COMMUNICATING WITH CHILDREN (1)
Helen Cameron
University Teacher // Speech and Language Therapist
Department of Human Communication Sciences
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…
Speech
• How sounds are
produced
• Pronunciation
• Articulation
• Phonology
• Dysfluency
(stammering/
stuttering)
• Rate
• Voice
Communication
• How speech and
language skills
are used
• Social language
• Social skills
• Pragmatics
• Attention and
listening
Language
• Expressive
language
• Receptive
Language
• Vocabulary
• Grammar/ syntax
• Word forms/
morphology
Key Skill Areas
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
Speech, language and communication development 0-5 years
Take a look at ‘ages and stages’/ ‘norms’ here:
www.talkingpoint.org.uk
Watch this video and think about how much children’s
communication develops in the first few years of life
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
What are the challenges of doing kay pictures
with a 2 ½ year old?
COMMUNICATION CHALLENGES: YOUNG CHILDREN
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
Developmental
Delay
Intellectual
Disability
Stuttering
Autism Spectrum
Disorder
Speech sound
disorder
Cerebral Palsy
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] fromhttp://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
What might be the challenges of doing cover
testing with a 4 year child with Autism?
COMMUNICATION CHALLENGES: DOWN’S SYNDROME
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/study-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
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