Gare) ; prejunsy fife) BOM MUNI CATION DIFFICULTIESCharlottes Story Charlotte is a little worried as she sets off for school. Although she likes school, she finds it really tricky. All the other children seem to do things so much better than she does. Charlotte's mum reminds her that she is just as clever and as able as the other children, it's just that she needs a little more time to know what she is doing. In the playground, some of Charlotte's friends are playing Mums and Dads. Charlotte likes to play but she can never make the other children listen to her ideas. This upsets Charlotte and sometimes she feels really mad! Today she thinks she will try to join in. “I mum," says Charlotte. The other children are confused. “You're not a mum, Charlotte," they say, laughing. “You're a girl, silly." Charlotte knows she isn't a mum, but is asking to pretend to be the mum. Charlotte often misses words out in her sentences and the children may misunderstand her. Charlotte feels cross and upset then. She is not silly and thinks the other children treat her as if she is.While Charlotte is with the other children, her mum talks to Mrs Judge, her class teacher. They talk about all the things that help Charlotte. Mrs Judge uses a choosing board as Charlotte may become confused if there are too many choices. The bell rings and everyone goes into class. Mrs Judge takes the register and calls Charlotte's name. All the children are supposed to say “Yes, Mrs Judge”, and this is when Charlotte starts to get worried again. “Judge” is a hard word for Charlotte to say and in the past some Children laughed when she said “Yes, Mrs Dudge." Now Charlotte has learnt to say just “Yes, Mrs J", which is much easier. The other children then copy that, which makes Charlotte happy. Today it is Show and Tell and everyone has brought in something to talk about. Charlotte feels funny in her tummy. She hates talking in front of lots of people. She worries that the others may laugh at her if she says the wrong words.Charlotte has practised for Show and Tell at home and with Mrs Lavender, her teaching assistant, so she will feel really confident when her turn arrives. Charlotte's mum has had a good idea. She has asked if Mrs Lavender can help remind Charlotte about what she wants to show and talk about by holding up little photos at the back of the class. Mrs Judge asks Charlotte to take her turn first. Charlotte likes being first as it means that she won't forget her story while listening to others in her class. As agreed, Mrs Lavender sits at the back of the class holding up reminder pictures to help her talk about the picture of her grandma at school. The other children don't even know Mrs Lavender is doing this, which makes Charlotte feel great. Charlotte finishes her story and feels really proud. When Charlotte listens to other children's stories she notices that she is not the only one who has difficulties in saying words. Becky says “sukar” instead of “sugar”, Tom says “lickle” instead of “little” and poor Isaac forgets what he is talking about completely and has to be helped by Mrs Lavender too. It makes Charlotte feel better, knowing that others get nervous when speaking in front of the whole group.Mrs Judge is really pleased with the children's efforts and tells everyone they can have 15 minutes of Golden Time today. After playtime, Charlotte needs to do her 1:1 work with Mrs Lavender. They have been working on her sounds. Mrs Lavender uses something called cued articulation. This is like a little sign next to your mouth, to help you know how to make the sound. Charlotte sometimes uses special colours too to help her remember each sound.Soon it is lunchtime and Mrs Bains, the midday supervisor, helps her decide what to have. Charlotte finds it difficult when there are many choices, so Mrs Bains offers her fish fingers or chicken pie. Se After lunch, Charlotte helps Mrs Lavender with jobs - it gives her the opportunity to work on her speech targets, and it's fun! Charlotte is asked to take a message to Miss Smith in year 2. “Can you ask Miss Smith for the paint cupboard key?” says Mrs Lavender. Before Charlotte sets off next door, Mrs Lavender takes her hand and says, “Paint cupboard key." Off Charlotte goes. She practises it over and over again in her head: “Paint cupboard key, paint cupboard key.” She likes it when people don't give her long instructions. Short instructions help her to remember. Charlotte delivers the message to Miss Smith and hurries back. She is pleased with herself when she gives the key to Mrs Lavender. Next Charlotte works on her colourful semantics sentence building. This helps her to remember all the important words in sentences. Charlotte loves her school work when she knows what she is expected to do.“You have worked really hard, Charlotte, and remembered all your sounds and colours. Soon it will be playtime. Go and look on the board to see who you will buddy up with this playtime,” says Mrs Lavender. Charlotte goes to the board and finds that Lucy's photo is next to hers for afternoon play. Charlotte loves playing outside with Lucy as she has lots of good games to play. After Golden Time, it is soon home time. Charlotte thinks about how well she spoke in Show and Tell. She feels more confident about doing it again next time. She has also had a great playtime with the other children and, best of all, she is going back to Millie's house for tea. Charlotte smiles to herself. Every day, she is more able to talk to her friends and talk in front of her class. She feels proud of herself.COMMUNICATION DIFFICULTIES Understanding terminology There are a number of specific communication difficulties with which your child may need help. These are divided into the following broad types. Phonological difficulties: Speech sounds develop in a clear developmental patie. Some children have difficulty in using the rules for making sounds. When children experience phenological difficulties, the sounds are stored incorrectly in their brain. Therefore the child may have stored "I" for "y", so “yellow” would be recalled as “lellow’ Many young children experiment with sounds and experience some earlier errors which they correct themselves. For other children the production errors stay, and they need to develop using the correct sounds through speech and language therapy. Articulation difficulties: When children experience articulation difficulties, the sounds are incorrectly produced physically. The child has difficulty in getting their lips. tongue, teeth and jaw in the correct place in order to produce the sound. skills developed in feeding are then used in speaking. Therefore if the child has, or continues fo have, messy eating habits or limited eating skills they may need to work on their oral placement skill. Oral motor/placement activities helo exercise the muscles used in speech and feeding. The development of oral placement skils involves using exercises which relate directly to speech production, and these can be very successful. An approach called Talk Tools founded in the, USA has made great steps forward possible. Alongside this, the Nuffield Dyspraxia programme and other such arficulation resources have developed seis of pictures fo helo with "driling” practice - repeatedly practising sound production with the child through speech and language therapy. ‘Comprehension difficulties: Comprehension means “understanding”. Whenchildren experience comprehension difficulties, they are having trouble in understanding language, whether that is single words or longer sentences. Assessments can be used to evaluate exactly how many words your child understands and how many words they can understand in sentences. Categories are broken down into size concepts (big andilite}, location concepts (in, on, under), adjectives (fast, shiny, smooth} and pronouns (|, you, he, she, him, her) as examples. if the child has difficulty in understanding a concept, they will not be able to use (say) the concept either. The ability to understand always develops before the ability to use these concepts in speech. Expressive difficulties: When children experience difficulties with the expression of language, they are having difficulty in using words or sentences to say what they want to express. Assessments can evaluate which concepts a child knows how fo say and which ones need more work. Language is used for commenting, greeting, questioning, reasoning and negating, and the child needs to have all of these skils in place to interact confidently using spoken language. Attention and listening: in order 1o develop a good understanding of lenguace, the child must develop the abliity to listen and attend. This means that they will be able fo recognise that information is important and that sentences which an adult says to themneed to be understood and perhaps acted upon. Children develop concentration through play and through tun faking. Therefore as parents you have often started to develop this skill in your child without realising It. f your child has problems in this area, they are likely to have speech sound and/or language difficulties and they may be missing what is being said to or asked of them. Somechildren have glue ear when they are toddlers; itis important to rule out the possibility that your child has that or any ofher hearing ciffcuity which f hindering ther speech and languoge development. Vital signs that may indicate a hearing problem include not responding fo th ir ame, turning the TV up and/or standing too close fo it, as well as not understanding what is said when they are not making eye contact with you. erficulation therapy and phenological therapy to help them, Some ehileren may experience moter dyspraxia at the same fime, affecting their coordination and organisation stily Ones May experience one or the other. Pysfivent speech: When children experience dystiuency (stammer/stutter), the sounds or words may become “stuck” and they may repeat a sound of a word or miss them oof altogether. Research has found that a combination of reasons affect a child who is dysfloent Cerner ones are discrete environmental pressure (pressure of time, competion 10 speak. interne Bressure placed on themselves (getting it wrong) and mistiming of the speech musculature foctalcommunication diffcullies: When achikiexperiences diffcuity withsocialcommunicetion, 1ney May hove the folowing problems: tugging with verbol and non-verbal language felts fgead Pody language and facicl expression, dficully in making eye contact, sincaging fo sigy on topic when they speak, faire to realise when they have lost the listener's arena Giffculty in fepating a conversation when it breaks down, and struggling to understand nice A speech and language therapist can work with a number of resources such as the Talk: Aboat and the Social Use of Language Programme (SULP} fo target areas of social commuricction and help your child improve in these areas, How can you help? KF you have concems about a child's communication, it is essential that the child hes an casessrment from a speech and language therapist. This will help to determine precisely which Parts of the child's communication are delayed and how you can support the child, Speech andlanguage therapists willalso establish whether they need to workon the foundations ef communication - such as attention, listening and understanding of language - in ore: thet You can support the child in learning fo use language. 10What programmes can be used? if a child has been assessed, the speech and language therapist will advise on which approaches may be useful. The following programmes of work may be used, depending on the area(s} of difficulty experienced by the child. The list should be helpful when you are speaking toa therapist, who will be able to inform you if any of these approaches would be appropriate for your child. Colourful semantics to support sentence building: This approach uses coloured boxes and corresponding photos to support the child in sentence building. This helps not only to develop key words in the child's sentences but also the grammatical joining words such as “the”, “and”, “in the” and “by the”. The programme helps children’s spoken and written language ‘and provides a motivating method fo support them in achieving this. Contact Daisy Kits for information, Cued articulation to support literacy and production of speech sounds: This approach makes use of a set of signs to represent the place, voice and manner of the spoken sound used by the child. In this way the child uses kinesthetic learning, which means that they are calling upon more than one sense fo help produce sounds. The system also has a colour-coded version which allows children to mark letters in theirreading and writing. This helps them become better at reading, spelling and writing. Contact Cued Articulation and Thrass. Symbols and visual communication systems: Examples are Boardmaker and Communicate in Print. Many symbol systems are available to help parents and schools make small pictures to support children in understanding spoken instructions. These allow you to make visual timetables, reward charis, activity sheets and much more. Sign systems: These include Makaton, Signed Support English and Signalong. These signing systems focus on the words rather than the individual sounds in speech. They ensure that the child's language is stl developing even if their speech productions poor at the time. There isno evidence fo suggest that signing with your child prevents spoken language from developing. On the contrary, bables who use signing can offen communicate their needs earller than others. Contact Makaton and Signaiong Language programmes to support social skills: Examples are Talk About ond Social Use of Language Programme (SULP}. These programmes help to break down and teach the rules of good social communication - such as turn taking, staying on topic and checking listener feedback. The programmes can be used for individuals and for group sessions. Other language programmes: These include Language Steps, Rhodes to Language and CLIP sheets. There are many published language packs that therapists can provide that will enable parents and teachers to work on specific aspects of language, such as pronouns: he/she/it/ wer/theit/them. Contact Stass Publications. Speech sound programmes: For example, the Nuffield Dyspraxia programme and Black Sheep worksheets. There are several speech sound programmes which therapists use to target speech sound production. Often the therapists will adapt support fo make use of the phonics programme the child is using in school too, such as Jolly Phonics. Oral placement programmes: These include Talk Tools. For some children speech sound difficulties are linked to the physical inabiity to produce sounds. Others cannot store the correct sounds in their head and therefore use the wrong sound. Talk Tools helps children to use the Positions needed in feeding to develop the positions needed in spoken language. If a child's oral placement skill are not established in feeding, there is likely to be a knock-on effect in their speech production.How can | access a speech and language assessment? Parents no longer need to go to their doctor or heath visitor in order to seek support for their child; most speech and language therapy departments now presently run an open referral system. A child may be referred by their parent fo the local NHS speech and language therapy department free of charge. It you type the words “referring a child for NHS speech and language therapy in [county]", into a search engine, that will take you to advice about your local health service facilities and systems. There is no age requirement for a referral; you can refer a child as soon as you have concerns. The earlier the child can be assessed, the better. After referral, you should receive notification in the post about when your assessment will toke place. There is also the option of finding an independent speech and language therapist. It is likely that they will be able fo see you sooner and offer the same therapists throughout your child's therapy sessions. A list may be obtained from the Association of Speech and Language Therapists in Independent Practice (ASITIP). How can help be given in the classroom? There is no doubt that some strategies used at home and in the classroom have « great impact Inhelping the child develop their language and communication skills. Here is alist of suggestions. Try to keep your language simple: Be sure to use the most important words when giving an instruction so that the child understands what is required. For example, say “Leroy, write the date in your notebook" rather than "You should put the date down firs." Avoid long sentenc freak Up what you say into chunks. Use the child’s name and make physical contact to ensure you have their attention: You could make a tap on their arm. Don't repeat instructions in a different way: If they have not understood the first time, they may simply need time to process the information you have given. Wait and say the same thing gain if necessary. Allow time for processing: Children with speech, language and communication difficulties may jake twice or three times as long to respond, but they will usually respond. They need to know that you will be understanding and patient. Help with “crowd control”: The child needs to be able to establish when to contribute and ensure others won't interrupt. is their turn Ensure there are clear class rules: These should cover good listening, turn taking and speaking. Try not to let other children speak for them: Also avoid letting other children answer their questions. Ensure that you are focused on the child when giving instructions: Avoid multitasking as this will distract them from the instruction. Ensure that the child is focused on you when you are giving instructions: Do be aware, though that some children will need to use sensory fdgets to help them focus. 12Be explicit when giving instructions: For example, don't use words with double meanings (such as “break’ and "brake" when talking about having a break or needing to brake). Tellthe child what you wantthem to do rather than what you don't wantthemto do: An instruction such as "No tunning" may be heard as "Run" by the child with communication cifficutties Another example is that you should say “Listen to me” instead of "Please stop talking.” Use a range of methods fo get the message across to the child: Hold up related objects, show photos, do the actions, use a sign. Any Way and every way should be used to help you to ‘access their leaming style. Deal with selective mutism: Some children find il very difficult to talk at school. If a child has not spoken at school for two weeks, act before the problem becomes entrenched. Make a referral to the child's therapy team if appropriate, or contact ihe Selective Mutism Information and Research Association (SMIRA) ‘Make the opportunity to explain to the whole class that some children may have difficulties: Point out that some children may have problems in following instructions, saying words, and sitting and listening, but they are important members of the class. All the children are to be kind ‘and considerate to each other. Pair children who will support each other's skills: Don't always pair the most able with the most needy as this may create too much of a contrast for the child that is struggling. Use buddy systems in the classroom and playground: These help fo build up the confidence of less able children, Try to be consistent in your teaching systems: Avoid swapping in and out of phonic systems - stick to one that the child is confident with. Ensure that the parents know your shategies/approaches for teaching maths and literacy: This information avoids the child becoming confused between home and school. Use a home-school diary: Feed back information between home and school. Use video cameras to record children completing activities: This can provide a useful baseline for teaching staff, and also a useful way to feed back to the child and the parent about things you have observed (positive and negative] Use visual systems in the classroom: Choice boards, visual timetables and buddy boards are all very useful in aiding children’s understanding and memory. Visual prompts remain when spoken words are gone within seconds. Speech and language activities need to be completed litfle and offen in order to have an Impact: Be sure to ask your speech and language therapist to demonstrate programmes of ities, so that you and the child's parents feel confident in carrying them out. concerns about a child's speech and language development as soon as you note them: Waiting is not going to help the child catch up. Its better to access services and get advice as early as possible. Usten fo parents’ concerns about their child's speech and language development at home: The child offen presents differently at home from at school. 13hitp://Awww.afasicengland.org.uk/ Association for Research into Stammering in Childhood: hitp:/Avww.stammeringcentre.org/ Association of Speech and Language Therapisls in Independent Practice (AST): hitp:/Awww.helpwithtalking.com/ Brilish Stommering Association: hitp:/www.stammering.org/ Dysprexxia Foundation hitte://www.dyspraxicfoundation.org.uk/ Hearing Link hitp://www-hearinglink.org/ Independent Parental Special Education Advice http://www ipsec.org.uk/ Royal College of Speech and Language Therapists: hitp://www.resit.org/ Selective Mutism Information and Research Association (SMIRA|: htfp://www.smira.org.uk/ Useful websites for resourcing Special Direct: For a wide range of special needs equioment for therapists, schools and parents: hitp://www.speciaidirect.com/ Black Sheep Press: hitip://www.blacksheeppress.co.uk/ Boardmaker: hitp://www.mayer-johnson.co.uk/ Communicate in Print: hitp://www.widgit.com/products/inprint/indexhim Cued Articulation: http://www. thrass.co.uk/cuedarticulation. htm Daisy Kits: http://www. daisykits.co.uk/ Integrated Treatment Services: hitp://www.integratecireatments.co.uk/ Makaton: hitp:/www.makaton.org/ Nuffield Centre Dyspraxia Programme: _htfp://www.ndp3.org/ Signalong: htip://www.signalong.org.uk/ Social Use of Language Programme: http://www.wendyrinaldi.com/wr-sulp-u.him Speech-language therapy.com - Caroline Bowen: hifp://speech-language-therapy.com/ Stass Publications: hife://www.stasspublications.co.uk/ Tolk About: http://www.alexkelly.biz/ Talk Tools: hitp:/Awww.talktools.com/ 14as LP Gharlotte has COMMUNICATION DIFFICULTIES STORIES FOR SPECIAL CHILDREN by Alison Harris and Sarah Davis A collection of stories to address special needs. Each book contains a descriptive story about a child who has a specific difficulty. The story aims to reassure the reader that they are not the only child who has these issues, and highlights areas of need for the adult who shares the book with the child. The second section of each book contains valuable information and suggested methods of supporting these children and enabling them to develop their potential. Other titles in the series include: © Katie has AUTISM ‘= Jackhas ASPERGER’S SYNDROME Matilda has TOUCH SENSITIVITY Daniel has DYSPRAXIA __ James has SENSORY PROCESSING DISORDER __ Thomas has DYSLEXIA _ Andrew has ADHD