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Supporting social, emotional and mental health and well-being: Roles of speech-language pathologists
174
JCPSLP
Volume 19, Number 3 2017
Journal of Clinical Practice in Speech-Language Pathology
Karen James
3 A focus on problem-solving/cause-and-
effect reasoning
It is common to find difficulties in higher level language skills
especially problem-solving and reasoning (e.g., identifying
consequences of actions). Impulsiveness, brain
development or simply not knowing how to approach
problems or unfamiliar situations can underpin some of
these difficulties. Points 5 and 8 outline some ideas about
how to target these areas.
4 A focus on literacy skills
Literacy is a common difficulty seen in individuals with EBD,
ADHD, and/or ODD. Poor spelling, reading fluency and
comprehension means that students may try to avoid tasks
involving these skills. It is not uncommon to observe a
student reluctantly start a written task and suddenly stop
and refuse to proceed because they come to a word they
can’t spell. To help, have a pre-prepared vocabulary list with
simple common words for them to refer to, including words
such as
there
,
because
,
they
,
which
, etc. Read the words
to them and point out that they can choose to use this to
help if they want. Encourage them to ask you to add other
words they need help with during written tasks. Emphasise
the fact that the bigger the list the better it is, because it
shows that they are recognising words that they need help
with.
With respect to generation of written texts, students
can often recite the parts required in a written text but
either an inability or lack of confidence in generating ideas
prevents them from doing so. They need help drafting
ideas and determining appropriate vocabulary to use. A
basic
Wh
scaffold can help. Once the basic
Wh
elements
are completed, you can ask the student to expand on
each idea by providing scaffolds for specific information to
include, for example: “What does the boy look like?” “Think
about his size” (introduce list vocabulary related to size);
“What is he wearing?”
Oral texts may be easier to produce than written. For
this reason, consider using a voice to text program (e.g.,
Dragon Naturally Speaking) to get the student started on a
story. Once the student sees their story in writing, they are
more likely to attempt editing or adding details.
5 Games!
Games are powerful tools in both assessment and therapy,
irrespective of a student’s age. Even the most “defiant” and
“toughest” child/teenager will, more often than not, agree to
“have a look” and then participate in a game. A game can
be perceived as non-threatening and therefore non-
stressful. Games are interactive which means students are
more likely to attend for longer than during pen and paper
K
aren James is a speech pathologist who works with
clients (particularly teenagers) who have emotional
behavioural disorders (EBD), attention deficit
disorders (ADD/ADHD) and oppositional defiant disorders
(ODD). Karen has compiled a list of her Top 10 ideas
and resources for working with this population including
useful assessment ideas, ideas to help focus clients who
have problems attending to tasks, and strategies that
have proven effective in overcoming defiant and resistant
behaviours.
Poor communication can be one of many contributions
to disruptive behaviour as is seen in emotional behavioural
disorders (EBD), attention deficit disorders (ADD/ADHD),
and oppositional defiant disorders (ODD). Individuals may
have difficulties with: (a) understanding what is being
asked of them, (b) explaining themselves and the actions
of others, (c) relaying the story around a single or series of
events, and (d) understanding interpersonal relationships
and social cues. Individuals may also have challenges with
supplying sufficient or specific information, higher level
executive functioning for problem-solving, planning and
expressing ideas (particularly in writing), auditory processing
difficulties, making inferences, and thinking about abstract
ideas. Social communication difficulties are also prevalent.
1 A focus on oral language
Narrative production can be difficult for individuals with
EBD, ADHD and/or ODD. They may be literal in their
interpretations and explanations, may omit important
information, and may be unable to take alternate
perspectives and adjust their message accordingly.
Problems commonly occur in narrative microstructure (e.g.,
amount and variety of vocabulary; length of utterances;
specificity; unnecessary repetition of information) and
macrostructure (e.g., story introduction, event sequencing,
identifying emotions, problems and possible solutions;
providing a clear conclusion). Oral language skills are
usually stronger than written language and therefore provide
the strongest platform for learning.
2 A focus on social communication
For those with EBD, ADHD and ODD, language and social
communication problems are often masked by the
presence of difficult behaviours. Receptive and expressive
components involved in social communication may be
impaired. Most individuals may be able to state social
conventions, however are less successful at demonstrating
them. Emotional vocabulary frequently requires
development, with students often unable to distinguish the
difference between feeling “bored” versus feeling “anxious”
or “confused”. Ideally teaching needs to happen in the
“here and now” to allow for maximum impact.
Top 10 resources
Supporting individuals who have emotional behavioural
disorders, attention deficit disorders and oppositional
defiant disorders.
Karen James