What I can do for you

Advice and support

I treat and advise only in the area of my expertise: What is the essence of a child’s problem with speech or language? What is the best I can do to fix it? How long might this take? How likely would it be for the problem to fix itself?

Before I do any work I need to get an idea of what the problem is. For this I need to do some investigation. For some children, the investigation itself is therapeutic. And for soime children, one of the most useful investigations is from a diary which parents can keep of their child learning to talk. I explain how to do this in Someone special

It is always useful to know what you think the problem is. If you like, I can give you some pointers about some things which you may find useful to think about.

Support is sometimes the most important thing I can offer.

Treatment

Speech and language are incredibly complex capacities. It normally takes around ten years to learn the basic structures. It seems to me not surprising that this learning should be problematic for some children. The muscular actions and their co-ordination are obviously complex. But I am surprised by the expectation that the core problem is in the musculature or the co-ordination of this when there is an obviously simpler possibility: that that the core problem is in the natural process of of learning itself. I believe that this should be investigated clinically before any other assumptions are made. I find that a linguistically motivated intervention often produces the fastest results.

There are many energetic and convinced proponents of what they call ‘oral motor treatment’ or OMT involving a variety of exercises for ‘jaw stability’ or the strength of the tongue, flicking it up and down, wagging it from side to side or moving it round in circles. Various devices are on sale to help in such endeavours. But as far as I know there is no evidence from phonetics for any of these things. I believe that the claims made for these treatments are either mistaken or fictitious and not based on any reputable research or evidence.

It is, of course quite possible that there will be improvements after a sensitively administered program of exercises. And this may be taken to justify the exercises. But it is also possible that the critical factor here is the sensitivity of the administration rather than the exercises. 

So my focus is on what is happening in the brain rather than what’s happening or not happening in the mouth.

Although the act of speaking is often to achieve some goal, to interest, to persuade, to endear, to get information, and so on, which may work or not work, as the case may be, the way we order the words, as in ‘good person’ and ‘someone good’, is quite remote from any goal we have in the utterance in which these phrases occur. What we do with words can be funny or honest or deceptive. But that is not behaving in the ordinary sense. So I do not think of either speech or language as intrinsically forms of behaviour

So I do not believe in Applied Behavior Analysis, or ABA, as a way of helping children who have problems putting words together or pronouncing them.

Neither OMT nor ABA are new. But the treatment possibilities by a linguistic approach range more widely than by either OMT or ABA.

Fees on a sliding scale

I offer a free initial one hour consultation. From then on, my fee is £150 per hour, but on a sliding scale.

To the best of my knowledge I am the only clinical linguist working in London. 

Privacy

If you give me your Email address and any other credentials, these are not used or accessed for any other purpose, and not disclosed to anyone for any predictable purpose of any sort.

Privacy is strictly maintained. No parent or child is publicly identifiable in any way.

Clinical records bear on research in unpredictable ways. New research questions pop up all the time. So I keep the records indefinitely.

Social distance – not face to face – for now

Normally I only work face to face. But in the current situation my clinic is closed. So unfortunately for the time being children can’t touch the toys, books, and doll’s house. So the best I can do is to use social conferencing instead, putting toys on the table, discussing with the child what can be done with them or what the child is doing wherever he or she is. Or we can make a picture – of whatever emerges from the conversation. Of course, I may also need to discuss the situation with one or both of the parents.

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Contact Dr Aubrey Nunes