Supporting Communication in Children with Behavioural Difficulties

Is my child really school ready? A guide to expected communication levels for school starters.

Parent Child Interaction: The tools to support your child’s speech and language

English as an Additional Language (EAL) or a Speech and Language (SLCN)

Teaching children with English as an additional language (EAL) is not new for schools in the UK, but it still presents many challenges for lots of teachers.

Children with EAL are just as likely as their monolingual peers to have a speech, language or communication difficulty.

So, how do you identify these needs when English isn’t their first language?

For starters, you are not alone! This is an incredibly complex issue and is definitely not straight forward. Best practice in the ideal situation is for the child to be assessed by a speech and language therapist who is a native speaker of their first language. But, as we know this is rarely available in schools anywhere – not just here in the UK.

So, although I always advocate best practice, I also recognise there may be difficulty accessing bilingual speech and language therapists to provide you with the information you need. With that said, I am going to give you a few tips on how to piece the puzzle together, and give you some advice about when to make a referral to a Speech Therapist.

Let’s break it down

Fundamentally, we must identify:

  • Children with EAL who have normal speech,language and communication development

  • Children with EAL who have speech, language and communication difficulties.

So here is the reality of EAL in school: There are over 300 different languages spoken in the UK. In some primary schools in London up to 76% of learners have English as an additional language.

As many as 1 in 5 children are starting Reception without adequate receptive and expressive language skills to access the curriculum. For many children, this is because they are new English speakers, or they are learning English as an additional language. For others, this is due to SLCN and for a minority few, it can be both.

Unsurprisingly, bilingual children are just as likely to experience communication impairments as their monolingual peers.

Identifying children with speech and language needs is intuitive for a lot of teachers. But, how can you begin to gather the evidence you need to support your intuitions?

Does it affect all the child’s spoken languages?

If a child has EAL and SLCN, difficulties will occur in all languages – not just in English. Asking the child’s parents how they are communicating in their home language will give you an insight into their abilities.

Where possible, ask a bilingual interpreter or member of staff to ask them questions about their child’s development in their first language.

Understand the culture

Sometimes a child’s perceived difficulties with interaction can be explained by cultural differences and we must demonstrate knowledge and awareness of these cultural differences in order to get a full picture of the child’s communication abilities.

I have provided some examples below.  Please understand these examples are cultural stereotypes and do NOT apply to individual families. You must use your common sense as well as sensitive information gathering skills to decide whether an idividual’s culture is impacting on perceived communicative behaviour.

  • Islamic children may demonstrate passivity in the presence of an authority figure – which could be interpreted as a communication difficulty by western standards.
  • Similarly, In countries such as China and Japan, eye contact is not a marker of social communication as it is in western cultures. Reduced eye contact can often be considered appropriate in these countries, yet would present as a red flag for social difficulties in The West.
  • In Pakistani families, fathers are not encouraged to take part in direct child care.  However, fathers are considered the major decision maker for health care, education, and money spending matters in a family. Consequently, the major responsibility lies on the mother’s’ shoulders for childcare and rearing.  This is NOT the case with all Pakistani families. 
  • In some African cultures, intense eye contact is seen as aggressive, confrontational and extremely disrespectful. This would prove important not only when observing and assessing the child’s communicative ability, but also when communicating with family members.

As educators, we must ensure cultural stereotypes are not assumed and we must be sensitive to those behaviours that appear communicative but are embedded in culture rather than a manifestation of specific difficulties.

Understanding these cultural differences can guide information gathering, and decision-making procedures; ultimately reducing the gap between what we know about the child’s communication, and the full picture.

For more information about bilingual assessment or further information on supporting children with English as an additional Language contact the Royal college of Speech and Language Therapists or Association of speech therapists in independent practice

Can he hear me? or is he ignoring me? – Explaining the Development of Attention.

He’s playing with his Ninja Turtles: Donatello and Raphael are immersed in an exhilarant adventure. Or maybe he’s watching TV eyes glued to the screen.

You call his name and he doesn’t respond, you call again, still…nothing. A third time and he doesn’t even flicker.

You feel a flash of anger, ‘I can’t believe he’s ignoring me!’ Then a feeling of worry, ‘is something wrong with his hearing?’

If you identify with this scenario you are not alone. Sometimes it can be difficult to figure out whether to be mad, or concerned in these situations.

More specifically, whether this is an expression of defiance; or just part of normal development.

For most kids up to the age of 4 this type of behaviour is completely normal. At this age they are still developing their attention skills. Their attention is  what they call ‘single channelled’.

Ok so let me explain, single channelled means they can only attend through one ‘sensory’ channel at a time. They can concentrate on something they have chosen to do. But, in order to do this they have to ignore outside stimulation so they can organise their thoughts, and concentrate.

Here’s the thing, when the turtles are on an adventure,  it is taking up all of his sensory brain power. He doesn’t have any left, to attend to you calling his name.

Simply stated? he is ignoring you… but it’s not his fault.

Of course, as children get a bit older between 4-5 they begin to develop dual channelled attention. They can understand verbal instructions related to what they are doing without interrupting what they are doing to look at the speaker

So, at this age, They should start to be able to listen to instructions about what they are doing without needing to shift their full attention to you. 

By 6 Their auditory, visual and manipulatory channels are fully integrated and attention is well established and sustained. They can sure hear you when you call them to lay the table!

Let me switch gears here for a moment: I am describing typical development of attention here. There are Red Flags you should be aware of that may indicate a child has a hearing loss or attention difficulty.  If you are at all concerned at all about your child’s hearing you should take them to you GP and ask for a referral to Audiology.

Some things to look out for.

  • Speech/language delay or differences
  • Says “what?” or “huh?” often
  • Difficulty understanding speech in background noise
  • Difficulty hearing in one or both ears on the phone
  • Increased TV/stereo volume compared to rest of family
  • Not startling to very loud sounds
  • Attention or behavioral problems
  • Academic difficulties
  • Unable to detect where sounds are coming from

For strategies for how to gain the attention of a younger child – read next week’s blog post

How do I get a referral to a Speech Therapist?

The Health Visitor has told you not to worry, that she might be a little bit behind but she will catch up in a few months.  So you wait…and wait but you still feel like her language is not developing as quickly as other children. Her speech is not as clear as others at nursery and she is not progressing as fast as her older sister.

Sound at all familiar? If the answer is yes, there are a couple of things I would recommend you try to fast track a referral to a Speech Therapist

Get a hearing test.

If your child cannot hear it – then they won’t be able to say it. Nearly 80% of children under the age of 8 will suffer with glue ear which can affect their hearing and access to speech sounds. It is always worth getting this checked out before doing anything else.

Get your facts straight.

The more you know about child development, the more you will understand about your child’s difficulties. Often, the more you find out about your child’s delay, the less concerns you will have.

But don’t take my word for it, take a look at the Talking Point website and the Cochlear’s Integrated Scales of Development to get an idea of where your child is up to. It may surprise you, what is ‘typical’ for a child at 2 years.

Be specific.

Let me explain, if you go to your GP and say, her speech doesn’t sound like the others at nursery this doesn’t give the doctor enough information about what’s going on and whether to refer to a Speech therapist or not.

if you say:

She isn’t using any functional words to request and she is playing on her own agenda or

She seems to be replacing all of her initial consonants with a ‘t’ or a ‘d’

This gives the Doctor much more information to go on. And a more specific reason to give you a referral to a Speech therapist.

Think about it, if you are vague about what the problem actually is, it’s difficult for the health visitor or doctor to know what you are concerned about.

Vitally important, last and final point:

Be the expert.

You may have a ‘gut feeling’ but you will get a lot further into the referral process if you have facts and examples to show to your Health visitor, GP and paediatrician to back-up your concerns.

Demonstrate your child’s knowledge and skills and track their progress on this ‘talking point chart’

Have videos demonstrating behaviour in situations other than the GPs office.  Show the Doctor what they are like at home; in a crowd or at nursery.

Gather as much information as you can from nursery staff or their childminder.  Ask them to write a note or short letter to support your concerns.

It is a shame we have to go to such lengths as parents to get an NHS referral to Speech and Language Therapy. But,  honestly, it is worth doing if you are concerned.

If you don’t want to wait, you can call me at Mable or sign up for a free consultation when we Launch in October – I will be happy to talk things through and advise on assessment and therapy options.

For all of you trying to get a referral to a Speech Therapist I hope this is useful! – Let me know how it goes