1. Communication Counts September 2011

2. Social Use of Language and Anger Management Catherine Webster Senior Educational Psychologist Conwy Educational Psychology Service

3. 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

4. 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.

5. 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

6. Specific difficulties impacting on behaviour The Communication Chain (Elklan) Abstract language/questions Blank Levels Pragmatic Skills

7. Adapted from Elklan © Liz Elks and Henrietta McLachlan The Communication Chain Have 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 Language Receptive Language

8. 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

9. 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)

10. 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

11. 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

12. 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

13. 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.

14. The support triangle/hierarchy Individual/specific support Group support Environmental strategies

15. 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.

16. Multi-element plan strategies Environmental strategies Skill development strategies Reward and praise strategies Strategies for responding to difficulties

17. 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

18. 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

19. Functional analysis Speech and Language assessment ABCC charts/STAR Full functional analysis

20. ABCC Charts Date/TimeAntecedent – 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?

21. STAR SETTINGS: Environmental or personal RESULTS: What happens- for the child? TRIGGERS: What sets it off? ACTION: Observable behaviour

22. 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

23. 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

24. Skill Development Strategies Group Individual

25. 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

26. 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

27. Strategies for Responding to Difficulties Group Individual

28. Group interventions Circle of Friends Circle Time Cognitive Behavioural Therapy Personal Construct Psychology interventions Solution Focused Therapy

29. Individual interventions Comic Strip Conversations Visual prompts/situation ‘grids’ Role Play Cognitive Behavioural Therapy Personal Construct Psychology interventions Solution Focused Approaches Time Out

30. Example multi-element plan Adapted 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 Strengths Main Concerns BehaviourFunctions“I…” Messages

31. 2.Target Setting Targets for Support Staff/Parents & Carers Targets for Child/Young Person

32. 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 Development Building on strengths and interests Addressing areas of difficulty Functionally Equivalent Skills Coping Skills Praise / Reward strategies To acknowledge improvements For a gradual reduction in the behaviour causing concern For the absence of the behaviour causing concern Responding to Difficulties Early Active Strategies Reactive strategies Post-incident support for pupil for adults (You may wish to complete or refer to a Risk Assessment)

33. Review of MEPEnter here the date that the MEP is to be reviewed……/…/………………….. Who is to be involved in the review? MEP completed by ………………………………………………………………… Date ……………………. Signature……………………………………………………………

34. 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

35. Questions