastically, with others having to take unpaid leave. I received a call last week to see if I had sufficient ITU experience as a dysphagia (swallowing difficulties) therapist to work at the Nightingale Field Hospital set up for COVID-19 at the Excel Centre, London. It made me reflect on how much SLTs with dysphagia experience are needed at this time.

There has been so much to consider in all this global change, both personally and professionally.
There are many models about the theory of change, but this one is my favourite. It views change as something empowering and encourages embracing change. Given the circumstances, I think it’s all we can do. We also need to be aware that changes will keep happening for a while, but we can be flexible, and meet those challenges head on.

Taken from Kristine Quade and Renee Brown’s The Conscious Consultant.

Us ‘speechies’ are generally very good at adapting to change. In reality we do it all the time in all our everyday therapy sessions; everything has to be fluid to meet clients’ needs.

For lots of therapists, it’s been a complete change in practice. In the first few days after schools closed to the majority of children, the change was significant for our practice. There were packs to send out so that parents could support their children in home learning, emotional regulation and social communication skills, Social Stories™ to write to help people understand the changes, getting our heads around all the different platforms (so many ways to communicate remotely!!), consent forms for online therapy, preparing families and clients for the change in sessions, lots of thought regarding ideas that would work – the ASLTIP (Association of Speech and Language Therapists in Independent Practice) forum went crazy with sharing ideas! So much to think about – it left lots of people feeling overwhelmed and exhausted. Now, everyone seems to be adapting to that change and getting into more of a routine.

Luckily, our team at Amica SL&CC already had some experience of delivering therapy and training remotely. Independent therapists everywhere were checking their tech and many of us bought new gadgets; love a new gadget! We have purchased visualisers to be able to continue to offer initial assessments and reassessments, to draw symbols, or comic strip conversations™, share materials, toys, games or stories. Also, I have purchased an USB microphone to ensure high quality sound when delivering therapy or training which looks like a droid from Star Wars – trying to think of a name, suggestions welcome!

Direct therapy is only one part of our jobs. Most of us also deliver training regularly. Both families and professionals that support children, young people and adults with speech, language and communication needs will still need training. Course Beetle have swiftly adapted to change and are offering a range of courses which can be accessed online. In fact, they have always offered a great online course, but the range has increased to include their CPD Masterclasses. The go ahead, along with new guidelines, for official Makaton Tutors to deliver Makaton training online was announced last week. Before long, in association with Course Beetle, I will be delivering some online Makaton workshops and very much looking forward to it.

Using all this new tech and working remotely has opened up so many ideas of how we can work with clients and the people that care for them effectively and cheaply. Online multidisciplinary working, training, showing people how to sign vocabulary as and when they need it, playing games, parent-child interaction sessions, the list is endless. It is an exciting time, but we need to be aware of the pros and cons and take steps to minimise any barriers to effective therapy.

I have been included in many online discussions with other therapists across the country (and even a chat with a therapist in Jordan – couldn’t have done that without an online meeting platform). I thought you might like to hear some of our tales of challenges to effective therapy and of course some success stories…

  • An amazing song about Coronavirus made up by a young person with Autism
  • A child who spent half the session with their mouth taped up (similar stories of hands over mouths)
  • A child who spent the session with a bucket on their head
  • Using the kazoo to play a track by The Weeknd with a young person with Selective Mutism
  • Brilliant resourcefulness – treasure hunts, sock puppets, the hat game, what’s in the box? Recycled object robot building, and marble runs to name just a few
  • A child who kept closing the laptop lid because he just wanted to watch ‘Thomas’
  • A young person who would not use the camera function (it was fine – he could see the therapist)
  • Several young people who were not engaging with online education are now accessing it due to SLT support
  • Lots of clients engaging with apps via screen share

SLTs are used to engaging with clients face to face so all this screen time is taking its toll a little – we need to make sure we are taking breaks away from the screen otherwise we’ll all burn out.

My advice to all you amazing SLTs is “embrace change, support your clients, go with it, spend some time doing online CPD, have fun but look after you and stay safe!”