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“Pugh, Pugh, Barney McGrew, Cuthbert, Dibble, Grubb.” The importance of play!

Whilst driving along in the car on the way back from an appointment the other week, I was listening as ever to radio 4. The obituary show “The Last Word” came on and they were talking about the death of Gordon Murray, the creator of Camberwick Green and Trumpton (children’s television shows in the 1970s).  It brought back memories.  I used to love those shows.  So, in a fit of nostalgia I went on Youtube and looked it up to see if I could find any old editions to watch.  Well, what a funny treat!!!!

Aside from the happy memories that came flooding back, several things struck me.  Firstly, how slow paced the programmes were in comparison to today’s fast, frantic world.  It seemed to me that this taught children to wait.  Secondly, I was struck by how lovely the language was.  It is full of beautiful vocabulary and rhyming!  Such an enriching experience for kids!  Mind you, I did laugh out loud when the episode I watched talked about how “Windy Miller likes cider” and tells children that “cider is good”.  I can’t imagine that being in a children’s programme today, can you?

I’m sure that every generation looks back with nostalgia and thinks life was much simpler, but I really do think that for my generation of children we preoccupied ourselves more simply.  You couldn’t access tv cartoons almost all day long, you couldn’t play games and watch things on phones and tablets, in the car, in the supermarket, in bed and at the table.  We spent our time playing games with real people and real toys and not just that, but also created games out of abstract objects.  This enabled us to use our imaginations and be creative.  We developed so many skills through this.

So where am I going with all this?  Well, lots of parents ask me what they can do to help their little ones with communication difficulties?  I’ve found myself saying “play with them” a lot lately.  Play helps children develop in so many ways.  It develops language skills, helps them with vocabulary, but more than that it helps develop their symbolic understanding, their attention and listening skills, memory, abstract thinking, social skills and imaginations.  Play is important for the development of their brains.  Learning to play well, both by themselves and with others, sets children up to be contented and sociable.  It is through play that children engage with and make sense of the world around them.

It’s good for parents too.  It will help you bond with your child and encourage them to communicate with you.  Spending time when you focus completely on your child will tell them their value to you.  It can bring you closer together.

Play enables children to explore and to imitate.  This is where it is crucial to their communication development.  They’re listening to and learning language when you play with them.

Play doesn’t have to be complicated.  You can involve them in drying the dishes and make a game out of it.  Get down on the floor and make some roads out of masking tape.  Push cars along them.  Pretend to stop at some imaginary traffic lights.  Grab a saucepan and some dry pasta and pretend to make a meal.  Feed it to a doll, or a toy doggie.  Pretend to wash a toy car with a water spray.  Push a ball backwards and forwards between you.  Sing songs and nursery rhymes to them.  Encourage them to join in.  Play clapping games, swing them in a blanket, blow bubbles, count pennies, build towers and knock them down.  When you’re doing this your child will pick up lots of new words and lots of skills.  You will find yourself commenting on what you’re both doing and saying things like “look the blue car is wet”, or “oh oh, it’s fallen down”.  Believe it or not simple comments like these are exposing them to verbs, adjectives, nouns and concepts.

Give it a go, I promise you it will reap rewards.

Oro-facial assessments

Cutting corners is a really bad thing

This has been on my mind for a while now so I thought I would say something about it.  I came across a social media group for speech and language therapists and someone had posted a question about teaching a child to say the s sound. The child in question wasn’t able to make the sound without air escaping from her nose.  So, the therapist wanted advice because what she was doing wasn’t working.  I read the responses with interest. It is always good to see what other therapists do and the approach they take. A few therapists gave suggestions about different techniques to use, to see if it helped.  Fortunately, many more all said the same thing (including me).  The majority wanted to know if the child had had an oro-facial assessment and strongly advised referring the child to a specialist cleft, lip and palate clinic for further assessment.

The reason most of us recommended this is because speech difficulties can be caused by a variety of factors. Sometimes there is something different about the structure of the vocal tract.  For example, the child has a tongue tie, has a cleft palate, or their velum isn’t working properly (that little piece that dangles down at the back of the throat).  They may also have a condition such as dyspraxia or weak muscles which will impact on their speech.  Sometimes, they just haven’t learned to say the sound properly, or learned to say it the wrong way when they were much younger and kept on doing it that way.  The treatment methods for these difficulties will vary depending on its cause.


My point is that if you don’t know the cause then you can’t treat it properly. In fact you could make things worse by putting the child through ineffective, unnecessary therapy.  Too often therapists don’t do an oro-facial assessment.  An oro-facial assessment s when the therapist will look at a child’s face (for things like facial symmetry), look into their mouths, get them to say “ah” and then ask them to perform a series of tasks involving moving their tongue up and down, puffing out their cheeks etc.


I believe this to be a vital part of assessment and I always do one when assessing a child who has been referred for speech difficulties, but I am dismayed to find therapists that don’t and it causes me concern. I have seen patients who have been in treatment for a long time and never had one.  I have performed this assessment with patients and discovered conditions such as a weak velum, that ultimately needed surgery.

I did some locum work for a neighbouring health trust and on my first day when being shown around my new clinic room, I asked where the alcohol gel and gloves were kept?  The person giving me the guided tour ( a therapist) asked me why I needed them?  I responded “for oro-facial assessments” and was told “oh we don’t really do them”!!!!!  I kept my poker face on, but was so, so shocked.  It is ingrained into every therapist at university that you should always perform one as part of your assessment. However, I have noticed increasingly that this is left out. Corners are cut and it is not good folks!!!

So, to every parent I say “please ask the clinician to do one if you are seen for speech difficulties”.  To every therapist colleague of mine, I respectfully say “please, please don’t cut corners and leave this out, as you cannot treat someone effectively without a full understanding of what is occurring and you cannot gain a full understanding without performing an oro-facial assessment.


Thank you x