Intervention for a child with persisting speech and literacydifficulties: A psycholinguistic approach

This paper illustrates a psycholinguistic approach to investigating children's speech and literacy difficulties by describing a “three-way” intervention plan for Jarrod, a 7 year old boy with unintelligible speech. First, a speech processing profile, a speech processing model and developmental phase models of speech and literacy were used to determine the relationship between his spoken and written language skills and what strengths could be built on in an intervention programme. Second, an analysis of the speech data was used to examine contributing factors to Jarrod's unintelligibility and what intervention targets might be selected to promote his speech, phonological awareness and literacy skills. Third, who might be involved in his intervention programme is suggested and what training might be needed to ensure appropriate interaction between child and listener in the therapy/teaching situation. A psycholinguistic approach can be helpful for children like Jarrod as it tackles speech and literacy simultaneously and has inbuilt assessments, monitoring and evaluation. The intervention can also be carried out by others and in groups. However, this approach needs to be combined with that derived from other perspectives (e.g. linguistic, educational, medical and psychosocial) to ensure a comprehensive management programme is carried out.     

Parents' Views about Special Provision for their Child with Severe or Profound and Multiple Learning Difficulties

This paper reports on the findings of a research study, conducted via a postal questionnaire, which aimed to elicit the wishes, needs and satisfaction with special educational provision of parents of children with severe or profound and multiple learning difficulties. Parents' views regarding services received, type of housing and employment preferred for their child, present and future concerns are also reported. The results indicated that the majority of parents in the sample are generally satisfied with their child's current special school placement and do not want a change of placement. However, one in five parents did indicate a desire for a change of placement, with the preferred option being a special class in an ordinary school. A priority for their child's learning is communication skills. A desire for a high level of involvement in their child's education was indicated but, on the whole, parents did not achieve as high a level as they would wish. Parents were generally satisfied with services received but a significant proportion expressed a desire for additional services. In terms of the future, the majority of parents expect that their child is unlikely to live or work independently or semi-independently as an adult. The paper concludes by discussing ways of enhancing parents' involvement in the decision-making process regarding special provision for their child.     

Effects of AAC interventions on communication and language for young children with complex communication needs

Children with complex communication needs (CCN) who require augmentative and alternative communication (AAC) are at considerable risk in many aspects of their development: (a) functional communication skills, (b) speech development, (c) language development, (d) cognitive/conceptual development, (e) literacy development, (f) social participation, (g) access to education, and (h) overall quality of life. Early intervention is critical to address these areas and provide successful and functional outcomes. AAC offers the potential to enhance communication, language, and learning for children with significant communication disabilities. This paper provides an overview of the effects of AAC interventions on communication, behavior, language, and speech outcomes for young children with CCN for pediatricians and other medical and rehabilitation professionals. Future research directions to maximize the communication development of young children with CCN are also discussed.     

Development of a quality of life measure for children and young people with speech,language, and communication needs

Children's speech and language difficulties affect more than their communication skills, impacting on their experience at school, relationships, and later employment opportunities. These wider sequelae, arguably, contribute to a child's quality of life (QoL), which is routinely measured in the care and research of other childhood conditions, but no measures exist for children's communication needs. Using a psychometric approach, a new QoL measure for children with speech, language, and communication needs was developed. Pretesting produced a clinically acceptable measure, which was then completed by 303 children and young people with speech, language, and communication needs (SLCNs) in a field test. This field test provided a psychometric basis for the reduction of items in the measure into statistically coherent subscales. The “Paediatric Speech and Language QoL” Scale (Ped SaL QoL) appears to be an acceptable, reliable, and valid measure of condition specific QoL for children with SLCNs. It would seem to have potential for use in both clinical practice and investigations of treatments in speech and language therapy. Further testing in larger, more representative samples of children with SLCNs is needed to further establish its reliability and validity and its potential for use as an outcome measure in clinical trials.

Source of funding: The research was funded by the National Institute for Health Research Grant RDA 01/05. The research was conducted according to the Declaration of Helsinki and received a favorable opinion from a National Health Service Research Committee (Rec. No. Q1701/47).     

Learning to support children with complex needs in their homes

There are an increasing number of children with complex and continuing health needs. The aim is that wherever possible they and their families should be supported in a way which enables them to remain at home. A part of achieving this aim is increasing the competence and confidence which nursing staff have to provide such support. This paper reports on a pilot placement for preregistration nursing students focused on supporting children with complex needs in their homes. The major findings were that such a placement can be extremely beneficial in enabling students to develop practical skills and attitudes and values which will assist them to provide appropriate support. It also clarified some of the major organisational and practical issues which must be considered in facilitating such placements.     

Application of Signs with Speech in the Parent Infant Training Programme for Young Cerebral Palsied Children

This has been a pilot study using signs and speech based on the Makaton Vocabulary. It involves one group of the Parent Infant Training Programme at the Queensland Spastic Welfare League, consisting of four cerebral palsied non-verbal children. It was instigated following non-achievement of expectations using a traditional therapy approach. There has been ongoing assessment, including a video in July. As a result of the success of the programme to date there has been an extension of the aims and new initiatives have evolved.     

ADAPTIVE FUNCTIONING AND BEHAVIOUR OF CHILDREN WITH SPECIAL NEEDS: COMPARISON BETWEEN ETHNIC GROUPS

This study investigated the relationship between behaviour and adaptive functioning in 70 children of 5–16 years of age with special needs from three ethnic groups who lived in an urban health district. Parents were interviewed and completed the Vineland Adaptive Behaviour Scale (VABS) and the Aberrant Behaviour Checklist (ABC). The most pronounced developmental deficits were found in communication and daily living skills. Two-thirds of the subjects were rated as having a moderately severe behaviour problem on at least one item of the ABC. Asian children presented slightly more difficulties in communication, and Afro-Caribbean children did better than the other children on all domains (though this was not statistically significant). In addition, European children were rated significantly higher than the other two groups in the behavioural scales of hyperactivity and inappropriate speech. Within the whole sample, domains of adaptive functioning, particularly socialisation, were negatively correlated with behavioural problems. Inappropriate speech, as rated by the ABC, was associated with developmental delay on all three VABS domains.     

Using MINSPEAK: A case study of a preschool child with complex communication needs

Young children with complex communication needs require the best possible start to their educational lives, and for some, this will involve the use of communication technology supports and collaborative teams. This case study describes the outcomes of a pilot investigation that utilised MINSPEAK as a means of enhancing emergent language and literacy skills in a young girl with a range of participatory challenges. Results indicated that when family members and educational teams work together, it is possible to achieve important progress in early language skills using relevant software, systematic teaching and an accessible speech generating device (SGD). The implications of this modest case study are discussed in terms of innovative practice amongst collaborative alternative and augmentative communication teams.     

Effects of Training with Total Communication or Cued Speech on Language Comprehension in Hearing-Impaired Children

Twenty-five hearing-impaired children from two educational centres were assessed on their oral comprehension and word recognition performance. Fifteen children had been trained by the cued speech method, and ten had been trained by total communication. Chronological age and oral comprehension age were significantly more highly correlated for subjects trained by total communication than for those trained by cued speech. Chronological age and word recognition skills were also significantly more highly correlated for subjects trained with total communication than for those trained with cued speech. These results were discussed in the light of recent findings suggesting that, compared to the oral method aided by a partial manual supplement, the total communication method leads to better performance by hearing-impaired children on language comprehension tasks.     

'Joined-up working' between early years professionals and speech and language therapists: moving beyond 'normal' roles

This paper draws on research conducted for the Nuffield Foundation (<citeref rid="b28">Mroz et al., 2002</citeref>) which looked at the knowledge, skills and confidence of early years professionals in relation to young children's speech and language development. Key findings from the project are reported in relation to the efficacy of initial and post-qualification training in preparing professionals for the identification and support of children with communication problems. The discussion centres around early years practitioners' experiences of working with speech and language therapists and the needs which they expressed, both for inter-professional training and for modes of working together.     

Pilot student placements with children with complex needs

Enabling the increasing population of children with complex and continuing health needs to live at home with their families is generally considered the ideal approach. Services for children with complex needs are commissioned from a wide range of providers, including the private and voluntary sectors. Pilot placements for two student nurses with a private company that had a significant caseload of children with complex and continuing needs were evaluated as a way of enabling student nurses to develop knowledge and skills in this field. The objective was to increase understanding of the issues involved in facilitating this type of placement and to develop placements in line with the findings. Semi structured interviews with students and mentors were used to generate evaluative data. The placement was well evaluated by all parties. Students gained important clinical skills but also appreciated in greater depth the humanistic needs of children, young people and their families. Advantages of working with a company whose focus is the provision of complex care at home included variety and continuity in the placement and a greater number of families across whom the students can be spread to avoid excessive or constant intrusion. Such placements can offer valuable learning opportunities, however, ongoing development and evaluation of placements is needed, particularly as these are predominantly based in family homes.     

Hardship, dedication and investment: an exploration of Irish mothers commitment to communicating with their children with cerebral palsy

This qualitative study investigated the experiences of mothers who have a child with communication difficulties resulting from cerebral palsy (CP). There is a dearth of information about parents' experiences of having a child with CP and communication difficulties. Three participants, whose children had moderate or severe CP and communication difficulties, were recruited from a voluntary organization. Participants were interviewed using an in-depth, semi-structured interview guide. Interviews were audio-recorded, then transcribed and subsequently analysed using Grounded Theory methods. Five main themes emerged, combining to form the core category of mothers dedicating their attention to their children . The information gleaned from this study could have important implications for nurses involved in facilitating communication, including speech and language therapists, occupational therapists and registered nurses. By becoming more aware of the experiences of parents with a child with CP and communication disorders, nurses may be better able to plan and implement therapy and also support communication aims. The study concludes with a discussion of further research avenues, suggesting that a study investigating the experiences of parents of children with other types of physical disabilities affecting communication should be conducted to determine the similarities and differences of parents of children with other kinds of disability. A similar study with a larger sample could be conducted to validate the findings of the current study.     

Relations Between Activities and Cooperative Playground Interactions for Preschool-Age Children with Special Needs

The playground is a setting wherein teachers, therapists, and early intervention specialists may facilitate the inclusion of children with special needs. For this study, the relations among cooperative interactions of children with and children without special needs in groups of only typically developing peers, in groups of only peers having special needs, and in inclusive groups, as well as the complexity of the activities in which they were engaged were investigated. Complex activities were those involving fine motor skills as well as higher levels of cognitive, social, and language abilities. The associations among child and program level factors and the children's involvement in different cooperative activities also were examined. Findings indicated that children with and children without special needs were likely to engage in cooperative play only with other typically developing children during complex activities (e.g., playing with small toys in the sand or talking). Results also indicated that children with and children without special needs tended to engage in cooperative play in inclusive groups (composed of children with and children without special needs) during less complex or low-demand activities involving predominantly gross motor skills (e.g., sliding or running). Interventions are needed to facilitate involvement of children with special needs in complex activities on the playground. This is an important area for future research and educational practice efforts.     

Children's views of communication and speech-language pathology

Children have the right to express their views and influence decisions in matters that affect them. Yet decisions regarding speech-language pathology are often made on their behalf, and research into the perspectives of children who receive speech-language pathology intervention is currently limited. This paper reports a qualitative study which explored experiences of communication and of speech-language pathology from the perspectives of children with speech, language, and communication needs (SLCN). The aim was to explore their perspectives of communication, communication impairment, and assistance. Eleven school-children participated in the study, aged between 7-10 years. They were recruited through a speech-language pathology service in south west England, to include a range of ages and severity of difficulties. The study used open-ended interviews within which non-verbal activities such as drawing, taking photographs, and compiling a scrapbook were used to create a context for supported conversations. Findings were analysed according to the principles of grounded theory. Three ways of talking about communication emerged. These were in terms of impairment, learning, and behaviour. Findings offer insight into dialogue between children with SLCN and adults; the way communication is talked about has implications for children's view of themselves, their skills, and their participation.     

Children's views of communication and speech-language pathology

Children have the right to express their views and influence decisions in matters that affect them. Yet decisions regarding speech-language pathology are often made on their behalf, and research into the perspectives of children who receive speech-language pathology intervention is currently limited. This paper reports a qualitative study which explored experiences of communication and of speech-language pathology from the perspectives of children with speech, language, and communication needs (SLCN). The aim was to explore their perspectives of communication, communication impairment, and assistance. Eleven school-children participated in the study, aged between 7–10 years. They were recruited through a speech-language pathology service in south west England, to include a range of ages and severity of difficulties. The study used open-ended interviews within which non-verbal activities such as drawing, taking photographs, and compiling a scrapbook were used to create a context for supported conversations. Findings were analysed according to the principles of grounded theory. Three ways of talking about communication emerged. These were in terms of impairment, learning, and behaviour. Findings offer insight into dialogue between children with SLCN and adults; the way communication is talked about has implications for children's view of themselves, their skills, and their participation.     

Supporting the communication, language, and literacy development of children with complex communication needs: state of the science and future research priorities

Children with complex communication needs (CCN) resulting from autism spectrum disorders, cerebral palsy, Down syndrome and other disabilities are severely restricted in their participation in educational, vocational, family, and community environments. There is a substantial body of research that demonstrates convincingly that children with CCN derive substantial benefits from augmentative and alternative communication (AAC) in their development of communication, language and literacy skills, with no risk to their speech development. Future research must address two significant challenges in order to maximize outcomes for children with CCN: (1) investigating how to improve the design of AAC apps/technologies so as to better meet the breadth of communication needs for the diverse population of children with CCN; and (2) ensuring the effective translation of these evidence-based AAC interventions to the everyday lives of children with CCN so that the possible becomes the probable. This article considers each of these challenges in turn, summarizing the state of the science as well as directions for future research and development.     

Elementary-aged children's aesthetic experiences with music

This study examined the perceived aesthetic experiences of elementary school children. Sixty 4th graders, from 3 intact public school classes that included students identified as gifted and with special needs, listened to 'Rhapsody on a Theme of Paganini, Op. 43, Variation 18,' by Rachmaninoff and simultaneously indicated responses by manipulating a Continuous Response Digital Interface (CRDI) dial. One week later, participants repeated the listening activity under identical experimental conditions. As in similar studies with adults, aggregated graphic analyses showed that many of the children's highest and lowest reactions tended to cluster at the same places, and test-retest reliability showed a high positive correspondence between the two listening sessions (r = .99). Although it is impossible to know if these 4th graders actually had aesthetic experiences, it seems clear that they did respond to this music. It was determined that 57 students, including most of those with special needs, successfully used the CRDI dial to indicate their reactions and 58 expressed comfort with the simplicity of its use. Additional analyses, which compared responses based on developmental statuses, found a wide range of correlations between children who were categorized as normally developing, gifted, or having special needs.     

Tantrums are Not Associated with Speech or Language Deficits in Preschool Children with Autism

Communication problems and tantrums are common in children with autism. It has long been postulated that lack of speech is a cause of these tantrums. The goal of our study is to determine if impaired speech is associated with tantrums in preschool children with autism. The relationship between language and tantrum frequency in 240 children with autism, 15 to 71 months of age was investigated. Children were administered standardized IQ and language tests, and mothers rated tantrum frequency and speech intelligibility on a 4-point scale on the Pediatric Behavior Scale. Verbal and nonverbal IQ, expressive and receptive language quotients and age equivalents, and speech intelligibility explained less than 3% of the variance in tantrum frequency. Children whose mental age was sufficient for verbal communication but who lacked speech did not have more tantrums than children with adequate speech. In fact, children with an expressive language age at or above 24 months had more tantrums than children whose speech skills were below 24 months. Our findings and those of others do not support the belief that preschool children with autism have tantrums because they cannot speak or because their speech is difficult to understand.     

The Heuristic Programme: A Combined Use of Sign and Symbols with Severely Mentally Retarded,Autistic Children

A method of teaching formal communication skills to severely mentally retarded autistic children is described and illustrated with two case studies. The programme employed graphic symbols and manual signs. One outcome of the programme was to suggest that the autistic children involved found the use of symbols in communication easier than the acquisition of signs. The strengths and weaknesses of the programme are discussed.     

Development and testing of the social capital scale for families of children with special health care needs

The purpose of this study was to develop and psychometrically test the Social Capital Scale for families of children with special health care needs. Researchers have suggested a link between social capital and health, however, psychometrically tested measures of social capital are not described in the literature. The Social Capital Scale (SCS) demonstrated internal consistency, stability over time, and construct validity (as evaluated through factor analysis, correlation with existing measures, and hypothesis testing). Five subscales provide insight into family strengths and areas for improvement related to their investment in relationships that support health. Use of the SCS will contribute to the establishment of consensus and precision in communication about social capital's utility and measurement in the population of families of children with special health care needs.