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20/11/2015
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The Social Communication Intervention Project (SCIP)
An evidence-based intervention for school aged children with pragmatic language
impairment
Jacqueline Gaile Clinical Lecturer in Speech and Language
Therapy University of Manchester, UK
Website:
http://www.psychsci.manchester.ac.uk/scip
Email:
catherine.adams@manchester.ac.uk
13 November 2015 University of Copenhagen
Overview
• The Social Communication Intervention Project summary
• Assessment for children with PLI /SCD
• SCIP assessment to intervention mapping
• The three Phases of SCIP Intervention
• Metacognitive content of SCIP Intervention
• Discussion
13 November 2015 University of Copenhagen
The Social Communication
Intervention Programme (SCIP) Trial A randomised control trial of intervention for children with
pragmatic language impairment
Catherine Adams and Elaine Lockton
Funded by the Nuffield Foundation
RCT (N=88) of effectiveness of SLT for children with PLI /SCD (aged 6-11)
International Journal of Language and Communication Disorders: Vol 47:3 (2012)
& Vol 48:1 (2013)
Acknowledgements Researchers & assistants:
Jenny Freed
Jacqueline Gaile
Gillian Earl
Kirsty McBean
Jenny Gibson
Anna Collins
Ruth Wadman
Rachel Stevens
Catherine Bird
Vivienne McKenzie
Sibyl Havers
Collaborators:
Dr Catherine Aldred
Dr Janet Baxendale
Professor Jonathan Green
Dr Marysia Nash
Professor James Law
Dr Andrew Vail
Advisory committee:
Bonnie Brinton
Martin Fujiki
Geoff Lindsay
Sue Roulstone
Thanks also to
Nuffield Foundation
Greater Manchester and
Edinburgh NHS SLT Services
Parents and children in Edinburgh
and NW England
University of Manchester
undergraduate and postgraduate
SLTs
13 November 2015 University of Copenhagen
Social Communication Intervention Project
• Randomised controlled trial
• Manualised SLT intervention
• Children with pragmatic language impairment
• Aged 6-11 years old
• Mainstream schools in NW England and Edinburgh region of Scotland
• SLTs and Assistants
13 November 2015 University of Copenhagen
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Aim of SCIP study
• Ascertain the effectiveness of an intensive social communication therapy (SCIP), compared to treatment-as-usual, for children who have PLI
• On standardised language assessment functioning
• On functional pragmatic ability and broader social communication as rated by parents and teachers
13 November 2015 University of Copenhagen
85 children who have PLI
57 Children Intervention group
28 Children Control
Intensive intervention in one school term
20 sessions
Delivery by therapist or
trained assistant
Continue therapy with local services
13 November 2015 University of Copenhagen
SCIP intervention
protocol
Up to three, one-hour therapy
sessions per week (up to a maximum of
20 sessions)
Delivered in school by specialist
therapist or trained assistant
One-to-one sessions, provision of whole class and
home based activities
Parent/teacher/LSA attendance and input solicited
throughout
Manual of intervention
Complex individualised intervention
13 November 2015 University of Copenhagen
Time 1 Pre-intervention/control assessment
outcome measures and baseline assessments
Intervention or control phase
Time 2
Assessment on outcome measures immediately after therapy
Time 3 Follow-up assessment on outcome measures
Study phases
13 November 2015 University of Copenhagen
CELF 4 = standardised language test, receptive and
expressive language
Targeted Observation of Pragmatics in Children’s
Conversation (TOPICC)
Pragmatics and Autism Communication lists from
Children’s Communication Checklist CCC-2
SCIP Parent ratings of social communication
SCIP Teacher ratings of classroom listening and
communication
Outcome measures
13 November 2015 University of Copenhagen
Masked or
not masked?
Intervention effect?
Standardised language test
CELF-4
Masked No
Ratings of conversational skills
change TOPICC
Masked Yes
Parent ratings of pragmatic skills
CCC-2 lists
Not masked Yes
Parent perceptions of
improvements in social communication and related skills
Not masked Yes
Teacher perceptions of change in
classroom listening skills
Not masked Yes
SCIP Main Outcomes Summary
13 November 2015 University of Copenhagen
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Conclusions from trial
Preliminary non-definitive
evidence of effectiveness
Non-specific effects on
pragmatics
Small effect sizes and
heterogeneity
Not everything measures what it
claims to measure
Qualitative study adds to essential
information
Importance of participation measures
13 November 2015 University of Copenhagen
Bishop (2000) proposed pragmatic language
impairment (PLI) as a descriptor of the
communication profile within this overlap = “an
intermediate condition”
Kjelgaard &Tager-Flusberg (2001) Children with
ASD “exhibit language profiles of grammar,
vocabulary, and phonological processing similar to
children with SLI = “co-morbidity”
Theories of the impairment
13 November 2015 University of Copenhagen
Main pragmatic and language impairment features
observed in PLI
From Adams C (2013) Pragmatic language impairment in F. Volkmar (Ed.) Encyclopedia of Autism, Springer: New York.
Pragmatics
Responsivity
Initiations
Turn-taking
Verbosity
Topic
Presupposition
Reference
Language impairment
Non-literal language
Inference
Word meaning
Narrative
13 November 2015 University of Copenhagen
Social features related to ASD
Unusual or stereotyped intonation
Abnormalities of non-verbal communication
Social interaction difficulties
Difficulty with peer relations
Secondary behavioural difficulties
Anxiety and other co-occuring mental health problems
Lack of flexibility
13 November 2015 University of Copenhagen
SCIP
Theoretical
rationale
Social Understanding Social Interpretation
Pragmatics Language
Processing
13 November 2015 University of Copenhagen
Assessment for SCIP
• Comprehension of spoken language: sentence level
• Comprehension of spoken language: above sentence or discourse level
• Expressive syntactic competence
• Receptive and expressive vocabulary
• Oral narrative skills
• Observation of pragmatic ability in formal and informal settings
• Report of social communication ability from carers and teaching staff
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SUSI components PR SUSI 1 Understanding social context cues
HSS CCC-2 PR TR SUSI 2 Understanding emotion cues
SUSI 3 Increasing flexibility
CCC-2 HSS PR SUSI 4 Understanding thoughts and intentions
CCC-2 MIPO SUSI 5 Understanding friendships
Assessment or
Parent/Teacher Report
show identified need
Maps to SCIP Intervention Components
Prioritised aspects shaded
13 November 2015 University of Copenhagen
PRAG components PR TOPICC PRAG 1 Working on conversation skills
CCC2 TOPICC PRAG 2 Understanding information
requirements
PR TOPICC PRAG 3 Improving turn-taking skills
CCC2 TOPICC PRAG 4 Managing topic change and drift
PR TR PRAG 5 Improving and expanding discourse
styles
Assessment or
Parent/Teacher Report
show identified need
Maps to SCIP Intervention Components
Prioritised aspects shaded
13 November 2015 University of Copenhagen
Assessment or
Parent/Teacher Report
show identified need
Maps to SCIP Intervention Components
Prioritised aspects shaded
LP components WS* RS * CCC-2 LP 1 Vocabulary and word-finding interventions
FS* ERRNI LP 2 Improving narrative construction
ACE NL TR LP 3 Understanding non-literal language
CFD * WS * USP* FS * LP 4 Improving comprehension of discourse
CFD * TOPICC TR LP 5 Enhanced comprehension monitoring
13 November 2015 University of Copenhagen
SCIP Intervention
• Developmental approach
• Emphasise comprehension monitoring
• Language scaffolding
• Therapeutic techniques – Role-play, role reversal
– Sabotage, problem-solving
• Phased approach
• Integrate skills across components
13 November 2015 University of Copenhagen
Metacognition in speech and language therapy for children
with social communication disorders
Jacqueline Gaile SLT and Clinical lecturer
University of Manchester
University of Copenhagen 13 November 2015
Overview
University of Copenhagen
• Background to this research
• What is metacognition?
• Data
• Method of analysis
• Results
• Discussion– the SCIP therapy process
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SCIP Intervention
SUSI
Social Understanding and Social
Interpretation
PRAG
Pragmatics
LP
Language Processing
University of Copenhagen 13 November 2015
University of Copenhagen
PRAG
PRAG 1.1
Enhanced listening skills
PRAG 1.1.1
Listening for content
PRAG 1.1.2
Understanding looking in listening
PRAG 1.2
Understanding
speaker roles
PRAG 1.3
Giving
Information
PRAG 1.4
Understanding reciprocity
PRAG 1
Conversation skills
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Why study SCIP intervention?
• RCT evidence of effectiveness of new intervention (Adams et al. 2012a & b)
• Unique experience as Research SLT on RCT
• Frequently used components
• Parents and teachers valued comprehension monitoring and reported change in academic engagement (Baxendale et al 2013)
University of Copenhagen 13 November 2015
Aims of research
University of Copenhagen
• To determine which aspects of metacognition can be identified in speech and language therapists’ interactions during therapy with children with SCD.
• Develop a method of coding metacognitive content in the therapeutic interaction between speech and language therapists (SLTs) and children with PLI
• Conduct a thematic analysis of the identified metacognitive content of SCIP intervention
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Exploratory study
• Metacognition is important in SLT but implicit (Law et al. 2008)
• Therapy tasks are – Skills acquisition or
– Metacognitive
• Theory of therapy – Form and Process
(Byng & Black 1995)
• Mixed inductive deductive analysis
• Develop theoretical perspective on data
• Constrain the analysis
• Limit influence of tacit knowledge / beliefs
University of Copenhagen 13 November 2015
What is metacognition?
University of Copenhagen
Flavell (1979)
Metacognitive knowledge
• Person knowledge
– the knowledge one holds about one’s own learning,
• Task knowledge
– the design and demands of tasks
• Strategy knowledge
– How to select and apply the right strategy to succeed
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What is metacognition?
University of Copenhagen
Veenman et al., 2006
• WWW&H Rule
– the what, when, why and how rule
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Metacognitive monitoring and control
University of Copenhagen
Lyons & Ghetti, 2010
• Monitoring one’s mental processes
• Taking action to ensure success on a task
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Thematic analysis
• Mixed inductive and deductive analysis
• Iterative process of analyis
– Define actions with the data at different stages of analysis
Fereday & Muir-Cochrane 2006
Whitebread et al 2009
Bryce & Whitebread 2012
University of Copenhagen 13 November 2015
Data
• Existing data set of SCIP video recordings
• Ethical procedures – NHS Ethics
– Local R&D approval
– Consent
• Sampling procedure – Typology to gain representative sample of SCIP cohort
– Purposive sample
• Critical case (Patton, 2001)
University of Copenhagen 13 November 2015
Data selection criteria
• Clinical profile of SCIP cohort
– +/- ASD; +/- Language Impairment
• Therapy content
– 3 sections in SCIP Manual (SUSI, PRAG and LP)
• Time point in each child’s therapy
– Spread over 20 sessions
• SLT and SLTA
– Sessions from each member of the team
University of Copenhagen 13 November 2015
Data set
Case Age CELF-4 CLS SCQ Clinical profile
1 71 56 21 PDD-NOS + Language Impairment
2 123 67 14 Non-ASD + Language Impairment
3 102 87 37 ASD + normal limits language
4 94 90 15 PDD-NOS + normal limits language
5 109 62 11 Non-ASD + Language Impairment
Mean 99.8 72.4 19.6
Range 71-123 56-90 11-37
SCIP Mean
100.5 72.6 20.3
SCIP Range
71-128 40-114 2-37
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Data set
University of Copenhagen
Case no
SCIP session number
RSLT or ThA
SCIP Intervention content: Section and activity numbers
1* 1 RSLT PRAG 1.1.1
PRAG 1.1.2 LP 5.1.1 LP 5.1.2
SUSI 1.1.1 LP 2.1.2
1 8 RSLT SUSI 1.4.1 LP 1.2.1a LP 4.2.1 LP 4.1.1
2 11 ThA SUSI 2.5.1 SUSI 2.5.2 SUSI 5.1.1 PRAG 5.3.1 SUSI 4.2.1
2 18 RSLT LP 3.1.2 LP 1.1.6 LP 4.2.3 LP 1.5.2
3 14 ThA SUSI 2.2.1 SUSI 2.5.2 SUSI 4.2.1 PRAG 5.3.1
4 16 ThA LP 4.2.3 LP 4.2.2 LP 4.2.4 PRAG 5.1.4 SUSI 4.2.1
5 15 RSLT SUSI 3.1.1 SUSI 3.1.2 LP 4.2.4 PRAG 1.5.3
5 4 RSLT SUSI 1.3.1 SUSI 1.4.1 PRAG 1.4.4 LP 2.2.1 LP 2.3.1
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Selecting the critical case
University of Copenhagen
• Integration of SCIP intervention activities
• Included all three areas of SCIP Intervention, i.e. LP, PRAG and SUSI goals
• Included activities on comprehension monitoring LP 5 and metapragmatics PRAG 1
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Planned method for analysis
University of Copenhagen
• Development of the initial metacognitive coding framework (MCF) using the critical case
• Use of the MCF to code transcripts of therapy sessions for the selected sample
• Thematic analysis of the data to determine the nature of metacognition in SCIP therapy content and delivery
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Initial Metacognitive Coding Framework
1. Literature Review: metacognition terminology
2. Transcribe critical case; familiarisation
3. Examine each utterance; create a list of codes
4. Review and emphasise metacognition
5. Search for patterns and relationships
6. Create the initial Framework
7. Verify the MCF against the critical case
13 November 2015 University of Copenhagen
Initial Metacognitive Coding Framework Steps in analysis Contribution to developing the IMCF
1. Literature Review: metacognition Search for terminology and key concepts
2. Familiarisation Repeated viewing, transcription, accuracy checks Add notes on context & initial thoughts on the metacognitive content
3. Examination of each utterance Interpret utterances in metacognitive concepts Create a list of codes using metacognitive terminology
4. Review of the list of codes with the transcript
SLT content and aims reconsidered in terms of metacognitive concepts and terminology
5. Search for patterns and relationships between codes
The codes were grouped into categories of super-ordinate and ordinate terms.
6. Framework compiled using code numbers (e.g. 1.1.2)
Codes were allocated to the IMCF in the order in which they were observed in the critical case
7 Verify the MCF against the critical case
The transcript of the critical case was coded using the initial MCF. Illustrative examples were added to the MCF for each category and sub-category. University of Copenhagen 13 November 2015
Step 3 – metacognitive interpretation
University of Copenhagen
• Terminology from SLT practice re-coded using metacognition terminology
• ‘feedback’, ‘praise’, ‘correction’ and ‘reinforcement’
• ‘reinforcement’ coded to represent its metacognitive function, i.e. ‘feedback on using a strategy’
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Iterative process
Case 1 • Coded using Initial MCF
Case 2 • Add new
codes as needed
• IMCF_V2
Case 3 • Code using
IMCF_V2
• Add new codes as needed
13 November 2015 University of Copenhagen
Making analysis explicit
University of Copenhagen
• Thematic charts – Data from all the transcripts allocated to the same
code are separated from their original context and collected together in one chart.
– Patterns within and across cases
• Thematic maps – represent the hierarchical relationships between codes
• Potential themes – Links between potential themes
• Main themes
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Results
University of Copenhagen
• Metacognitive coding framework • Metacognitive knowledge
– Person – Task – Strategy
• Metacognitive skills of monitoring and control • SCIP therapy process • Task design and demands
– Controlled by SLT – Adjusted the metacognitive content
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Metacognitive coding framework
University of Copenhagen
• Category 1: Talking about tasks
• Category 2: Talking about prior knowledge
• Category 3: Talking about strategies
• Category 4: Talking about monitoring
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Metacognitive Coding Framework
Category 1: Talking about tasks
Code and sub-code with reference numbers Example to illustrate
1.1 naming
tasks
1.1.1 using specific names
for tasks
And what you and I are going to do today,
we’re going to think about good listening
1.1.2 the non-specific
names for tasks
We’re going to do lots of nice things today,
shall I tell you what we are going to do?
1.1.3 CHILD names a task Child: Good listening
University of Copenhagen 13 November 2015
Metacognitive person knowledge
University of Copenhagen
• Mental state verbs taught (LP 5)
• Explicit in discussion
• Explicit discussion about other people’s knowledge, thoughts and feelings
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Monitoring person knowledge
University of Copenhagen
• Comprehension monitoring strategies to reflect on knowledge and aid comprehension
• Benefit of using a strategy was made explicit (LP, PRAG and SUSI)
• Explicit links between using the strategy (or not) and mental and feeling states
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Metacognitive task knowledge
University of Copenhagen
• Demands, materials and strategies
• Steps explained alongside a demonstration
• Task design
– Role-play and role-reversal
– The child’s actual experiences
– Include rule breaks: error-detection and problem-solving
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Using real events in therapy
University of Copenhagen
Ok, so let’s drive. I think I saw your mum this morning. Child: Yeah, she always drives. So there’s the car, [drawing] and in the back, there’ll be you Child: No I’m not in the back, I’m in the front. Are you? [drawing] There’s mummy in the front driving, and you on the other side and your sister is in the back. Anyone else? Child: No. After discussion about the child’s actual routine a fictional problem is introduced for him to solve. I know, that’s your routine, that’s right. OK, so once you get in the car, you always drive the same way. But, one morning, [drawing] there are some road works. Child: No! We don’t have road works at my school.
(Case 5 session 15 SUSI 3.1.2) 13 November 2015
Metacognitive strategy knowledge
University of Copenhagen
• Strategy names – explicit and implied
• The steps in strategies were:
– discussed
– modelled through role play
– represented using drawings and symbols
• Strategies were demonstrated to the child correctly and incorrectly
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“Thinking about the work”
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• [Arranges puppet to look at the story] So I need you to think about the work • Child: yeah • How the cat purred and how the witch grinned, as they sat on their
broomstick and flew though the wind • Child: phew phew [actions for wind swooshing] • But how the witch wailed, and how the cat spat
• Child: I • when the wind blew so wildly it blew off her hat • Child: I got four toys in my pocket
• Were you thinking about the work? [points to icon on chart] You were thinking about something else.
• Child: nods and smiles • You were thinking about toys in your pocket. So you missed the [shows
picture of hat to child] • Child: hat
(Case 1 session 1 PRAG 1.1.2)
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‘Play with other children’
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Have you tried out playing with other people? Child: I did. You did? What did you play? Child: Um… football. … • The steps in the strategy are reiterated So did you go over? What did you say? Child: Do you want to play football? Do you want to play football? That was really good… because we talked about that last time, didn’t we? Going up to other people and saying, “Please can I join in?”
(Case 4 session 16 SUSI 5.2.1)
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Making strategy use explicit
University of Copenhagen
• Child: It’s in a café
• It is in a café, isn’t it? So what are the clues that tell you where it is?
• Child: Cos there’s drinks, and people, order-taking people….
• Brilliant. So you are looking at the picture and you are doing some working out as well.
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Independent use of strategies
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• If you have a strong feeling like being angry or upset or something,…what you could do is turn to a blank page in your book and you could draw the feeling, draw the big triangle
• Child: I remember I drew that • And have a think about what might make you feel
calm. • Child: I remember you doing that. • I did draw that didn’t I? But you’ve written nice and
quiet. (Case 5 SCIP session 15 SUSI 3.1.1)
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13 November 2015 University of Copenhagen
Sabotage and problem-solving
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• Multiple examples in the data from all time-points
• All sections of the SCIP manual (LP, PRAG & SUSI)
• All cases
• SLT and SLTAs
• Materials – task design
• SLT/A made deliberate errors as part of task delivery
• Role play and role reversal
• SLT used the child’s errors as they arose
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Task materials
University of Copenhagen 13 November 2015
Task materials
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Sabotage- do not ask for help
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• Can I have 5 guesses? • Child: Yeah • Is it a telephone? • Child: No • Is it a watch? • Child: No! • [SLT marking guesses wrong with an ‘x’ and draws a sad
face next to the ‘x’] Oh I feel a bit sad now. • Child: Yeah [looks at SLT with concern] • I’m beginning to feel a bit sad now because my guesses are
wrong (Case 1 session 1 LP 5.1.2)
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Role play plus sabotage
University of Copenhagen
• Do you know that sometimes we have conversations with problems? And we sort them out. I’m going to be him and you can be her, OK, are you ready?
• Child: Pardon, excuse, hello • Can you just stop squashing me? [angry voice] • Child: Sorr – eee! [angry voice] • Was that a problem? • Child: [nods]
(Case 5 session 15 PRAG 1.5.3 within LP 4.2.3)
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Review actual attempts to use strategies
University of Copenhagen
• And there were balloons, weren’t there? • Child: Yeah • Did any pop? • Child: once … near the door there was pop and it was close to my
mouth and I nearly cried. I didn’t…… • So you don’t need to feel a ‘big nervous’, do we? • Child: No • Just a ‘small nervous’ • Child: Yeah • Ok, so let’s see if next time there’s a party, see if you can, if you can
keep • Child: Calm
(Case 2 session 11 SUSI 2.5.2)
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Metacognitive skills in SCIP intervention
University of Copenhagen
• Monitoring and control of listening skills
• Monitoring feelings in self and others
• Monitoring use of language strategies
• Monitoring social interactions self and others
• Self-monitoring in real time
– Using child errors on tasks to promote monitoring
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Monitoring and control of listening skills
University of Copenhagen
• Monitoring a puppet using strategies for listening to a story
• Controlling a puppet to use strategies for listening • Self-monitoring listening to the same story
So well done, keeping your hands still. What were you thinking about? Child: I was thinking about listening You were, you were thinking about the work.
(Case 1 session 1 PRAG 1.1.2)
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Monitoring feelings in others
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• Role-play to monitor other people’s feelings • Comment on how people feel when others ‘make mistakes’ So we are going to look at their faces and see who is OK and who is not OK… And how close do you think she is standing to him? Child: Really close… Child: [reaches for pen] I want to do the face What is the face? What’s the feeling with that sentence? Child: [draws angry face] Oh, is that worried or angry? Child: Angry
(Case 5 session 15 LP 4.2.4) 13 November 2015
Monitoring feelings in self
University of Copenhagen
• Shall we write that down in your book, under nervous?
• Child: Mmm, they’re like, [gesture hands over tummy] they’re like, you get a bit of sadness in your tummy. If it goes up you feel nervous.
• OK, so what do you do when you feel nervous?
• Child: Keep breathing. Keep breathing, yeah.
• What about when you are driving to the party … and you start to feel really nervous, and you’re breathing slowly and you still feel nervous
• Child: Yeah, it doesn’t work
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Monitoring use of language strategies
University of Copenhagen
• Child: To the car do you know, what that thing, cross, crash-down truck, not like crash down.
• Not crash down, there’s another word instead, isn’t there? • Child: Oh, I forgot, what is it? • Do you know what it begins with? • Child: [shakes head no] … • How many syllables has it got? • Child: Three. Crash down truck [uses same gesture with fingers] ….. • Child: Break down truck! Aw, I know it! • And does thinking about the first letter help? • Child: Yeah, sometimes, but sometimes, I just don’t get it.
(Case 2 session 18 LP 4.2.3)
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Monitoring social interactions in others
University of Copenhagen
• Do you remember the two boys in our story and they were fighting about PlayStation, weren’t they?
• Child: PlayStation, yeah
• Can you remember we had a sad ending, because, look, how is everybody feeling here?
• Child: Angry
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Monitoring social interactions self
University of Copenhagen
• Now we’ve got to draw a story that happened to you on Saturday….What happened to you at your house on Saturday? … Well I’m going to draw the same picture as we’ve got, one of these big pictures, and I know …
• Child: [interrupts SLT] Frustrated.
• Frustrated? Is that how you were feeling on Saturday?
• Child: [points to page] Freddie, my brother..
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Self-monitoring in real time
University of Copenhagen
• How did we start talking about wrestling? • Child: By playing PS2 wrestling. • Because we were talking about noise weren’t we? Ok, and I said,
you didn’t like noise, but there was noise at Thomas’s party and you had a good time. And then, you started to tell me all about the game and how you were making the noise. I got a bit lost because I didn’t know what you were talking about.
• Child: Right The SLTA modelled and explained the strategy that will repair the problem. • So if you were going to tell me about the wrestling game on the
PlayStation you need to say, ‘The reason we were making lots of noise was this really noisy game’.
(Case 2 session 11 using a strategy from PRAG 4.2.1 in SUSI 2.5.2)
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Metacognition in SCIP therapy
University of Copenhagen
• Manipulation of the therapy task
– Task demands
– Therapist actions
– Task materials
– Therapy goals
• Skills acquisition
• Monitoring use of skills
• Control of skills once acquired
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Design variables in SCIP therapy tasks
University of Copenhagen
• Strategy use by SLT/A or child – Incorrect strategy use
– Correct strategy use
• Events in communication and interaction – Generic events to illustrate communication and
interaction
– Actual events in child’s attempts at communication and interaction
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The SCIP therapy process of modification of task design and delivery variables
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Generic event Actual event
Correct strategy use
Incorrect strategy use
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Q1:correct strategy use in generic
• GOAL- learning WHAT strategy to use and WHEN
• SLT ROLE – modelling correct use
• METHOD - Role play
• MATERIALS – visual representations of skilled use of strategy
13 November 2015 University of Copenhagen
Q2:correct strategy use in actual event
• GOAL- learning HOW and WHEN to use a strategy
• SLT ROLE – give feedback on use
• METHOD - Role reversal
• MATERIALS – visual representations of skilled use of strategy
• Self-monitoring skilled use
13 November 2015 University of Copenhagen
Q3:Incorrect strategy use in generic event
• GOAL- learning to monitor others’ strategy use
– WHAT, WHEN and WHY it is important
• SLT ROLE – modelling incorrect use (approximate child errors)
• METHOD - Role play plus sabotage
• MATERIALS – visual representations of error in others’ use of strategy
13 November 2015 University of Copenhagen
Q4:Incorrect strategy use in actual event
• GOAL- learning to monitor and repair own strategy use
• WHAT, WHEN, WHY it is important and HOW to use it
• SLT ROLE – give feedback on strategy use
• METHOD - Role reversal plus sabotage
• MATERIALS – visual representations of error in child’s use of strategy in actual event
13 November 2015 University of Copenhagen
University of Copenhagen 13 November 2015
Discussion
University of Copenhagen
• Metacognitive Coding Framework
• Explicit explanation of metacognition in SLT
• Process of SCIP therapy – Skills acquisition
– Metacognitive
• Generalisation – flipped context (Timler et al 2007)
• Clinical education
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Limitations
University of Copenhagen
• Bias arising from extensive knowledge of the SCIP intervention manual content and delivery
• Small sample size necessary
• Reported the steps in analysis
• “Thick description” (Geertz, 1973)
• Written a reflexive account of research across
the research process
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What next?
University of Copenhagen
• Can MCF be used to determine metacognition in SLT for other development language disordered populations? (cf Whitebread et al. 2005, 2009, 2012)
• Can metacognition be positioned within a theory of therapy alongside theories of impairment and development?
• Can this method of close examination of therapy contribute to our understanding of mechanisms of change?
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