Natalie
Chapter two: Advanced level
On this page:
Task one: Initial ideas
Response sheet - Natalie (PDF, 123KB)
Watch the three video clips of the interview with Natalie.
Write down your initial thoughts about Natalie’s communication in the interview.
How would you describe Natalie’s profile of speech, language and communication difficulties to her family member or a colleague in education?
Clip one
Clip two
Clip three
Task one feedback
You might have included notes on:
Lots of positive communication skills such as clear speech, good turn-taking and topic maintenance, strong non-verbal communication skills.
A difficulty with using words - word finding difficulties.
Relative to children and young people of the same age, those with word finding difficulties ‘find’ or retrieve a lower proportion of words from their receptive vocabularies (the bank of words that they know).
Also known as naming deficits or word retrieval deficits.
Often contrasted to those who find it difficult to learn new words (vocabulary acquisition problem).
However, there is often an overlap between vocabulary difficulties and word finding difficulties - may find it easier to recognise a word’s meaning but have difficulties producing it.
Not unusual - about a quarter of those with language difficulties have word finding difficulties.
Difficulties understanding language, such as longer sentences or less common words.
Facilitate understanding by breaking down instructions and complex language into chunks.
Potentially ‘invisible’ difficulty - need to check understanding.
Insight into own understanding - able to request clarification.
Task two: Planning intervention for receptive language difficulties
Watch each video clip again carefully. Observe and reflect using the following task prompts and feedback:
In clip one, Natalie describes what happens when she has difficulties understanding spoken instructions. As noted in the beginner level, Natalie demonstrates insight and comprehension monitoring skills here.
How could you plan intervention targeting receptive language difficulties with an older child or young person such as Natalie?
Task two feedback
Your notes might have included ideas such as:
Building on Natalie’s level of insight by agreeing intervention targets with her. Considering even drawing up a communication contract for work - see Paul, Norbury and Gosse (2018) and Larson and McKinley (2003).
Targeting functional communication: Further development of strategies to monitor understanding, practicing using different types of prompts and requests for clarification.
Working with people around the young person (eg teachers, college tutors, family) so that they are able to use strategies to support understanding. Involve the young person in this training if appropriate.
Further assessment to see what types of sentences and instructions are difficult (eg longer sentences, connecting words such as ‘although’, ‘even though’ etc), clausal structures such as relative clauses (eg ‘Students who revise regularly each week do better in their assignments’).
Working on expressive use of complex sentences at the same time as understanding. For example, Paul, Norbury and Gosse (2018) suggest providing students with simple sentences and asking students to find a way of combining them into one complex sentence.
Developing meta-linguistic skills.
Considering a structured intervention approach such as Shape Coding (eg Ebbels et al. (2007) or Ebbels and Spencer (2018) for 11-17 year olds; see Ebbels (2014) for review of intervention for grammar in school-aged children).
Working on the meaning and function of complex sentences, as outlined by Kamhi (2014). First a ‘type’ of sentence is targeted (eg relative clauses) and then worked on. This would involve:
a) Discussing and illustrating the meaning and structure of a complex sentence.
b) Supporting the young person to find examples of this structure in a piece of written text.
c) Manipulating sentences so that they can be broken down into smaller sentences and then re-built back up into complex sentences.
d) Applying this in functional reading or listening (eg to online radio programmes or audio-books) with ongoing discussion of what the type of sentence ‘adds’ to the text.
Working on receptive language skills within expository texts (explanations). This is advocated as an approach to intervention for two reasons. Firstly, understanding expository texts and producing complex explanations are a key part of school and college across the curriculum (Scott 2014).
Secondly, expository text involves increased sentence complexity as well as complex vocabulary (Nippold et al. 2005). It is therefore a useful context for work on understanding and using complex language.
We referenced the following sources in our feedback and you may wish to follow some of these up with additional reading:
Ebbels, S. H., Van Der Lely, H. K., and Dockrell, J. E. (2007). Intervention for verb argument structure in children with persistent SLI: A randomized control trial. Journal of Speech, Language, and Hearing Research, 50(5), 1330-1349.
Ebbels, S. (2014). Effectiveness of intervention for grammar in school-aged children with primary language impairments: A review of the evidence. Child Language Teaching and Therapy, 30(1), 7-40.
Ebbels, S., and Spencer, S. (2018). Intervention for grammar for adolescents with developmental language disorder. In Spencer, S. (eds) Supporting adolescents with language disorders. Guildford: J&R Press.
Larson, V. L., and McKinley, N. L. (2003). Communication solutions for older students: Assessment and intervention strategies. Thinking Pub.
Nippold, M. A., Hesketh, L. J., Duthie, J. K., and Mansfield, T. C. (2005). Conversational versus expository discourse a study of syntactic development in children, adolescents, and adults. Journal of Speech, Language, and Hearing Research, 48(5), 1048-1064.
Paul, R., Norbury, C., Gosse, C. (2016). Language disorders from infancy through adolescence: Listening, speaking, reading, writing, and communicating. Elsevier Health Sciences.
Scott, C. M. (2014). One size does not fit all: Improving clinical practice in older children and adolescents with language and learning disorders. Language, speech, and hearing services in schools, 45(2), 145-152.
Task three: Supporting word finding difficulties
In clip two, Natalie demonstrates and is able to describe some difficulties with retrieving words. Natalie hesitates when using the words ‘enthusiastic’ and ‘responsible’, and later in clip three says ‘dyscalculis’ instead of dyscalculia. (See Natalie’s feedback in the Introductory level for notes on word finding difficulties).
Such phonological errors, hesitations, false starts, and use of fillers (eg ‘er’) are common in word finding difficulties, as are circumlocations (talking around the target word), and semantic or phonological substitutions (Ebbels et al. 2012). Natalie describes word finding difficulties well herself; she has lots of good words but sometimes can’t get them out of her head.
Reflect on what you know about the underlying causes of word finding difficulties.
Describe how you would apply this knowledge when planning intervention for someone with word finding difficulties.
Task three feedback
Your notes might include something like:
There is consensus that difficulties with word retrieval are at least partially caused by reduced familiarity with words, leading to less automatic access to these words in the memory, along with fewer connections between words (as summarised in Paul, Norbury, and Gosse 2018). Word finding difficulties are thought to be indicative of underlying difficulties with semantic representations (Dockrell and Messer 2013). As outlined by Ebbels et al. (2012), this could be caused by a number of reasons, including ‘sparse’ or ‘fragile’ representations leading to young people accessing an organised semantic category related to the target word but not the target within the category.
Therefore, one approach to supporting word finding skills is to increase the knowledge and connections among words that the young person already knows. Intervention focused on elaborating semantic representations and links between words may decrease semantic errors and improve naming (Ebbels et al. 2012). Activities to target this include:
Sorting words by semantic category (starting off broad and getting narrower.
Discussing the semantic attributes of a word.
Comparing pictures or written words and discussing how they are similar and different in terms of semantic information.
Use word webs or concept maps to make links between words explicit.
Complete odd one out activities with words, increasing difficulty by increasing the similarity between words. Ask the young person to explain the reason behind their choice.
Providing elaborated, multiple exposures to words to deepen knowledge.
Using attributes and categories in word games.
The ‘Password’ game can be used to develop strategies in word retrieval. One student thinks of a word and gives a semantic (or phonological) clue to another student, who tries to guess the word. More clues are provided until the word is guessed. Young people can then be encouraged to use these types of clues when they struggle to think of a word.
(based on Paul, Norbury, Gosse 2018 and Ebbels et al. 2012)
There is also some debate about the role of difficulties accessing accurate phonological representations of words in word finding difficulties (Messer and Dockrell, 2013). Some intervention studies have focused on phonology to support word finding difficulties (eg Best 2005). Others have combined both semantic and phonological information during intervention (eg Easton, Sheach and Easton, 1997). Some research advocates concentrating on semantic representations during intervention (Messer and Dockrell, 2013). To incorporate phonological information into intervention, you could:
Highlight syllable structure (encourage syllable tapping).
Discuss and compare words based on phonological properties such as rhyme and first sound.
Discuss words which sound similar (developing awareness of how and why words differ or are similar).
We referenced the following sources in our feedback and you may wish to follow some of these up with additional reading:
Easton, C., Sheach, S., and Easton, S. (1997). Teaching vocabulary to children with wordfinding difficulties using a combined semantic and phonological approach: an efficacy study. Child Language Teaching and Therapy, 13(2), 125-142.
Ebbels, S. H., Nicoll, H., Clark, B., Eachus, B., Gallagher, A. L., Horniman, K., … and Turner, G. (2012). Effectiveness of semantic therapy for word‐finding difficulties in pupils with persistent language impairments: a randomized control trial. International Journal of Language & Communication Disorders, 47(1), 35-51.
Messer, D., and Dockrell, J. E. (2013). Children with word finding difficulties: continuities and profiles of abilities. First Language, 33(5), 433-448.
Task four: Reflect on the associations between language and mathematics as a wider academic skill
Natalie describes her difficulties with maths here, indicating that she has dyscalculia.
Make notes on your understanding of the difficulties associated with dyscalculia.
Some young people with language difficulties find it difficult to achieve highly in mathematics.
What are the potential links between language ability and mathematical knowledge?
Why might the two be related?
Task four feedback
Dyscalculia is a condition that can affect understanding of the concept of number as well as learning numerical facts and procedures (Shalev 2004). It is thought to affect comprehension of number concepts, production of numbers and calculation. It is unknown what causes dyscalculia but it is thought to involve underlying difficulties with verbal aspects of mathematics as well as visual skills and estimates of magnitude (Shalev 2004).
Mathematics is a topic which includes many language demands such as:
Use of verbal reasoning to facilitate mathematical thinking.
Understanding syntactic structures such as comparators - greater than/less than.
Understanding syntax associated with logical relationships such ‘as if… then, given that’.
Grasp of technical vocabulary such as ‘coefficient’.
Understanding multiple meanings of words in a mathematics context, such as ‘power, square, volume’.
Using talk as a means of supporting learning new ideas and concepts.
(Based on Kim and Wai, 2007)
We referenced the following sources in our feedback and you may wish to follow some of these up with additional reading:
Alt, M., Arizmendi, G. D., and Beal, C. R. (2014). The relationship between mathematics and language: Academic implications for children with specific language impairment and English language learners. Language, speech, and hearing services in schools, 1-14.
Kim, T. L. S., and Wai, M. C. (2007). Assessing teachers’ and students’ use of language in science and mathematics classrooms: why and how. In Proceedings of the international conference on science and mathematics education (CoSMEd) (pp. 1-7).
Shalev, R. S. (2004). Developmental dyscalculia. Journal of child neurology, 19(10), 765-771.
Summary task
Summarise your thoughts on Natalie’s speech, language and communication skills.
What have you learned from watching this?
How will your learning impact on your own professional practice?
No feedback.