COMMUNICATING WITH CHILDREN (1) Helen Cameron University Teacher // Speech and Language Therapist Department of Human Communication Sciences h.m.cameron@sheffield.ac.uk 14/02/17
LEARNING OUTCOMES Discuss general features of children s speech, language and communication development Identify and discuss challenges to effective communication and interaction with children and families in the orthoptic clinic Describe the principles of effective communication with children and families Demonstrate strategies and approaches for maximising effective communication and interaction with children and families
SESSION 1 Recap on what is meant by interpersonal communication Discuss children s typical speech, language and communication development Discuss atypical speech, language and communication development in children Consider some examples of more challenging interactions (barriers to successful interaction)
SESSION 2 Discuss principles/ solutions for effective communication with children and families in the orthoptic clinic Consider how to interact and work with parents/carers Discuss assignment
YOUR ASSIGNMENT (ON MINERVA) A 7 year old child with severe hearing loss presents in the clinic. Discuss, with the use of the literature, how such a hearing impairment might impact on orthoptic clinical assessment (45 marks), and how orthoptists can work with the child and caregivers to resolve the barriers to successful clinical assessment (45 marks). Presentation, organisation and referencing (10 marks).
WHAT IS INTERPERSONAL COMMUNICATION? Exchange of information Involves more than one person Bidirectional Contextual Can take many forms Complex! From: www.freepik.com/free-vector/colorful-people-communicating-with-speech-bubbles_714774.htm
ACTIVITY Arrange yourselves in order of your birthdays (day, month) using any form of communication you wish EXCEPT for talking
FORMS OF COMMUNICATION Words Spoken Written Facial expression Eye gaze Body language Positioning Tone of voice/ intonation Positioning Touch Gesture Sign/ Makaton Devices (e.g. ipad) Silence
REMEMBER! Communication can be in more than one form at once
COMMUNICATING WITH CHILDREN AND FAMILIES Interactions participants include you, the child and the parents/carers. Communication is bidirectional Need to think about all parties
CLINICAL INTERACTIONS Clinical interactions involve more than just the time when you re doing your clinical tasks In pairs, think about the variety of situations, from the very beginning of an appointment, which will involve communicating and interacting with children and parents? Image from: www.freepik.com/free-vector/people-with-speech-bubbles_765065.htm
FROM START TO FINISH
THINKING ABOUT THE CHILD
Key Skill Areas Speech Language Communication How sounds are produced Pronunciation Articulation Phonology Dysfluency (stammering/ stuttering) Rate Voice Expressive language Receptive Language Vocabulary Grammar/ syntax Word forms/ morphology How speech and language skills are used Social language Social skills Pragmatics Attention and listening
WHICH GOES WHERE? Responds to name being called Waves goodbye Can pronounce animal correctly Points to head when asked Takes turns in conversation Signs to ask for more milk Babbles Plays with sounds e.g. cup p p p Can tell you where they live
POSSIBLE ANSWERS Speech Language Communication
AGES AND STAGES Watch this video and think about how much children s communication develops in the first few years of life Speech, language and communication development 0-5 years Take a look at ages and stages / norms here: www.talkingpoint.org.uk
TYPICAL COMMUNICATION DEVELOPMENT Receptive language (understanding) is typically ahead of expressive language Children learn words that are concrete, frequent, and relevant first Norms gives you a place to start, but there is variation between children
OTHER ASPECTS OF DEVELOPMENT In addition to speech and language, it is important to consider: ocognition (intellectual functioning, information processing, memory) otemperament (e.g. shy, outgoing) osocial experience (used to other people and new situations?) obehaviour
COMMUNICATION CHALLENGES: YOUNG CHILDREN What are the challenges of doing kay pictures with a 2 ½ year old?
COMMUNICATION CHALLENGES Go to the padlet on your mobiles/laptops/tablets and post your responses (anonymously): https://padlet.com/h_m_cameron/kay
I DON T WANNA DO IT You are attempting to assess a 3 ½ year old child in the clinic. They won t co-operate, they throw away the pictures and begin to yell, wrestle their way off their Dad s lap and hide behind the cupboard and start to cry. Why? What are they telling us?
HOW MIGHT THEY BE FEELING?
BEHAVIOUR IS COMMUNICATION Sometimes children don t have the language to explain to us what is wrong. Sometimes, even when they do have the language, the situation is too stressful for them to use it. In these cases, negative behaviours are an effective method of communicating their feelings, needs and wants.
SPEECH, LANGUAGE AND COMMUNICATION NEEDS Umbrella term to refer to difficulties in speech, language and communication, either as isolated diagnoses or associated with other conditions. Language impairment Stuttering Autism Spectrum Disorder Cerebral Palsy Speech sound disorder Intellectual Disability Developmental Delay
CHILDREN WITH SLCN Difficulties can be across one or more areas of speech, language and communication Some children develop speech, language and communication at a slower rate than expected (delayed development) Some children develop on a path not expected, and possibly also at a slower rate (disordered development).
CHILDREN WITH SLCN Approximately 10% of all children have long-term SLCN Communication disorders can be specific e.g. Specific Language Impairment, phonological disorder and sometimes we won t know the cause. SLCN can also be associated with other conditions e.g. autism, learning disability, physical disability, syndromes, hearing loss, cleft palate etc. See Bercow (2008) Accessed [ 12/03/15] from http://dera.ioe.ac.uk/8405/
SPEECH & LANGUAGE DELAY/DISORDER Short video of child with speech difficulties From: https://www.youtube.com/watch?v=tymm23epxju Short video of child with language difficulties From: https://www.youtube.com/watch?v=oeyhnmloids
COMMUNICATION CHALLENGES What might be the challenges of doing letter recognition with a 7 year old with speech and language disorder?
COMMUNICATION CHALLENGES: SPEECH & LANGUAGE DIFFICULTIES Go to the padlet on your mobiles/laptops/tablets and post your responses (anonymously): https://padlet.com/h_m_cameron/letters
DOWN SYNDROME Genetic condition- extra chromosome Diagnosed in utero or at birth 1 in 1000 births in the UK Developmental disorder affecting ointellectual development ospeech and language omotor development (muscle tone) ohearing and vision
DOWN S SYNDROME Short video about Emily who has Down Syndrome From: http://www.nhs.uk/video/pages/downsyndrom.aspx
AUTISM Pervasive developmental disorder Diagnosed via observation of behaviours Is a spectrum (varying presentations and severity) Key features (DSM-5, APA, 2013) Difficulties with social interaction and communication Restricted/ repetitive interests and behaviours
SOCIAL INTERACTION IN AUTISM Unusual use of: oeye gaze ogesture oposture ofacial expression Lack of reciprocal social/emotional interest in others odelayed development of pointing
SOCIAL COMMUNICATION IN AUTISM Delay in, or absence, of spoken language development Specific features such as: orepetition oecholalia (delayed versus immediate) oidiosyncratic language ( learnt phrases ) ounusual intonation/stress
RESTRICTED/ REPETITIVE INTERESTS In more severely impaired/younger individuals: ofocus on sensory experience ostereotypical motor mannerisms oapparent absence of pretend/imaginative play In more able/older individuals: otopics of pre-occupation odifficulties with flexible thinking ounusual/limited imaginative play May have hypo/hypersensitivity to certain stimuli
AUTISM Short video about Autism: https://www.youtube.com/watch?v=d4g0htiubli
COMMUNICATION CHALLENGES: DOWN S SYNDROME What might be the challenges of doing cover testing with a 4 year child with Autism?
COMMUNICATION CHALLENGES Go to the padlet on your mobiles/laptops/tablets and post your responses (anonymously): https://padlet.com/h_m_cameron/cover
HEARING IMPAIRMENT Hearing impairment is when one or more of the parts of the ear are not working effectively Sensorineural deafness is a permanent hearing loss in the inner ear (cochlea). Conductive deafness means that sound cannot pass efficiently through the outer and middle ear into the inner ear. This is often due to blockages (e.g. glue ear ). Mixed deafness is a combination of sensorineural and conductive loss.
SIMULATED HEARING LOSS https://www.youtube.com/watch?v=ar1dq-m2ok4 You can explore this further at home at: http://www.phon.ucl.ac.uk/resource/hearloss/
EFFECTS OF HEARING LOSS ON DEVELOPMENT It causes delay in the development of receptive and expressive communication skills (speech and language). The language deficit causes learning problems that result in reduced academic achievement. Communication difficulties often lead to social isolation and poor self-concept. It may have an impact on vocational choices. From: http://www.asha.org/public/hearing/effects-of-hearing-loss-on- Development/
ENGLISH AS AN ADDITIONAL LANGUAGE Bilingual/ multilingual Children who speak and/or understand more than one language Should be respected: multilingualism is an asset Children s language skills may differ from parents (+/-)
COMMUNICATION CHALLENGES: EAL What might be the challenges of doing stereotests with a 5 year old child with okay English and their parent who has very little English?
COMMUNICATION CHALLENGES Go to the padlet on your mobiles/laptops/tablets and post your responses (anonymously): https://padlet.com/h_m_cameron/stereo
RECOMMENDED FOLLOW UP ACTIVITY Activity: Draw a mind-map of barriers to effective communication as discussed today Don t know how to mind-map? See: https://www.sheffield.ac.uk/ssid/301/st udy-skills/everyday-skills/mind-mapping
NEXT SESSION Summarise barriers to effective communication Discuss principles for effective communication with children and families in the orthoptic clinic Consider how to interact and work with parents/carers Discuss completion of assignment