Transcript Inclusion for Children with SLI in Mainstream Education

Inclusion for Children with SLI in
Mainstream Education:
The Challenges for Schools
March 2014
Nyborg, Denmark
Kate Ripley
Programme
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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?
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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?
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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?
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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 can’t 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 Grammar
5.25 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
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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
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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
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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.
Locke (2006)
What Teachers say
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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
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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
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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
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A whole school audit for a communication friendly environment
Worcestershire Speech, Language and Communication Pathway
www.worcestershire.gov.uk/slcnpathway
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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:
http://www2.warwick.ac.uk/fac/soc/cedar/better/
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 child’s interests
Visual support: gesture, signing, diagrams,
pictures, watching how, experiential learning.
What visual support do you use in Denmark?
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Keys to understanding:
vocabulary
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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 x̅ of 7,100
words: learn 3 new words a day
Lowest 25 centile enter school with x̅ 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
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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
Stimulus
o.
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?
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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?
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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
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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.
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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.
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Language Problems in Excluded Children
Kate Ripley (East Sussex LEA County Psychological Service)
Nicola Yuill, Nicky Hayers, Antonia Valerio, Melainee Woodun (Sussex University)
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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.
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Do children with behaviour problems have more trouble with
receptive or expressive language?
The Sample
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All contactable boys, permanently excluded from
schools in East Sussex Sept 1999 - July 2000
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20 excluded boys:
Year 4 to Year 11, mean age 13 yrs 2 months
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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)
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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)
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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)
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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.
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Residential placement for children
with challenging behaviour
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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
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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*
Don’t expect
to understand
*Behavioural
distractions
*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 :
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Hedbury (1986) Poor Narrative skill linked to difficulty
reconstructing and sharing personal experiences
making and maintaining friendships
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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
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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
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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
 3–4 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
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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
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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