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

Adapted from Elklan © Liz Elks and Henrietta McLachlan

The Communication ChainHave ideas and decide what to say

Choose words

Choose appropriate sentence structure

Select the sounds= phonology

Coordinate instructions to the speech muscles

Speak fluently

Speak appropriately

Look/attend

Listen/hear

Remember= auditory memory

Understand sentence structure

Self monitor

Understand the meaning – literal and non-literal

Articulate sounds

Understand words

Interpret non-verbal communication

Expressive LanguageReceptive 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

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 ChartsDate/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?

STAR

SETTINGS:Environmental or personal

RESULTS:What happens- for the child?

TRIGGERS:What sets it off?

ACTION:Observable behaviour

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 planAdapted 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

StrengthsMain 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 DevelopmentBuilding on strengths and interestsAddressing areas of difficultyFunctionally Equivalent SkillsCoping Skills

Praise / Reward strategiesTo acknowledge improvements For a gradual reduction in the behaviour causing concernFor the absence of the behaviour causing concern

Responding to DifficultiesEarly Active StrategiesReactive strategiesPost-incident supportfor pupilfor 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