CHERI Conference 2013 · ESL/cultural diversity issues e.g. family understanding and ... Formal/informal codes ... empowered in the learning process,

CHERI Conference 2013

‘I’ve still got it, haven’t I?’: The whys and hows of supporting adolescents with

language impairment.

Julia Starling PhD

Speech-Language Pathologist

[email protected]

Outline of presentation Introduction to the population: Who are they, and what

do we know?

The impact of persistent language impairment.

Supports are needed: but why is it so difficult?

One idea? Creating „language-friendly‟ secondary

classrooms.

Onwards and upwards…..

CHERI Conference, Westmead 2013: Starling 2

Language disability, SLI, receptive/expressive language

impairment, language-based learning difficulty, language

disorder, language difficulty….

Impaired comprehension and/or use of spoken, written or other symbol system (ASHA 1993).

Language impairments:

Affect between 7-16% school students McLeod & McKinnon’s prevalence study (pub. 2007):11.05% of Year 7 students are communication disordered (1st wave), 15.29% (2nd wave). LINCS study: 16% of Year 8 students/2 schools.

Are life-long difficulties (e.g. Clegg, Hollis, Mawhood, & Rutter, 2005; Conti-Ramsden, Simkin, & Botting, 2006; Johnson et al, 1999; Whitehouse, Line, Watt, & Bishop, 2009)

Affect students in all subjects at all grade levels (even [especially?] Maths, Visual Arts and PE!)

Are highly correlated with literacy difficulties (Smart, Prior, Sanson, & Oberklaid, 2001; Stothard, Snowling, Bishop, Chipchase, & Kaplan, 1998)


Primary/secondary associated

diagnoses ADD/ADHD

Reading disorders, including specific learning difficulty (dyslexia), problems with reading comprehension, written expression

ESL

ASD including high-functioning autism/Asperger‟s Syndrome (Social Communication Disorder: DSM-5)

Sensory/motor deficits

Hearing loss

Intellectual disability

Neurological basis to problems e.g. acquired brain injury, epilepsy.

Syndromes e.g. Down Syndrome, Fragile X


What we now know about the nature of

adolescent LI Oral and written language comprehension difficulties (Bishop &

Snowling, 2004; St. Clair et al., 2010),

Oral expression difficulties (Nippold, Mansfield, Billow & Tomblin, 2009;

Wetherell, Botting & Conti-Ramsden, 2007),

Written expression (Culatta, Blank, & Black, 2010; Dockrell, Lindsay &

Connelly, 2009),

Lack of cohesion in oral and written narratives , expository

discourse (Nippold, Mansfield, billow, & Tomblin, 2008; Snow & Powell, 2005,

Wetherell, Botting, & Conti-Ramsden, 2007)

Difficulties with new word learning (Nash & Donaldson, 2005),

Executive function problems (Hughes, Turkstra, & Wulfeck, 2009)

Short-term and working auditory memory problems (Archibald &

Gathercole, 2006; Leonard, Weismer, Miller, Francis, Tomblin, & Kail, 2007)


Common characteristics

Language comprehension/expression

Difficulties following instructions: verbal and written e.g. misinterpret written questions

-Slow information processing and organisation of ideas for expressing themselves

-Oral presentation difficulties

-Poor inferential, analytical abilities

Written language

Problems taking notes, writing to dictation, copying from board

-Writing difficulties: initiating, organising and expanding thoughts, following structures, starting and completing written work

-Poor cohesion, syntax, spelling and punctuation.

Year 8 student with NDL: Jason prefers to play with the silver robot as it is more entertaining, however the gold robot is more useful as he has trained it to do his chores.

Year 8 student with LI: One is big and however one is small


Literacy

Overlap of language and

literacy difficulties (Smart, Prior,

Sanson, & Oberklaid, 2001;

Stothard, Snowling, Bishop,

Chipchase, & Kaplan, 1998)

Gap between reading

accuracy and reading

comprehension

General learning abilities

-Behind in prior knowledge

-Restricted range of personal learning strategies -Performance on nationally standardised basic literacy and numeracy skills tests below national benchmarks (Bercow, 2008; Conti-Ramsden, Durkin, Simkin & Knox, 2009)

-May have strengths in non-verbal learning areas: sports, art, design, drama i.e. not “core” academic abilities


But I

know

nothing

about

bees!

Associated issues Organisational difficulties

-“Stuff” e.g. school materials, clothes,

equipment…..

-Time: planning and completing tasks

-Ideas and thoughts for oral and

written expression

-Latter especially affects all aspects

of school work

-Often described as “chronically

disorganised”

Life problems

Social, emotional and behavioural problems (Clegg, Hollis, Mawhood, & Rutter, 2005; Joffe & Black, 2012;Law, Rush, Schoon, & Parsons, 2009; Lindsay& Dockrell, 2012; Whitehouse, Watt, Line, & Bishop, 2009) Academic failure (Snowling, Adams, Bishop, & Stothard, 2001). Juvenile offender populations: 46% (Snow & Powell 2008).


High-order language difficulties

May be first identified during adolescence

Strong visual and/or kinaesthetic learning skills

A gifted and talented learner

Early speech and language delay

Early reading and spelling difficulties that may have resolved

Attention/organisation difficulties

Fine and/or gross motor difficulties

Poor or „different‟ socialisation skills


Impact on language

Inferential comprehension: reading and listening

Interpretation of instructional language

Planning, organisation and structuring ideas for speaking and

writing

Restricted vocabulary

Literal interpretation of inferred meanings and figurative language


JS: How will

you be

situated during

the holidays?

AW: At the

computer.

Language: one

adolescent‟s perspective


RALLI SLI campaign

Harry: Finding my strengths

http://www.youtube.com/watch?v=J2eR0Te6wFA


http://www.youtube.com/watch

http://www.youtube.com/watch?v=J2eR0Te6wFA

How we observe them…..

Not listening

Lazy

Forgetful

“Space cadet” like, withdrawn or…

The “Class Clown”

Not engaged with class activities

Overly talkative

Disruptive

Disorganised

Incomplete work

Misreading/misinterpreting assignment tasks


I don‟t get

the

questions

The

teachers say

it too fast!

I don‟t know

about

anything but

then I can‟t

go and read

about it… History…its

too hard and

I don‟t get

the meaning

of it

She gives us

words all the

time that I

don‟t

understand

It‟s not fun, its

complicated

and stuff

From their

point of

view…….


Why are students with language difficulty so „at

risk‟?

Classroom learning, across ALL

subjects, involves language

more than 80% of the time!



What we‟re up against…..

Challenges in the academic/social

environment Expectation to be an organised, independent

learner, including being a good listener, and „switch

learning gears‟ frequently.

Literacy competency needed for effective learning

Complex timetables, range of subjects and teachers, teaching styles

Incompatible teaching/learning styles

Written assignments, tests, exams

Different teachers/different rules

Inconsistent homework


Importance of peer groups, and “fitting in”

Increasingly complex communication processes (social networking)

Self-esteem and self-concept issues

Related behavioural issues: general tendencies e.g. “acting out” vs. withdrawal

ESL/cultural diversity issues e.g. family understanding and acceptance of a “learning difficulty”

Denial, avoidance and learned helplessness

Need to look at individual profile, as well as generalities: Huge variance in attitude, resilience and coping strategies.



The language of adolescence

Abstract language: inferential, analytical, problem solving

Figurative language: idioms, metaphors, proverbs

Social language: Formal/informal codes (including “electronic communication”), peer group, slang, sarcasm, jokes, innuendo, opinions, discussions, arguments, debate

Academic vocabulary:

Literate (more formal)

Technical

Instructional

Written expression: essays, reports, analyses, expositional, comparative studies, creative writing

Metalinguistic development: Ability to use words to describe words (e.g. definitions)


The language of instruction

Spoken and written language provides the building blocks for

conveying information to students, and testing their knowledge and

progress.

“Build The Field”: developing students‟ knowledge through

Prior knowledge (word and world knowledge)

Use of context, resources

Glossaries, definitions

Brainstorming

Text deconstruction

Students‟ supported and independent reconstructions

Vocabulary: often assumed knowledge

From one Year 7 Science lesson (mixed ability class):

Endangered Carnivore

Differentiated Herbivore

Extinct Variables

Solitary Dichotomous

Pelt

Feral Savanna

Adaptations



Language and Maths?? Definitely……..

Same or Different?

If Billy is 13 years old, how old will he be in 29 years?

A car is traveling at 84 km an hour. If it maintains a consistent speed, how far does it travel in 30 minutes?

Find the sum of 27 and 15.

Mandy and Sally want to buy 8 bags of lollies for a party. Each bag costs $5.25. They have $50 to spend. Is this sufficient money? Do they need more or less?

Find the product of 2 and 21.

31 + 11 =


Expectations and frustrations….


How come my head‟s

buzzing and my hand freezes?

How can I

write 6 pages

when I don‟t

even know

what the

question

means?

Miss said it‟s

due a fortnight

tomorrow and

I don‟t know

when that is.

Government-level policy initiatives and

directives Australia:

Commonwealth Disability Standards for Education, 2005/Commonwealth Disability Discrimination Act, 1992: Schools required to treat students with disability on the same basis as students without disability.

More Support for Students with Disability National Partnership, 2012-13:

Nationally consistent data collection on students with disability (commencing Oct. 2013): Huge variance in teachers‟ ID in pilot study.

Industry Skills Council report (2011): No More Excuses.

Ombudsman NSW: A Level Playing Field? HSC Disability provisions (2013). Essential that ID and support start in Year 7. Get‟s lost Year 8 -> 9, Year 10 -> 11 (McLeod & McKinnon, 2007: Huge „drop‟ in #‟s between Years 8 and 11: ID issue??)

UK: The Bercow Report: Removal of barriers to learning for young people with SLCN (Bercow, 2008)


Informed developments

Professional literature:

Collaborative, school-based services, including teacher training to facilitate inclusive support (e.g. Ehren, 2002; Elksnin, 1997; Gascoigne, 2008; Law et al. 2002; Shaddock, 2007, Snow, Sanger, Childers, Pankonin, & Wright, 2013).

Professional development research:

Sustained, site-based professional development for teachers presented by “outside experts” leads to positive effects on student outcomes (Guskey & Yoon, 2009)

Clinical best practice guidelines:

e.g. Direct vocabulary instruction (Beck, McKeown, & Lucan, 2002); graphic organisers (Mastropieri, Scruggs, & Graetz, 2003); written language (Wolf Nelson, Bahr, Van Meter, & Kinnucan-Welsch, 2004; Wong, 1997)


CHERI Conference, Westmead 2013: Starling

There are many barriers to providing effective support during the adolescent years.

A lack of professional services

Mostly private services so costs involved

School-based services: Secondary school timetabling issues

Generalisation and application of new ideas and strategies to classroom learning

Student reluctance/stigma

…to name a few…….

But….it‟s not that easy!

27

Looking at things from a

different point of view…..

Creating ‘language-accessible’ secondary classroom environments?

SLPs empower secondary teachers in providing inclusive support to students with LI in their classes.

By facilitating changes to mainstream secondary teachers‟ oral and written instructional language.

Teachers ensure improved access to curricular instruction for their students with LI.

Secondary students with LI become more engaged and empowered in the learning process, across subjects and grades.


Why do we want this to work?

Most adolescents with LI attend mainstream secondary schools.

The problem is……

Secondary teachers often use complex oral and written language for curricular instruction, across subjects and grades (e.g. Whitmire,

2001).

The result is…..

Students with LI are disadvantaged in understanding curriculum content; disengaged in class activities; disempowered in expressing knowledge through writing (Ehren, 2002; Starling, Munro, Togher, & Arciuli, 2011; Whitmire, 2000 )



The language-friendly secondary classroom: What could it look like?

Reduced complexity of

teachers‟ instructional language: oral and written

Written information that students can process mainly by themselves

Direct instruction of prioritised essential curricular vocabulary with descriptions that are relevant and use-able

Increased use of visual supports

Reduced speed of delivery/increased time for processing and production


The collaborative conversation

Teachers are the experts in acquiring and

disseminating curricular information; they can provide topical information regarding curricular goals and content, ensuring any intervention has immediate academic relevance and opportunities for practice and generalisation.

SLPs have expertise in the expression and reception

of information; they can provide specific information regarding individual students‟ communication and learning support needs, as well as training in general strategies applicable to teachers‟ grade and subject needs.

Program developed and piloted at a Sydney secondary school (The University of Sydney and NSW Department of Education) leading to….

An RCT, with the aims of:

Evaluating the efficacy of a teacher training program.

Evaluating the sustainability of the ideas presented in the training program.

Evaluating the impact of the training program on the language abilities of secondary school students with language impairment. (Starling, Munro, Togher, & Arciuli, 2012)


The program Mainstream secondary teachers were trained by an

SLP in the development and application of oral and written instructional language accommodation and modification techniques.

Training occurred over a school term (10 weeks)

Strategies used in teachers‟ regular classroom teaching practices

Addressed the needs of whole populations of students with LI inclusively, across many teaching disciplines and grades.


Study participants 2

secondary

schools

Randomised to experimental/control condition

Government, co-educational

Population matched

13

teachers

(primary

cohort)

6 experimental/7 control

Teachers of identified Year 8 students with LI

Across disciplines: Maths, English, Science, Physical Education (PDHPE), History, Visual Arts, Agriculture

44

students

with LI

(secondary

cohort)

22 experimental/22 control

Year 8: age range 12y 10m - 14y 3m

34m/10f

Identified by school staff, LI confirmed by screening

Tested at all study phases (WIAT-II: 4 expressive/receptive subtests)


Examples of language modification strategies Direct vocabulary

instruction

•Identification of key vocabulary for

new curriculum topics (10 Key

Words)

•Interactive creation of relevant

descriptors/definitions

Information processing

•Breaking down texts: Mapping

central idea, associated

facts/details

•Supplementing verbal/print

information with visuals

Teachers’ written language

•Modifying the language of

worksheets, assignments and

tests.

•Changing the sequence of

presented information e.g. text and

questions layout

Teachers’ oral language

•Slower speech rate, or better

voice projection

•Facing the class, not the board

•Repetition of key facts

•Pausing longer to allow for

students‟ slower processing


Teacher outcomes Concerns-Based Adoption Model

(CBAM) (Hall & Hord, 2006): Measurement of diagnostic aspects of the adoption of a new program

Levels of Use: Behaviours that individuals develop as they become more familiar with, and more skilled in using, a new program.

e.g. Knowledge, Assessing, Planning, Performing and Sharing,

Involved a structured interview with individual teachers, and rating 7 parameters across 8 levels of non-use/use.

Interviews administered, transcribed and rated by blinded and independent RA‟s.

Level Description

0

1

2

Non-Users, with

degrees of

preparation

3

4

5

Users, mainly self

and classroom

focused

6

7

Users, adopting a

more collaborative

approach CHERI Conference, Westmead 2013: Starling 36

Pre/post trained (T1-7) vs. control teacher (C1-6) group comparisons

Planning: Designs and outlines short and/or long-range steps to be taken during process of adoption of a new program.


Pre/post trained vs. control teacher group comparisons

Sharing: Discusses the intervention with others. Shares ideas, plans,

resources, outcomes and problems.


Trained teachers over time.

Pre-post condition : Asymptomatic (two tailed) p = .017 (sig.) Post-follow-up

condition: Asymptomatic (two tailed) p = .297 (non-sig.)


Student outcome data:

Experimental/control group comparisons

WIAT II: Written Expression Subtestp = <0.05 (time x group)

70

75

80

85

90

95

Pre Post

Time

Sta

nd

ard

sc

ore

Control

Experimental


Student outcome data

Experimental/control group comparisons

WIAT II: Listening Comprehension Subtest

p = <0.05 (time x group)

60

65

70

75

80

85

90

Pre Post

Time

Sta

nd

ard

sc

ore

Control

Experimental



Quotes from teachers “Because (the students) can understand better, they can perform

better”.

“They‟re not so scared of big words as before the intervention.”

“They love to write, I just couldn‟t believe it! It‟s a Maths lesson and they actually enjoy writing about the specific terms and what they know!”

“The (program‟s) brought back the awareness that some kids, behaviour-wise, may play up simply because they can‟t do the work”.

“Some teachers have actually used (the ideas) with a different year group and found that they worked really well.”

“If I had this knowledge when I first started teaching I think I would have been a better teacher from the start….it‟s taken me so many years to identify the fact that language is so important”.

Implications of results. High degree of teacher use and application of the

program techniques.

Positive impact on language abilities of students with LI: written expression and listening comprehension.

Ideas applicable to secondary school teachers from a range of teaching disciplines.

Use sustained over a period of time without further

direct support.

Collaborative sharing of

ideas across the whole school. CHERI Conference, Westmead 2013: Starling 43

CHERI Conference, Westmead 2013: Starling

The potential impact on students with

language impairment. Better able to:

Access the curriculum i.e. attend to, process, retain and use presented information

Be more engaged in learning by increasing their direct participation in class activities

Demonstrate a better understanding of curriculum content on assignments, projects and tests (written expression)

Develop and use a broader and more “robust” vocabulary

Feel better and more confident about themselves as able learners

Be less at risk of developing psychosocial problems

44

The empowered team

The adolescent: takes ownership of issues, seeks assistance, finds personal value in

adopting strategies

Parents: as advocates, supporters,

negotiators…

All school staff: classroom and

learning support teachers, TA‟s executive…

Other Important People: sports coaches, youth workers, tutors,

mentors….

Professionals: speech-language

pathologists, counsellors,

paediatricians…


Further developments and

future plans -Program implementation across Sydney (Sydney Catholic

Education Allied Health Project/MSSD funding): 6 secondary schools to date.

-Trialing different approaches e.g. collaborations with learning support teachers.

Plans and possibilities……

-International Communication Project 2014:

Equal Attention for Adolescents!

-Program manual/train the trainer workshops

-Upper primary school version: addressing transition issues

-Language screening of all Year 7 students


Three Main

Points to take away…..

1. Language Impairment is a life-long disability

2. We CAN support adolescents with LI, we just have

to be flexible and creative

3. Team Work Rules!!


Thank you! And may your time spent with young people with

language impairment be inspiring, fascinating, challenging, thought-

provoking, stimulating, informational…… and full of wonderful words!

With thanks to the wordsmiths at Holy Sprit College,

Lakemba.


Documents

CHERI Conference 2013 · ESL/cultural diversity issues e.g. family understanding and ... Formal/informal codes ... empowered in the learning process,