"He never listens, he can’t sit still, he’s disruptive, inattentive and has no eye contact.” These are frequent behaviours witnessed in the key stage 1 classroom. In these situations, are we too quick to suspect conditions such as ADD/ADHD, development co-ordination disorder (DCD) or autism spectrum disorder (ASD)? Or might these poor behaviours be due to speech, language and communication needs (SLCN)?
In some areas, 50 per cent of children begin school with speech, language and communication difficulties and 10 per cent of these children will continue to have problems well into adulthood.
These causes of SLCN are wide and varied. The child may already have a diagnosis such as ASD, ADD, DCD or ADHD. There may have been a lack of exposure to spoken language and books in the child’s pre-school years, or the child may have had limited life experiences that delayed language acquisition.
SLCN is often labelled a “hidden disability” as it is very difficult to recognise. However, Karen Fell, an experienced speech and language support assistant working in the London borough of Bexley, reports that the most common difficulty presented by a key stage 1 child with SLCN is the inability to sit still and pay attention. How can a child pay attention if they cannot understand or process the language spoken by the teacher?
Alongside attention and concentration difficulties, she reports that a child with SLCN may present a range of the following:
- Speech that is difficult to understand.
- Inability to formulate coherent sentences.
- Difficulty understanding language spoken to them.
- Immature vocabulary.
- Inability to describe or explain.
- Difficulty following instructions and understanding the task set.
- Difficulty taking turns.
- Difficulty initiating conversation.
- Poor listening skills when others are speaking.
- Poor social skills.
- Anger and frustration.
Many state primary schools have access to a speech and language therapy service. A referral from the SENCO, in agreement with the parents of the child, can lead to a diagnostic assessment by a speech and language therapist, which in turn will result in intervention given by a visiting speech and language support assistant. Sadly, not all schools have access to such a service and many parents cannot afford a private assessment and intervention.
So, is it possible for schools to recognise that a child has SLCN and offer their own intervention based on the best practice offered by speech and language support assistants?
At Sydenham High School, an all-through girls’ school in south London, children with SLCN are identified at key stage 1 and may be offered a social skills group. SLCN-based activities are then incorporated into learning support lessons throughout key stages 2 and 3. Regular small group work is a very effective way of boosting a child’s language acquisition and communication skills.
One particular child with communication difficulties benefited greatly from the SLCN intervention group offered in year 1. The Time to Talk game was used to develop turn-taking, receptive and expressive language, listening, problem-solving and an awareness of emotions. A Box Full of Feelings (Smallwood Publishing) was also invaluable at helping her to name and differentiate emotions in herself and others.
Additionally, role-playing very specific social interactions that had caused difficulties at playtime helped her to articulate clearly when someone had treated her in a way that she did not like and offered the strategies she needed to cope with periods of unstructured play.
Although the SLCN groups are run by specialist teachers at Sydenham, teaching assistants are a valuable resource and there is a wealth of resources available online that will enable teaching assistants to run a their own SLCN intervention groups.
Running an key stage 1 SLCN intervention group
Select your group: A group of four is ideal. Choose your group carefully. Try to have a good role-model within the group. Avoid putting older children with much younger children. If this is unavoidable, give the older child special responsibilities.
Choose your space: Work in a space where the children can both stand in a circle and sit at a desk. This will allow the possibility of movement for fidgety pupils. Include a range of multi-sensory activities – allow the children to see, hear, say and do.
Choose your time: Aim to see your group twice a week for 15 to 30 minutes. Alternatively, 10 minutes a day can have a great impact on the child’s language development. If possible, run the group for half a term.
Be aware of your own communication skills: Establish firm eyesight when speaking to each child. Speak slowly and clearly. Keep your sentences short. Use clear visual gestures. Allow the child time to process your language and respond. Lean towards the child to show you are interested in their response. Strive to achieve a balance between how much you speak and how much the children speak.
Establish your rules: Children learn best when they know what to expect from the session and understand the rules. Make the group rules very clear and revisit these at the beginning of each session. For example, “in our group our rules are good looking (point to your eyes), good speaking (point to your mouth), good listening (point to your ear), good sitting (sit still with crossed arms and still legs).
Include a range of multi-sensory activities: If possible link the group objectives with the teacher’s planning. Use a menu of activities: a “starter” that is quick and involves everyone, a “main meal” that is linked to the class work, and a “dessert” that is a fun game to revisit the main objectives. Use props, pictures, gestures – anything that will help the children understand. The activities could include:
- Tailor-made board games to support the teacher’s lessons.
- Memory games such as Kim’s Game or “pairs”.
- Describing activities, for example use a bag of unseen concrete objects.
- Speaking and Listening through Narrative resources, based on who, what, when, where, why? (see Black Sheep Press).
- “Chatterbox” pictures and resources (see LDA Learning).
- Songs with repetition such as Head, Shoulders, Knees and Toes.
- Simple stories such as the Jake and Tizzy set from ICAN.
Focus on praise and rewards: Use a reward system. Focus on what is going well and give immediate and regular praise. Praise the children for following the rules: “I can see you are listening well because you are looking.” Praise the children for asking questions if they have not understood. At the end of the session let the children know how well they have done. Give personalised comments to each individual, for example, “Johnny I was very pleased when you asked: Can you say that again please?” Also let the children know how they can be better next time.
Revisit the new vocabulary each week: Children with below average auditory memory skills need repetition in order to store language in their long-term memory. Teach the same thing but in different ways. Come back to the same vocabulary again and again.
Assess the child’s progress: Use the following five questions as an assessment framework:
- Attention and listening: was he able to listen and respond? Could he share news with the group?
- Understanding: could he respond to instructions and join in?
- Speaking skills: was he able to use appropriate vocabulary and speak in sentences?
- Social skills: was he able to initiate conversation and take turns?
- Phonology/speech sounds: did he show awareness of sounds in words. Can he identify rhyming words and initial sounds?
Conclusions
Speech, language and communication skills underpin the child’s ability to develop reading and writing skills, their ability to socialise and make friends and to understand and control emotions and feelings. If a child has not acquired these skills in their pre-school years, it is highly likely that the language deficit will result in unwanted behaviours. With early intervention, we can put these disadvantaged children back on track.
- Kristina Symons is head of learning support at Sydenham High School, an all-through school in south London and a member of the Girls’ Day School Trust.