Communication Counts

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Communication Counts
September 2011
Social Use of Language
and Anger Management
Catherine Webster
Senior Educational Psychologist
Conwy Educational Psychology Service
Agenda
• Background
• The relationship between social use of language and
behaviour
• Popular approaches to behaviour and ‘anger
management’
• Potential difficulties with these approaches
• The multi-element plan
• Future plans
Background
•
Number of children with language difficulties being referred to Social
Inclusion Service.
•
Number of children with language difficulties attending Pupil Referral Units.
•
Number of secondary age pupils identified with ESBD subsequently being
recognised as having language difficulties.
•
Not responding to range of behavioural/anger management focused
interventions.
•
Why?
•
What was working and looking for alternatives.
The relationship between social
use of language and behaviour
•
Approximately three quarters of children with identified emotional and
behavioural difficulties have significant language deficits.
•
Approximately half of those with language disorders have identifiable
emotional and behavioural difficulties.
•
The prevalence of language deficits in children who exhibit anti-social
behaviours is ten times higher than in the general population.
•
The strength of the association between language difficulties and anti-social
behaviour increases with age.
•
Difficulty in initiating and maintaining interpersonal relationships is a
key mediating variable between language disorders and antisocial
behaviours.
Taken from Southwark NHS website
Specific difficulties impacting on
behaviour
• The Communication Chain (Elklan)
• Abstract language/questions
• Blank Levels
• Pragmatic Skills
The Communication Chain
Understand the meaning – literal
and non-literal
Have ideas and decide what
to say
Choose words
Understand sentence
structure
Choose appropriate sentence
structure
Understand words
Select the sounds
= phonology
Remember
= auditory memory
Coordinate instructions to
the speech muscles
Listen/hear
Interpret non-verbal
communication
Articulate sounds
Speak fluently
Look/attend
Self monitor
Speak appropriately
Adapted from Elklan © Liz Elks and
Henrietta McLachlan
Expressive Language
Receptive Language
Understanding of abstract
language/questions
• Where? – Positional language
• When? – Temporal language
• What? – Naming; descriptive language; making predictions; problem
solving
• Who? Which?- Naming; descriptive language; making choices
• Why? - Justification
• How? – Making an inference
Blank Levels
• Level 1 – Matching perception; naming things
• Level 2 – Selective analysis of perception; describing
things, answering who? what? where?
• Level 3 – Reordering perception; talking about stories
and events
• Level 4 – Ability to solve complex and abstract verbal
problems; solving problems and answering why?
questions
Blank, Rose and Berlin (1978)
Blank Levels cont.
• 60% of 3 year olds understand level 1 and
level 2 questions.
• 65% of 5 year olds understand level 3 and
4 questions.
Adapted from Elklan © Liz Elks and Henrietta McLachlan
Pragmatic Skills
• Attention and listening
• Non-verbal communication
• Awareness of the needs of the listener
• Turn-taking
• Reduced opportunities to interact and learn how
to socialise
The focus of many popular
approaches to behaviour and
‘anger management’
•
Often reactive
•
Language ‘heavy’
•
Expectations of pre-existing skills such as planning, inference, self-talk etc
•
Assume general or consistent cognitive, language and emotional
developmental levels
•
Focused specifically on skill development – do not always consider context
•
Often not elective
•
Bias towards boys
•
Group focused
Why may these not be appropriate
for children with social use of
language difficulties?
•
Interventions aimed at chronological age or cognitive ability may not take account of language
difficulties.
•
Children/young people may not have the pragmatic skills required to have positive access to
group work
•
Organisation of groups often focus on peer groups – language levels may be significantly different
•
Often assume language skills at Blank Level 3/4 – activities therefore too complex
•
Often assume language of emotions is already present
•
Targets are usually represented in language – these may never have been fully understood
•
Generally focus on the importance of the child/young person having the opportunity to express
their own feelings about and interpretation of an event, and being involved in target setting and
agreeing rewards/sanctions. Very difficult for the child with language difficulties without a high
level of differentiation and modification.
•
Focus on the individual or group without considering context/environmental factors.
The support triangle/hierarchy
Individual/specific
support
Group support
Environmental strategies
The ‘multi-element plan’ model
• Idea originated as a plan to support children/young people with
behavioural difficulties, (courtesy of the University of Manchester).
• There are three parts to drawing up an adapted multi-element plan
for children/young people with language and behaviour difficulties.
• 1: We try to understand the function of the problematic behaviour.
• 2: Agree clear targets for skill development, and strategy targets for
those supporting the child/young person.
• 3: We think about four types of strategy which we can use to support
the child or young person.
Multi-element plan strategies
• Environmental strategies
• Skill development strategies
• Reward and praise strategies
• Strategies for responding to difficulties
Forming the plan
• Seek the child/young person’s views
• Carry out a simple functional analysis
• Agree clear targets for those supporting the child/young
person
• Agree clear targets for skills development
• Draw up environmental strategies
• Draw up skill development strategies
• Agree reward and praise strategies
• Agree strategies for responding to difficulties
• Summarise the main actions
• Review
Pupil interviews
• Use their own language
• Encourage them to think of their behaviour as an
‘external’ thing
• Use visuals for understanding functions of behaviour –
‘most/least like me’
• Use visuals for understanding what is most/least
important about the environment.
• Responding to difficulties cards
Functional analysis
• Speech and Language assessment
• ABCC charts/STAR
• Full functional analysis
ABCC Charts
Date/Time
Antecedent – Who
was present? What
events occurred?
Please give facts.
Behaviour – What
did you observe your
pupil doing?
Consequence –
What happened after
the incident as a
result?
Communication –
What is the
behaviour trying to
communicate?
SETTINGS:
Environmental or personal
RESULTS:
What happens-
STAR
for the child?
ACTION:
Observable behaviour
TRIGGERS:
What sets it off?
Target Setting
• Environmental – targets for those
supporting the child/young person
• Skill development – targets for the
child/young person (these can be divided
into language skill development and
Environmental strategies preventative
•
•
•
•
•
•
•
•
•
•
•
•
•
Language Friendly classrooms/ environment
Elklan training for staff
More specific language training for staff
Shared communication style
Shared understanding
Shared problem solving/solution finding
Nurturing schools’ philosophy
Nurture Groups
Narrative as a classroom ‘theme’/integral to literacy teaching
Visuals
Classroom organisation
Close liaison with SLT
PATHS and SEAL
Skill Development Strategies
• Group
• Individual
Group interventions
• Narrative Groups
• Targeted Language Therapy Groups (as advised by
Speech and Language Therapy Service)
• Social Use of Language Groups
•
•
•
•
•
Nurture Groups
SocialEyes
Talkabout materials
Unearthing Boxes
Think Good, Feel Good, Be Positive
Individual interventions
• Individual language therapy (as advised by Speech and Language
Therapy Service)
• Individual Communication Plan
•
•
•
•
•
•
•
•
•
•
Social Stories™
Comic Strip Conversations
Cognitive Behavioural Therapy
Role Play/Puppets
Individual PATHS interventions
Time Out
Art Therapies
Worry Book
Play Therapy
Bibliotherapy
Strategies for Responding to
Difficulties
• Group
• Individual
Group interventions
•
•
•
•
Circle of Friends
Circle Time
Cognitive Behavioural Therapy
Personal Construct Psychology
interventions
• Solution Focused Therapy
Individual interventions
•
•
•
•
•
Comic Strip Conversations
Visual prompts/situation ‘grids’
Role Play
Cognitive Behavioural Therapy
Personal Construct Psychology
interventions
• Solution Focused Approaches
• Time Out
Example multi-element plan
Adapted from information given by the University of Manchester
Multi-Element Plan (MEP)
Child’s Name:
Date of Birth:
School:
Date:
Behaviour Analysis – Here, we are trying to identify and understand something about the child’s behaviour
Strengths
Main Concerns
Behaviour
Functions
“I…” Messages
2.
Target Setting
Targets for Support Staff/Parents & Carers
Targets for Child/Young Person
3. Strategies to support the pupil
Environmental Strategies – support around the child
▪Physical Environment
▪Social Environment
▪Teaching & Curriculum
▪Meeting Basic Physical and Emotional Needs
▪Some Preferred Activities
Skill Development
Building on strengths and interests
Addressing areas of difficulty
Functionally Equivalent Skills
Coping Skills
Praise / Reward strategies
To acknowledge improvements
For a gradual reduction in the behaviour causing concern
For the absence of the behaviour causing concern
Responding to Difficulties
Early Active Strategies
Reactive strategies
Post-incident support
for pupil
for adults
(You may wish to complete or refer to a Risk Assessment)
Review of MEP
Enter here the date that the MEP is to be reviewed……/…/…………………..
Who is to be involved in the review?
MEP completed by ………………………………………………………………… Date …………………….
Signature……………………………………………………………
Future plans
• Pilot the adapted multi-element plan
• Evaluate and review the adapted plan
• Continue to create a bank of appropriately
differentiated resources to support the plan
• Make amendments to the adapted plan
Questions
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