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