Banter Speech & Language

Sydney speech pathologists helping adults and children speak for themselves.

Language

Developmental Language Disorder Awareness Day: our free DLD guide for families

by

Today is Developmental Language Disorder (‘DLD’) Awareness Day.

DLD is common. But it is not well understood.

It’s hard to find evidence-based information that is easy to read. We’ve written a lot about DLD. But the information on our website wasn’t organised very well.

So, we put together 64 of our articles and created a free guide for children, adolescents, adults and families affected by DLD.

Simply look for a topic that is interesting to you, and click on it to get to the article. We hope you like our DLD Guide for Families!

If you’d like a free PDF copy of the guide, sign up below.

Watch our video for more information:

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Not about ‘fixing’: using the ‘F-Word Framework’ to support children with communication disorders and their families

by

The ‘medical model’ of communication disorders focuses on ‘fixing’ children through assessment, diagnosis, and ‘treatment’. But children with communication disorders aren’t ‘sick’ or ‘broken’. 

A modern approach to health is the World Health Organization’s 2001 International Classification of Functioning, Disability and Health (ICF), which shows that health is determined by complex interactions between body functions and structures, activities and participation, and environmental and personal factors.

But the ICF can be hard to apply in practice. An adaptation is to consider six ‘F‐words’:

  • Function: Thinking hard about what children do; their activities and participation; capacity and performance. Focusing on achievement of the activity – not whether it is done ‘normally’. Encouraging practice of the function without regard to how ‘nicely’ it is achieved.
  • Family: The essential environment for most children. Knowing parents and siblings bring talents and strengths and are dealing with their own physical and mental challenges and concerns. Involving the wider family, e.g. grandparents. Helping families to feel competent. Providing respect and continuity of care; enabling informed decision-making and partnership. 
  • Fitness: Promoting children’s physical fitness and recreation, whether in ‘therapy’ or not. 
  • Fun: Asking children what they enjoy doing, what do they want to do, and how they can be more involved in meaningful life situations. Thinking about formal (structured) and informal (free‐range) activities; done alone, or with others. Helping children to do the things they want to, and not worrying about what’s ‘normal’. Using purposeful activities to build children’s confidence, competence, sense of achievement, and capacity. 
  • Friends: Encouraging social development and inclusion. Focusing on quality relationships (not the quantity of acquaintances). Supporting peer connections and involvement in meaningful group activities. 
  • Future: What child ‘development’ is all about! Thinking positively, right from the start; and encouraging families to do so as well. Not deciding what is impossible. 

The F-words are connected: e.g. increasing a child’s (self‐identified, meaningful) participation might affect the scope and intensity of activities, and lead to changes in body functions and communication skills. Participating in a desired sport program, for example, might increase physical/social capacities and performance, including in the social use of language.

The F-Word framework is an appealing way for speech pathologists to think beyond ‘fixing’ kids, and to incorporate ICF concepts into their practices and relationships with clients and their families.

Key sources:

(1) Rosenbaum, P.  and Gorter, J.W. (2011). The ‘F‐words’ in childhood disability: I swear this is how we should think! Child: Care, Health and Development, DOI: 10.1111/j.1365-2214.2011.01338.x 

(2) Cunningham, B.J., Thomas-Stonell, N., and Rosenbaum, P. (2020). Assessing communicative participation in preschool children with the Focus on the Outcomes of Communication Under Six: a scoping review, Developmental Medicine & Child Neurology, DOI: 10.1111/dmcn.14665

Related articles:

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Focusing speech therapy on functional outcomes: a refresher

by

Traditionally, many speech pathologists were trained to break their clients’ communication difficulties into parts in order to identify and treat communication ‘disorders’, e.g. speech sound disorders, voice disorders, fluency disorders like stuttering, developmental language disorders, and dyslexia.

But most clients don’t see their challenges as disorder ‘types’. They might say:

  • ‘No one understands me’;
  • ‘I have trouble talking’; or
  • ‘I can’t follow conversations or understand what I’ve read’. 

Health is a human right. Health includes physical, mental and social well-being – not just the absence of disorders.

People have a right to live capable, functioning lives. Communication problems often affect people’s mental and social well-being.

The diagnosis of a disorder does not predict function: A diagnosis doesn’t alone say much about its effects on a person’s overall health and quality of life.

Communication disorders can affect:

  • mental health;
  • basic activities, like communicating; and
  • participation in routine activities, like school and play for children; and work and maintaining a household for adults. 

The line between activities and participation is often hard to draw with communication because it usually involves interaction with others. 

Often, differences emerge between how people perform communication tasks in a clinic, and how they do them ‘out in the real world’. 

Clients have legal rights to make informed decisions about their health care and to choose goals that matter most to them. 

Key source: Threats, T. (2008). Use of the ICF for clinical practice in speech-language pathology. International Journal of Speech-Language Pathology, 10; 1-2: 50-60.

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Project-based Pragmatic Language Interventions: The SENSE Theatre

by

  • Play is not the only way: Play is one way to combine peer mediation and video-modelling to increase children’s pragmatic language skills.  Another idea is for students with pragmatic language challenges to work with peers on a project.
  • SENSE Theatre Intervention: Developed at the Vanderbilt Kennedy Center, the therapy uses theatre games, improvisation, character development, singing, and performance with peer actors to improve pragmatic language of children and adolescents with Autism Spectrum Disorder (ASD).
  • Real world goal: At the end of the intervention, participants perform a play with their peers about belonging, acceptance, and making friends for the public. 
  • Who? Students with high-functioning ASD are paired with typically-developing peer actors of similar ages.
  • Peer training: Peers and staff are first trained to work with people with ASD. 
  • Intervention: Participants engage in theatrical games, role-plays, singing, and exercises, and then rehearse their roles in the play with their peers.  
  • Home practice: For 15 minutes a day, participants with ASD watch and rehearse lines and exercises using video models made by typically-developing peers.
  • How long? Designed as a summer camp program, the manualised intervention involves 10, four-hour sessions across two weeks. 
  • Key Results: Participants showed improved social awareness, social cognition, adaptive skills, social perception (e.g. facial recognition), and theory of mind. Parents reported improved social communication at home and in the community. Some treatment effects were maintained two months post-intervention.
  • Why does it work? (a) Peer-mediation and modelling (live and video). (b) Peers were both the main teachers and social partners of participants, with frequent, direct interactions. (c) Fun activities, encouraging participants to join in and have opportunities to learn from social experiences. (d) Acting provides opportunities for children to engage in reciprocal social communication.

Key sources:

  • Corbett, B. A., Swain, D. M., Coke, C., Simon, D., Newsom, C., Houchins-Juarez, N., Jenson, A., Wang, L., & Song, Y. (2014). Improvement in social deficits in autism spectrum disorders using a theatre-based, peer-mediated intervention. Autism research: Official Journal of the International Society for Autism Research, 7(1), 4–16. https://doi.org/10.1002/aur.1341
  • Corbett, B. A., Key, A. P., Qualls, L., Fecteau, S., Newsom, C., Coke, C., & Yoder, P. (2016). Improvement in Social Competence Using a Randomized Trial of a Theatre Intervention for Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, 46(2), 658–672. https://doi.org/10.1007/s10803-015-2600-9

Related infographics:

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Planning a play date for your child during the school holidays?

by

Why arrange a play date? 

Play develops motor skills, construction skills, symbolic pretend play, problem-solving, negotiation, reasoning skills, social language skills, independence, creativity and risk-taking in a safe environment.

More importantly: it’s fun!

Here’s an evidence-based list of toys to get kids talking and playing with each other:

  • Sandbox (buckets, spades, diggers, dinosaurs)
  • Small figurines (e.g. army, animals, pirates)
  • Dress-ups (e.g. superheroes, knights, princesses, emergency/medical workers)
  • Subject to parents’ views, stylised toy guns, foam bullets and swords
  • Board/talking games (e.g. Snakes & Ladders, Monopoly, Cluedo, Battleship, The Game of Life, Checkers/Chess, Ludo, Guess Who, Hedbanz)
  • Card games (e.g. Fish, Snap, Uno, Old Maid, Memory, Werewolf)
  • Blocks (classic wooden, Castle Logix, Lego, Jenga)
  • A train set (train engines, cars, cabooses, freight, bridges, ramps, tracks, landscapes, stations)
  • A large whiteboard and markers (or blackboard and chalk)
  • Playdough and tools (stampers, rolling pins, moulds) 
  • Small tables and chairs, blankets and cushions (imaginary forts, castles, secret bases, ‘cover’)  
  • Sports equipment (balls, hoops, cone markers)

Sources:

(1) Gray, P. (2017). What exactly is play, and why is it such a powerful vehicle for learning?. Topics in Language Disorders, 37(3), 217-228.

(2) Parsons, L., Cordier, R., Munro, N., & Joosten, A. (2019). The feasibility and appropriateness of a peer-to-peer, play-based intervention for improving pragmatic language in children with autism spectrum disorder. International Journal of Speech-Language Pathology, 21(4), 412-424.

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

Play-based, peer-mediated pragmatic language intervention for school-aged children

by

Too many pragmatic language therapies focus on teaching individual skills with structured practice. But pragmatic language is about using social skills out in the real world.

This week, Cherie Finocchiaro and David Kinnane join forces to review a promising play-based, peer-mediated intervention for children (aged 6-11 years) that focuses on capacity AND performance. 

We can’t wait to give it a go!

  • We want all children to have friends. But too many school-aged children with pragmatic language difficulties – including many children with Autism Spectrum Disorder (ASD) and/or Attention-Deficit/Hyperactivity Disorder (ADHD) – don’t have any close friends and are lonely.
  • Lots of pragmatic language interventions for school-aged children are about building kids’ capacity to use different social skills. Examples include computer- and manual-based ‘social skills training’ programs with structured activities like role play and worksheets.
  • But pragmatic language is about performing language tasks in real life social interactions. Many kids learn social principles in the clinic, but have difficulties using them ‘in the moment’, e.g at home, at school, and in sports.
  • Pragmatic language interventions should focus both on practical knowledge and how to use language in real social situations.
  • A new intervention for 6-11 year olds seeks to to do this in child-led, free play interactions between a client with pragmatic language difficulties and a typically developing peer of a similar age (e.g. a sibling, cousin, or friend). 
  • The child is assessed with an instrument called the ‘POM-2’. Goals are then selected from a “menu” of pragmatic language behaviours (outlined earlier in this series).
  • Intervention includes:
    • 10, weekly in-clinic sessions: with self-modelling through video-feedback and -feed-forward, peer- and therapist modelling – all in the context of child-led play and therapist/parent discussions; and
    • home practice: 10 manualised modules with videos, weekly ‘play-dates’ with the peer between clinic sessions, and feedback/discussions with parents.
  • Randomised controlled trials show the treatment is effective in improving the pragmatic language performance of both children with pragmatic language difficulties (including children with ASD or ADHD) and their typically developing peers. Gains are maintained in the clinic/home for at least a short time afterwards. (We don’t know yet whether gains transfer to school or play with other friends.)

Principal sources:

(1) Parsons, L., Cordier, R., Munro, N. and Joosten, A. (2019). A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism. Front. Psychol. 10:1960. doi: 10.3389/fpsyg.2019.01960;

(2) Wilkes-Gillan, S., Bundy, A., Cordier, R., Lincoln, M. and Chen, Y-W. (2016). A Randomised Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention Deficit Hyperactivity Disorder (ADHD). PLoS ONE 11(8): e0160558. doi:10.1371/journal.pone.0160558; and  

(3) Parsons, L., Cordier, R., Munro, N. and Joosten, A. Peer’s pragmatic language outcomes following a peer-mediated intervention for children with autism: A randomised controlled trial, Research in Developmental Disabilities. 99 (2020) 103591 (forthcoming).

Related infographics:

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.