Inclusion for Children with SLI in Mainstream Education: The ...

Inclusion for Children with SLI in Mainstream Education: The ...

Inclusion for Children with SLI in Mainstream Education: The Challenges for Schools March 2014 Nyborg, Denmark Kate Ripley Programme Identification of children with SLI UK and Denmark perspectives Break

Support for inclusion of children with SLI Break SLI and challenging behaviour The UK Context Similar to Denmark?

The majority of children with Speech and Language Impairment (SLI) are educated in mainstream schools. Children with more significant difficulties may attend Resourced Provisions (RPs) attached to mainstream schools. They join mainstream classes as appropriate. There are fewer RPs at the secondary phase: assumptions that they are not needed? Children with the most severe difficulties attend generic special schools or specialist schools that are outside the maintained (state) system. Different from Denmark? Children

start formal education at 4-5 years. - Implications for latter attainments? - We are 23rd in the European league table. Children start secondary school at 11 years. The school leaving age is currently 16 years and the majority go into further education or higher education. Children with a history of SLI are more likely to be NEET : Not in Education, Employment, Training Speech & Language Impairment (SLI) How many children in UK? UK

estimates 7-10% have a specific language impairment (Law, 2000) Language impairment in association with other conditions, e.g. Down Syndrome, Autism. Language delay associated with social deprivation (Clegg, 2010) Stoke on Trent 83% Hampshire screening 33% Language delay / Language disorder How good are we at identifying children with SLI? Those with speech / phonological problems are

easy to identify. We cant understand them referral to a Speech & Language Therapist. Longer term implications for reading and academic success may not be recognised. Case Study: David Introducing David Introducing David .. Medical Officer: behaviour lacks control Social Worker: active, trying, he has got brain damage? Family Aid: told mother his behaviour was abnormal Mother found him:

- hard to manage - she was on medication - temper tantrums wore her out - the family worked around avoiding upsets - she did not understand his speech Introducing David Continued . Speech & Language Therapist Assessment - comprehension age appropriate problems with phonology, expressive language Educational Psychologist Assessment Educational Outcome There are many children like David who by the age of 4 have seen many professionals

The missing children Nuffield Foundation Longitudinal Study (Conti-Ramsden & Botting, 1999-2011) Estimated a 5% prevalence of SLI at 7 years (Present estimation is 7-10%) Only 1% recognised as having SLI as main special need 4% were missing We still miss them . They are referred to the Educational Psychologist for concerns about literacy or behaviour Introducing Delia.. One that got away - almost

Girl C.A. 8.08 Referred for : Slow progress with reading after two terms in a Sussex School Previously in London Risk/resiliance Attractive, good non-verbal skills, relationships with peers seemed fine, well co-ordinated, worked hard, spoke clearly BUT Confused by verbal instructions Followed class routine by observing others

Class discussions and verbal exchanges not accessible to her Assessment indicated Receptive Grammar5.25 years BPVS (Vocabulary) 4.10 Case Study introducing Demelza YR referral to the Behaviour Support Team for challenging behaviour at home and school. Y1 EPS referral refusal to join group at carpet time refusal to attempt tasks with LSA hiding, running from class

loud noises-disturbing the class Spoke clearly, used some learned adult phrase Severe Receptive Language Disorder How can this happen? Could it happen in Denmark? Discuss the case studies of Jancis, aged 14 and Brian, aged 14 The missing population Key markers : Conti-Ramsden & Botting (1999) Immature expressive grammar Limited progress with early number skills (why?)

Immature story re-telling skills Poor reading comprehension Ripley (2010): Listening attention Vocabulary Discuss in pairs/trios Are these markers the same for Danish children? How would you explore these markers in the classroom - informally? - in a structured way, but not necessarily

using standardised tests? Plenary The issue for schools in UK NUT survey of SENCos ; 74% no CPD in SLCN Many teachers lacked the confidence to assess spoken language and to design strategies to support spoken language in the classroom Rose Report (2006) DfES Teachers are not trained in the importance of spoken language or its role in learning and literacy . They are not taught to recognise

children with inadequate language, assess the extent of the delay and how to help them. What Teachers say Limited SEN components, including SLCN, in initial training Dockrell & Lindsay (2001) 90% of KS1 teachers no input about SLI or normal language development on initial training course, Sadler

(2005) 88% of KS1 teachers related their knowledge/confidence about working with children with SLI as limited or very limited Sadler (2005) Discussion in pairs / trios What training do classroom teachers in Denmark have to help them to identify and support children with SLI? What specialist training is available for teachers? In UK one of the three post-graduate courses closed in September 2013. There are problems

recruiting suitably qualified teachers to manage resourced provisions. Inclusion Development Programme: Schools Audit : Handout Support for children with SLI Identify those at risk The informal markers Observational checklists Screening for all? : Language Link Screening for those at risk?

British Picture Vocabulary Scale: receptive-vocabulary Bracken Test of Basic Concepts : receptive-concepts Narrative Assessment : expressive grammar + narrative skill. Squirrel story, Peter and the Cat Create a Communication Friendly Environment A whole school audit for a communication friendly environment Worcestershire Speech, Language and Communication Pathway

Specific focus on aspects of the physical and learning environment - visual support systems in place - adult language and communication - the physical environment, including acoustic - support for understanding instructions and verbal explanations - teaching of vocabulary Sample sheets from Warwickshire Local Authority Better Communication Research Programme 2012 Communication Supporting Observation Tool designed to profile the oral language environment of the classroom

Language learning environment Language learning opportunities Language learning interactions Available to download from The Communication Trust. For further information: Discussion in pairs/trios: What assessments are available in Denmark? Adult use of language in the classroom ..or Listening to someone speaking in a language that is not your first language Discuss in pairs/trios:

What makes understanding hard? What supports understanding? How do you feel when you struggle to understand? Support for understanding Attention first Simplify vocabulary, grammar Keep sentences short, simple (10 word rule) Allow processing time Repeat key information: get repeat back Use the childs interests

Visual support: gesture, signing, diagrams, pictures, watching how, experiential learning. What visual support do you use in Denmark? Keys to understanding: vocabulary In UK vocabulary at 5 years is a strong indicator of academic success and later life chances (Clegg et al 2009) Top 25 centile enter school with x of 7,100 words: learn 3 new words a day Lowest 25 centile enter school with x of 3,000

words learn 1 new word a day Do you have this gap in Denmark between the most and least advantaged children? Vocabulary children learn Vocabulary important for that child Understanding the language of the classroom Common use vocabulary, e.g. line up New technical words, e.g. sentence, periodic table New concept words, e.g. multiplication, digestive system Attach new meanings to familiar words, e.g. light/dark Flexibility how many meaning for the word bat Vocabulary for their reading

What vocabulary to teach? Word Aware Approach: Parsons 2012 Anchor Words Goldilocks Words Students have a thorough understanding. Able to use the word spontaneously. Not too easy, not too hard,

but just right. Likely to be encountered again. Average adult has a good level of knowledge of the word. These are BASIC words commonly used in spoken language. They are heard frequently, in numerous contexts. e.g. bed, happy, boy, burger, clock

They are not the most basic way to express an idea; they represent a more sophisticated vocabulary. e.g. Warm, darker, nearly, remarkable, mischievous, awe, light, insist, admire, compare, gentle, obstacle, sarcastic, meticulous Step On Words Average adult does not have much knowledge of the word.

Particularly topic specific. These words appear in more specialist situations and rarely in general use in everyday conversation. They tend to be limited to specific domains and subject areas, e.g. metamorphosis, symmetrical, peninsular, conceptual, archaeologist, alkaline. Activity in Pairs Think of a current topic in a class you know.

Try to complete the table for your topic: Weather Anchor Words Goldilocks Words Step-on Words Rain Hot Cold Snow Wind Clouds

Sun Weather Jet stream High/low pressure Isobar Temperature Isotherm Warm/cold front Hurricane How to teach new words Build up a network of meaning. The stronger the network of meaning, the more easily we remember the word.

Phonological Links Grammatical Links Semantic Links Signing and Function Words Visual support for phonological representations . o Stimulus

Phonological Memory Semantic Memory Vocabulary interventions Support for grammar: Understanding and expression Colour Pattern Scheme Colour Coded Grammar noun ------------ verb

--------------- noun ------------- article preposition article ------------ -------------- --------------- ---------------- ------------- ------------- The complexity of grammar can build adjective subject ------------- ------------- ------------- ------------- ------------- -----------------------object

------------- connector ------------- A whole word approach to reading, writing and development of grammar Narrative: Why is it important? The ability to create an oral narrative precedes and underpins the ability to create a written narrative Poor oral narrative, pre-school, predicts

difficulties with reading. (Boudreau et al, 1999) Narrative skill at 5 years is a predictor of academic success. (Bishop & Edmundson, 1987) but More important? We experience our lives as a narrative: This narrative is us, our identity (Oliver Sachs) A social skill: 70% of utterances are anecdotal relating to real or vicarious experiences. (Preece, 1997) Sharing personal information: make and

maintain friendships A survival skill. The Narrative Approach (Becky Shanks,2000) The Story components 35 Who? The strategies and techniques that have been developed for children with SLI, help all children. We can effect change by working alongside

mainstream class teachers to embed good practice in every classroom. 37 Break SLI and Challenging Behaviour The evidence that children with SLI are at risk. Setting the scene for UK Children are excluded from school for

challenging behaviour Resourced Provisions: small group setting within a mainstream school. Education Centres: short term placement. Aim to return to mainstream school. Special schools for pupils with challenging behaviour. Benner et al (2002): Review of 26 studies - 71% BESD had clinically significant language deficits. Language Problems in Excluded Children Kate Ripley (East Sussex LEA County Psychological Service) Nicola Yuill, Nicky Hayers, Antonia Valerio, Melainee Woodun (Sussex University)

To what extent do children with behaviour problems have language impairments? Can we rule out general intellectual impairment? (few previous studies assessed non-verbal skills) Published evidence conflicts on whether receptive or expressive language problems are more closely associated with behaviour problems. Possibly the relationships change with age.

Do children with behaviour problems have more trouble with receptive or expressive language? The Sample All contactable boys, permanently excluded from schools in East Sussex Sept 1999 - July 2000 20 excluded boys: Year 4 to Year 11, mean age 13 yrs 2 months

20 control children: Same age boys from the same class, if possible similar academic level as judged by teacher, with no marked behavioural problems. Results from the Study (I) verbal skills were significantly impaired in excluded boys c.f. age matched non-excluded peers

non-verbal abilities were not significantly different between the two groups expressive language difficulties were more implicated in behaviour problems post 8 years than receptive language problems Results from the Study (II) two thirds of the excluded pupils had SLI but one third

had average or above language skills excluded students with expressive language problems had a high incidence of emotional problems Expression of feelings is highly dependent on early language competence Link to Emotional Literacy Expressive language helps with self-regulation excluded students with SLI had a long history of difficult relationships with peers. Children in Resourced Provision 71% - 90% have previously undetected language problems Camerata et al (1988) 71% significant

language problems Heneker (2005) 91% had some difficulties with communication 45% had significant language difficulties Burgess & Bransby (1990)

17 students: EBD Unit for aged 6-12 yrs 16 students had SLI sufficient to require SLT 11 students: 5 tests of language assessments used severe SLI Perception: deviant & unco-operative speech was intelligible comprehension and expressive language problems not considered The management & therapy in the unit was language based. Residential placement for children with challenging behaviour

Warr-Leeper (1994) 80% undetected language problems Alfano (2009) Swanwick Lodge. 80%+ had undetected language problems. Two thirds of delinquents have deficits in verbal abilities (Quay 1957). Research suggests this is independent of social class, race, motivation and academic achievement. (Moffitt, 1990) Pryor (1998) - 64% of young offenders have expressive language

difficulties Powell (2005) Young offenders produce poorer narratives than controls Gallagher (1999) Children with limited verbal communication used more direct action to solve interpersonal problems. Our response Language awareness training for all staff in resourced provisions and schools for challenging behaviour (2012-14 ongoing) SLT provision for special schools from September 2012

Research Programme: Language profiles of children excluded from school. Communication Passport to support return to mainstream school. Psychological processes linking SLI to challenging behaviour Self-esteem Self-Regulation Language Profile Receptive Expressive Language learning

environment Emotional Literacy Academic Achievement Relationships In school: Difficulties with Receptive Language * Teacher Talk (e.g. carpet time) Understanding compromised* *Behavioural distractions

Dont expect to understand *Stop listening *Opportunities for intervention In School: Difficulties with Expressive Language As children get older expressive language impairment is increasingly linked to challenging behaviour : Pryor (1998) 64% young offenders : Expressive language scores significantly lower than receptive language Ripley (2005) 66% boys excluded from school lower

scores for expressive language Gallagher (1999) link between aggressive behaviour and expressive language. Narrative skill a missing link? Limited Oral Narrative Skill : the evidence : Hedbury (1986) Poor Narrative skill linked to difficulty reconstructing and sharing personal experiences making and maintaining friendships

dealt with social situations in non-verbal, aggressive ways Powell (2005) young offenders produced significantly poorer narrative than controls Gallagher (1999) children with limited verbal communication used more direct action to solve interpersonal problems Self-regulation and emotional literacy A baby experiences global feelings of

distress/contentment of discomfort/comfort but these feelings are not processed or labelled by the baby Gerhardt 2004 makes distinctions between these states with the help of carers emotional literacy reliance on others to manage these feelings self regulation Feelings state talk Parent/Carer helps a child to become aware of their own feeling by using Feelings-State talk Feelings-State talk spontaneous interactions

between child and carer in the context of real life events The quality of Feelings-State talk at 3 years predicts empathetic behaviour at 6 years (Dunn 1991) Emotional literacy Learning emotional language helps children to understand emotions and talking about emotional states helps children to manage and control emotions Kopp (1989)

Children learn first to recognise and control their own emotions before they can understand and respond to the emotions of others How do you think he felt when you .? only becomes meaningful then. Self-Regulation Once we have learned to recognise emotions in ourselves and others, we can learn to control them. Small children rely on carers to regulate their states of arousal. High cortisol levels lower threshold for stress/sensibility to stress triggers.

Language and Self-Regulation Language plays a key role in the development of selfregulation Barkley (1995) Low verbal ability linked to poor self-regulation and behaviour Nussbaurn et al (1996) Reactive Response (small children, people with limited executive function)

EVENT RESPONSE Self-Regulated Response EVENT RESPONSE Executive Function evaluate prioritise select response

Language as a key tool for SelfRegulation Vygotsky (1962) : The development of private speech 2 years - some impulse control with aid of developing receptive language behaviour mainly under adult control. Need : clear, simple, consistent rules but SLI may not understand the language 34 years - self-regulation as children use their language for self-control (Luria 1961) 6-7 years - internalised private speech : self-talk which

is used to guide behaviour A Self-Regulated Response brings action and responses under conscious control enables behaviour to be modified according to events facilitates behaviour that is linked to delayed or distant outcomes Barkley : self-regulated behaviour is a maturational development mediated by

language Summary In the UK we are not always skilled at identifying children with SLI There are issues for teacher training A range of strategies are available to support children with SLI The children whose SLI needs are not identified and met are at risk for challenging behaviour which may lead to exclusion from school.

The limits of my language are the limits of my world Wittgenstein

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