Speech and language therapy provision for children using augmentative and alternative communication systems

A proportion of children with physical impairments experience significant difficulties in communicating with others and may be recommended augmentative and alternative communication (AAC) systems such as speech synthesizers and symbol charts to support ‘natural’ communication skills. However, AAC systems are often under-utilized. Parents have identified barriers to AAC system use to include the organization of speech and language therapy. Speech and language therapists are developing services to school-aged children in response to changes in education, health reforms and models of speech and language development. However, there is little evidence for commissioners of children's services about what constitutes ‘enough’ or ‘good’ speech and language therapy. This paper examines speech and language therapy provision to 23 children using AAC systems in six London authorities. Research strategies include documenting the amount, type, organization and objectives of provision. Evidence for collaboration between school staff and therapists is explored, analysis is made of child characteristics associated with provision and criteria for decision-making documented through interviews with therapists. However, little conjunction exists between what therapists said guided their decision-making concerning provision and observed provision. For the children surveyed in this study it seems that that provision in amount of therapy is related to educational placement rather than individual needs.     

The influence of socio-economic status and ethnicity on speech and language development

A number of factors influence the speech and language development of young children. Delays in the development of speech and language can have repercussions for school attainment and life chances. This paper is based on a survey of 3- to 4-year-old children in the city of Stoke-on-Trent in the UK. It analyses the data collected from 255 children in 26 schools, and discusses the effects of socio-economic status and ethnicity on delayed or advanced language development in young children. Language development in the project was measured using the New Reynell Developmental Language Scales. The study shows mean standard scores for language Production and Comprehension within the low average range, thus demonstrating a challenge confronting nurseries/preschools in the area in preparing children for compulsory schooling. The research has implications for early years education policy and practice.     

Meeting the needs of children with specific speech and language difficulties

Clinical and diagnostic approaches to special educational needs do not translate easily into educational models. In some cases, these approaches can serve to limit understanding of children's wider needs. Children with specific speech and language difficulties (SSLD) are a case in point. Clear criteria exist for identification, but identification mechanisms may not relate to the child's wider educational needs. This paper addresses the ways that children with SSLD present in mainstream educational settings. The study aimed to identify all Year 3 children with SSLD in two English local education authorities. One hundred and thirty-three children (95 boys and 37 girls were identified). Sixty-five per cent of the children were in mainstream schools, 14.3 per cent in mainstream schools with designated units and the remainder in special schools. Half were at stage 5 of the Code of Practice, with most of the remaining participants at stage 3. Children experienced a wide range of difficulties, in addition to their primary speech and language problems. Patterns of difficulties varied across children, and associations existed between particular forms of language problems and learning and relationship problems. Professionals (teachers, educational psychologists and speech and language therapists) varied in their understanding of the children's needs. The data highlight the range and diversity of the needs of children with specific speech and language difficulties and the need for a multi-professional approach to these children. It is argued that ‘best practice’ for these children must consider the impact of speech and language problems on children's access to the curriculum and their social and behavioural needs. Narrow diagnostic models do not provide the appropriate information to inform educational practice and support inclusive policies.     

Early childhood education of children with specific language impairments

Early intervention for children with specific language impairment by teachers with experience in supporting their needs is critical to language acquisition. In Western Australia this small number of children are catered for in designated settings with specialised teachers. The length of time that these children are able to access intensive instruction may be shortening and therefore the potential effect on their learning is crucial. Teachers from five Language Development Centres were asked to respond to a range of issues associated with these children's ability to cope with the proposed early re-entry into the mainstream classroom. A total of 120 responses were received from teachers, speech therapists and educational assistants who highlighted the specialist skill set required to teach students with specific language impairments. Discussion focuses on the perceived ability of mainstream teachers to provide appropriate support for children with specific language impairments in the early years.     

The challenges of evaluation: assessing Early Talk's impact on speech language and communication practice in children's centres

This paper describes the findings of a qualitative evaluation of an early years' intervention, I Can's Early Talk (ET) programme. ET was designed to improve speech, language and communication outcomes for children aged 0–5 by focusing on enhancing practitioners' knowledge and skills. The research focused on children aged 3–4 years and was conducted in 14 Sure Start Children's Centres across England, using a combination of observations and interviews with practitioners, centre managers and local authority staff, along with a questionnaire survey of parents. Findings revealed improvements in practitioners' confidence and practice as a result of participating in the programme. The results also suggest that participating practitioners felt their capacity to understand and reflect on how to support children's speech, language and communication improved, particularly in the children's centres which had been accredited for over six months. ET was also found to offer a balance of support and challenge which consolidated and extended good practice and identified areas for development where practice was less effective. In addition, some of the challenges, which characterised and ultimately enhanced the research process, are described.     

Small Talk: Identifying communication problems in maltreated children

Development of speech and language is rapid in early years, yet if developmental problems in speech and language are not addressed they are likely to continue and impact negatively on a child's overall development and their life trajectory. Children who have experienced abuse and or neglect are particularly vulnerable. The aim of this study was to develop a tool to assist in identifying a child's need for assessment by a speech pathologist so that there could be early identification of problems. A culturally sensitive tool was developed to be completed by the child's carer included questions on language, speech and hearing, voice, fluency, understanding sentences, vocabulary and expression. Sixty-five children aged between 4 and 8 years, who had experienced abuse and/or neglect participated in the study. Fourteen percent were Aboriginal. A speech pathologist undertook an assessment for each child and the results were compared with the information on the Small Talk tool. The Tool was found to be high in sensitivity but low in specificity, requiring further refinement. However, it has the potential to assist non speech pathologists to identify a child's need for speech and language assessment with the findings identifying the Tool as promising practice.     

The overall knowledge of genetics in Serbian speech and language pathologists

ABSTRACT

An increase in the number of children with speech–language pathology also having a genetic disorder imposes the need for speech and language pathologists (SLPs) to have sufficient knowledge about genetic basis of speech–language disorders. Research aim was to estimate in Serbian SLPs different aspects of theoretical and practical knowledge about intercorrelation of genetics and speech and language pathology and to compare obtained results with the results of SLPs in the United States. The questionnaire from Tramontana’s study was used in our study. Comparison of the results that obtained in our study with those in Tramontana’s study has shown that our study respondents have higher General Knowledge Index (78.6%: 66.2%), higher mean confidence summary score (22.2: 16.7) and higher mean score of ‘overall’ attitudes about genetics and its relation with communication disorders (20.8: 13.6). Differences which emerge from educational programmes, educational levels and practical experience in the observed groups are indicated as possible causes of differences in the obtained results. On the basis of the obtained results, it may be concluded that it is necessary to elevate SLPs’ level of general knowledge about genetics and to acquire their knowledge through clinical practice.     

Friendship and bullying patterns in children attending a language base in a mainstream school

This study involved perceptions of bullying in six Year 7 children attending a speech and language base part‐time and the perceptions of their mainstream peers without speech and language problems. Base‐taught children and mainstreamed peers completed a bullying questionnaire and a social inclusion survey. Base‐taught children with language difficulties rated themselves three times more likely to be bullied than mainstream peers. Half of these base children, however, rated bullying as rare. These two sub‐groups differed on the number of peers willing to “hang out” with them, suggesting language difficulties and attendance at a segregated language base together are a “risk factor” for bullying whereas peer‐acceptance may be a “protecting factor”. An intervention helping children to use a “fogging” technique did not reduce bullying perceptions. It is suggested that inclusion‐oriented ecological interventions are more likely to encourage friendships and social acceptance among the wider peer group and thus may be the most effective interventions to prevent bullying.     

Teaching English Language Learners At Risk for Reading Disabilities to Read: Putting Research into Practice

The purpose of this article is to describe features of interventions that are empirically validated for use with first‐grade students at risk for reading disabilities who are English language learners (ELLs) and whose home language is Spanish. The empirical evidence supporting these interventions is summarized. Interventions for improving oral language and reading abilities with struggling readers who are ELLs taught in either Spanish or English are described as a means to assist school districts and teachers in defining and implementing effective interventions for ELLs at risk for reading difficulties. The interventions described may be useful to educators seeking information about Response to Intervention as a means of identifying ELLs who require services for learning disabilities.     

Speech perception in infancy predicts language development in the second year of life: a longitudinal study

Infants' early phonetic perception is hypothesized to play an important role in language development. Previous studies have not assessed this potential link in the first 2 years of life. In this study, speech discrimination was measured in 6-month-old infants using a conditioned head-turn task. At 13, 16, and 24 months of age, language development was assessed in these same children using the MacArthur Communicative Development Inventory. Results demonstrated significant correlations between speech perception at 6 months of age and later language (word understanding, word production, phrase understanding). The finding that speech perception performance at 6 months predicts language at 2 years supports the idea that phonetic perception may play an important role in language acquisition.     

Enhancing English among second language learners: the pre‐school years

Informed by knowledge of linguistics, research findings in the areas of monolingual and bilingual acquisition, dyslexia and speech therapy clinical practice, five factors are proposed to argue that the acquisition of English by young non‐native learners can be enhanced by learning activities which take into account factors of developmental sequence in language acquisition, language‐specific properties, the relationship between oral and written language, the what‐to‐learn‐first issue and the quality of the language input. Proper language goals can be set and appropriate activities designed, only if the language input provider interacts with a learner in a concrete activity while being sensitive to the developmental trajectory of monolingual speaking children, the development of the less dominant language in a bilingual child, the prosodic and phonological differences between the learner's mother tongue and the target language, the importance of phonological awareness which defines dyslexia, the use of non‐abstract language structures grounded in concrete lexical items in the early stage of language acquisition and the strategy of expanding learners' utterance by one element as used in speech therapy.     

Not Yet Identified: The knowledge,skills, and training needs of early years professionals in relation to children's speech and language development

This article draws on a research project, funded by the Nuffield Foundation, looking at early years professionals' knowledge about speech and language development and their confidence and skills in assessing normal and delayed language development. Key findings, based on 829 questionnaires and 50 interviews, reveal very limited training in speech and language difficulties as part of initial training and low levels of post-qualification training in children's speech and language. Practitioners are aware of the need for early identification of children's communication difficulties but lack the tools with which to perform this identification. In order to provide a context for these results, a content analysis of the curricula from a variety of initial training routes explored the extent to which there was a focus explicitly on assessment and identification of children with speech and language difficulties. The role of professional journals and key texts in supporting practitioners in making judgements about children's language development was also investigated. The access to, and provision of, post-qualification training to support the assessment process is identified as a key area for development.     

Basic research in speech and lateralization of language: Some implications for reading disability

Basic research in speech and the lateralization of language is shown to illuminate the problems of reading and some of its disabilities. First, it is pointed out how speech, or language for the ear, differs markedly from reading, or language for the eye. Though the sounds of speech are a very complex code and the optical shapes of written language are a simple cipher or alphabet on the phonemes, we all perceive speech easily but read only with difficulty. Perceiving speech is easy because, as members of the human race, we all have access to a special physiological apparatus that decodes the complex speech signal and recovers the segmentation of the linguistic message. Reading is hard because the phonemic segmentation, which is automatic and intuitive in the case of speech, must be made fully conscious and explicit. The syllabic method supplemented by phonics (used with certain reservations) is suggested for remediation of segmentation problems. Second, it is posited that since the sounds of speech are processed differently from non-speech sounds, the two should not be diagnosed and remediated interchangeably. Third, it is shown that the relationships among cerebral lateralization for language, handedness and poor reading can now be studied more meaningfully because of the recent development of new techniques. A truism often heard in the opening lecture of graduate classes in education is that we have few answers to the problems that beset us, only questions. In the field of reading, the difficulty may be owing at least in part to our impatient attempts to find immediate solutions for the teacher and the student in the classroom, and our consequent neglect of basic research. I should like to suggest today how knowledge of basic research in related disciplines may lead to clues for improving beginning reading instruction and the lot of the disabled reader—if only by affording us a deeper understanding of the reading process. Paper based on a talk given at the Twenty-first Annual Conference of The Orton Society, Washington, D.C., November 14, 1970.     

Games and foreign language teaching

Active spoken mastery of a foreign language all too often remains an illusive wish on the part of language learners. There is a tendency to seek the causes of non‐fluency and accurate speech outside the classroom, for example, too little involvement, interest and time investment on the part of learners. In this article Manuela Macedonia asserts that the problem is attributed primarily to the type of exercises that are employed to process foreign language input. Traditional transmission of morphology and syntax by way of rules, and practising such rules via written exercises, does not lead to spoken language, for with this type of practice the retrieval of learned material is too slow and often incomplete to enable successful speech. While games in language and SEN instruction are not new, in this article their targeted usage based on cognitive/neurological evidence is proposed in order to proceduralise declarative knowledge and thereby to elevate accuracy and fluency to a level that enables real‐time speech.     

When learning a second language does not mean losing the first: bilingual language development in low-income, Spanish-speaking children attending bilingual preschool

This article discusses two investigations which explored the bilingual language development outcomes of comparable groups of low-income, Spanish-speaking, Mexican American children who either did or did not attended a bilingual (Spanish/English) preschool. Study 1 is a replication of a study by Rodríguez, Díaz, Duran, and Espinosa, involving a new sample of 26 children who attended bilingual preschool for one year and 20 control children who remained at home. Study 2 represents a 1-year, longitudinal follow-up of Rodríguez et al.'s, sample of children during and after the children spent another year at home or in the preschool. In both investigations, standardized, objective measures of three components of children's language proficiency (productive language, receptive language, and language complexity) in English and Spanish were obtained at the beginning and end of the academic year. Contrary to fears that have been expressed by some that early exposure to English would lead to children's native language loss, the results of both studies offered no evidence of Spanish proficiency loss for children attending bilingual preschool. Children who attended bilingual preschool, compared to those who remained at home, showed significant and parallel gains in Spanish language development as well as significant and greater increases in English language proficiency over time. Results are discussed in terms of the need for more systematic research to be conducted in this area to inform policy and practice in the early education and development of language-minority children.     

Teachers and speech and language therapists: a shared framework

Carol Miller, a speech and language therapist in the School of Education at The University of Birmingham, identifies the different perspectives of speech and language therapists and teachers in looking at language and language difficulties and suggests that they can be combined to ensure a morecollaborative language practice.     

Policy-to-practice context to the delays and difficulties in the acquisition of speech,language and communication in the early years

The aim was to investigate the policy-to-practice context of delays and difficulties in the acquisition of speech, language and communication (SLC) in children from birth to five in one local authority within the context of Bronfenbrenner’s bio-ecological model. Methods included a survey of early years practitioners (64 responses), interviews with 11 early years practitioners and observations of 9 children in the context of their early years settings. Policy texts revealed a growing consensus on the importance of early learning and development, the centrality of language and early intervention. Practitioner survey and interview findings indicated confident practice in relation to early identification, assessment and support, despite minimal initial professional training in SLC and virtually none for children with English as an additional language. Greater use of specialist assessment tools and alternative communication systems was made in specialist than mainstream settings. Observation showed considerable variation in the organisation of staff, groups, activities and interactional patterns with more targeted, short and intensive adult-led activity in special settings that led to less child-initiated interactions and private ‘self-talk’, characteristic of large-group free play of mainstream settings. Challenges and opportunities of generalist and specialist provision are discussed.     

Children with cochlear implants and complex needs: a review of outcome research and psychological practice

In recent years, the number of children receiving cochlear implants who have significant disabilities in addition to their deafness has increased substantially. However, in comparison with the extensive literature on speech, language, and communication outcomes following pediatric implantation in children without complex needs, the available literature for this special group of children is relatively sparse. This article reviews the available research on outcomes, grouping studies according to the nature of the additional disabilities and specific etiologies of deafness. The methodological problems relating to outcome research in this field are outlined, followed by some tentative conclusions drawn from the literature base while bearing these problems in mind. The remainder of the article focuses on the challenges for clinical practice, from a psychological perspective, of implanting deaf children with complex needs. Two groups of children are considered, those whose additional disabilities have been identified prior to implantation and those whose difficulties become apparent at some point afterward, sometimes many years later. A case example describing the psychological assessment of a deaf-blind child being considered for implantation is presented.     

The effects of speech and language therapy intervention on children with pragmatic language impairments in mainstream school

In this article, Catherine Adams, clinical senior lecturer in speech and language therapy at the University of Manchester, and Julian Lloyd, senior lecturer in psychology at Newman College, Birmingham, describe the implementation and effects of an intensive programme of speech and language therapy for children who have pragmatic language impairment (PLI) attending mainstream education in the north west of England. An intervention which focused on aspects of pragmatic language such as conversation, inference and narrative was developed. Six children who have PLI (mean age=7;10 years), all with a Statement of special educational needs, participated in a single case study series in which they each received 20 sessions of the speech and language therapy programme in their own school. Guidance and specific training was provided for learning support assistants and classroom teachers. Despite showing heterogeneity in their initial profiles of impairment, progress in conversation skills was seen in all six children and some significant changes in language test performance were found. These findings suggest that intensive speech and language therapy intervention has the potential to produce generalis-able gains in language and communication skills in children who have PLI and indicate appropriate outcome measures for future effectiveness studies.     

汉语二语语音韵律的听辨实验与教学研究

语音是语言学习的重点也是难点.海外的汉语语音教学,缺少现实的语言环境,学生们在规则指引下比较容易习得单字调,但是一旦进入语流,仍然普遍存在洋腔洋调的现象,这是教学中没有重视连续语流的韵律结构造成的.多数学者认为,在构成语音韵律的音长、音高、音强三要素中,音高是决定汉语语音自然度的主要因素.然而,我们通过对德国学生汉语发音的听辨实验发现,音长对于汉语语音的自然度同样重要,音长偏误也是产生洋腔洋调的主要原因之一.因此,对外汉语教学在训练单字调的同时,更要重视训练多音节词的音高与音长模式.本文结合第一作者在澳大利亚的对外汉语教学实践,提出了一些行之有效的语音教学方法.