Attending the GOSH language profiles course

GOSH language profiles

A few members of the SBT Team were at today’s GOSH’s Language Profiles in Children with Neurodevelopmental Conditions course.

This one-day course was presented by SLTs working in the neurodisability department at Great Ormond Street Hospital for Children and was aimed at SLTs working with children and young people in early years, mainstream and specialist settings.

The course was designed to encourage delegates to:

  • Broaden their knowledge of complex speech and language profiles associated with neurodevelopmental conditions (topics covered included: epilepsy, language disorder, movement disorder and ASD).
  • Share best practice around methods of assessment and formulation and how these can guide long-term management.
  • Consider the role of the multi-disciplinary team in assessing children and young people with neurodevelopmental conditions.
  • Network with SLT colleagues to access peer support.

The whole team found it really beneficial and look forward to putting their learning into practice!

Developmental Language Disorder by Shelley Parkin

‘Developmental Language Disorder’

The new name in Speech and Language Therapy.

Have you ever wondered why your child’s speech and language therapy diagnosis seemed to change depending on who was describing it? Perhaps even the same professional described to your child’s difficulties using several different labels, leaving you confused as to what to call it? Well, you’re not alone.

Historically, Speech and Language Therapists themselves were not always clear on terminology for language difficulties. There was not one clear set of guidelines to follow, and therapists often relied upon the received wisdom of their experienced colleagues, or the broad descriptions learned in our training.

Some clinical areas were more straightforward. Stammering, Autism, Cleft Palate, Dysphagia (swallowing difficulties), Hearing Impairment- amongst others. We all had a pretty clear idea how to define these. But there was no clear consensus about terminology for language difficulties- this required interpretation from the treating clinician, and therefore resulted in some variation within the profession. You may have heard any or all of these terms before: Language Delay, Language Disorder, Expressive Language Disorder, Receptive Language Disorder, Language Difficulties, Language Impairment, Specific Language Impairment (SLI).

It’s no wonder people were sometimes left feeling confused- is my child’s language delayed? (which implies they will catch up) Or is their language disordered? (meaning they may need support throughout their education). Language difficulties are incredibly varied, and no two children will have quite the same profile. This is likely to be a contributing factor in the variation of terminology we see in the profession.

Courtenay Frazier Norbury, Professor of Developmental Language and Communication Disorders at University College London, has stated that if a child still has language difficulties by the time they have settled into primary school, there’s a good chance they will continue to do so. Some children do indeed have delayed language development, and can catch up with the right support. But for many children, the gap can seem to widen, rather than narrow, as they get older. By the time children reach Year 2, the distinction between language delay and language disorder should become more apparent.

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SCERTS by Katy King

SCERTS stands for Social Communication Emotional Regulation and Transactional Supports, it’s an approach for working with clients with Autism. It was designed by Prizant, Wetherby, Rubin & Laurent in 2007, they are a team of highly experienced multi professionals in America.

One thing that makes SCERTS different from other approaches to working with clients with Autism is that it focuses on the positives and the child’s strengths and it also acknowledges the importance of the strategies being used by the adults working/interacting with the client. SCERTS doesn’t rule out using other approaches, but through the detailed SCERTS assessment process you are able to identify which other approaches and strategies are best for the client at that point in time. SCERTS involves everyone working with the client in the assessment process from the SLT, Teacher, TA’s, SENCO and family members making it a very holistic approach.

There are 3 areas to SCERTS: –

  1. Social Communication – this looks at how they interact with those around them through communicating with them, collaborating with them and understanding them.
  2. Emotional Regulation – which looks at how they regulate their emotional levels through self-regulation (strategies they use themselves) and mutual regulation (how they use others to manage their emotions)
  3. Transactional Supports – looks at the systems in place in the natural environment and interpersonal supports which aid the client in understanding the world around them as well as communicating and interacting with others. This takes into account all of the other approaches that are around for supporting children and adults with Autism such as PECS, TEACCH, ABA, Visual timetables etc.

When looking at clients through SCERTS they are described in one of 3 ways

  1. A Social Partner
    1. This is when the client is pre words or words are just beginning to emerge.
    2. They may use sensory behaviours to soothe or alert themselves and they have a tendency to hold onto items that self regulate their emotions
  2. A Language Partner
    1. This is when the client has emerging language and they are beginning to combine words into simple phrases such as Subject Verb Object phrases e.g. ‘boy drinking juice’
    2. They tend to use language for engaging and soothing and they are beginning to use language for mutual regulation
  3. A Conversational Partner
    1. This is when the client is at conversational level with their interactions but finds social conventions challenging
    2. They are functioning at a metacognitive level – this is where they are beginning to think about their thoughts

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Backward chaining by Katy King

Backward chaining: helping children with Autism and Attention and Listening difficulties succeed and learn

Often when working with children with Autism and/or Attention and Listening Difficulties it can be difficult to get them to attend to see a task through to the end. This can lead to frustration for the adult working with them but also a sense of frustration and failure for the child themselves.

Backward chaining is a simple method that we use in many areas with children when teaching them a new skill without realising it and one that can be applied to more areas to support our children and to teach them new skills. It breaks down complex tasks into discrete steps (task analysis). Backward chaining is an effective way of developing complex sequences of behaviour.

When teaching a child to put on a sock we don’t just give them the sock and walk away, we place the sock over the ankle and let the child pull it up the last bit. Once they have succeeded with that we then leave them a bit more each time to do themselves before they are the able to put the sock on from the start. So why don’t we apply the same strategies to other areas such as speech and language and attention and listening?

A child struggles to sit during carpet time at school, we tend to bring them in at the start and then after a few minutes they are struggling and they are then taken away and removed from the carpet activity to walk around the school or take part in an activity of their choice. If we took that length of time as their successful length of attention and brought them in at the end of the carpet time session they would then get up with the rest of the class to move on to the next activity. The student would then learn that they sit until everyone gets up. As the weeks go on you can gradually bring them in for a little bit longer each time until they are then sitting there for the full time. The child feels success and learns to follow school routines in a successful manner.

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LEGO® Therapy Research Project – Update

You may recall that we were undertaking an MSc research project investigating LEGO® -Based Therapy for supporting language skills. The project is now complete and we would like to share our results!

LEGO® -Based Therapy is an intervention that was originally designed to be used with children with autism to develop social competence skills. Our research project investigated adapting this intervention to be used with children with mild-moderate language impairment.  In our clinical experience, a LEGO® -Based Therapy approach can be used with language impaired children to target a range of functional communication skills including, but not limited to: resolving conflicts, problem solving, negotiation, organising and sequencing ideas, turn taking, communication initiation, formulation of questions, listening and communication repair skills. As an initial investigation our study selected only one particular aspect of functional communication to examine: repairing conversational breakdown through initiating clarification.

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Auditory Processing Disorders by Kathryn Moyse

This month we have been focusing on children with difficulties with listening, or Auditory Processing Disorders.

When we are thinking about a child with an Auditory Processing Disorder (APD), it is useful to think about the difference between hearing and listening. At first, it might seem that these words mean the same thing, but actually there is more to it than this. Hearing is a sense, and when we talk about hearing, we are thinking about the physical ability of the ear and the brain to receive sound. Listening, on the other hand, is a learnt skill. Listening involves paying attention to the sounds that we hear and then processing this sound to work out what the sound means. Listening, or auditory processing, is a really important component of understanding speech and language. What is more, from a very young age, children need to learn how to listen – they need to learn to tune in to the sounds that are meaningful to them, and to filter out all the background noise.

Some children will have difficulties with learning this vital skill. Difficulties with listening can arise in children for a number of reasons – it could be that child experiences persistent glue ear, or has a developmental condition such as Autism Spectrum Disorder or a Specific Language Impairment to give a few examples. Regardless of the cause of these difficulties, it is important for us to think about how we can support these children. Often, it can be tempting to remind the child to listen, and whilst it can be helpful to secure the child’s attention before talking to them, it is important for us to think about ways that we can make ourselves more ‘listenable’ to support the child with their listening.

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