10- Children with social, emotional and behavioural difficulties Flashcards
In what ways did the SLTs adapt their DIRECT therapy and service delivery models?
direct-
Gradual introduction to toys, recognition some may not have experienced them.
SLTs emphasised language stimulation, modelling, parallel play, expansions
Trauma-informed practice e.g. for externalising behaviours..
+ visual stimuli in room minimised
+ one activity introduced at a time
+ visual activity scheduling board
+ positive reinforcement for accurate speech sound attempts only
For Internalising behaviours…
+ strategies to reduce proximity of FC to child in session
+ SLT liaised with school for increased number of visits before school entry
+ Info presented in a calm manner
+ Toys with low level of noise
+ Noises were encouraged in play (gradual desensitisation to noise by promoting them as fun and positive)
+ Vocab provided to describe noise e.g. bang, crash
+ Clapping and singing activities introduced
SLTs used non-standardised assessments adapted for children who have experienced trauma, give examples:
Language samples taken with more familiar partners e.g. foster carer, sibling, using own toys/books
FC questionnaires about child’s reading ability, emotions etc.
In what ways did the SLTs adapt their INDIRECT therapy and service delivery models?
Foster Carer Education and Support for language stimulation techniques, trauma-informed practice
Caseworker Collaboration- SLTs maintained contact with caseworkers, providing them with summary reports
Service Prioritisation
Flexible service delivery to accommodate needs e.g. additional sessions without referral, continuity of services where possible (same SLT), transfer of care to equivalent waiting times if change across services/locations should occur.
What potential risks for the child were avoided by using a trauma-informed approach?
considered impact of maltreatment on the children’s sensory systems, neurological development
What potential risks for the child were avoided by using a trauma-informed approach?
Avoided:
SENSORY OVERLOAD- maltreated children may have heightened sensitivity to sensory input. Minimising visual stimuli and noise prevents child becoming overwhelmed
RE-TAUMATIZATION- trauma informed approach emphasizes importance of building trust/rapport. Worked closely with FCs to establish supportive environment avoid triggering any past traumas.
MISINTERPRETATION OF BEHAVIOURS-
SLTs recognises challenging behaviours were not intentional but coping mechanisms in response to their experience, so SLTs could respond in a helpful rather than punitive way to avoid escalating the situation.
INACCURATE ASSESSMENT-
due to anxiety, difficulty focussing. Sources of non-standardized assessment used instead.
What does ACEs stand for?
Adverse Childhood Experiences
Maltreatment ie abuse/neglect
Violence/coercion ie gang membership
Household adversity e.g. substance misuse
Adjustment ie asylum
Adult responsibilities ie young carer, child labour
Bereavement ie traumatic deaths.
Order of brain development. What are the most important years?
- Brainstem (motor/sensory input)
- Limbic brain (attachment, emotion, behaviour)
- Cortical brain (thinking. planning, learning)
0-3 years
Insecure attachment styles- avoidant attachment
If showing caregivers emotions tended to push them away. To keep close must switch them off. Those children like to let you know they are completely fine.
ambivalent attachment
They learn that expressing really big emotions is what keeps carers there. Really large behaviours e.g. screaming
disorganised attachment
Child couldn’t find strategy that keeps them safe e.g. carers frightening OR frightened. May organise behaviour around perceived danger. Changes way they behave in different places.
Disinhibited Social Engagement Disorder
indiscriminate attachment to absolutely anybody.
Direct link with language development
Poor quality of attachment and interaction with caregivers- e.g. need shared attention, labelling things.
Insecure attachment increases risk of poor vocab development.
Neglect and a lack of stimulation.
Insecure attachments impact learning behaviours.
Poor home environment and not attending school.
Percentage of the youth offending population with SLCN
60%
What are externalising behaviours?
Oppositional, attention seeking and hyperactivity e.g. child did not like receiving specific feedback, child presented with reduced attention
What are internalising behaviours?
Being withdrawn, fearful, scared of loud noises, separation anxiety e.g. may not let FC out of sight, child scared of loud noises, child withdrawn
Children only begin to regulate own nervous system after repeated experiences of trust i.e. baby feels hungry, baby cries, someone feeds them. Eventually know they will be fed.
Complex PTSD throughout childhood leads to shame, how is shame different from guilt?
Guilt= i have done something bad
Shame= I am bad
There is a direct link with language and development,
Poor quality of attachment and interaction with caregivers- e.g. need shared attention, labelling things.
Insecure attachment increases risk of poor vocab development.
Neglect and a lack of stimulation.
Insecure attachments impact learning behaviours
Poor home environment and not attending school
What are masking behaviours?
Children with SEMH (social, emotional and mental health) and children with unidentified SLCN often use behaviour to mask their needs
e.g.
Watch and copy everyone else.
Be aggressive, shout, swear, get angry.
Be quiet and compliant and agree with everything.
Pretend not to hear or ignore you.
Repeat words you say so you think they understand.
Ask pointless questions/ talk about something else
