Supporting Children with Communication Problems

Sharing the Workload

Myra Kersner, Jannet A. Wright

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781134095292
• Edition: 1
• Topic: Education
• Subtopic: Education General

First Published in 1998. Supporting Children with Communication Problems: sharing the workload is, therefore, for practising teachers and therapists who have begun to work together and wish to know more about the process, as well as for those professionals who may be considering embarking on such work but need to consider the 'pros and cons' of working in this way. The book is also for student teachers and speech and language therapy students.

Chapter 1

Supporting children with communication problems

Introduction

There are a range of communication problems which may affect school-aged children and these may occur for a variety of reasons. While children with such problems are within the education system, several different professionals may be involved with the identification and amelioration of their communication difficulties. These include: teachers and classroom assistants; speech and language therapists, and educational psychologists. Parents too normally play a significant and important role. However, whilst it is important to recognise this, the focus of this book will be on the interaction between the professionals; in particular, the relationship between the teachers and the speech and language therapists who work together in order to help such children.

Who are the children?

Classification – an historical perspective

The 1945 Handicapped Pupils and School Health Services Regulations listed 11 categories of handicap of children for which local education authorities were required to make special educational provision. These included: physical handicap; educationally subnormal; maladjusted; epileptic; deaf and partially deaf. Many of the children within these categories would have had associated speech and language difficulties. At the same time – and for the first time – speech defects was also recognised as a specific category.

Those children who were labelled as having speech defects and who normally attended ordinary schools were seen by the speech therapist at the local school clinic. Those attending special schools, which were designated by the primary classification of their difficulties, may have been seen by a speech therapist within their school setting. The medical approach to such difficulties was the prevailing influence at that time, when it was thought that children would be ‘cured’ by regular treatment from a speech therapist.

Children who were classified as mentally handicapped (or severely educationally subnormal), most of whom also had associated communication problems, were the responsibility of the local health authorities and, as such, were not automatically entitled to an education. It was not until 1971, following the implementation of the Education (Handicapped Children) Act (1970) which removed the power of health authorities who provided training for these children, that local education authorities assumed responsibility for them. All children of school age who had hitherto attended Junior Occupation Centres and Junior Training Centres were then entitled to education for the first time, although their speech therapy continued to be provided by the health authority, usually within the newly designated special schools.

Current descriptions

The 1981 Education Act changed the way in which children’s problems were conceptualised. The categories of handicap were removed and there was a shift of emphasis, encouraging more descriptive reporting and classification of children’s special educational needs, including their communication difficulties. It was envisaged that a description of needs would enable the education authorities to offer the most appropriate form of educational provision, and to recommend services and resources such as speech and language therapy as required. For some children this provision is recorded on a Statement of Special Educational Needs* – the current formal statutory assessment procedure. However, there are many children whose needs are currently being met without a Statement having been written.

What is a ‘communication problem’?

The range of communication problems

Some children who have no cognitive deficit or physical problem may be described as having a specific speech and language impairment, so identifying communication as the primary problem (this used to be referred to as developmental dysphasia). However, in many other cases, such as children with more complex needs, the speech and language problem may be a secondary aspect of their overall difficulties. For example, deaf children, children with cerebral palsy, or severe learning disabilities may have problems developing speech as well as language as a result of their medical condition or intellectual impairment. In some instances it may not be possible to distinguish which is the primary and which the secondary problem. Such may be the case where children exhibit challenging behaviour; it may not be clear whether this is the cause or the effect of the speech and language difficulty (Wintgens 1996).

For some children, their speech and language difficulty may have been identified in their pre-school years and have been resolved by the time they enter school. However an underlying difficulty may then be manifest, such as a specific learning difficulty (dyslexia) where the development of their literacy skills will be affected (Catts 1996; Stackhouse 1996).

As well as problems which may affect speech and/or language development of young children, other developmental communication problems which may be prevalent in school-aged children include dysfluency (or stuttering/stammering), and voice problems. It is also possible that children may acquire a communication problem as a result of illness or accident.

Identification of expressive problems

There are some communication problems which are easier to identify than others (MorganBarry and Wright 1996). Difficulties with expressive language which may affect the form and/or the content of what children have to say (Bloom and Lahey 1978) are usually identified more readily. For example, children’s speech may be difficult to follow if they are unable to sequence sentences correctly according to acceptable English word-order, or to use appropriate grammatical structures (syntax). Similarly apparent are articulation or phonological problems, where children are not able to formulate or sequence English speech sounds correctly, or cannot use them contrastively, so reducing their intelligibility.

Children who have complex needs may not have the physical ability to produce sounds accurately or may not have the voluntary control to produce sounds at will (dysarthria and dyspraxia). In some situations such children may use alternative or augmentative communication systems (AAC) – such as a signing system (Makaton; Paget Gorman Signed Speech) or a symbol system (Rebus; Makaton Symbols; Blissymbolics) to supplement speech.

It is not always a straightforward task, however, to identify the problem when children have difficulty with semantics or the meanings of words. Such children may have intelligible speech and use syntax appropriately, but may be unable to select appropriate vocabulary or recall the names of specific objects.

Identification of pragmatic problems

Sometimes children have problems interacting and communicating with other people. This use of language (Bloom and Lahey 1978) or the development of pragmatic skills is closely intertwined with social behaviour and, whilst it may not be difficult to identify children whose social communication behaviour is ‘odd’, it may not always be easy to pinpoint the exact nature of the problem. The majority of children learn unconsciously how to address friends, parents and teachers in a variety of ways, all of which are socially acceptable. Children who have difficulties in this area, however, do not acquire these pragmatic skills automatically. For example, they may not know how to attract another’s attention, how to initiate or end a conversation, or how to take turns when talking. Similarly, if a conversation comes to an unexpected halt due to a misunderstanding they would not know how to restart or repair it.

They may also have difficulties with non-verbal communication so that they have poor eye-contact, use gestures inappropriately or fail to appreciate culturally acceptable distances which people maintain when conversing with others.

Overall, such children may not be aware of the nuances which many people take for granted in general conversation. They may not know how to deal with vocabulary which expresses emotions and abstract concepts such as happiness or sadness, or they may not be aware of the subtle difference, for instance, between ‘liking’ and ‘loving’ people. Failure to understand the implications of specific vocabulary may mean that they find it difficult to link topics in conversation, or to talk about something or someone who is not present.

Identification of receptive problems

Difficulties with the comprehension and understanding of spoken language – ‘receptive’ problems are also less obvious and thus more difficult to identify, for as Wright (1995) says: Often, [these] can be overlooked due to the prominent nature of expressive language difficulties’. Nevertheless they may have serious consequences for children in relation to their speech and language development.

In the classroom where there are organised, predictable routines, children with comprehension problems may function unnoticed for they will make good use of non-verbal and contextually linked clues to enable them to follow instructions. Often, however, they will interpret instructions literally which can lead to difficulties, not least in understanding sarcasm and verbal humour. They may also have difficulties understanding abstract concepts, favouring concrete examples and ‘real’, current situations. However, the fact that they have difficulties in making inferences and predictions and in understanding the relationship between cause and effect may create potentially dangerous situations for them, for they will be unable to predict the consequences of their own or someone else’s actions.

Despite their lack of comprehension, such children often have expressive language, although this will usually be limited and inappropriate. Children who echo the teacher’s – and other children’s – words or whose own conversation is plentiful yet meaningless may have an underlying comprehension problem which is masked by their apparent ‘chattiness’.

All these difficulties can manifest themselves in both oral and written work and have implications for the children’s social and educational development and progress. Aspects of identification will be discussed in further detail in Chapter 5.

What provision is currently available?

In the wake of the 1981 Education Act, children were described as having special needs and special educational provision was made available as appropriate. According to the Code of Practice on the Identification and Assessment of Special Educational Needs (DFE 1994) special educational provision for children over the age of two means: ‘educational provision which is additional to, or otherwise different from, the educational provision made generally for children of the child’s age in maintained schools, other than special schools, in the area’ (2.1, p. 5).

Children with communication problems will need speech and language therapy as part of this provision although, according to the Code of Practice, ‘speech and language therapy may be regarded as either educational or non-educational provision depending on the health or developmental history of each child’ (4:34).

The ways in which speech and language therapy is provided will in part depend on how it is recorded on the child’s statement, i.e. as an educational or non-educational provision. However, speech and language therapy provision will vary from one geographical area to another, according to the way in which the speech and language therapy services are organised in the area, and dependent upon the educational setting.

Currently children with communication difficulties may be found in a variety of educational settings so that the provision offered may be at any point on a continuum, which ranges from mainstream schools in which children are either fully integrated or are supported individually in specific areas, through specialist units where children are only partially integrated, to the opposite extreme of specialist schools, where children with special needs are segregated.

The nature of the setting will not only affect the speech and language therapy service provision but also the ways in which the therapists may work; in particular how they may work together with the teachers. The fact that in some areas speech and language therapists are funded partly by the education authority whereas, more often, therapists continue to be funded predominantly by the health authority, may also affect how they work alongside teachers and function within a school. Some of these issues will be discussed below.

The different settings within which teachers and speech and language therapists may work together will be discussed in more detail in Chapters 5, 6 and 7. The effects of a communication problem will have different implications for children at different stages in their education – at preschool, primary, or secondary stages – dependent on when the problem is first identified and whether or not it is persistent. This will also have implications for the professionals working with these children and will be discussed in other chapters.

Who are the professionals?

Some children with speech and language difficulties may have been identified at an early age, for example by a health visitor, and consequently may begin to receive speech and language therapy prior to starting school; therapy may then continue after they have entered the education system. For other children, the class teacher may be the first professional to identify their communication difficulties. The teacher will then be the one who will refer them to the speech and language therapist. Irrespective of who has the initial contact, in both situations these two professionals – the teacher and the therapist – will need to bring together their knowledge and skills in order that the communication difficulties are addressed and the children in their care may benefit.

How then may a professional partnership result in educational plans for children with communication problems? And how may speech and language therapy be incorporated into the requirements of the National Curriculum? In order to understand how this may be achieved, it is important to look at the individual roles of each of these professionals; to examine their training; and to consider some of the factors which may affect the ways in which they may work together.

Teachers – roles and ways of working

In mainstream schools, teachers are responsible for the education of the children, which includes the delivery of the National Curriculum. The ways in which individual schools are organised will vary according to the size of the school and its overall structure. Naturally, there will be some differences in teachers’ roles and the ways in which they work within individual schools. However, there are significant differences between the role of the classroom teachers in primary schools and their role in secondary schools. This may be important when considering teachers who work with children with communication problems, for it may affect their approach to working with such children.

Primary teachers have responsibility for all subject areas, even where individual teachers within a school may be responsible for staff development within a specific subject area. This means that primary teachers normally maintain contact with all the children in their class for most of the working day, including children with communication problems or other special educational needs. However, in secondary schools all teachers have a subject specialism and work within departments. They normally focus on their subject area, teaching across years and within years where ability groups will vary considerably. Their contact with individual children, therefore, may be minimal, unless they have the additional role of form tutor, or are involved in the pastoral care of the children.

The departmental structure and the large number of students who attend the majority of secondary schools will mean that the management and organisation of the secondary school will differ greatly from that of most primary schools, which generally have smaller numbers of staff and students. Indeed, secondary schools will often have a special needs department as well as designated staff who provide pastoral care. This, therefore, creates a network of subject teachers, support staff and staff on pastoral care teams all of whom will need to liaise together in order to help children with special educational needs, including children with communication problems (Miller and Roux 1997).

In larger primary or secondary, mainstream schools children with such problems may be catered for by a learning support team, often led by the special educational needs coordinator (SENCO). In smaller schools, the SENCO will be more directly involved in the special educational provision. The SENCO has the overall responsibility within a school to maintain the appropriate records, and coordinate the special provision for the children with special educational needs, which will include children with speech and language problems, in line with the school’s policy. This may involve working with specific children either in the classroom or on a withdrawal basis. In addition, it is the responsibility of the SENCO to liaise with, train and advise the staff of the school, and to liaise with parents and any external agencies which may be involved with the children (Stage 2; Code of Practice 1994). However, in many primary schools, the SENCO will also have a teaching commitment for part of the week, which naturally reduces the time available for the specialist role.

Class teachers in a mainstream school may have an additional role – as managers. There may be many different adults involved in classroom activities during the course of a week. Such adults may include non-teaching assistants, parents, volunteers or teachers in training, as well as support workers such as the SENCO or external advisory teachers. If there are children in the class who have communication problems, the speech and language therapist may also be a regular visitor. It is the class teachers who have the overall responsibility for the organisation and management of all those working within their classroom and, where other professionals are involved, they have additional responsibilities. Not only must the teachers ensure that their own class-based tasks are completed so that the pupils may continue to learn and function effectively but, through careful negotiation and liaison, they need to ensure that th...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Introduction
• 1 Supporting children with communication problems
• 2 Sharing the workload – models of working practice
• 3 Why work together?
• 4 Factors influencing a shared professional relationship
• 5 Current practice in mainstream schools
• 6 Current practice in special schools
• 7 Current practice in special units
• 8 Developing the relationship
• References
• Index