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Explaining speech, language and communication needs (SLCN)

2 : 3 Explaining speech, language and communication needs

Children and young people with speech, language and communication needs (SLCN) have difficulties in communicating with others; it may be that they cannot express themselves effectively or they may have difficulties in understanding what is being said to them.

Alternatively those who support them may not understand their way of communicating. This paper gives information about the group of children and young people described as having SLCN. Using case studies, it illustrates the range of needs covered by this umbrella term and gives an overview of how they may be supported.

Introduction


What are speech, language and communication?Speech refers to:• Saying sounds accurately and

in the right places in words

• The sounds people use to communicate words

• Speaking fluently, without hesitating, or prolonging or repeating words or sounds

• Speaking with expression with a clear voice, using pitch, volume and intonation to support meaning.

Language refers to speaking and understanding language:• Using words to build up

sentences, sentences to build up conversations and longer stretches of spoken language

• Understanding and making sense of what people say.

Communication refers to how we interact with others:• Language is used to

represent concepts and thoughts

• Using language in different ways; to question, clarify, describe etc.

• Non-verbal rules of communication; good listening, looking at people



Many children and young people communicate successfully using non-verbal means such as signing, gestures, communication books or electronic communication equipment.

when in a conversation, knowing how to talk to others and take turns, how to change language use to suit the situation or the person being spoken to

• The ability to take into account other peoples’ perspectives, intentions and the wider context

• Many children and young people communicate

successfully using non-verbal means such as signing, gestures, communication books or electronic communication equipment.

Children and young people may have difficulties across one or many of the different elements of speech, language and communication resulting in a communication breakdown.

SLCN is often known as a ‘hidden disability’, it is not always easily recognised and children can become quite proficient at hiding the true

nature of their difficulties.There are many different terms used to describe difficulties with communication, which can be confusing. In this paper, the term SLCN is used to describe the whole group of children who have difficulty with some aspect or aspects of communicating.

This may be minor and temporary, or it may be

complex and long-term. Under this umbrella term, there will be many different labels used. The term ‘needs’ refers both to the needs of the individual and to what society can do to support their inclusion. It implicitly looks both at the individual and the environment in which children play, learn, communicate and live.

Children and young people with SLCN



There are many different terms used to describe difficulties with communication, which can be confusing.


Who has SLCN?

Many children, across the age range have SLCN. There is a wide range of severity of SLCN:

Some children may have a mild delay in one or more areas of SLCN, but with the right support and early intervention may ‘catch up’ with peers.

Some children will have long-term, persistent SLCN. They may need direct and specific teaching with the involvement of a speech and language therapist (SLT) in order to progress.

SLCN can be short-term and temporary, they can fluctuate over time or they can be long-term, even with support and intervention. In addition to this, the pattern and impact of SLCN usually changes over time as children and young people get older.

A child or young person may have difficulty with speech, with language, with communication or a combination of all of these – every child is individual.

Any one or a combination of the following can be difficult:

• Making speech sounds, or speaking clearly. Some children may communicate without spoken language

• Putting words together in sentences

• Understanding spoken language or listening to long or complex instructions

• Having conversations or interacting with others.

Emma’s story

Emma started school with delayed speech. She was not using all the correct speech sounds for her age so it was difficult to understand her. She didn’t join in with classmates or answer questions.

Emma had regular speech and language therapy to help develop her speech. Emma’s mum, SLT and teacher worked together to make sure they were all working towards the same goals. Her teacher started to ask her questions where answers were the sounds Emma could say more clearly and brought speech work into her literacy lessons.

Emma is making excellent progress and is steadily catching up with her friends.

Sam’s story

Sam is a bright, intelligent eight year old boy who has stammered since he was three. He finds it hard to communicate with his friends because they all talk too quickly for him to join in. He often doesn’t put his hand up in class even when he knows the answer, because he dreads getting stuck, being unable to say what he wants, and the other children laughing at him. His mother is worried that he is becoming anxious and withdrawn, and she fears that he may not achieve his potential in school, with adverse effects on his future life as an adult.


A significant group, around 5-7%1 of children starting school, have SLCN in the absence of any other difficulty. They do not have a general learning difficulty, or any physical or sensory impairment.

This is often referred to as specific language impairment (SLI). A child with SLI may have difficulty in only one, or a combination of language areas. The nature and complexity of their difficulties can often be hidden due to skills they have in other areas. Very often there is no identified cause of SLI.Many more children and young

people have SLCN as part of another condition. SLCN are a feature central to and common across most areas of disability. They represent the most prevalent type of special educational need (SEN) amongst pupils with statements of SEN. The following are examples of some of the conditions where children and young people are more likely to have SLCN:

• General learning difficulty (mild, moderate, severe, profound)

• Autistic Spectrum Disorder (ASD)

• Syndromes such as Down’s syndrome, Williams

syndrome, Worcester-Drought syndrome, Fragile X

• Sensory impairment (hearing, visual or multi-sensory)

• Cerebral palsy.

• Dyslexia

• Attention Deficit Hyperactivity Disorder (ADHD) /Attention Deficit Disorder (ADD)

• Selective mutism

Jack’s story

Jack’s mum was concerned, he seemed bright but wasn’t talking at all – he could still only string a couple of words together when he started school. He was assessed by a psychologist who reported he was above average intelligence, though the SLT confirmed he had severe difficulties with understanding language.

Jack has support in school to help him understand and combine words into sentences. He is really good at Maths and Science, especially practical activities, though still really struggles with English. He gets frustrated and as he gets older is realising he cannot do the same things as his friends - he is supported by his teacher, mum, SLT and support worker.

He works hard, is popular and sociable, and loves his football.

Lucy’s story

Lucy has profound and multiple learning disabilities (PMLD). This means she has more than one disability, the main one being a profound learning disability. It also means she needs a lot of support and finds it very difficult to communicate. Lucy does not use formal communication like speech, symbols or signs. She communicates using facial expressions, gestures and vocal sounds. Lucy enjoys spending time with her friends. They have got to know how Lucy communicates through spending time with her. It is important that new people Lucy meets take time to understand her individual communication. Lucy has a communication passport with a video clip showing how she communicates which she can share with people.

1 Tomblin, J. B. et al (1997) Prevalence of Specific Language Impairment in Kindergarten children Journal of speech, Language and Hearing Research 40 and Law J. Boyle J. Harris F. Harkness A. and Nye C. (2000) Prevalence and Natural History of Primary Speech and Language Delay: findings from a systematic review of the literature IJLCD Vol 35 no.2 in Lindsay G and Dockrell J with Mackie C and Becky Letchford (2002) Educational Provision for Children with Specific Speech and Language Difficulties in Engand and Wales CEDAR

Daniel’s story

Daniel now aged six started to show problems with language at 18 months, by 20 months he had no language at all, had stopped making eye contact and interaction was difficult.

Daniel was referred to a SLT who was instrumental in identifying other impairments leading to a diagnosis of autism. Since the age of two and a half Daniel has had speech and language therapy which has helped to develop his language dramatically.

He now goes to a mainstream primary school which he is able to enjoy and he continues to receive support from a SLT.

The impact of SLCNSLCN do not only affect language and communication, they can have a profound and lasting effect on children’s lives. Making friends, sustaining relationships, emotional regulation, problem solving and behavioural control are dependent on good speech and language skills as well as learning to read and academic achievement. In order to be

included into school, home and community life good communication skills are vital.

Poor communication is also a risk factor for mental health difficulties and impacts on emotional well-being. Because of these links, there is a knock-on impact on further education opportunities, employability and family stress. In addition

to this, people with SLCN are significantly over-represented in the young offender and prison populations.

It can often be the case therefore that SLCN can look like something else: behaviour or literacy difficulties, mental health needs, school refusal.



Making friends, sustaining relationships, emotional regulation, problem solving and behavioural control are dependent on good speech and language skills.

Sanjay’s story

Sanjay has difficulty understanding complex language. Because of this, when the teacher began to explain the lesson he often started to get flustered and began muttering. Then he would be told off for not listening which caused further stress. He would often refuse to start work or destroy what he had done because he knew he couldn’t do it. When people tried to ‘talk through’ his behaviour with him he would often become aggressive, because all he understood was that he was in trouble again.

Children and young people with SLCN can be supported in a wide range of settings, from mainstream schools to more specialist placements such as ‘resourced provision’, language units or residential special schools. Studies have shown that the level of specialist knowledge and expertise in supporting children’s needs is of crucial importance. As most of a child’s communication happens at home it is vital that close links are made between professionals and family members/carers and to look at ways of supporting the child/young person at home.

The best way of supporting children and young people with SLCN is by making sure that:

• any support is given as early as possible

• practitioners work closely together

• managers and policy-makers plan together

• children, young people and their families are involved in decisions about their support

• following assessment of need children and young people to have prompt access to appropriate provision and resources, such as

Augmentative or Alternative Forms of Communication support (AAC)

• those who work with children and young people have the right skills and are confident.

Whatever the placement, a ‘communication supportive’ environment is essential. This means that interaction is encouraged and supported through positive approaches such as visual support, modified adult language, awareness of children’s language levels.


Support for children and young people with SLCN

Andrew’s story

Andrew was diagnosed with global developmental delay and when he started in the mainstream nursery class four years ago he had no speech and was very withdrawn. It was decided to try sign-supported communication with him and it soon became clear that he has a lively mind and a good sense of humour. His whole class have learned to sign and school assemblies are also signed.

As a result Andrew is a full member of his year group, and has been able to keep up with much of the curriculum. He is now beginning to read, and as his confidence has grown, his speech is also developing.

Paul’s story

Paul was diagnosed with autism at three years. He had started to make sounds and say a few words but then it disappeared. Paul became a very frustrated and cross little boy, not being able to express what he wanted.

Paul started school at five years where he was taught to use signs, symbols and speech to communicate. He started school in September and by Christmas he had learned over 200 signs and symbols.

The frustration slowly disappeared as Paul became able to communicate and people could understand him. Paul is now ten and his speech is fantastic. He can make himself understood through speech but sometimes signs to back it up.

This will support the communication development of all children and young people but for some, more specialist interventions will be needed by suitably qualified and experienced professionals e.g. SLT’s and specialist teachers. This might be through a recognised programme such as the Nuffield Dyspraxia Programme, Language through Reading or Social Use of Language Programme, or through a combination of approaches tailored to suit the individual child.

Communication may be supported through AAC such as signing, use of low-tech strategies such as Picture Exchange Communication System (PECS) or an electronic voice output device. This will also mean that adults supporting these children will need specialist skills and training.

With the right support at the right time, children and young people with SLCN can have their needs understood, identified and supported. This will enable them to engage positively with learning and socialising, to develop independence and a positive self image and to experience a wide range of life chances.

Ruby’s story

Ruby was developing speech and language typically at four years of age, but from an early age she showed anxiety and distress when expected to speak outside the home remaining silent with both adults and children. Before starting school her worried mother approached the health visitor to refer her to a SLT which resulted in an onward referral to a clinical psychologist.

Because of the long waiting list, parents contacted Selective Mutism Information Research Association (SMIRA) for advice. They found the personal accounts useful and worked closely with Ruby’s school. Her teacher and parents followed a step-by-step programme in school and finally, after nearly a year, Ruby started to speak to her friend at school in her mother’s presence. She also then began to talk to her teacher and everyone else.


Chloe’s storyChloe is 15 years old. She has cerebral palsy and attends a mainstream secondary school, which has facilities to support pupils with physical disabilities. Chloe has very limited spoken language and has used an electronic voice output communication device since she was in nursery – progressing from a simple 4-choice message device, through to more complex systems, which have helped her to be successfully included in mainstream education. Chloe is a popular young woman who maintains her independence through the use of her communication aid and a laptop, and is aiming to sit her GCSEs next year alongside her peers as a direct consequence of the provision of this technology.

Tom’s story

Tom had a road traffic accident while he was on his way to his work experience placement and suffered very severe brain damage. When he first attended a specialist rehabilitation centre he was unable to sit up, walk, or eat. Tom understood everything said to him, communicated using facial expression and gesture, and he soon started to spell out words on an alphabet board. His language was intact but he could not physically produce speech.

He gradually started to communicate more by writing although this was physically difficult. He trialled different communication aids, and then had the loan of a Lightwriter, which has voice output and a visual display. Tom now communicates effectively using the Lightwriter.


www.1voice.info

www.languageforlearning.co.uk

www.ace-north.org.uk

www.afasic.org.uk

www.arcos.org.uk

www.stammering.org

www.childrenssociety.org.uk

www.communicationmatters.org.uk

www.barnardos.org.uk www.contactcandle.co.uk

www.ncb.org.uk

www.cafamily.org.uk

www.btbetterworld.com

www.cenmac.com www.communicationsforum.org.uk

www.ican.org.uk

The Consortium:

This paper has been developed by The Communication Trust’s stakeholder group the Communication Consortium.This is a collection of voluntary and community sector service organisations who have expertise and knowledge of children’s speech, language and communication needs.The aim of this paper is to introduce speech, language and communication to the children’s workforce, particularly to those who would not consider themselves to be specialists in this area.

The Speech, Language and Communication Framework (SLCF) outlines what the workforce needs to know what they can do to support children’s communication.

Please refer to www.thecommunicationtrust.org.uk for more information about the SLCF.

The Board:


www.mencap.org.uk

www.sebda.org

www.selectivemutism.co.uk

www.treehouse.org.uk

www.makaton.org

www.nas.org.ukwww.naplic.org.uk

www.timetogetequal.org.uk/communication

www.southdowns.nhs.uk

www.vcsengage.org.uk

www.makesensetraining.co.uk

www.ndcs.org.uk

www.signalong.org.uk

www.stammeringcentre.org

The Inclusion Development Programme (year 1) includes advice and guidance for all teachers and teaching assistants on developing a communication supportive environment.This may be viewed and downloaded from http://nationalstrategies.standards.dcsf.gov.uk. Supporting pupils on the autism spectrum also gives advice on communicative supportive environments.

This paper was compiled by: Mary Hartshorne, Head of Expert Advisory Services, I CAN Marc Bush, Children and Young People Policy and Government Affairs, Scope Sasha Daly, Policy and Public Affairs Officer, Treehouse Nicola Matthews, Project Assistant, The Communication Trust

In association with members of the Communication Consortium

The Department for Children, Schools and Families have funded the production of this paper

To find out more contact:Cara EvansProgramme ManagerThe Communication Trust8 Wakley StreetLondon EC1V [email protected]

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