Category Archives: disability

Lost for Words

It is generally assumed that young children will become more confident speakers as they grow up and go to nursery and school. But for one group of children this is certainly not the case. According to the British charity SMiRA (Selective Mutism Information & Research Association), one child in 150 is likely to experience selective mutism. A recent survey estimates that 1.7 million children – almost one in five school-age children struggle to talk and understand words.

This is not a high incidence disability but the figures suggest that at any one time a school will have a child who cannot speak in certain situations.  SMiRA describes Selective Mutism (SM) as ‘an anxiety-based mental health disorder, Those affected are able to speak freely in familiar circumstances such as with family in the home, but will remain consistently silent in others, perhaps exhibiting a blank expression or appearing ‘frozen’ when expected to speak.’

Research and support

The Selective Mutism Foundation in the USA believes Selectively Mute children have no related learning difficulties  and will talk and respond well in settings where they are comfortable and that some are able to speak on the phone because the face-to-face eye contact is removed.

Looking through forums around the world, the first impression is that there is not much known about the condition and a desperate need to find a ‘cure’.  However, as different organisations share research and examples, certain key piece of information are emerging.

We can now say with some confidence that it often starts between that ages of three and six, that mutism is not linked to speech/language deficits, abuse or emotional problems and that while the general figure  is one in 150, it is three times as common in bilingual children.

In Israel, Ruth Perednik heads a treatment clinic for children with Selective Mutism. Like many involved in this field, her interest was sparked by personal experience. She had just moved from Argentina to Israel when her four year old son, stopped speaking in kindergarten. She found the work of Maggie Johnson and Alison Wintgens especially useful and set about treating her son, both at school and at home. She researched the incidence of SM in immigrant families for her PhD at The Hebrew University and found selective mutism was significantly higher in immigrants than in native families.  She has developed a Selective Mutism treatment manual which has been published in English, and a Hebrew language treatment manual together with Professor Yoel Elitzur of the Hebrew University.

Research by Lorraine Carmody of the School of Clinical Speech & Language Studies at Trinity College, Dublin, Ireland identified three key factors predisposing, precipitating, perpetuating. Children have an increased risk of developing SM because of genetic factors or a family history of excessive anxiety. Separation, trauma, starting at nursery, experience of bullying may precipitate selective mutism but it is likely to persist if children become socially isolated or find that they can convey messages non-verbally and so do not need to use speech.

The need for early diagnosis

Without early intervention, Selective Mutism may persist into adulthood. Melanie, who lives in the UK, is a case in point. She just talked to one friend at nursery who the staff used as a go between. The problem persisted into school but when Melanie was 9 her mother saw a programme on Channel 4 called Help Me to Speak and recognised many of the characteristics so contacted the family doctor who referred Melanie to Child and Adolescent Mental Health Services (CAMHS) who formally diagnosed Selective Mutism.

Sadly, because Melanie was diagnosed late her behaviour had become entrenched and she experienced further mental health problems including self-harming and depression. ‘Her SM is still present,’ said her mother, ‘but she seems to be coping a lot better having left her secondary school and is now attending college.’

Selective mutism around the  globe

This story is not unique. Generally, throughout the world SM remains under recognised and forums in India and South Africa feature parents’ experiences and worries.  Many are looking for a quick solution, something which will help their children be at ease and be part of a group. 

Brave Buddies is an intensive group behavioural therapy program in the USA that helps children with SM speak in school and other public settings. Using a simulated classroom, the program offers children a safe environment to practise ‘brave talking,’ perhaps talking on a phone to one person and then, with intensive support, building up to group talking. In some cases they offer drug treatments including antidepressants or selective serotonin reuptake inhibitors (SSRIs).

Some countries avoid medication. There is little research on the effect of these meds on young children and the long term effects or side-effects are unknown. Coming off anti-depressants sometimes results in another ‘downer’ which may exacerbate SM.  SMiRA’s view is that although medication may be considered in order to relieve anxiety in older children/teenagers, it should always be used in conjunction with a programme of behavioural therapy to alleviate selective mutism.

Phil Thomason is father of three children. The eldest was diagnosed with selective mutism in 2007 after 5 years’ silence in school settings. He is the International Representative for SmiRA and has close links with European organisations such as Ouvrir La Voix in France and AIMuSE in Italy. SMIRA has been helping a group of Polish parents and there are also parent groups in Japan, Australia, New Zealand, Belgium, Germany, the Netherlands and Portugal.

He has been delighted by the preventative measures that are in place in Germany where the kindergarten has a planned step-by-step approach during those first few critical days in child care. The approach is known as the Berlin Model and is aimed at all children entering kindergarten.  It helps identify those children who might react badly: ‘This approach was used with my two younger children in Germany. I only wish it had been used for my eldest in another country.’

Dr Elizabeth Woodcock professional profile picture
Dr Elizabeth Woodcock set up the Selective Mutism Clinic in St Leonards, Sydney

Dr Elizabeth Woodcock has the challenge of geography to content with. She set up the Selective Mutism Clinic in St Leonards in Sydney in 2006. The clinic offers a service to children in remote and rural areas, and provides telephone consultations to parents, instead of the usual face-to-face sessions with parents and children in the clinic.

They also provide training by phone for the classroom teacher every month.  The techniques that will help the child to recover need to be practised many times each day and the parents and teachers are the ones spending time with the child. ‘The ‘school program’ is essential, as the child’s mutism is generally strongest in that environment.’

There are barriers: ‘The phone consultations that we provide to families are not currently covered by our government health rebates (unlike face-to-face consultations), so the expense is much greater for our remote families. Unfortunately, many families want or need to reduce the frequency of their sessions due to the ongoing costs, and this reduction in intensity usually means that treatment takes longer.’

Training is also difficult. The clinic runs seminars to train parents, kindergarten staff, school counsellors, learning support teachers and some speech pathologist. While there has been considerable interest in the training, not everyone can attend the seminars in person so they have been recorded and will be available on DVD in the next few months. See their website and Facebook pages for more information.

As well as behavioural support and drug therapies, technology has a role to play.  Michael Jones is a speech and language expert and co-author of Supporting Quiet Children with Maggie Johnson.

Tech support

Choose and Tell from Inclusive Technology encourages children with learning disabilities to make choices and develop stories. The program is widely used in special education but is becoming increasingly popular for children learning English as an additional language.

There is anecdotal evidence that Clarocom text communicator is being used by teenagers. It has text to speech prediction and phrase banks ClaroCom and ClaroCom Pro are both available for iOS and there is also Clarocom Free which uses the iOS system voices.

However, the program most often mentioned in connection with Selective Mutism is proloquo2go which proved useful for 15 year old Ellie as her mother explains:

‘From the day she could talk she’s not used her voice to people outside of our immediate family. Ellie is mute at school, with family we don’t see much, if people she doesn’t know talk to her when we are out, any family friends, basically anyone she doesn’t see as secure and completely trustworthy.

Proloquo2Go has definitely been a learning curve for all involved with Ellie – us, her carer, school staff and friends. She needs full prompts, and an easy grid to use so there’s not a lot to press which helps reduce her anxiety levels.  Also, I can see the history on how she has/hasn’t communicated in the day. Using the app has given Ellie an understanding that she has a voice, she can be listened to and has choices. This is still an ongoing exercise with Ellie and will be for a long time I think.’

A version of this article appeared in Special World in 2015

#Covid19 – critical care symbols – when words are not enough

The Critical Care Communication Chart – A free symbol chart from Widgit Software

  • Developed with the Speech and Language Therapy Team at Weston General Hospital
  • Helps medical staff communicate with patients who are critically ill with coronavirus
  • Can be freely downloaded so that anyone, anywhere can access it
  • Print it off or use on a smart phone or tablet
  • Also available in 37 community languages

For further information contact Jane Batchelor 07977 190584

No Show Bett?

Many assistive technology companies have already decided that the Bett Show is no longer on their radar but we are promised that Inclusion, Social Mobility and SEND will be one of six content themes for Bett 2020. So, is it worth a visit?

Jigsaw showing how the new elements of Bett fit together
new look Bett










Held at ExCeL London every January, Bett was one of the key events in the technology calendar but in recent years there has been little evidence of disability and assistive technology exhibitors. There used to be a Special Needs Village and a Fringe but these have long gone. Critics feel that technology that levels the playing field for those with physical disabilities or offers extra support for those with dyslexia or helps people with mental health issues secure and continue in a job has been so ‘integrated’ into the show that it is now invisible.

So is it worth attending Bett 2020? Ieva Stuikyte said: ‘In 2019 we had over 180 SEN specialists attending Bett so for SEND companies in attendance this can be an effective way of getting in front of key influencers and decision-makers.’

At present there are several ways for companies to benefit from Bett:

  • Companies that choose not to exhibit at Bett this year can set-up meetings with relevant attendees via Connect@Bett, a facilitated meeting tool that can provide a cost-effective way of networking
  • BESA members who are new to Bett, or haven’t participated in the past two years, can join the BESA Pavilion where they can exhibit in a plug-and-play pod and speak in the workshop area each day of the show
  • All BESA members can benefit from a 5% discount on any stand at the show
  • EdTech start-ups can join Bett Futures, a start-up zone with plug-and-play stand options as well as peer networking and support in the months leading up to Bett

Networking and finding customers

  • Five solution zones at Bett 2020 to help attendees connect with relevant suppliers
  • SEND will feature in each of these zones
  • A Leaders’ programme to help buyers and decision-makers ‘find the solutions, ideas and contacts they need’
  • Two new Professional Development theatres offering free CPD to educators at all levels
  • Bett is partnering with the Global EdTech Start-Up Awards in 2020 and all start-ups and Bett Exhibitors can attend the awards in the Arena on the Thursday evening at no cost.
  • This could be a good networking opportunity.


A deadly disease in our schools you’ve probably never heard of

Today -July 4th – is National Mesothelioma Day and this year the charity Mesothelioma UK is drawing attention to the risk to children in primary schools.

Politicians and environmentalists are rightly concerned about the quality of air in our cities and the traffic pollution around schools where parents leave their engines idling while waiting to collect pupils at the end of the school day. But there is a menace that lurks behind the plaster, in the damaged roofs, rotten windows and broken ceiling tiles of primary schools built or repaired roughly between the years of 1940 to 1980.

Mesthelioma is a cancer caused by breathing in asbestos dust and while asbestos is banned in the UK, it is still to be found in many homes, schools and offices.

Last year the Department of Education asked all schools to report how much asbestos was in their buildings. Nearly a quarter (23%) of schools failed to respond by the February 2019 deadline. A Freedom of Information (FOI) request by Stephensons Solicitors LLP received replies from just 69% of the 152 local education authorities in England but the results give cause for concern:

• 5,196 maintained primary schools are likely to contain asbestos
• A further 3,791 schools could contain asbestos
• At least 319 teachers have died from mesothelioma since 1980
• 205 of these deaths have occurred since 2001 (source: National Education Union)
• Academies and free schools are not required to report to their local education authority on asbestos because they are outside their control
Kate Sweeney, partner in personal injury at Stephensons, pointed out that asbestos is found in many primary schools because the buildings are very old: ‘Parents and teachers have a right to know if asbestos is present and what measures are being taken to manage exposure.’

There is no safe level of asbestos and the effects will not show up for several decades so Stephensons and Mesothelioma UK are calling for all schools and local education authorities to publicly disclose if asbestos is on the premises and the measures being taken to manage it.

Liz Darlison, Head of Services at Mesothelioma UK, said: ‘Sadly, the UK has the highest incidence of mesothelioma in the world.’
See the NEU fact file:

Invisible barriers to inclusion

Today March 16th 2019 is Disabled Access Day.

Our government has promised to get one million disabled people into work over the next decade. This will certainly be a challenge as many disabled workers will not be able to get to work using transport. Recently, BBC journalist Alex Taylor described finding himself stuck on a train in his wheelchair and apparently Govia, parent company of Southern Rail Thameslink Railway recently is putting profits before people by telling staff not to help passengers who are disabled on and of trains if it is going to cause delays.

If these newly appointed workers are using a website or any form of technology they may find the systems inaccessible. Hilary Stephenson, managing director of digital user experience agency, Sigma, has found that many websites still have barriers to access which make it difficult – or even impossible – for people with disabilities to use.

Her company found that a third of council websites in the UK are not accessible for disabled people. From booking travel to accessing vital health services, poor digital design is leaving millions of vulnerable users confused, alienated and often severely isolated.

‘Living with an impairment, disability or health issue of any kind should never exclude people from accessing the same online and digital services as everyone else,’ she says. ‘It is scandalous that there are still so many companies not willing to invest the time and money into making their sites inclusive to all.’

Accessible Spaces – Exploring access to public, leisure and event spaces By Simon Wissink | 24/09/2018

Pupils with autism are victims of bullying in primary schools

According to the NHS, there are about 100,000 children in the UK with autism and 70% are educated in mainstream schools. They can find it hard to read facial expressions and body language and misunderstand what other pupils say and do. Girls with autism are especially vulnerable because of:
• great sympathy or emotional empathy
• social naivety
• misinterpreting other people’s intentions
• being less able to read facial expressions and body language
• not understanding the unwritten social rules
• being overly idealistic about relationships
• social immaturity
Some of the key challenges for pupils with autism in school are:
• understanding the social world
• understanding instructions
• being misunderstood and misunderstanding others
• being bullied for being different (because they are ‘odd’, ‘out of the box thinkers’, or ‘weird’ as described by neurotypical pupils)

Tania Marshall, Autism Ambassador at Education Placement Group, suggests how children with autism can be supported. ‘It is important to educate all pupils about autism and tolerance of difference. Students with autism could also be assigned a ‘neurotypical buddy’ who makes sure they are safe and supported. Friendship skill acquisition, from as young as possible, is crucial for pupils with autism to learn. The best basis for this is through commonly held interests with peers. ‘
Watch out for some of the key signs that a child is being bullied- refusing to join in, staying physically close to a member of staff, hiding. If left undetected these small signs may escalate into more serious behaviour such as selective mutism and school refusal. The less structured parts of the day such as breaks and mealtimes can be a source of anxiety so give them alternatives such as supervised lunchtime clubs, library activities.

Teachers must instil values of acceptance, inclusion and tolerance among all pupils says Marshall: ‘The type of teacher a pupil with autism has can make or break their school experience – teachers who are patient, creative, accepting and intuitive can help children with autism thrive in the school environment.’

Tania Marshall, M.Sc. is AspienGirl Project lead for girls with Autism or Asperger’s Syndrome and Autism Ambassador for Education Placement Group, specialists in education recruitment

Providing top quality care for those who cannot care for themselves.

According to experts, one in 10 children aged 5-16 has a clinically diagnosed mental health disorder and around one in seven has less severe problems that still affect how they feel, their relationships with family and friends, their education and job prospects.

Some will get suitable treatment though psychologists, CAMHS (Child and Adolescent Mental Health Service) or through the NHS and as adults will be able to look after themselves, hold down a job and raise a family but some will have more intractable conditions such as severe autistic spectrum conditions and will need the intervention of specialist services which can provide intensive mental health support, care and accommodation.

Charlie was sectioned in 2005. He is now 34 and has learning disabilities and severe autism. He has limited verbal communication and it is often difficult to interpret the sounds he makes. He expresses his displeasure and anger by smearing faeces over the wall and ceiling and urinating in public. He also vomits a lot – up to 70 times a day. Sometimes this is a physical reaction to food but he also does it when he is frustrated.

But while Charlie has major physical, mental and emotional issues, he is one of the lucky ones. He lives at Options Malvern View, part of the Outcomes First Group, a well-established, specialist residential service accredited by the National Autistic Society.

After accommodation in other settings broke down, Options built Charlie a single occupancy flatlet where he has his own bedroom, bathroom, lounge, kitchen area and garden. It was a major undertaking. They couldn’t have skirting boards because he was strong enough to rip them off and use them as a weapon. The walls had to be scrubbable to keep the accommodation hygienic.

Staff work in pairs with Charlie around the clock and are using symbols systems to help address some of his communication needs. They have also weaned him off Coca Cola and adjusted his medication so these days he is calmer and able to take in what is going on around him.

‘The change in Charlie has been quite dramatic,’ said Nick Waller, house manager at Options Malvern View. ‘We have had far fewer violent incidents, less destruction of property. Soiling only happens a couple of times a week, usually when he is anxious, and he only vomits a few times a day.’

While Charlie will never live independently, hold down a job or get qualifications. Options can help him develop communication and some basic life skills so he will be able to lead a more fulfilled life.

Snap election affects mental health petition

The announcement that we are to have a general election on 8 June has thrown many campaigns into disarray.

The petition Make mental health education compulsory in primary and secondary schools needs 100,000 signatures to ensure it can be considered for debate in Parliament. So far over 75,000 people have signed it.

Originally the organisers had until 6 July to meet the target but the snap General Election means they now only have until next Wednesday 3rd May.

The mental health charity The Shaw Mind Foundation (SMF) and HealthUnlocked, a social network for health, have joined forces to promote HeaducationUK

This sets out to:

• Help prevent the development of mental ill health in children and teenagers
• Decrease the vast numbers of children and young people suffering from mental illness
• Rid our society of the ‘sticking plaster’ approach that the UK government have long adopted when trying to deal with mental illness in children and young people
• Educate our children and future generations for a happier and healthier adulthood
• Take a huge physical and financial strain off the NHS, CAMHS, social services and teachers
• Create huge advantages for the UK economy and industry for decades to come
• Normalise mental health issues as an accepted human condition so that children will feel confident enough to open up to each other and those who care for them Enable a more proactive society in addressing mental health issues, giving children the ability and confidence to speak out during their childhood and indeed into adulthood, as they go into the workplace and have their own families

Click here to sign

COMING SOON :The Ed Show at the NEC

The Education Show is a firm favourite with many teachers in the midlands and north of England and, sitting alongside Birmingham airport, it attracts staff from Ireland and Europe as well. It offers schools everything from pencils and stickers to high cost technology and is increasingly popular as a source of professional development. Those responsible for special needs will appreciate having time to catch up with the latest products and enjoy some first-rate free training in the Early Years and SEN Theatre.

On the first day of the show, Alison Woolf from Wrexham Glyndwr University, will be talking about Supporting Mental Health in Schools: Counselling Skills and Therapeutic Play Skills Training. (Thursday 16 March, at 3.10pm). It is not only children who struggle; Robert Whitelock, teacher of mathematics at Garforth Academy, claims that 1 in 4 school staff are likely to suffer from mental health issues. With increasing numbers of staff absent through stress it would be a good idea for senior leaders to attend Managing Mental Health – A Resilience Toolkit, at 10.40am Saturday 18th March.

The last 18 months have seen the biggest migration of people across borders in living memory and UK schools are struggling to cope with recent arrivals. On Thursday 16 March at 3.50pm Alison Prowle and Janet Harvey from the University of Worcester will be sharing good practice in their session: Including Refugee Children in Your Setting.

I have just visited Columbia Grange in Sunderland, a special school with an outreach team that also supports 1200 children with autism in local mainstream schools. The number of children with a diagnosis rises year on year. There are two good relevant sessions at the Ed Show: At 15:50 on Friday 17 March, Simon Birch, Deputy Head at Pictor Academy, will be discussing challenging behaviour in a school environment and proving examples of practical strategies while Joy Beaney and Kay Al Ghani, consultants for the Autism Train, will be presenting Creating Autism Champions through developing Peer Awareness at 11.20pm on Saturday 18 March.

The Education Show not only offers seminars but also gives visitors a chance to see the latest resources, ask the suppliers questions, compare the relevant products and even negotiate the best price!

My top five picks are:
1. SSS Learning showcasing their CPD-accredited e-learning courses on stand H81. These cover a broad spectrum of issues, from child protection and child sexual exploitation (CSE), to forced marriage and honour based violence, prevent duty (radicalisation and extremism) and Female Genital Mutilation (FGM)
2. Dekko Comics stand N95 who used crowd funding to get their comics off the ground. They work alongside Dyslexia Action and Dyslexia Scotland to create comics that help children with dyslexia engage with their education
3. First News, the only UK newspaper written especially for 7-14 year olds, with more than 2.2 million weekly readers on stand N87
4. PIVATS from the Lancashire Assessment Team can help teachers measure very small steps of progress. Talk to them about their latest products on stand GG88
5. Talking Products Limited on stand M10. They provide Talking Tins and talking Photo Albums to encourage young children to talk and express themselves in sentences. They are also ideal for older pupils who need to develop their speaking and listening skills.

The Education Show runs from 16-18 March at the NEC in Birmingham. Visit to reserve pre-book your entry admission to the show and a seat at any number of CPD sessions, all of which are free of charge

Yoga therapy for children with disabilities provides an oasis of calm

Set in the heart of Islington, just a five minute walk from Highbury and Islington station, the MahaDevi Yoga Centre is a unique place of tranquillity and peace.

The centre opened its doors just over a year ago offering yoga therapy to children with special needs from 6 week old babies to teenagers in wheelchairs.

It is a specialist centre for the Sonia Sumar Method. Forty five years ago, senior yoga teacher Sonia Sumar had a daughter with Down’s Syndrome. At that time in rural Brazil, there were not many interventions for children with special needs so Sonia used her skills and knowledge of yoga to help Roberta. Soon she could see the benefits as Roberta grew strong, well balanced and developed new skills.

After her daughter’s death, Sonia Sumar decided to develop her approach and share it with other parents who faced similar challenges. Now she works with children who have cerebral palsy, autism, attention deficit disorder and ADHD as well as children like Roberta with Down’s Syndrome.

The MahaDevi Centre offers 100 therapy sessions per week in the centre as well as treatment in schools, day centres, nurseries, hospitals and children hospices across London.

There are also regular Hatha Yoga classes every day and monthly workshops and 25% of each payment goes directly to the MahaDevi Fund. This subsidises the yoga therapy sessions for children with special needs whose families cannot afford the fees.
This little community is making a difference. “My son Derek is 8 and has Cerebral Palsy. When he started yoga therapy his muscles were so tight and he was unable to sit unsupported, with very weak core strength and generally floppy posture. The main change is his increased ability to hold himself up in a sitting position more independently. He has a lot more core stability and head and neck control.”
For more information or to make a donation, please visit