means by which we forge our relationships. The Communication Trust () Explaining Speech, Language and . education and difficulties with using language to reason, to . A systematic review, looking at the prevalence of primary. The relationship between speech, language and communication needs .. Prevalence of conduct problems and hyperactivity was also higher. 2 Speech, language and communication difficulties: young people in trouble with the law . age of the population sampled (16 years old) Problems in relationships with .. prevalence and associated needs London: Prison Reform Trust.
Hence, it is not certain which language markers can be used to accurately identify children with language difficulties and by corollary there is a dearth of information about how teachers might detect language difficulties. It is currently not clear which, if any, features of language performance alert teachers to language difficulties and the extent to which SLTs view these as features of SLCN. In contrast to the limited work examining language behavior in the classroom that might indicate that a child has a speech or language difficulty, there is a better understanding of the educational and social implications when such problems are present.
However, the distinction between speech and language is rarely a focus in these contexts. Children with language difficulties tend to have poorer educational outcomes Durkin et al.
There is a high risk of difficulties in literacy for both groups language: Snowling and Hayiou-Thomas, ; speech: Leitao and Fletcher, Numeracy Cowan et al. Also, difficulties in producing written text Dockrell et al. Problems with peer relations and self-esteem have been reported for children with language difficulties Lindsay and Dockrell, ; Lindsay et al.
Whilst further comparative research is required, the current research evidence suggests that children with language difficulties have more pervasive problems associated with a range of educational and social processes than do children with speech problems alone. Moreover, there is currently little evidence concerning whether teachers and SLTs distinguish between the impacts of speech versus language difficulties in educational contexts.
SLCNs are more common in children who live in areas of social disadvantage Korpilahti et al. There is also consistent evidence that children from lower socio-economic backgrounds SES are exposed to less high quality language both at home for example, Vanormelingen and Gillis, and in school Wright and Neuman, and that this leads to poorer vocabulary, grammar, and language processing Schwab and Lew-Williams, Although disadvantaged populations in England receive greater levels of service from SLTs, there are still large inequalities in provision among socially deprived groups Pring, Similarly, children whose first language is not English [English as an additional language EAL ] are over-represented in samples of children with SLCN compared with monolingual English speakers Dockrell et al.
In sum certain population characteristics are associated with SLCN but there are disparities in their use as flags to provide additional services or monitor progress and in the extent to which different professional groups are alert to these disproportionalities. To our knowledge, no attempt has been made to systematically examine the differences between the views of experienced Education and SLT professionals in a large sample working in mainstream settings about children with SLCN.
This is of central importance to policy and practice in England, as in other countries, since the guidelines emphasize the importance of multiprofessional working Department for Education,p. To address this gap, this study sought to elicit professional understandings of SLCN to inform research and practice using an online questionnaire. To achieve this objective, the study focused on four major areas of which have been examined in the research literature: We expected that Education staff would be less familiar than SLTs with current terminology surrounding different speech and language problems and would be less aware of different proposed language markers of SLCN.
In contrast, we anticipated that Education staff would have better awareness of the range of educational and behavioral problems that are often experienced by the children with SLCN Dockrell and Lindsay, ; Wilson et al.
We also expected SLTs to distinguish clearly between speech and language problems given their training, have a more nuanced understanding of the types of problems which occur with speech and language and clearly differentiate speech from language problems. We also predicted that SLTs working in schools as opposed to clinics would be more aware of the wider educational implications of experiencing an SLCN.
Materials and Methods Respondents The online survey was accessed by respondents in England. Two-hundred and four self-declared as Education professionals and as SLTs.
A significant proportion of respondents omitted sections which were intended for both groups and therefore precluded comparative analyses. For those remaining in the sample, there were still within discipline questions where respondents did not give an answer, thus respondents were dropped from those analyses when answers were missing.
The majority of the respondents from the Education group were from Greater London The two groups estimated the percentage of pupils that they worked with who had: There were significant associations between respondent group and: The SLTs were initially divided into three subgroups based on where they worked: They reported similar locations of work, time in role, and work with pupil groups see Tables S1—S3 in Supplementary Material.
Subsequent analyses compared responses from SLTs working in education and clinics. However, as there were no statistically significant differences on any measure the results are not presented here but are available from the authors. Only respondents in Education settings were asked about their patterns of working with SLTs. Those with access to SLTs also reported that about a quarter Procedure Education, SLT services, and training providers working for children with SLCN were contacted and asked to distribute the link to the survey.
Participation was voluntary and responses were anonymized. The deadline for completion was indicated on the survey. Two reminders were sent before the survey was closed. Email lists for both groups of professionals were used to identify and contact potential participants and the people contacted were also asked to pass the link on to other appropriate parties.
As participation was voluntary and the details of the distribution lists were confidential, there was no control over who completed the survey. However, all participants provided background information about their professional status. This included details about gender, years in post, contact time with children only for SLTsand school type. This provided indicative data of the representativeness of the sample. Items which were ambiguous or failed to discriminate across respondents in the pilot work were eliminated.
Given that the aim was to compare teachers and SLTs, a preliminary version of the survey was given separately to a group of SLTs and experienced teachers. The majority of items required respondents to indicate their views on Likert scales. The survey comprised five sections. There were specific questions for Education staff about children in their classes and access to SLTs, and for SLTs about caseloads and work in schools.
Section 2 examined barriers to successful working practices and training needs. Categorical responses were required. Nine items were identified as potential barriers to effective practice and are presented in Table 5.
Training needs were examined with six items which asked information received and can be found in Table 6. Section 3 presented 14 terms used to refer to children with SLCN [see, for example, Bishop ] and responses about familiarity were indicated. Items are presented in Table 1. Respondents were asked to indicate whether these indicators were associated with speech only, language only, speech, and language difficulties or neither.
Items were drawn from the research literature. See Tables 3 and 4 for educational needs and behavioral challenges. Familiarity with speech, language, and communication needs SLCN terminology M and SD for the education and speech and language therapist groups. Percentage of respondents in the education and speech and language therapist SLT groups who reported difficulties which were either a feature of a speech difficulty, a language difficulty, both, neither or not sure.
Reported associated difficulties [M SD ] for children with speech difficulties for education and speech and language therapist SLT groups. Reported associated problems [M SD ] for children with language difficulties for education and speech and language therapist SLT groups. The remaining items required respondents to indicate their views on three- four- or five-point Likert scales.
Effect sizes quantify the size of the difference between the two groups and by convention effect sizes above 0. To examine whether the two groups could be differentiated by their responses about the language behaviors, a recursive partitioning and regression tree analysis were conducted using the rpart package Therneau et al. This works by first finding the variable which best splits the data into the two groups, as achieved by minimizing generalized Gini impurity.
The ideal value for this measure is 0 when all cases in a given group belong to one category, Education or SLT. The process is then repeated recursively on the resulting groups using remaining variables until no further splits can be made. Results The results are presented in five sections reflecting the research questions.
As expected, the responses given by the SLT group were virtually at ceiling consequently, analysis to compare respondent groups statistically to determine differences in familiarity with terms could not be performed for them. However, familiarity differed significantly across the terms for the Education respondents [F 8. Respondents indicated whether each behavior was associated with: The classification tree in Figure 1 depicts the pattern of answers about language behaviors that best differentiated between respondents from the two groups.
The response options are designated S for speech difficulty, L for language difficulty, B for both speech and language difficulties, N for neither type of difficulty, and D for unsure do not know.
The relationship between SLCN and behavioural difficulties
Each branch in Figure 1 lists the behavior and, after the equals sign, the responses a selection from S, L, B, N, and D given to that behavior which bifurcates the groups. The response options that are omitted for each behavior do not discriminate between the two groups.
Classification tree indicating how response options about the first seven language behaviors in Table 2 differentiated between the education and speech and language therapist groups. The first behavior identified was circumlocution. In the case of this question, the Education group was unsure what type of difficulty circumlocution was as reflected in the response options that they employed. Relatively smaller numbers of professionals were picked up by other patterns of response; see Figure 1.
Activities of daily living, Communication, Communication disorders, Disability, Hearing loss, Participation, Social support 1. Individuals with low levels of social support have higher mortality rates, particularly from cardiovascular disease but also from other causes such as cancer and infectious diseases Uchino, A variety of characteristics of social relationships have been described in the literature to date, including social support, positive and negative social exchanges, social isolation, loneliness, social network size, and social participation.
The World Health Organization has targeted the enhancement of social participation by older adults as part of its policy framework in addressing concerns about population aging. Older adults with communication disorders may be at particular risk for negative consequences since communication is central to the process of successfully adjusting and adapting to the aging process. Studies have shown that the conversational skills of normally aging older adults tend to remain well-preserved, even though the semantic content and syntactic structure of language use change over the life-course Shadden, With increasing age, however, there is an increase in the prevalence of conditions that may interfere with communication Yorkston et al.
Hearing impairment is the most prevalent communication disorder nationally and it is the third most common chronic condition of older adults Wallhagen, As the list of medical conditions above suggests, the conditions that cause communication disorders vary widely in their type and severity, as well as in their co-occurrence with other types of disability Yorkston et al.
It is difficult to make general statements about the impact of a communication disorder, therefore, because many conditions are associated with physical, cognitive, or other limitations that have the potential to profoundly affect social relationships.
Previous research has demonstrated associations between communication disorders and various aspects of social relationships for individuals with a wide variety of conditions. For survivors of laryngeal cancer, those with poorer communication have been shown to have smaller social networks, less social support, and poorer psychological adjustment Blood et al.
These studies would suggest that communication disorders of various etiologies negatively impact social relationships in many ways. There are some contradictions in the literature, however.
Possible reasons for these discrepancies include differences in study design, instrumentation, and covariates in the analysis, as well as the low prevalence of communication impairments in some study samples. In individuals with communication disorders, it is unclear to what extent changes in social relationships are the result of the communication impairment itself or should be attributed to other limitations, such as physical disabilities.
It is not well-known, for example, whether all social relationship characteristics are affected equally by a communication disorder. Older adults may be at increased risk for negative consequences since they are more likely than other age groups to experience a communication impairment of some kind in addition to co-occurring physical changes and comorbidities Hoffman et al.
Most previous studies have examined one type of communication impairment or a single population e. It is also unclear whether these findings can be generalized to older adults with other types of communication impairments.
In addition, many studies have been limited by small sample sizes and have not attempted to isolate the relative contribution of the communication impairment itself from other aspects of health and disease. The current study accordingly investigated the following questions: Is communication difficulty regardless of type or etiology associated with any characteristic of the social relationships of community-dwelling older adults? If so, is this association significant after controlling for other health and demographic factors?
Finally, are all characteristics of social relationships affected by communication difficulty equally or are some aspects affected disproportionately?