JCPSLP vol 19 no 3 2017 low res. pdf

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JCPSLP Volume 19, Number 3 2017 127
supporting a student with SEBD with the formulation of a
behaviour support plan (BSP). A BSP is a school-based
document designed to assist individual students who have
experienced harm, are at risk of harm, or have caused harm
to others (Victorian Department of Education and Training,
2017). This document is developed jointly by school staff
and the student’s parents or carers, allows the expectations
and planned supports for a student to be communicated
clearly, and documents any known triggers for unwanted
behaviours. Guidelines for promoting positive behaviour
place a strong emphasis on the importance of clear
communication between all parties involved, including the
student (Victorian Department of Education and Training,
2013).
If indicated, Victorian government schools may make an
application for a student in the severe behaviour category
under the PSD. To be eligible to receive additional support
and funding, students must meet the criteria outlined
in Table 2. It is at the point of application that students
are often referred to a SLP to ensure they meet the
exclusionary criterion of not presenting with a language
impairment. Standardised language assessments are
used to measure language at a word and sentence level,
but are often not sensitive to subtle higher level language
difficulties that affect discourse or pragmatic skills. The
criterion of excluding language impairment is at odds
with both the Australian and international literature that
demonstrates the high rate of co-morbidity between SEBD
and communication difficulties.
A growth in alternative educational settings, offering
smaller classes and individualised programs, has been
seen across Australia in recent years (McGregor & Mills,
2012). Mainstream settings may refer students who are
at risk of disengagement and not able to participate in the
classroom to these alternative programs. These settings
are predominantly for secondary school students; however,
alternative (often temporary) placements are available
for primary school-aged students in some locations.
Support may also be available from psychologists and
counsellors, in both mainstream and alternative school
settings; however, the success of behavioural interventions
with students with undiagnosed complex communication
difficulties is likely to be less than optimal if specialist SLP
services are not also made available to these students.
Despite the current provisions for intervention and
support, students with severe SEBD are at the highest risk
of being suspended and excluded from school (Armstrong
et al., 2016; Graham et al., 2010). While all students are
required to attend school full-time until the age of 17 in
the state of Victoria, students with SEBD are known to
often have reduced attendance, and may be removed
before the completion of the school day. Disrupted
education experiences have long-lasting implications for
the acquisition and development of language and literacy
skills (Stringer & Lozano, 2007) and for opportunities to be
exposed to and acquire prosocial interpersonal skills.
A current service example
A speech-language pathology role was instigated in a
Victorian Department of Education and Training specialist
unit for primary school students with SEBD in an outer
metropolitan area of Melbourne. Students are referred to
this specialist unit by their mainstream school and attend
the unit for three or four days per week for the duration of
two consecutive school terms, while remaining enrolled in
their mainstream school the remaining one or two days.
Teaching staff at the school have a variety of professional
who present with primary social, emotional or behavioural
difficulties (Benner, Nelson, & Epstein, 2002; Bryan, Freer, &
Furlong, 2007; Hollo et al., 2014; Ripley & Yuill, 2005; Snow
& Powell, 2011; Stringer & Lozano, 2007; Tommerdahl &
Semingson, 2013). The results of a recent meta-analysis
show that it is likely that four out of five children with SEBD
have unrecognised language impairment (Hollo et al., 2014).
Numerous studies confirm an increased prevalence of SEBD
in children with communication impairments, and vice versa
(Benner et al., 2002; Botting & Conti-Ramsden, 2000;
Cross, 2011; Ripley & Yuill, 2005; Stringer & Lozano, 2007).
Academic achievement is consistently identified as a
protective factor against antisocial behaviour, youth
offending, and drug misuse (with the inverse, academic
failure, a risk factor) (Snow & Powell, 2011; Snow, 2014). If
it is possible to identify primary school-aged students who,
because of significant SEBD, are at risk of academic failure
and school disengagement, it may be possible, through the
use of targeted, evidence-based interventions that support
language and literacy skills, to alter their educational
trajectories and prevent future social marginalisation (Law,
Plunkett, & Stringer, 2012).
Both locally and internationally, most research on the
topic of co-occurring social, emotional, behaviour and
communication difficulties in the field of speech-language
pathology has taken the form of prevalence studies.
Interventions targeting social and emotional well-being
and functioning in students with SEBD are reviewed in
the literature; however, fewer interventions that directly
target communication are available. Law, Plunkett and
Stringer (2012) have published a review of communication
interventions that have targeted behaviour in children
between the ages of 5 and 11 years of age. They
reviewed 19 studies that all showed a positive impact on
the students involved; however, there was a high level
of heterogeneity between studies. Interventions trialled
included speech and language interventions at both
and individual and classroom level, as well as functional
communication, peer and behavioural interventions
that have been delivered in school, clinic, and home
environments. This review highlighted the need for ongoing
research in which both communication and behaviour
are considered, with collaboration between SLPs,
psychologists and other health professionals.
For SLPs working in Australian primary schools, there is
an ongoing need to advocate for assessment, intervention
and support for these students, to reduce their risk of
disengagement from school, or the later emergence of
offending behaviour that may result in contact with the law.
In recent years, understanding and insight into the particular
communication needs of adolescents in the youth justice
system has grown (Bryan et al., 2007; Snow & Powell,
2011). With increasing recognition of the school-to-prison
pipeline (Christle, Jolivette, & Nelson, 2005), learnings can
be extrapolated to younger, vulnerable primary school age
students. Indeed, conceptualising the provision of services
to primary school students with SEBD as preventative
intervention is warranted. Of critical importance is the
provision of evidence-based instruction for these vulnerable
students, to ensure the transition to literacy is made in the
first three years of school (Snow, 2014).
Clinical insights
Current provisions for students with SEBD
In Victoria, a staged approach to managing challenging
behaviour generally includes a recommendation for