Children's speech, language and communication development in the context of complex vulnerabilities - Attention Deficit Hyperactivity Disorder (ADHD) and Reluctant Talkers

Flashcards from DDoC Lecture 8

what is childhood psychiatric disorder

children who show severe impairments in their behaviour, development, learning, mood and social functioning, where these are not adequately explained solely by primary medical factors

what is social competence

child engages appropriately in social interaction

what is attachment

child established a secure attachment with primary carer from bith

what is emotional competence

child aware of their emotions and those of others and are able to manage / regulate how they express or show these emotions to toerhs

what is self-perceived competence

child is aware of their own strengths / weaknesses in relation to their peers and are able to use this in their own motivations

what is temperament

child’s intrinsic personality in how he / she reacts to experiences and then manages these

to what extent are child’s developing communication skills needed for socio-emotional competence

attachment - if primary carer can’t engage in attachment it makes communication harder - infant needs to prerequisite intent to be communicative and to encourage their caregivers to communicate with them as well

emotional competence - learn how to express emotions through primary caregiver modelling, child needs to learn vocabulary of emotions and how this maps onto emotions in order to understand and express to others

social competence - children need to be competent communicators with adequate and appropriate social communication skills to engage appropriately in social interaction

self-perceived competence - children need to be effective communicators who can then have strengths in effective interactions, friendships and relationships

temperament - children have different temperaments expressed through being shy, quiet or more talkative and communicatively confident

what is the foundation of child’s development in terms of psycho-social adjustment

secure attachment

what is Attention Deficit Hyperactivity Disorder (ADHD)

behavioural disorder, defined by impulsiveness, inattention and hyper / over-activity

impulsiveness - interrupts others, impulsive behaviour, unable to think of consequence of behaviour, difficulty waiting turn, blurts out answers before question finsihed

inattention - impaired attention, unable to attend to task sufficiently, v easily distracted, difficulties maintaining attention to one task, doesn't listen when spoken to, doesn’t follow instructions through

hyper / over-activity - v fidgety, runs about or climbs excessively in inappropriate situations, describes as constantly being on the go, talk excessively

when do behaviours have to present before to get an ADHD diagnosis and where must they impact

before 12 years old, over multiple settings, aspects and domains of child’s life

what are some ADHD difficulties in psycho-social functioning

result in anti-social behaviour, peer and family relationships affected because of poor behaviour, progress at school is poor

what was the DSM-V update for ADHD

recognition that ADHD continues into adult life

symptoms must be present before 12 rather than 7 (in DSM-IV)

recognition of comorbidity

how many children under 18 have ADHD in the UK and what is the demographic

5% though many undiagnosed cases

boys diagnosed more frequently than girls

majority of cases referred from GPs

often diagnosed in comorbidity with other disorders - learning disability, autism, conduct disorder, language disorder

what are some environmental and genetic factors for having ADHD

having a biological relative with ADHD, extreme early life adversity, pre and post natal exposure to lead, low birth weight / prematurity

what is hyperkinetic disorder

term sometimes used for children with more severe symptoms, usually in the hyperactivity domain although still need to be symptoms in all three domains

what is explanations for comorbidity between speech and language difficulties and ADHD

comorbidity of neurodevelopment disorders

difficulties in attention and distractibility impact on how well children can listen and attend to environment - thus affects language learning

can often have mild learning disability which slows rate of language learning

social communication difficulties often result of impulsive behaviour - blurting out answers, not waiting turn

what is a reluctant talker / selective mutism

consistent failure to speak in specific social situations in which there is expectation for speaking (eg: classroom) despite speaking in other situations (eg: at home)

interferes with education / occupation achievement/ social communication

must last for at least 1 month - not 1st month of school as could just be social anxiety / attachment

not due to lack of knowledge or comfort with language in use

not better explained by communication disorder (eg: stuttering)

how rare is selective mutism

0\.8 per 1000 population in US

describe the demographic of selective mutism

comorbidity common

slightly more common in girls

onset usuallly between 3 and 5

anxiety major feature

children have wide IQ and come from range of backgrounds

what does an SLT consider when desensitising a child to talking

child’s communication environment & communication load of the communication task

what are the stages of confident speaking

no communication or participation

cooperation but limited communication

visual but not verbal communication

can use non verbal sounds

can speak within earshot of someone

single words with certain people

connected speech with certain people

generalising to others

communicating freely