When Speech and Language Problems appear as behaviour difficulties - and how speech therapy can help
The tiny girl with a BIG personality bursts into my room, shouting 'Where Maagi?' WHERE Maaagi?!'
And so begins a session in which the most-used word is 'No!'. I have since come to fondly call her 'Tiny No', due to her favourite way to respond to any kind of request. "No!".
‘There’s something wrong here’, says her teacher, worried about Tiny NO! girl’s confused looks as she tries to follow what is going on in her nursery class.
‘I knew there was something not quite right with this little one: my older kids didn’t have any difficulty like this’, says her Mum. (when a Mum expresses concern, in my mind, it sets off a great big alarm bell – Mums know their children best).
The Nursery Head takes advice from the Special Educational Needs staff.
Any concerns about children in Nursery are quickly flagged up so that problems can be sorted out early, before they affect the child’s progress in learning.
So ‘Tiny NO!’ is observed, by specialists in the school, including myself.
Image: Tiny No & me in a therapy session. Photo used with permission.
What I learn from observations of Tiny No
Concerns about her behaviour - lack of talking, her limited interactions with other children and with adults, poor eye contact and listening – they all add up to the decision being made for her to have a full assessment in a Child Development centre.
The assessment looks at all the aspects of her development – and considers possible causes for the difficulties we have seen. One obvious reason for her difficulties could be ASD: Autistic Spectrum Disorder, (Autism).
And indeed, she does show a few of these signs. Some of her behaviour, like poor eye contact, and the repetitive way she plays with certain toys like cars, is rather like the way an autistic child might behave.
The Psychological assessment finds she is able to understand non-verbal tasks and information well, above her age level.
However, assessment of her speech and language shows that she has a specific difficulty in learning to speak, and in putting sounds together to make words clearly. She also finds it hard to follow verbal information at her age level.
'Tiny No' has difficulty in sorting out ideas in her mind, and saying what she wants to express.
This small child’s behaviour is more likely to be linked to her whole confusion about words and how to communicate, than to a diagnosis of Autism.
It is a problem that affects her – and other children like this – so much that she needs continual help in school, to understand what is going on and to help her communicate what she wants – and does not want: hence Tiny NO!’s constant use of one word she can use effectively! 'No!'
Using Speech and Language Therapy to help Tiny No
Thus, Speech and Language Therapy sessions begin, working through the summer holidays, helping prepare her for being in school properly, and understanding routines and behaviour that will help her to learn. And when school begins, what she has learned help her to fit in to her new class.
However, continuing, daily, individual support is needed for this little girl in school.
Although well staffed, the Teacher and Assistant teacher’s focus needs to be upon helping the whole class of little 4 year olds to build a good foundation of learning together and following the school routines so that each child is able to benefit.
Tiny Miss No, deciding to wander off and play in the home corner when the rest of the class is learning their numbers, is both distracting to the class and unhelpful to her. And dealing with her angry ‘NO, NO, NO!’ when being brought back to the group stops everyone learning for several minutes.
Here's how Speech Therapy has benefitted Tiny No in her preparation for school, and now while she is at school:
1. It provides her a structure for special learning time where her unique needs can be addressed
2. It provides a measurable set of outcomes for each lesson that she and Mum can use to know where her level is with speech and language and to map this to her Individual Educational Plan (IEP) at school - very helpful for school and home
3. It assures school that Mum is taking concerted, proactive action to help integrate her child, and helps them know she is on the same team!
4. It gives Mum and school access to a 'neutral party' - a therapist who can give impartial and unbiased advice about the need for school support like a shadow teacher
5. If extra school support is taken on, the therapist can train the shadow teacher in the ways unique to your child's situation and needs
So, though Tiny No's main problem is her disordered speech and language, she needs help in a holistic way - to start learning. I have been honoured to be a part of the journey in helping her towards this.
A consistent approach to her development has been critical: especially in helping to change what she says to ‘Yes!’ and by giving her other words with which to express herself.
Have you considered speech therapy for your child? Do you have a child who says 'No' all the time?
Let me know!