The Verve Approach

These might not be the words you’d expect from Speech and Language Therapists, but in this article, we’re going to introduce you to the ‘VERVE’ approach and explain why, when it comes to communication, silence really is golden.

Modelling Speech and Language

If you’ve ever sought advice from a Speech and Language Therapist because of concerns around your child’s communication skills, you’ve likely encountered the concept of ‘modelling’. This is where adults are encouraged to give clear, correct models of speech and language during everyday interactions. You may even have been urged to provide a constant commentary for your child – a dialled-up version of the narrative ‘chatter’ that parents often produce as they go about their day with small children.

“Ooh, you’re playing in the sandpit”… “We’re putting the clothes in the washing machine” and so on.

As important as modelling is, it is equally important to consider when to model, and when to give children quiet time to think and process what they are doing and what is being said to them. When we model language without considering whether a child is ready to receive it, we may be “throwing words into the room with little impact” – as Speech and Language Therapist Bryony Rust says in her book, How to Help Non Speaking Children in the Early Years. Or we risk overwhelming the child, reducing the opportunity for them to offer their ideas and contribute to the conversation, and inadvertently causing them to tune us out as background noise.

So, how do we know when it is the right time to model speech and language, and when we should be silent?

According to Speech and Language Therapist and VERVE pioneer Keena Cummins, children show us when they are ready to listen by looking at us (face-watching). When they are not looking, they may be signalling that they are unable to tune in to what we are saying – perhaps because they are busy focusing on whatever they are doing or looking at, or processing their own ideas or the last thing that we said, or thinking about what they are going to say or do next.

Speech and Language Therapist and VERVE pioneer Keena Cummins

VERVE, which evolved from a model of therapy called Parent Child Interaction, works on the premise that children learn moment by moment from interactions with their loved ones. The approach uses video to analyse interactions between the child and their important adult(s) – parent, carer or grandparent; teacher, teaching assistant or nursery practitioner.

There is a focus on the development of the foundational skills that underpin speech and language and the child’s ability to focus on what they are doing, specifically:

To think things through
To explore ideas through play
To initiate and maintain interactions with others
To ‘self-regulate’ or calm themselves.

Keena Cummins explains that, while other approaches tend to treat individual symptoms:

“VERVE is about supporting each child’s whole developing system. It is about supporting the individual child in knowing how to become calm in difficult situations, how to develop the ability to read one another, to see the meaning in communication and underneath words and to know how to get others to hear and see you.”

How Does Verve Work?

When communication is difficult, whether because of a language delay, speech difficulties, or social communication challenges, children tend to respond by face-watching less, while adults over-compensate by talking more, with each pattern reinforcing the other. The VERVE approach is designed to reset these patterns by helping adults and children to tune in to each other’s intuitive face-watching signals.

To be effective, a minimum of 4 to 6 sessions is recommended. These can take place either face-to-face or via video call, with each session tailored to the individual family.

At each session, the therapist and the adult review a short video of the adult and child doing an activity that the child enjoys. The therapist freeze-frames the interaction, catching subtle details that are often missed in the moment, and enabling the adult to reflect on the skills they are already using that are working well, and what could be exaggerated or tweaked to better support the development of the child’s skills.

Who is VERVE for?

VERVE is a holistic, neuro-affirmative approach that can benefit all children with regulation and communication difficulties.

At ISLTS we have used the approach successfully with children with delayed and disordered language, speech sound difficulties, Down syndrome and autism. It is fascinating to observe children (neurodivergent children included) naturally starting to face-watch more when the adults around them adjust their interaction style, with this shift in turn supporting the development of skills such as regulation, interaction, language and speech.

It’s important to note that in VERVE we never force face-watching, or explicitly teach eye contact as a skill – practices which have rightly been criticised in recent years by autistic advocates.

VERVE in Practice

ISLTS Speech and Language Therapist Charlotte Jarman uses the VERVE approach regularly, and shares two successful case studies below.

Autism & ADHD Case Study

6-year-old D was recently diagnosed with both autism and ADHD. When Charlotte first met D, she was a talkative child with a fantastic imagination, but she struggled with attention, emotional regulation and some aspects of social interaction. Since going through the VERVE process, D’s parents feel that the whole family has benefited. They report that:

They appreciate no longer feeling “the obligation to talk constantly”.
D’s ability to play independently has increased dramatically, as has her ability to tolerate adult conversation.
There has been a natural reduction in D’s screen time – she doesn’t appear to need as much ‘winding-down’ TV time as she did before.
D’s parents feel that she now plays in a way that would be more accessible to other children, and are hoping to arrange more play dates.
At dinner time, D gets less frustrated with other people talking; she listens more, and asks more (relevant) questions.
The clarity of her speech has improved.

Speech and Language Delay Case Study

B first came to see Charlotte aged two and a half. His mum reported that he was chatting away quite a lot, often very rapidly, with much of his speech unintelligible “babble”.

Following 12 VERVE sessions, B has made marked progress, with his mum noticing that:

His speech is becoming slower and clearer.
He is producing much longer, intelligible sentences.
He has started to ask more questions, such as “Are you ok, Mummy?” and “What’s that?”
He is more confident at nursery, and is interacting more with other children.
His ability to play independently has increased significantly.

Moving Forwards

A major benefit of VERVE is that it empowers parents and other ‘important adults’ with the tools to continue supporting their child’s communication development themselves. This means that after an initial block of four sessions over around six weeks, sessions are likely to reduce in frequency.

In today’s fast-moving, noisy world, perhaps we could all benefit from a little (or a lot) more silence in our lives.

Get the Right Support

If you think your child might benefit from the VERVE approach, get in touch to discuss it further. Our team is here to listen, assess, and support you every step of the way.

Silence is Golden …. The Verve Approach

Modelling Speech and Language