Child Speech & Language Development

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    • 00:01

      [MUSIC PLAYING][Child Speech & Language Development]

    • 00:09

      RACHEL TANG: My name is Rachel Tangand I work at I CAN Meath School as a speech and languagetherapist. [Rachel Tang, Speech and LanguageTherapist, I CAN Meath School]

    • 00:15

      JENNIFER COOK: My name is Jennifer Cookand I work at I CAN Meath School, as well,as a speech and language therapist.[Jennifer Cook, Speech and Language Therapist, I CAN MeathSchool]

    • 00:21

      RACHEL TANG: From this film, I thinkthat students will probably get the idea of how we, as speechand language therapists, work in a specialist speechand language school, the different types of disordersthat they might get, such as autistic spectrumdisorder or SLI, which is specific language impairment.

    • 00:41

      JENNIFER COOK: And you might get to see some of the approachesthat we're using with the children, someof the collaborative working that we do,the way that we work across the school day,and an idea of some of the specific interventionsthat we're using.[What does a speech and language therapist do?]

    • 00:59

      RACHEL TANG: We work with a rangeof children and adults on their communication difficulties,as well as their eating and drinking difficulties.We assess and we diagnose and then from diagnosing,we are able to tailor our interventions and programs.Listening first.

    • 01:18

      ALESSIO: Yeah.

    • 01:19

      JENNIFER COOK: OK.Can you put Mr. Tumbles, oop, oop.The main thing is for them to be able to communicatefunctionally in the wider world.We also work very closely with teachers of the healthprofessionals, such as nurses, doctors

    • 01:39

      JENNIFER COOK [continued]: educational psychologists, and within workingas a collaborative team, we are able to tailor that therapyfor the children to progress.So some therapists will be clinic basedand work very much with the parentsand some will work in mainstream schools.Here, at I CAN Meath School, we work within the classrooms,specifically with one class group supporting the children

    • 02:00

      JENNIFER COOK [continued]: with their targets.It's a very collaborative approach,which means that you can actuallyhave your therapy targeted to support the curriculumand make sure the children make the maximum progressthat they can overcoming their barriers to learning, whichin this school would be their speech and language.[What are the specific approaches for the children?]

    • 02:22

      RACHEL TANG: It's important to know what a child'stypical development is.A child can have delayed development,which is where their development is goingat a normal developmental patternbut obviously, at a later stage.Or a child can have a disordered development,which means that their pattern of development is atypical.By knowing whether a child has got delayed development

    • 02:45

      RACHEL TANG [continued]: or disorder development, you can thentailor that and your intervention.

    • 02:49

      JENNIFER COOK: So there's a range of thingsthat we'd be looking at in the children.So some children we work with will have social communicationdifficulties and that's a lot about the motivationto communicate.So that would fall into things like the autistic spectrumdisorder.Then you're looking at making them moreinterested in communication.You have children who have difficultieswith attention and listening.So you would focus on that for some children,

    • 03:10

      JENNIFER COOK [continued]: and that might be their main barrier.Some children would have difficultieswith receptive language.So the understanding of language and them actuallybeing unable to understand what's said to themwill be the thing that they're finding the most difficult.Whereas other children will have difficultywith expressive language, actually using their language,building sentences.And in that bit, that's where the alternative

    • 03:30

      JENNIFER COOK [continued]: and augmentative communication aidsand different ways to support their communicationwould come in.And then also there's the clarity of their speech.So we'd been looking at how they're producing the soundsand whether it's to do with their motor skillsand they can actually articulate the soundsor whether it's more to do with that it's a developmental delay

    • 03:51

      JENNIFER COOK [continued]: in their speech production.So all of those things you need to look at the childand work out which things they're having difficulty with,and for some children it would be multiple things.And then on top of that, they'd haveextra associated difficulties.So you would assess and find the right areaand then whether they're disordered or delayedwould impact on what you pick first.So all those things are very importantfor the particular child.

    • 04:12

      JENNIFER COOK [continued]: And then on top of that, their personalitieswill guide you in the way that you approach the therapy.So some children will need somethingthat's presented in a much more sort of fun way.The therapy might need to be a little bit more hidden in gamesor certainly supported by games, whereas other children mightbe able to sit down and just do their therapyand really enjoy wanting to learn and not need

    • 04:35

      JENNIFER COOK [continued]: quite so much coaxing.[What is a typical day?]

    • 04:43

      RACHEL TANG: You never know when a child comes inand how they're going to be whether they'vehad a good night's sleep or if something happened on the wayhere, that could all affect how they are in the day.They're so quirky and sometimes they'llcome out with things that you wouldn't evenexpect them to come out with.

    • 05:01

      JENNIFER COOK: You get to be part of the whole school dayso you get to actually have the timeto interact with the children and that'swhere you see a lot of the progressthat they're making through what you're doing in one-to-oneand actually see that come out in them beingable to sort of show themselves and show their personalitiesand communicate things that they want,both to you and with their friends.

    • 05:18

      RACHEL TANG: Although we set specific targetsin one-to-one sessions in our room,it's nice to have that generalizedthroughout the school and in our other settingsas well, which is lovely to see.And we can work on things that mightbe more functional for them, you know, for example,in the dining room.

    • 05:34

      JENNIFER COOK: Well, there's a very structured timetableand the children obviously need thatbecause of their difficulties in understandingand use of language, they really relyon knowing what's happening next because otherwise,the world is quite confusing for them.But we have a lot of visual timetables and thingslike that that support with the structure.And within the school day, you'd have--you know, you'd obviously, come in and have registrationand then you might be doing some whole group work,

    • 05:56

      JENNIFER COOK [continued]: so sometimes speech and language therapists wouldbe supporting in the classroom, either supporting a teacher netgroup or running a group themselves.And then some of the time would be spent in the therapy roomsdoing one-to-ones or small group therapy.And then obviously, all of the break times and lunchtimesyou'd then be with the children, sort of eatingor out supporting them in their play.

    • 06:18

      RACHEL TANG: Looking at the timetable.

    • 06:20

      ALESSIO: Yeah.Even in an individual session, they'd need it structured.For example, with Alessio, he hasto have a specific visual timetable for himto know exactly what was going on in that sessionand what's expected of him and to knowwhen things are going to be finished and what's next.And a lot of the children do find that visual support

    • 06:41

      ALESSIO [continued]: quite helpful.[How do you involve parents?]

    • 06:49

      JENNIFER COOK: The parents here get quite a lot of timeto come in and see the children in the classroomsand come and see them working with the therapistso that they get a good idea of what's actuallybeing done with the child and how their child's progressing.And they get to input to the targetsand sort of let us know what they want to work on.I do think that is something that very often as a speech

    • 07:09

      JENNIFER COOK [continued]: and language therapist, if you're working in a clinicand possibly here, as well, from time to time,you do find yourself breaking bad news and particularly,a clinic, you may well be the first professionalthat a parent will see if they have a child with difficultiesand then you'd be the one to make the onward referralsto pediatricians or, you know, to other specialists,

    • 07:30

      JENNIFER COOK [continued]: allied health professionals.And so I do think that that is a skillto be able to sort of be supportive and understand wherethe parent is and make sure you areworking at the right pace for themto be able to accept their child's difficulties.[What is fundamental about how a child's language is acquiredand developed?]

    • 07:52

      RACHEL TANG: It is knowing what normal development isand from there, knowing whether it's a delayed or disorderedfrom what I've already spoken about before.

    • 08:01

      JENNIFER COOK: And that goes across all the different areasthat we talked about, so the social interaction,the attention and listening, the understanding, and the useof language and the speech.Not only the way in which we'd expect those to develop.So you would, for example, typicallywork on understanding before you work on expressionbecause a child should always understandmore than they can say but also within those,

    • 08:23

      JENNIFER COOK [continued]: whether or not they're disordered or delayedso that you know how to work within each area.

    • 08:28

      RACHEL TANG: And it's also important to knowthe characteristics of the specific disorders,such as specific language impairment or autistic spectrumdisorder and knowing what the difficulties liewithin those disorders.So then you're able to intervene appropriately.

    • 08:44

      JENNIFER COOK: I think it's underpinning theory,but then each child presents so differentlythat it's about pulling in that theoryand then sort of finding out or thinkingabout a particular child and how it presents in that childso no two children will be exactly the same.So although you have those underlying principles,it's then trying to see the similarities between children.[How do you put this knowledge into practice?]

    • 09:08

      JENNIFER COOK: The class groups are organizedby comprehension age decided by formal assessmentsof their understanding, so how they'regoing to actually access the curriculum within that classgroup, which allows us then to teach the childrenat the right level.The group that I work with is red class.So that's the lowest comprehension age of 18 monthsto about maybe 3 and 1/2.

    • 09:29

      JENNIFER COOK [continued]: There's a lot more class based workand I obviously, also put up one-to-one for thingsto support them with their language difficulties.We would use things like stories and lotsof over teaching of vocabulary to make surethat they've got the right vocabulary to be able to accessthe things that we're teaching.We try to title pick them together with a theme sothat they're getting the same vocabulary

    • 09:49

      JENNIFER COOK [continued]: and that's starting to generalize.And we use very visual and functional approaches.Snack time is a really good opportunityto get them to use their language to request.Storytelling is a really nice timefor working on their understanding of questionsand also their sequencing, their organization of language.We have to have photographs in the books for the children

    • 10:10

      JENNIFER COOK [continued]: because they don't retain what they've done in it.Without a photo in front of them,they can't really tell us.So they need things to be a lot morevisual than perhaps the children do further up the school.With phonics, we're looking at lotsof auditory discrimination, actuallythem hearing the difference between the soundsand recognizing, starting to make some thingswith the graphemes.[1:1 Sessions]

    • 10:33

      JENNIFER COOK [continued]: You come and sit down.What?Shall we show our best work?In the one-to-one sessions, we dotend to follow a particular pattern.They know that they come in, they sit down,they do their work, and they go and get their workfrom the drawers.Matthew, the little boy who was filmed,found it quite difficult to actually settle to the task.He is a child who needs short, sharp bursts of therapy

    • 10:56

      JENNIFER COOK [continued]: in any case.He finds it hard to focus for too long and loses motivation.In Matthew's session, we were actuallyworking on preparing him for usinghis computer, his AAC that you willsee him using in snack time.Drink Good.So we worked on him building a subject, verb, object phrase,and being able then to communicate it with sign,

    • 11:17

      JENNIFER COOK [continued]: but then that also transfers to him beingable to use that on his computer that he usesto communicate functionally.The sign is also very beneficial for him.It's another mode of communication.So it's about teaching those signsand teaching him to join signs to sort of communicatewhole sentences rather than just the single words.Matthew, at the moment, is nonverbal.So he relies heavily on his sign and his nonverbal communication

    • 11:40

      JENNIFER COOK [continued]: to be able to get his message across.Is she looking or waiting?Waiting, good.With William, we are working actuallyon his production of the words, as well.So his work is focused much more on high-frequency vocabularythat relates to the classroom.So some of the verbs that we were using

    • 12:00

      JENNIFER COOK [continued]: are verbs that we use in timetablebut they were also relating to places around the schoolso that he can tell us what he's been doingand what he's going to do.So we were using the sign but alsogetting him to start producing the right number of syllablesin words.And we would then look at trying to move onto getting the speech clarity a little bit further downthe line.And some of the words he is able to produce more clearly,

    • 12:22

      JENNIFER COOK [continued]: so we are working on the clarity a little bit more but the onesthat we were working on in that particular sessionhe was finding quite difficult. And thoughinitially, we had to work with him understanding those wordsand being able to find the right picture before we could moveon to him to producing them.So it's a combination with him.The sign is very useful for him and heis a very keen communicator.That tends to be his preferred mode, is a combination of sign

    • 12:44

      JENNIFER COOK [continued]: and spoken.So we're working on sort of building up his vocabularyand as a starting point, we've picked functional classroomwords.

    • 12:53

      ALESSIO: This is doing the stands in the hoop.

    • 12:56

      RACHEL TANG: Are you standing in the hoop?

    • 12:58

      ALESSIO: In front.

    • 12:59

      RACHEL TANG: Good boy.| work in blue class, which is the next class upfrom red class and the children in there vary in age from about7 to about 9 but their comprehension age,so their understanding of language,is from about 4 to about 5 years.Alessio has autistic spectrum disorder and he also has ADHD.

    • 13:22

      RACHEL TANG [continued]: Can you put the glasses in front of the bowl.A lot of his sessions need to be visual and structuredbecause of his autism.The session was specifically to teach the concept in front.He finds those abstract concepts quite

    • 13:42

      RACHEL TANG [continued]: difficult but with visual promptsand taking pictures of him around the schoolbeing in front of things and talking about thatand making it a much more practical session,rather than just sitting down all the time at desk,it becomes exciting and motivating for the childto learn a concept that they might not find that they

    • 14:04

      RACHEL TANG [continued]: can understand very well.So a lot of the sessions actually, especiallywith the younger children, they have to be quite motivatingand a lot of them have to be quite practical.When children get up to blue classthey are expected to sit for longer sessionsand they don't have as many short breaks

    • 14:24

      RACHEL TANG [continued]: between the sessions.That's also within therapy, as well.So Alessio sat very well for about 20 minutes, I would say,and during that session, he made good progressand because as a school, we sign we do sign language,and a lot of the children benefit from that.

    • 14:45

      RACHEL TANG [continued]: And Alessio, although he doesn't sign himself,and might not find signing beneficial for him,he actually took my visual cues and my signsand made actually a little bit of progressduring that session, which is really good to see.

    • 15:06

      RACHEL TANG [continued]: Good boy.

    • 15:08

      ALESSIO: Can we do it again?

    • 15:09

      RACHEL TANG: OK, one more.[Is there a particular I CAN way or formula?]

    • 15:17

      RACHEL TANG: We're very lucky to beable to work very closely with a lot of different professionals,which means that we're able to have that collaborative workingmodel.So we work very closely with OT.We have an OT onsite.

    • 15:30

      JENNIFER COOK: Occupational therapy.

    • 15:32

      RACHEL TANG: Yes, occupational therapy, onsite.We also work with family support workers.We also work with educational psychologists.And obviously, we work with the teachersand learning support assistants to deal and optimizethe children's learning by putting all those approachestogether.For example, Alessio was wearing a jacket, which

    • 15:53

      RACHEL TANG [continued]: is called a weighted jacket.He finds attending very difficultand he's very distracted by a lot of the thingsin his environment.So having that weighted jacket allowshim to be more grounded, which allows him to obviously, attendand then is in a better stead for learning.

    • 16:12

      JENNIFER COOK: We're using the therapeutic listening,which the occupational therapist will assess the children for.The headphones are put on for a set time.It might be 20 minutes.That would be instructed by the occupational therapist.Through their assessment, they'llpick music or a program that's appropriate for the childto help them to regulate themselves and maximizetheir learning.

    • 16:32

      JENNIFER COOK [continued]: We have an integrated approach and the occupational therapistwill assess the children to see which things will support thembest to be able to sit still, to be able to focus,to be able to regulate their emotions.And some of the things have to do with their motor skills,in general.Some of the children have the trip-trap chairs, whichare the slightly higher chairs.Some of the children have foot blocksso that their feet are up in the right position.

    • 16:54

      JENNIFER COOK [continued]: Some of the children have particular cushions,which might help them with their sensory needs.

    • 16:59

      RACHEL TANG: And all of those approachesfrom occupational therapy all help the childrento attend and learn.[What sort of tasks do children with language difficulties findchallenging, and how do you help them?]

    • 17:12

      RACHEL TANG: When a child has speech and languagedifficulties, they find it so muchharder to have social relationships,such as friendships or playing games, you know, simple thingsthat, you know, we take for granted.And in turn, they might lose confidenceand some might find it frustrating

    • 17:33

      RACHEL TANG [continued]: that they can't communicate.And Matthew has quite a lot of that.He exhibits quite a lot of frustrationbecause he's unable to get across what he wants to say.And so Jen will be working on sort of strategiesto help him cope with that frustration.

    • 17:49

      JENNIFER COOK: Because without the language,it's very hard for them to have that imaginary playand they can't keep up with their age matched pairsbut whereas here they are a bit more matchedand so it is nicer for them to have a peer groupthat they kind of can interact with on the same level.

    • 18:02

      RACHEL TANG: We have case discussionsin our therapy meetings.What's lovely about Meath School isthat we are able to have that rapport with all the childrenand the therapists do move classes every two, three yearsor so.

    • 18:18

      JENNIFER COOK: You may well have worked with childrenwho you then would then move to another classand so you would still see them around.And nice to be able to talk to other therapistsabout their progress and see how they're doing.And also, when you come to set targets,sometimes we would come to each otherand if it's a therapist who's been working with the childpreviously to see where they're at and make sure we,you know, sort of liaison to make sure

    • 18:39

      JENNIFER COOK [continued]: that we're working on the right thingsand also, as you said before about their personality,it's tailoring the therapy to the children's personalities.Show me, say goodbye.

    • 18:47

      MATTHEW: Bye, bye.Can you put the book in the box?From the perspective of some children, when they're little,you might not know whether or notthey'll develop that clear speechor develop that spoken language but whatwe would want is for them to be able to communicatefunctionally, for us to have found a way for them to beable to communicate and for them to be good at usingthat communication.

    • 19:06

      RACHEL TANG: You can never tell.I mean, some children might come in beingvery autistic for example and then later on,they might develop in a completely different waythat you wouldn't expect and actually their autism doesn'tbecome the main barrier to learningand actually other things will be in effect thatmight affect their learning.

    • 19:28

      RACHEL TANG [continued]: So you can never tell because children are always changingand they're sponges really.[What necessary skills are needed to become a speechand language therapist, and are there any professional issuesto be aware of?]

    • 19:41

      JENNIFER COOK: I think patience isa really, really vital skill.I think being flexible and adaptable because I don't thinkthere's anywhere that you work as a speech therapist where youcan predict what's going to happen and to get the job doneyou do need to be able to, you know,change your plans, both within sessions and for the whole day.Organization is quite important.Typically you have quite large or complex case loads

    • 20:04

      JENNIFER COOK [continued]: and so I think that's a really key thing in time keeping.All of those basic skills, but I alsothink those interpersonal skills are really, really important.You need to be able to sort of tailor your interactionsto be appropriate for the person or the childthat you are working with.But I think for me, it's working with people,knowing that my day is going to be differentand knowing that I'm going to affect change and make

    • 20:25

      JENNIFER COOK [continued]: a child's life to bit easier, I think,is really the key thing for me.

    • 20:29

      RACHEL TANG: They then trust you and you know them much betterso that you can motivate them in therapyand help them functionally progress.Finished.[MUSIC PLAYING]

Child Speech & Language Development

View Segments Segment :


Rachel Tang and Jennifer Cook discuss speech and language therapy and their work at the I CAN Meath School. Speech and Language therapists work with people to enable them to communicate functionally in the world. Tang and Cook discuss different techniques they use and different skills that are needed to be a speech therapist.

SAGE Video In Practice
Child Speech & Language Development

Rachel Tang and Jennifer Cook discuss speech and language therapy and their work at the I CAN Meath School. Speech and Language therapists work with people to enable them to communicate functionally in the world. Tang and Cook discuss different techniques they use and different skills that are needed to be a speech therapist.

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