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Wednesday, 1 January 2020

Finding one's 'voice'

Preface

Now that I'm a retired person in a stage of transition and de-cluttering, I'm sorting out papers from decades ago when I was in training and/or beginning work experiences. Rather than merely consign these to the paper shredder, it can be helpful for me to transcribe these and share them via this Web Log.

The paper I'm introducing below is from a Toynbee Training course I graduated from in early 1991 toward working with the under-5s, and the significance of its Speech & Language Therapy (SLT) roots were relevant to my own childhood development in the 1950s and 1960s and subsequent working with a speech impaired person as one of their domiciliary care workers in 2005 to 2006.

A true story with identities changed to help protect identities and also to help serve as a moral tale involves Liz Tentoomi and Ken Klutz and is fairly simply expressed in the dialogue below.

Ken: Hi! How are you?
Liz: [Garbling a response as a result of speech impairment resulting from the disability Dyspraxia]
Ken: [Not attempting in any way to clarify what Liz had just said] Ah! That's great! You must be really proud of yourself!

'Proud of herself' in no way described what Liz was feeling at that time, for what she had just said or attempted to say was, "My mum's just died," and Ken's ill-considered 'communication' must surely have exacerbated her feelings of being all alone in the world while in her mid-40s.

That story was told to me by one of Liz's regular care workers in helping me understand just how why Liz would greet me so warmly despite my difficulties deciphering her speech in 3 hour contact sessions. "The point is, Alan, that you care and make the effort to clarify what Liz says; too many people don't."

My own speech development as a person living with Dyspraxia

I was comparatively very fortunate in my development as a person with Dyspraxia. Family legend has it that my first word, in response to a command from my mother that I stop loudly opening and closing the lid of her sewing box, was, "No!" and Mum was so surprised at that being my first word that she did not 'discipline' me for my outright disobedience.

In those days my speech was impaired not only by Dyspraxia but also by over large tonsils that I had removed at age 4. From then to the point at which I entered Infants at around my 5th birthday, I reputedly spoke in the pseudo language of BBC children's TV characters 'Bill and Ben the Flower Pot Men'.

Later at a fee paying school, the extra attention paid to me helped bring me in contact with speech therapy that helped me develop my capacity to verbalise more clearly, although I still stuttered and mumbled into my early adulthood, with others incorrectly completing my sentences for me. Subsequent singing tuition and writing my own poems helped give me the experience of knowing what I was going to say before I said it, rather than feel pressured to respond immediately with poor 'working memory'.

Writing my own poems also helped me build bridges with audiences as an amateur entertainer, and connect with those audiences deeply from my own deep experiences.

Liz's experience of SLT

Liz's experience of SLT was perhaps too late and too brief in her teens while she was educated below mainstream schooling. I heard from my line manager that Liz had received some SLT at about age 13 but clearly not enough, and I noticed that Liz's old school peers who were also service users of domiciliary and other services from that charity for learning disabled adults were well grounded in deciphering what she said.

In her 40s Liz's socio-economic position was that of an Incapacity Benefit claimant and treated by the system as 'not worthy of quality investment of public resources' in her education. I had already experienced Learning & Skills Council low priorisation for adults with learning difficulties as they cut back on supporting the below Level 1 Literacy adults I had volunteered with, and in about 2004 I met someone who responded to my saying that I thought Learning & Skills Council had very little understanding of the educational requirements of adults with learning difficulties: "I would say that you are too kind: they have no understanding of the educational requirements of adults with learning difficulties."

The description given by the Learning & Skills Council on their website was, "The Learning & Skills Council exists to help make England better skilled and more competitive." Thus to them preparing the way for London 2012 Olympics involved disregarding the aspirations of those who had not yet made it to Level 1 in adulthood and also rubbishing the prospects of those like me who might have been able to make a living helping them.

Lack of vocal clarity clearly got in the way of Liz's capacity to grieve, and as a consequence she blew inheritance money to the wind through wasteful purchases, attempting to reclaim that which could never be got back, as a psychotherapist might say.

But when cost-cutting government ministers say, that people on state benefits are in the position they are in with limited prospects because of "poor lifestyle choices," they take no consideration for the impact of decades of under-investment in the lives of disadvantaged adults, and show no understanding of the Social Model of Disability.

As one who has 'found their voice' in various ways though, I become all the more determined to use it to help give others a 'voice' and tell the truths of their lives more accurately without impinging on their rights.

Tower Hamlets Health Authority

Speech Therapy Department


ARTICULATION e.g. production of sounds


This develops in fairly regular stages.

During babbling period several sounds used.

Towards end of 1st year child learns use of sounds for words, i.e. contructively.

Begins to build up sound system from scratch.

Children tend to use certain sounds before others, e.g. "p" "b" "m" (front sounds) before "k" "g" (back sounds; and "p" "b" before "f" "s" "v" etc.

CHART ORDER OF APPEARANCE OF SOUND AND APPROXIMATE AGE

by 2 years 'p' 'b' 'm' 'n' 'w'

by 2½ years 't' 'd' 'k' 'g' 'ng' (e.g. sing)

by 3 years 'f' 'g' 'l' 'y'

by 4 years 'sh' 'v' 'z' 'r' 'ch' 'j'

by 5 years * 'th'





but may depend on <em>where</em> in word sound is e.g. beginning, middle or end.
Also consonant clusters will be simplifed at first.

                e.g.    "sl" ........ "l"
                          "tr" ........ "t"     "tw"
                           "kl" ....... "k"


N.B.

* This sound may be substituted by 'f' of 'v' as features of the London dialect.

This chart refers to <em>sounds</em> not letters as many letters have different sounds, e.g., the letter 'c' may be pronounced as /k/ as in 'cat' or /s/ as in 'nice'.

Certain sounds may have been acquired by a given age, but may still cause problems in certain words till a little later e.g., The child may say 'door' but have trouble with 'dog' or may say 'like' but have trouble with 'little'. The areas are estimates only, but if a child is not producing the sounds by the stated age, speech therapy <em>may</em> be indicated.


COMPREHENSION

AGE
DEVELOPS
BEHAVIOUR
To 12 months Distracted by any new event
12 to 18 months Recognises many everyday objects when named, and can point to them
12 to 18 months Recognises and points to pictures when named
18 to 24 months Understands verbs: e.g. "sit down", "come here"
2 to 2½ years Understands sentences with 2 information carrying words:
e.g., "put the spoon in the cup"
2 to 2½ years Points to smaller parts of the body: e.g.,chin, elbow
2 to 2½ years Beginning to understand size: i.e., 'big/little'
2½ to 3 years Selects objects by function:
i.e., "Where's the one we eat with?"
2½ to 3 years Understands simple prpositions: 'in/on/under'
2½ to 3 years Knows if 'he/she' is a 'boy/girl'
2½ to 3 years Understands longer and more complex sentences
2½ to 3 years Knows several colours &emdash; blue/red &emdash; yellow/green
3 to 3½ years Follows verbal directions with 3-4 information carrying words: e.g., "make dolly sit down under the table"
3½ to 4½ years Understands "all", "both", "much", but not yet firmly established

EXPRESSIVE LANGUAGE

AGE
DEVELOPS
BEHAVIOUR
To 12 months Babbling, combinations of vowels and consonants
12 to 18 months Using some single words: mama, dad, ball
18 to 24 months Imitates 2-3 word sentences
18 to 24 months Links words together: e.g., "all gone", "my teddy"
18 to 24 months Asks questions using infomration: e.g., "see hide?"
18 to 24 months Calls him/herself by own name
2 to 2½ years Begins to use words creatively: "bye bye milk"
2 to 2½ years Begins 3 word utterances: "Daddy kick ball"
2 to 2½ years Begins to use "I" and "me"
2½ to 3 years Uses longer more complex sentences:
"Where's my mummy's hat gone?"
2½ to 3 years Signalling grammatical word endings:
e.g., 'ing', 's', 'ed'
2½ to 3 years Relates experiences from the past

Addtitional Notes by Alan Wheatley about SLTs

SLTs are almost solely employed by local health authorities rather than local authorities. I believe it would be better for equalities purposes if SLTs were also employed by local government rather than solely by local health authorities. Anyhow, the professional body for SLTs in the UK is the Royal College of Speech & Language Therapists https://www.rcslt.org/

Approximately 80% of children with emotional and behavioural disorders have significant language defects. At least 40% of Stroke survivors will initially experience some difficulty swallowing. If left untreated, swallowing difficulties can result in pneumonia, increased hospital admission and lengthier stays in hospital. Up to 80% of people with a learning disability have a communication need.
Statistics presented at RCSLT website
You can read RCSLT's letter to political party leaders at
https://www.rcslt.org/-/media/open-letter-to-political-party/open-letter-to-party-leaders.pdf

The UK's General Election 2019 may be over, but for many with speech and language disorders, their problems are only just beginning. The country has spoken?

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