In September 2004 the multidisciplinary team in St Catherine’s agreed to run an Early Intervention Group for an initial block of six two.hour sessions on a weekly basis. We had identified a cohort of children who had similar communication and develop.mental needs. The speech and language therapist, together with the nursing department, designed the content of these sessions to facilitate development in the following areas:
Early play skills
A requirement for attendance in the group is that at least one parent/caregiver attends with the child. Following the initial group we requested feedback from the parents. Based on this feedback, along with our own evaluations on the children’s progress, we continued to run group sessions throughout each term. In September 2005 we identified a need to run two sepa.rate groups because of the diverse needs and developmental levels of the children. The first group caters for seven children, all under three years of age. Three children attend the second group. We try to meet the varying specific needs of these chil.dren by the use of augmentative or alternative communication (AAC)—such as visual cues and Lámh. Evaluations are carried out at the end of each session.
At the end of a block of sessions we request parental feed.back, comments and suggestions. These group sessions are sup.plemented with individual sessions as required.
The Hanen model is used. ‘The Hanen model is based on the philosophy that language is best learned in the natural environ.ment and that those involved with the communicatively impaired have continuous opportunities to promote the devel.opment of communication skills’ (Watson 1994).
As the facilitators model the activities within the pro-gramme, the parents (who are the primary caregivers) are empowered to actually deliver the programme to their children.
The activities throughout each session aim to demonstrate how play and routines (which can also be practised at home) facilitate the development of the above areas. Play is one of the chief mediums for this.
Play is a powerful tool both for the development of cogni.tive skills and for communication. Maria Montessori described play as the child’s work; Hanen’s teaching reinforces this con.cept by use of the following:
Getting down to the child’s level
Following the child’s lead where appropriate
Interpreting for the child
Giving the child time to initiate or respond (Research has shown that it can take up to 14 seconds for our children to process incoming information.)
Through play children learn to: —have fun, be sociable —imitate —problem.solve —explore, and learn about the environment
—integrate many of the senses i.e., hear and see and feel. Play offers opportunities for repetition and is not always
dependent on words—gestures and actions can also be
Content of programmes
Socialisation This encourages awareness of self and others, thus build.ing self-esteem and interaction.
Listening and attention This is a prerequisite for all learning. Activities include auditory attention, discrimination and matching games.
Pre.verbal skills These include eye contact, imitation, turn-taking, joint attention and play. All of the above skills are intrinsic to language acquisi.tion and cognitive development.
Receptive and expressive language The language targeted is taken from the Living Language Programme, commencing with single words comprehension. New vocabulary is introduced through the use of themes and reinforced through stories, pic.tures and games.
Books It is widely recognised that books are a rich source of learning. Books encourage development of language. shared interests and bonding. Imagination, cognitive expansion. In the group we encourage the parents to make a per.sonal book for their child. This has proved a very success.ful activity. The children enjoy showing their book to the group. We also encourage adaptation of books to the children’s language level.
Oral motor function Strengthening of muscles in the oral area is vital for later development of sound production and verbal language. Fun exercises such as blowing, straws, blow football, banners and whistles are included in the group activities. Mirror work, including Mr Tongue story, licking exercises, humming and nonsense syllables are all included.
Children absorb concepts and information about the
world around them through their senses. In the group
we encourage parents to allow the children to experi.ence their environment through their senses. This fulfils the Montessori philosophy that the building up of intelli.gence is done through experience in the environment. We have done the following activities: tactile experiences with fabrics, sensory boards, play dough, brushing, paint.ing, pouring and spooning. All our activities are visually stimulating; a favourite one which closes our sessions is ‘the parachute’.
Auditory activities are included throughout our pro-gramme, including auditory matching and discrimination.
Movement is an integral component of the group. Children cannot sit still and must be allowed to move within a structured environment. We facilitate this by using motor activities and action songs. But mental development must be connected with movement and be dependent on it.’ (Montessori 1949, p.130)
Taste and smell will be included in future sessions.
Lámh is a sign system designed for people with intellectual disabilities and communication needs in Ireland. The signs can be used to support a person’s understanding of what is being said and/or as a means to express oneself or complement what one is attempting to say. Lámh can be used with both children and adults.
Research shows that the appropriate use of systems such as Lámh, accompanied by speech, improves communication skills in general (e.g. increasing interaction, developing lan.guage skills) and in many cases facilitates the development of spoken language. People will generally use speech if it is available to them.
Within the group activities emphasis is placed on the impor.tance of routines. They provide opportunities for repetition of language and familiarisation with daily activities.
We have included time for a snack break in the mid-
dle of our programme to allow the children to rest. It is
also a valuable time for the parents to chat. Staff supply
the beverages and retreat!