1. Manchester Metropolitan University Paper presented at the 27 th World Congress of the IALP 6 th to 9 th August 2007 Copenhagen Ann French a.french@mmu.ac.uk

2. Comparing Perceptions of SLI in Adolescent Mainstream School Students

3. Background  Experience of working in and with mainstream schools to support junior/secondary age students with speech, language and communication needs (SLCN).  Awareness of differences between stakeholders (education staff, health staff, parents, students…) in ways of talking about SLCN.  Differences may be deeper than terminology, and reflect underlying philosophies about aetiology and management.

4. Theoretical context  Incidence of SLI may be around 10% of primary school children 1.  Sparse data on older children, but linguistic difficulties persist for many years 2, and literacy difficulties may increase over time 3.  Significant impact on academic achievement, social skills, self esteem, behaviour, and peer/teacher attitudes 4,5,6,7.  UK drive for inclusive education 8 means that all children with Special Educational Needs (SEN) should have their needs met in mainstream.  Speech and language therapists (SLTs) must select ‘patients’ to be ‘treated’ using inclusion/exclusion criteria 7,9 ; the service to secondary pupils is limited 9.  Multi-agency collaboration is essential for positive outcomes 10.

5. Research question Practical barriers to collaboration between teachers and SLTs have been identified 11.  Do terminological barriers also exist: i.e. do professions have different understanding of ‘speech’ ‘language’ ‘communication’?  More importantly, are there also conceptual barriers: i.e. do professions think differently about the speech/language development, use and needs of students?  If so, what difficulties might these create for multi-professional working?

6. Methodology Design  Exploratory qualitative study of a large mainstream secondary school and associated SLT service. Data collection and analysis 1  Content analysis 12 of a range of central government, professional body and local policy documents. Data collection and analysis 2  Semi-structured interviews carried out with: oSchool staff: Special Educational Needs Co-ordinator (SENCo); learning support teacher; subject teacher; teaching assistant. oSLT staff: paediatric service manager; SLT with responsibility for secondary schools. oService-users: student (aged 17) with SLCN; student’s parents.  Framework analysis 13 of data using ATLAS.ti. 14

7. Results of documentary analysis  SLCN are often not mentioned at all.  ‘Language’ often refers to language spoken (i.e. first language) or to language stylistics.  ‘Impairment’, ‘disability’, ‘disorder’, ‘diagnosis’ most often refer to physical/sensory needs.  Speech, language, literacy, learning, and behaviour needs are most often referred to as ‘difficulties’.  All documents refer to ‘specialists’, ‘partnerships’, ‘training’, but named agencies are largely from education not health.  ‘Normal limits’ is not a concept that appears in education documents. Differences may be terminological, or may reflect deeper conceptual differences 15.

8. Results of interview analysis Areas addressed in interviews:  What is specific language impairment (SLI), and how does it differ from conditions such as specific or moderate learning disability?  How are the needs of a student with SLI identified?  How does SLI impact on academic and social development?  How should SLI should be managed in secondary school?

9. What is SLI?  ‘Specific language impairment’ meant nothing to education staff; had to be rephrased as ‘speech and language difficulties’ (SLD).  Parents found it hard to describe, talked of son having ‘very specific difficulties’.  Other participants varied in range of difficulties mentioned 

10. Difficulties of students with SLD (1) SLT; SLT manager; Learning support teacher  Short term memory  Spoken comprehension  Spoken sentence formulation  Word finding  Written comprehension  Written sentence formulation

11. Difficulties of students with SLD (2) Student  Short term memory  Spoken comprehension  Spoken sentence formulation  Word finding  Written comprehension  Written sentence formulation  Fluency  Handwriting

12. Difficulties of students with SLD (3) SENCo  Spoken comprehension  Written comprehension  Written sentence formulation  Word finding

13. Difficulties of students with SLD (4) Teacher; Teaching assistant  Spoken sentence formulation  Speech  Fluency

14. How does SLD compare with Specific Learning Disability (Dyslexia)? SimilaritiesDifferences  Problems with attention, short term memory, written comprehension, organisation, recording ideas.  Can be helped to improve functioning.  Same strategies useful.  Greater problems with spoken comprehension and vocabulary learning in SLD.  Word finding problems more typical of SLD.

15. How does SLD compare with Moderate Learning Disability (MLD)? SimilaritiesDifferences  Problems with social understanding.  Same strategies useful.  Size of verbal-nonverbal discrepancy.  Students with MLD less motivated, less enquiring, less aware of problems; less improvement possible.  Students with MLD more emotionally vulnerable.

16. How are the needs of a student with SLD identified?  If not previously identified, depends on teachers/head of year noticing a problem (but teachers may focus on speech) and referring to SENCo.  SENCo/learning support teacher assess literacy; may refer on to SLT (or to educational psychologist).  SLT assess spoken language; may refer on to educational psychologist for nonverbal cognitive assessment.

17. How does SLD impact on academic and social development? Responses mirror the literature, but are constrained by participants’ perceptions of SLD e.g.  Teacher/teaching assistant focus on effects of not being intelligible.  SENCo focuses on literacy.

18. How should SLD should be managed in secondary school?  General agreement on principles and strategies, but constrained by participants’ perceptions of SLD.  Some threats to successful outcomes (other than funding, staff shortages……..) 

19. National Curriculum: over-heavy demands on written language. Schools: too little attention to assessing/managing students’ spoken language skills. Teachers: too little interaction with student to understand problems; onerous task of managing whole class. Teaching assistants: too poorly paid/qualified to be student’s key teacher. SLTs: too little understanding of demands on teachers, so giving inappropriate advice. Students: may hide difficulties by being silent, or react angrily, so teachers focus on behaviour and not underlying difficulty.

20. How could things be improved?  A curriculum which values nonverbal as highly as verbal skills.  Education degree programmes and Speech Pathology degree programmes which give better insight into each others’ work.  Joint Education/SLT discussion/decision making on SLD ‘diagnoses’ and management.  Teaching assistants who are trained and paid to work specifically with SLD.  Wider use of technology to support students e.g. intranet accessible from home, with worksheets, homework details, modified lesson content.  Being prepared to support some students differently e.g. greater peer support in first year of secondary for those who need it.

21. A final thought: do students with SLCN develop more slowly than peers, and if so should they take public examinations later? The student with SLCN, now at 6 th form college: “it’s so much - easier at college - - I’m a lot. I’m a lot cleverer now.”

22. References 1.Dockrell, J. and Lindsay, G. The ways in which speech and language difficulties impact on children’s access to the curriculum. Child Language Teaching and Therapy, 1998, 14, 2, 117-133. 2.Baker, L. and Cantwell, D.P. A prospective psychiatric follow-up of children with speech/language disorders. Journal of American Academy of Child and Adolescent Psychiatry, 1987, 26, 546-553. 3.Snowling, M., Bishop, D.V.M. and Stothard, S.E.. Is preschool language impairment a risk factor for dyslexia in adolescence? Journal of Child Psychology and Psychiatry, 2000, 41, 5, 587-600. 4.Botting, N. and Conti-Ramsden, G. Social and behavioural difficulties in children with language impairment. Child Language Teaching and Therapy, 2000, 16, 2, 105-120. 5.Knox, E. (2002). Educational attainments of children with specific language impairment at year 6. Child Language Teaching and Therapy, 2002, 18, 2, 103-124 Bronfenbrenner, U. The Ecology of Human Development. 1997. Cambridge MA: Harvard University Press. 6.Marshall, J., Stojanvik, V. and Ralph, S. ‘I never even gave it a second thought’: PGCE students’ attitudes towards the inclusion of children with speech and language impairments. International Journal of Language and Communication Disorders, 2002, 37, 4, 475-489. 7.Dockrell, J.E., Lindsay, G., Letchford, B and Mackie, C. Educational provision for children with specific speech and language difficulties: perspectives of speech and language therapy service managers. International Journal of Language and Communication. Disorders, 2006, 41, 4, 423-440 8.Department for Education and Skills. Special Educational Needs Code of Practice. 2001. http://www.dfes.gov.uk http://www.dfes.gov.uk 9.McCartney, E. Include us out? Speech and language therapists’ prioritisation in mainstream schools. Child Language Teaching and Therapy, 2000, 16, 2, 165-180. 10.Department for Education and Skills. Removing Barriers to Achievement. 2004. http://www.dfes.gov.uk.http://www.dfes.gov.uk 11.Hartras, D. Teacher and speech-language therapist collaboration: being equal and achieving a common goal? Child Language Teaching and Therapy, 2004, 20, 1, 31-54. 12.Robson, C. (1993). Real World Research. Cambridge: Blackwell. 13.Ritchie, J. and Spencer, L. (1994). Qualitative data analysis for applied policy research. In A. Bryman and R.G. Burgess (Eds). Analysing Qualitative Data. London: Routledge. 14.ATLAS.ti. Demo Version WIN 5.2. www.atlasti.com 15.French, A. Perceptions of language impairment for students attending mainstream secondary school. AFASIC 4th International Symposium, 2007, Warwick University, UK.

23. The author would like to thank the British Academy and the International Association Of Logopaedics Edinburgh Trust for financial support to attend the 27 th World Congress of the IALP