smile Therapy for 4-5 year olds: Teaching social interaction skills in real situations together with teachers & parents

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1 smile Therapy for 4-5 year olds: Teaching social interaction skills in real situations together with teachers & parents The Ear Foundation Conference 20 th October 2017 Neema Salema & Karin Schamroth Specialist Speech & Language Therapists NHS Whittington Health, Haringey, London

2 What is social competence? To be a competent communicator during social interactions, one must know, interpret, and demonstrate socially appropriate behaviours as well as have adequate oral language skills. (Kaczmarek, 2002) 2

3 Effective social interaction skills include the ability to: Process, interpret & express non-verbal & verbal communication Predict & plan communication for future social interaction & contexts Flexibly respond to a dynamically changing communicative interaction Theory of Mind: social cognition & social understanding (Hwa-Froelich, 2012) 3

4 Early social competence & later achievements Early social communication skills are associated with later language competence and academic achievement (Greenwood, Walker, & Utley, 2002) 4

5 smile Therapy Strategies & Measurable Interaction in Live English Created to support deaf students in everyday encounters in an Englishspeaking world in their functional face-to-face interpersonal communication (Schamroth & Lawlor, 2015) 5

6 smile Therapy: key elements Real task Pupil filmed pre & post-therapy Complex task broken into component skills Pupils generate the skills checklist New skills taught through guided role play Techniques used to develop Theory of Mind Pupils self evaluate Outcomes: pre & post-therapy percentages Active generalisation: parent group, staff group 6

7 Participants Blanche Nevile School for deaf pupils, London Bilingual & bicultural Primary department co-located & in partnership with Highgate Primary mainstream school 4 & 5 year old pupils Child A Child B Child C 7

8 Child A Age 4 bilateral CI uses quiet voice reticent to communicate in new situations 8

9 Child B Age 4 unilateral CI as mid re-implantation for 2 nd CI interacts well with familiar others had become withdrawn, anxious and lost confidence with CI problems 9

10 Child C Age 5 Landau Kleffner Syndrome (LKS) lost language aged 4 regaining language reduced attention skills, highly self-directed, difficulties with communication, social interactions & behaviour 10

11 The real task To make a simple request for an item (pencil) from a familiar adult in an less familiar office environment 11

12 Delegates may not take photos or record any of the photographs or video material shown 12

13 Skills Required for this real task 13

14 Pre-Therapy percentage scores 70 65% Pre-therapy % 17% 10 0 Child A Child B Child C 14

15 smile Therapy adaptations for 4 & 5 years olds Very familiar adults Stooge very familiar Assistance & guidance through: self-evaluation role-playing Adults on their knees Silly voices 15

16 Completed Checklist 16

17 Progress % 81% 75% 70 65% Pre-therapy Post-therapy % 17% 10 0 Child A Child B Child C 17

18 Data analysis child A Participation in small group Confidence Smiling Polite language remembered: thank you & bye 18

19 Data analysis child B Started participating in role-play Substantial increase in confidence Open posture Polite language remembered: thank you & bye 19

20 Data analysis child C Sitting & turn-taking Understood social skills required Able to reflect on skills Contributing appropriate ideas Polite language remembered: thank you & bye 20

21 Teacher s view I saw his confidence within the small group transferred to interactions in class She s become more outgoing and is noticeably coming out of her shell Its been a very clear way of seeing both his needs and strategies we need to use daily for him to reach his potential 21

22 Parent s view This is really important because as a parent my main concern is social interaction and confidence to do everyday things. and fit into society as well as they can do and not be afraid to do things that other people do to push their confidence to do things, even if their speech might not be perfect, to feel they can do it - for instance apply for a job 22

23 What would the What world look like if.the if. world look like if. would the world look like if. would the world look like if. world look like if. 23

24 & 24