Favourite Resources

Lectures are over, all coursework has been submitted and returned (with high marks, hooray!) and now it's study leave before the big finals. 

This meant only one thing. I had to tidy my study. After 11 weeks of essays, placement and revision I hated going in there in case I got swallowed by a tsunami of paper. 

Mess mess mess

...and that's NEXT to my desk, I'm too embarrassed to show you what was on it!

So I piled everything up and sat down to an afternoon of sorting. I'm not going to lie, it got worse before it got better, but it is now back to something a bit more respectable. 

Keen eyed phoneticians may notice the IPA approximations on the pin board!)

Whilst clearing up, I came across piles of resources that I had made over the course of a 6-month, weekly placement at a language unit. Some of them I had forgotten that I'd done, and it brought back some really fond memories! I filed them all away carefully for use in the future, but wanted to share some of my favourites! (Not all of them were successful but you live and learn.)

Now really, I'm not a fan of laminating. I know that will cause shocks amongst most SLTs... but I'm just really impatient and hate fiddly things. However, I am also a fan of time-saving in future, so I did try to make myself prepare them so I can grab and go next time rather than having to re-print everything. 

*Disclaimer* I am not claiming to have invented any of these activities myself! They are all inspired from reading about and observing other sessions and therapists, and talking to peers. I adapt any I think my clients will like to make them appropriate to their needs and goals. I created most of the resources using Communicate in Print (you may also notice that half way through placement I worked out how to print in colour...)

Here are my top 6...

6. Two 'Simon says'-ish activities that I used with a Year 5 social skills group. The target was getting them to use self-help strategies - asking for repetition, or for the speaker to slow down, or to ask what a new word meant. We had two version of this and they went crazy for both: 

Evidence that I'm also not very good at laminating...

One with increasing part instructions (colour coded to make it easy for me to step up and down for individuals!) that required them to really concentrate and use verbal rehearsal to help them recall the instructions...

And one with  words I knew they wouldn't know, so they had to ask what it meant or for repetition. I used novel verbs and nouns (not together). We did this one as a 'what's in the bag?' style so they picked them out at random. I really pushed them to try and repeat the word they didn't recognise and to ask for specific help with it as I'd written them so they would know part of the instruction, or we could break it down together, .e.g. with 'elevate your arms' - which bit DO you know? That's right that's your arm. So what do you need help with? Do you know what all the words mean? Which one...' etc. with the aim being in class they could be more specific when they needed support.

'Features'

5. 'Features' - again used with the group above. This was an activity to get them listening to instructions to identify the odd one out amongst similar objects. So I would give them 3 clues and only one of the clues would help them differentiate which was the target, and they then had to put a counter on their chosen picture: e.g. for row 1, it goes on water, it is made of wood, it has a sail...

This was a great warm up activity as it was nice and quick but got them really concentrating as they worked out they had to listen carefully to be able to complete the task. It also complemented some work we were doing on categorisation, where we had been focussing on different features of objects and grouping of similar types of things, as well as describing things effectively. It helped them begin to understand the information they needed to think about to differentiate between the target and similar objects e.g. saying 'you wear it on your feet' doesn't tell us if they are describing flip flops or trainers.

Emotions pairs game

4. The same social skills group - now concentrating on feelings. They were a dramatic bunch who loved a bit of role play, so that seemed the task to capitalise on! I made these flash cards, with a scenario on one side and a feeling on the other. I made doubles of the feelings so the first task was to play 'pairs; then when they had found a pair they got a partner and then went to act out the feeling they had chosen. At the end of the session we took photos of each of them in this pose and we used them as a references in the following weeks.





3. 'Pride Charts' - One thing I noticed about the Year 5 group I had was their increasing awareness of being 'different' from the mainstream classes in their school. They referred to themselves as the 'special needs' class and knew they had different treatment. They were also all aware that they found a lot of things harder than the other children in their year - reading, writing, maths, most academic subjects. As such it was noticeable that they weren't as confident as other children.

On top of this, some of them had extremely challenging behaviour that meant they were unfortunately often being told off at playtime and in class for fighting or being naughty, as they struggled to resist the impulse to thump someone or mistook someone talking to them for someone laughing at them. They didn't have a full understanding of cause/effect so never fully appreciated the consequences of their actions until it was too late.

As a result, they were often being told off, or being sent to the Headteacher. This obviously was necessary for them to learn to make better choices and what is acceptable, but in combination with their needs, it was obvious that most of the children in the group had pretty low self-esteem.

I wanted them to feel good about themselves, and for this to rub off on them aiming high in whatever they did. We therefore filled in 'pride charts' at the beginning of every session. I unfortunately don't have a blank one but here's the top of what they look like, the bottom of the page is a table with a space for the date and a box to write the reason in.

We brainstormed every session something they had done that they were proud of in the previous week. It took a session to explain 'pride' as it is a fairly tricky concept, but the definition that seemed to help most was 'what did someone say "well done" to you for?'. The first few weeks did require support from the class teacher and the TA to identify events, but as time went on the children got better at thinking of these reasons themselves. They enjoyed reporting them back to the group and began setting themselves targets for the following week. The TA was great at pointing times out to them in between sessions, so if they did well on a spelling test she would say 'oh well done, you can put that on your pride chart on Friday!'. 

Even for a child who had not had a great week, we could find something, however small, to put on it 'i scored a goal at football'/'I sat quietly in assembly'/'I used a number square by myself'. If they'd done a class assembly that week it was even easier! It just got the session off to a positive start and left us all with a warm, fuzzy glow.

Social Skills Bingo

2. It was the final week of my placement and the last social skills group, and I wanted to recap everything we had learned (and also measure some outcomes!). What better game than social skills bingo! These kids love bingo. Voila... I knocked up some bingo cards that had challenges of a variety of the strategies and skills we had been focussing on: emotions, conversation, making friends and self-help. I mixed the challenges up on each of the cards so there was overlap but each one was different (these kids did not like sharing a victory so I needed a clear winner!). They used board pens to cross off each challenge they completed and we played for a line then a full house. I had made calling cards for me of each one so I could just pull them out of a bag. This game worked brilliantly and they asked for it the next week (when sadly I wasn't there...)



1. My pièce de résistance! This was actually for the younger group (reception/Year 1) I took, where we were working on concepts such as big/small, hard/soft, hot/cold. They are a very tactile energetic bunch so I wanted something that would allow them to move around and feel things. I found a tiny hot water bottle in a pound shop, and an ice pack, and took these in first of all for them to feel the sensations. We then used play food to identify what was hot and what was not, and put it into the correct place... A home made oven and fridge. I'm dead proud of them even if I do say so myself. I printed photos of an oven and fridge from Google images, and stuck them on to appropriate size boxes. 

Hot and not hot

I mean sure, they may have some funky cooking habits when they're older ("Where do we put a tin of soup? Into the oven!") but they really got the concept and the following week we moved onto hot/cold weather and they picked that up as well. Using the negation rather than the antonym helped the children who were struggling a little to pick it up faster, and the visual stimuli really supported their learning.



So there are 6 of my favourite activities, all of which I hope I get to use again! What are your most successful resources/activities? Have you done similar activities, in a slightly different (potentially more effective!) way? If you are interested in using any of these I am happy to send over the templates (apart from the oven and fridge. They won't email well). Share and share alike, we don't need to make more work for ourselves!

Life & Deaf

I've been meaning to blog about this for weeks - but the article in April's Bulletin has finally spurred me into action!

Last month I attended a guest lecture at City university given by Katie Ford. Having only skimmed the email information beforehand, I was under the impression it would be an interesting talk about working with deaf teenagers by a City Alumnus. I was NOT prepared to have a lump in my throat for a full hour (with full-on tears for the last 15 minutes!).

Katie was talking about a project (Life & Deaf) she instigated with another SLT, Jane Thomas, and a Teacher of the Deaf, Helena Ballard. They worked with deaf teenagers in Greenwich. This demographic are at increased risk of mental health issues such as depression, as well as under-achieving academically and poor literacy levels. With the rise in cochlear implants, many are more 'invisible' than they were previously, with very good speech and able to function in mainstream settings. However, this invisibility also puts them at risk of being overlooked, marginalised and not receiving the support they require.

Katie et al wanted to find a way to help these young people, aged 11-19, express the way they felt - difficult for any teenager! But in particular she highlighted the difficulty these teenagers have in feeling 'at home' anywhere, without being able to fully engage at home or school, feeling like nobody can understand them. She noted the lack of self-esteem that came from finding literacy tasks extremely difficult, and so the team began a poetry project, with the rationale that grammar and structure is not important, and doesn't have to be "right" - the meaning must just be conveyed. Some of the poems were written in BSL and translated into English, some were spoken, some were written - all of them explored their own individual Deaf identity.

Their idea worked, and the teenagers they worked with produced incredibly moving and expressive work, which stimulated conversation with their families and teachers and peers. The children worked with Deaf poets, instructors and actors to refine their work, and learn to perform. This also gave them exposure to Deaf role models, for the first time for many of the children. In addition, the group met other people the same age as them who were also Deaf, reducing the feelings of isolation and difference.

The work was showcased at the Stephen Lawrence Gallery in Greenwich, in an interactive exhibition. In addition, Katie, Helena and Jane worked to publish this work in a beautiful, extremely professional looking book - so the authors and contributors had something tangible to be proud of and show off. And they really should be proud, it is incredible. Alongside the book is an accompanying DVD, with all the poems translated into BSL, resulting in an accessible book for everyone.

This project was so successful, the Life & Deaf website began to receive submissions from Deaf children and teenagers all over the UK. In response to this, the team organised two poetry workshops, inviting more children and teenagers to attend to work on their poetry, make friends, and share their experiences of being Deaf.

Not content here, they then hired a film-maker and made a short film of a 'collective poem' made up of parts of many of the poems produced for Life and Deaf. The teenagers themselves starred in the film which was shot around Greenwich and premiered at the Southbank Centre. It left me completely speechless - it is extremely moving, and I've watched it about 100 times since and shown it to everyone and anyone who will sit still for long enough!

The aim of the project is to improve self-esteem, to improve mental health, to create networks and friendships between Deaf teenagers around the UK. The amount of compassion, effort and inspiration from the team behind it is beyond words. They have worked tirelessly, completely in their own time, through maternity leave, redundancy and retirement, to make this happen. Because it SHOULD happen, because it is an amazing project that has obviously reached hundreds of people and is so worthwhile.

Hearing Katie talk, I felt proud to be an SLT student and determined to achieve something similar and desperate to be involved in something so undeniably GOOD.

The next stage of Life & Deaf (because they obviously can't stop now!) is a UK tour. From 8-24th July, 'Life & Deaf: Include me in the world' will travel around in a VW camper van, visiting communities, schools and organisations all around the country to raise awareness of their cause. I am going to be there on 8th July in Greenwich to see them off! In addition, the Good Morning campaign aims to raise deaf awareness by encouraging everyone possible to sign 'Good Morning' - add your video to the website!

If you do one thing today, watch the Life & Deaf film. It reminded me that we all can, and all should, make a difference: That's not all of me

RCSLT Student Study Day

Firstly, apologies for the weeks that have passed since I last posted. It was deadline time at uni with placement portfolio tasks and ASD coursework due in, alongside Audiology, Phonetics and Neuroscience exams. However, they are all out of the way now so I have no excuse! 

I thought a good place to regroup while I get back into the swing of things is to write an entry about the RCSLT Student Study Day which I attended last week. Held at De Montfort University in Leicester, SLTs and RCSLT staff spoke on a range of issues – from their own career experiences, to e-learning, social media, GivingVoice and getting a job. The day was brilliantly organised – I have never been to a day of lectures that stuck so exactly to time, and the planning that went in must have been immense. Was also great to meet @GemSLT of Speech and Language Thera-peers in the flesh ;)  The speakers were all excellent and I left the day feeling so inspired to get out into the SLT world. Included in the delegate packs was a reflection/action plan form and this is what I have posted below. Now it’s public I shall have to make sure I do everything I say I will!

1. Why did I attend this study day?

My reasons were mainly to find out about jobs – the application process, tips for CVs/interviews, where to find out about vacancies… But also to meet other #SLT2Bs and hear about others’ experiences.

2.    How did the study day compare to my learning expectations of what I thought the day would be like to how it actually was?
It met all my expectations regarding jobs – hearing from Janet Harrison (SLT Service Manager) was particularly useful. It was great to hear what she looks for when interviewing an NQP, breaking down the interview criteria into distinct areas to focus on (Attitude; Clinical Skills; Big Picture etc). A lot of the interview tips were what I had thought already, but hearing it come from Janet was reassuring!
Although I think it’s common knowledge (to SLTs anyway!) that every SLT has a very unique background before entering the industry, and that there are a huge range of possibilities once you are qualified, hearing about a few of these completely different experiences is always fascinating. I loved hearing about combining practice with research from Emma Pagnamenta (RCSLT Research Manager); how to develop into independent practice VERY successfully (And take over the world...) from Chris Wade of London Speech Therapy, and Kim Turner’s description of working in the Justice sector really made me want to consider that pathway for myself!  What it also illustrated to me was the similarities between these diverse personalities. They had all made different choices about their careers, before, throughout and after studying SLT, but all of them were so passionate, ambitious, caring and determined and this was so evident when they spoke. If I have only 10% of their drive I will be happy!

What I honestly wasn’t expecting of the day was to be so invigorated and inspired by the information about Giving Voice from Ele Buckley, Emma Barnes and Derek Munn. Although I read about Giving Voice in the Bulletin, and hear about events going on at uni, I have to admit I haven’t been directly involved. Derek’s talk made me reflect on why – it was because I haven’t understood HOW I can help. Of course I know that SLT is important, and that cuts are bad – but I didn’t understand what I would be asking my MP, or what the aim of the cake sale was. Derek helped illustrate that raising awareness and knowledge to the public is what is needed – and helping MPs understand what’s in it for them.

3. What have I gained in knowledge from this study day?

- How to structure an application form/personal statement
- How to use social media to network with other SLTs
- How I can be involved in Giving Voice and what to aim for
- That the RCSLT provides a lot more resources than I realised!
- How useful SIGs and journal clubs can be
- What to consider when looking at practising independently
- The importance of clinical supervision

4. Has this study day enabled me to enhance my service delivery? If yes, how? If no, why?

Having attended the study day will enhance my clinical skills in the long run as I have learnt lots of tips about using social media to network with other SLTs and SLT students which I hope will allow for knowledge sharing and support which will improve my service delivery.

Specifically to me (I am counting this as my own service delivery!)  I feel like my ability to sell myself in applications and interviews has definitely been enhanced as I have reflected on the skills I have acquired over my life – not necessarily directly from university or placement, but from the range of experience I have had, and I understand how to apply these to make me a better candidate in the short term, and clinician in the long term.

5. What can I put into practice immediately to benefit service users or my role as an advisor?

Maybe not immediately relevant to service users, although I am sure it will knock on in the long term, I will immediately be making more of the RCSLT resources such as e-learning and the wealth of knowledge the staff there can provide. I also want to develop my use of social media such as Twitter and Linked In to help widen my network as I have already learnt so much from the people I have met through those resources.

6. What would I like to put into practice in the medium/long term to benefit service users?

Join a SIG; join  or start a Journal Club. I loved the impression of the support network that had arisen from the Leicester NQP journal club and think it would be something that could be really successful in London with the huge number of SLT students around. Getting different perspectives is so useful to developing clinical and inter-personal skills, and as well as that it will help keep up to date on the evidence base beyond university. Like this blog, I like to have perspective beyond actual university exams, and both of those activities help remind me WHY I am studying , particularly over the next couple of months when I am not on placement. That will help get me through those long stints in the library.

7. What further reading, research or study do I need to do?

I want to find out more about Basecamp; I need to research into local SIGs and decide which I am able to attend ASAP! Also researching job vacancies and arranging visits with services to find out more about specific values and priorities will help my application process. Finally, keeping on top of UK (and international!) policy that affects SLT specifically and Healthcare/Education in general is vital to help me keep in mind of that bigger picture, and help develop my understanding of the impact SLT can have on others – and how SLT can be affected by others.

8. How will I share this work / the outcome of this course with colleagues and other professionals?

This blog seems a good place to start! I will definitely be updating with my progress. In addition, I met with an SLT2B peer who due to attend the Study Day but unfortunately was ill, and gave her the lowdown. Talking through everything again really clarified things in my head and gave me new focus. I wanted to become an SLT as I love to talk and wanted to help others to be able to enjoy talking too, so making opportunities for discussion of these issues with as many people as possible is definitely a place for me to start to share and develop my ideas!

I had a really thought-provoking day and am so glad I attended (City SLT students had to sit an exam a week early in order to be there, but it was definitely worth it!). I hope in a few years to be standing up front speaking about my own glittering career!

The role of the Speech and Language Therapist in Awake Neurosurgery

This week, I attended a talk given by Professor Peter Marien from the University of Vrije, Brussels. He is a neurolinguist, and was talking about standardising a procedure for when performing awake neurosurgery involving the language areas of the brain.

Awake neurosurgery has been going on since the late 19th century, originally during the treatment of epilepsy. Since the 1970s, a neurosurgeons have been developing a procedure which involves waking the patient up during tumour resection operations in order to test which parts of their brain are involved in language. As everyone's brain is different, it is impossible to fully map which parts are involved in language (fMRI has been shown to not give a full picture). To gain a more accurate impression, the brain is stimulated using an electrode in different parts as the person talks, and each section is labelled (either with something that looks like a tiny post-it note(!) or through computer software imposing a grid on the microscope view). The areas that, when stimulated, affect language are then avoided as far as possible during the resection. As a result,  damage to linguistic areas is reduced.

Until recently these tests have been chosen, devised and carried out by the surgeon or anaesthetists present. As a result, the tests are not necessarily comprehensive - for example, just asking the patient to count to 10 and name some pictures, which does not represent all the complex language operations we carry out each day such as reading, understanding, pragmatics - and those interpreting the results are not specialists in doing so - the example Prof. Marien gave was of an anaesthetist who carried out the assessment accepting "donkey" as a label for "horse" - hello semantic substitution!

As a result, Prof. Marien is part of a team involving neuro-linguists and SLTs, focussing on championing their involvement in these operations. SLTs understand what assessments are appropriate in order to fully test receptive and expressive language: for example involving conversation, reading, understanding and expression, and identify symptoms of vocal interruption, dysarthria or aphasia more accurately. These assessments need to be carried out pre-operatively in order to discern a person's abilities (make sure they know all the words in the assessment etc) and then in theatre. 


At the moment no "gold standard" exists for  awake neurosurgery, and there is no obligation for SLTs to be involved. But with a shorter recovery period (patients are usually discharged within 5 days of the op) and reduced rehab costs, as well as better chance of language preservation it seems so important to create this, and for it to involve SLTs (or neuro-linguists).

I still have some more questions that I need to research: for example, although Prof. Marien stated each of these areas are generally distinct, presumably it is not always to preserve all of them. How do they prioritise which is saved, for example (to put it crudely) do they value receptive language over dysarthria? Also, how do you ensure that every function is tested in every brain area - presumably each section of assessment must be long enough for the electrode to be placed in every position otherwise something might be missed, but how can this be organised to avoid fatigue in the patient? 

This seems like a fascinating area to be involved in, and Prof Marien was an excellent speaker (the graphic videos helped - for a taster check out this video at 1min45secs of someone playing a violin during an operation to reduce tremors in the arm!). 

A bit of this, a bit of that

Over the past 18 months, as well as my course placements, I have been able to attend a number of additional placements in different settings. The hours I spend at these also contribute to my clinical hours, but more importantly give me even more perspective on different settings and exposure to different styles of therapists. 

One of the main things that attracted me to this career was the variety and the scope for creativity, to use your own individuality inform your intervention. It's therefore been reassuring that over the past couple of months in particular that's exactly what I've seen! But what I hadn't fully appreciated was how useful it is to pick up tips from everyone else - from extremely experienced clinicians, to your peers and other non-SLT professionals. 

One of my additional placements was at an independent practice, carrying out a nursery screen at a school. It was my first experience of independent working, and I have to admit I was wooed by the obvious flexibility and luxury of resources often lacking in NHS departments. Strict evidence based practice was the norm, with all therapy being measured quantitatively and qualitatively (while I have seen in the NHS everyone strives for this, limited time and other pressures often mean it is not as robust as would be desired). I admired the precision of the working in the practice and the minute attention to detail.

Another placement was a couple of days on a stammering management course at City Lit. This was pretty different from the paediatric language groups I was used to! Managing a group of adults requires more skills than the knowledge of stammering and management techniques. The facilitation of the group, balancing the dynamic and responding appropriately to all of the diverse personalities is a skill that must take years to fully develop. The course also introduced me to Mindfulness in SLT for the first time. Previously this was something I've only met through my own yoga classes, but it showed me the potential for its use in this setting to help with acceptance, awareness and relaxation when managing stammering. (and potentially managing PGDip deadline stress!). Definitely something I want to learn more about in the future.

Two completely different placements and two completely different views of SLT - but with new knowledge and insight that can transfer almost directly back to my ongoing, and also completely different, language unit setting.

Equality in services

First post… less about therapy itself as an outlet for some of the thoughts I’ve had about the system over the past 18 months on placement and time working in Education previous to that…

My current placement is in a pretty disadvantaged area. Most of the children have English as an Additional Language (EAL), and come from the local sprawling housing estates. Attendance and punctuality are a big concern at the school, with a current push to improve these standards through numerous incentive schemes.

While links between SES and language development and academic achievement are well documented (e.g. Campbell et al 2003), these factors go beyond the lack of financial and emotional support for development that I had assumed were the culprits.

Having sat in on annual review/progress meetings with parents, I’ve realised how intimidating they must be. We have two years of intense post-graduate education to understand how language develops: we are asking the parents to understand it all in 30 minutes. Everyone is careful to not place blame or paint a negative picture, but often parents feel guilt themselves and these meetings may reaffirm this despite best efforts otherwise. Some parents have had less than ideal experiences of the education system; many do not speak English as a first language; some cannot read; some may have language disorders themselves. Even without these factors trying to do the best for your child is difficult.

I’ve noticed the disparity between children whose parents have the resources (time, money, knowledge and willingness) to fight for the best versus those who do not have that advocate. Some of the children’s fates have been decided in tribunals as their parents fight to get the best outcome for them. Others have been neglected throughout their school life as their parents either do not realise they need help or if they do, do not realise what options are available.

More than once, in different areas, I’ve heard of children excluded from mainstream school for poor behaviour. Once they access the support and resources of a special school, these challenging behaviours disappear. Often these children have language disorders or needs that are not understood in mainstream schooling and therefore not dealt with appropriately. I would like to give the benefit of the doubt to the mainstream schools, as I have worked in many and now staff try very hard to accommodate all children, and I am sure they were struggling with limited resources to manage such specific and significant needs. Even so, exclusion it seems an extreme response to someone who clearly had severe needs. (I don’t have the head-space to debate here if this was the reaction that was needed to get the child the help so clearly required…)

Some children have parents who are now fighting to have the exclusion struck from the record, so it does not remain on file for the rest of their academic career. Others do not. Often the situation would not have gone to these lengths because these families either don’t realise they could fight it, or know how to fight it and where to get the support they need to do so.

Another family (that I know personally - not through placement), have a young son who is currently undergoing assessment for potential ASD. They are fighting for him to receive SLT while this is process going on. He’s moved from Early Years to mainstream primary, where there is much less intervention - he previously attended a language group which had a noticeable positive impact on his behaviour and general well-being: he was calmer and happier. Until he receives a diagnosis (which is not guaranteed) he is visited by the mainstream SLT in school once every half term. His parents are well-educated and financially well off, and are able to research independently how they can provide help for him themselves until something is put in place. They are persistent in contacting services to find out what is available. Many children do not have this backing.

While all the SLTs I know fight for their clients to get them the necessary support, this is an impossible battle - there are too many children needing support. The fact is that some parents can shout louder than others. But I don’t know what the solution is to this; some sort of advocacy system? An external party who understands the system who can review a child’s case to ensure they have the best support available at that time? I don’t even know what services are available, or what I would recommend to people in these situations. Every borough of London has different systems. Clearer, consistent support and information needs to be made available, and understood by all practitioners and professionals involved with children so they can recommend and refer as required.

Without it, services will remain unequal and unfair - and the children who need it most will miss out.

Introduction

Inspired by various SLT blogs (Speech and Language Thera-peers; Therapy Ideas and If Only I Had Superpowers to name a few), #slt2b and #slpeeps debates on Twitter, and my housemate Nicole's travel blog (This Is Europe 2012), I'm attempting to start my own SLT blog.

I'm currently in the final year of the Postgraduate Diploma in Speech and Language Therapy at City University London. I love the course and have no doubt it is the right career path for me. I'm still not entirely decided what path I wish to pursue when I graduate in (eek) July, as I come out of every lecture, be it aphasia, dysfluency, voice or SLI convinced that is my calling. I'm fairly sure I want to work in paediatrics, but I haven't had my adult placement yet (that is a treat for my summer block placement) so could well change my mind. I do enjoy working with parents, carers and teachers so perhaps my grown up side will come out. I can't imagine not working with children though so it's a hard call!

I'm currently on a weekly placement in a Language Unit in a fairly deprived London Borough. Over the past few months it's been a steep learning curve as I begin to take responsibility for my own caseload, but having that creative and clinical freedom is more and more enjoyable. I love trying to find new ways to teach new things, and finding out which technique works best for that particular individual over another.

I intend to blog about my experiences and thoughts about placement, university and the field as a whole; whatever takes my fancy! My aim is to clarify the thoughts that are often fleeting as I become preoccupied with essays and coursework, when in reality taking the time to think about these issues would probably help my improve my work as a developing clinician. Here goes...