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…

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