7.3 Emotional functioning and mental health 1 (R)

Trauma and its Impact on Speech, Language, and Communication Needs:

Systemic adversity can profoundly affect children and young people's outcomes. Economic disadvantage, racism, or other forms of discrimination contribute to systemic adversity. The term 'trauma' refers to the psychological response to one or more distressing or life-threatening events, whether one-off, prolonged, or repeated. Trauma can begin during pregnancy if the mother experiences severe stress. Early, repeated abuse, neglect, substance misuse, or mental health issues within a child's crucial relationships can lead to trauma. Many children and young people with adverse experiences or insecure attachments may have speech, language, and communication needs.

Speech, Language, and Communication Needs (SLCN):

SLCN is considered a hidden disability because it's not immediately obvious. Individuals with SLCN may struggle to understand and remember information, express themselves, or follow social interaction norms.

Adverse Childhood Experiences (ACEs):

ACEs are typically ten potentially traumatic events occurring before age 18. Research shows a cumulative relationship between the number of ACEs and negative outcomes in health, wellbeing, behaviors, and opportunities.

Size of the Issue:

- 31% of young people report trauma exposure, with 8% experiencing post-traumatic stress disorder (PTSD) by age 18.

- 80% of children in need in England had experienced at least one adverse childhood experience.

Groups at Risk:

- Trauma exposure is higher among certain groups, including children with developmental disabilities and those from Black, Asian, and ethnic minority communities.

Impact of Adversity and Trauma on Communication Skills:

- Children who have experienced abuse and neglect are more likely to have poor language and social communication skills.

- Flashbacks and chronic stress can affect language areas in the brain.

- Children with Reactive Attachment Disorder may have social communication difficulties similar to autistic children.

- Developmental trauma can shape the brain, making positive interaction difficult.

Attachment and Communication Skills:

Attachment refers to the bond between a child and a responsive adult. Securely attached children tend to have better language skills, learn words for thoughts and feelings, and tell longer, coherent stories. Attachment issues can be risk factors for mental health issues.

Baj's Story:

Baj, a 10-year-old, initially attributed her unconventional behavior to early traumatic experiences. A speech and language therapy assessment revealed a language disorder and social communication difficulties indicative of autism. An autism diagnosis helped understand and support her better.

Jem's Story:

Jem's speech and language development concerns were ignored, leading to behavioral issues and school exclusions. A specialized speech and language therapist diagnosed Developmental Language Disorder, and Jem is making progress with reduced exclusions.

Role of Speech and Language Therapy:

Speech and language therapists can:

- Identify communication and interaction needs, contributing to early intervention.

- Help children develop language and communication skills to express themselves.

- Provide appropriate therapy for those in need.

- Support fostered and adopted children.

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Speech and Language Therapists' Role in Supporting Children:

Collaboration with Other Professionals:

- Speech and language therapists (SLTs) collaborate with multidisciplinary teams, including those in education, social care, and mental health settings.

- They work to increase awareness of speech, language, and communication needs (SLCN) and how to support them.

- SLTs promote inclusive communication by creating communication-friendly environments that remove barriers.

Assessing Attachment and Language Skills:

- SLTs support professionals in assessing attachment by considering a child’s language skills, using language-based assessments and interventions.

Interventions and Accessibility:

- SLTs identify accessible interventions or adapt existing resources to make them accessible.

- They develop responses to behavior focusing on positive communication and language for emotions while avoiding exacerbating trauma.

Training for Parents and Carers:

- SLTs provide training to parents and carers, helping them access parenting language and other interventions.

- They equip parents with the skills needed to support children in developing their language and communication.

Early Identification of Abuse and Neglect:

- SLTs have a potential role in the early identification of abuse and neglect, as language development and attachment depend on sensitive interactions.

Speech and Language Therapists' Contributions:

- Increasing awareness of SLCN and supporting their needs.

- Promoting inclusive communication environments.

- Assisting professionals in assessing attachment through language skills.

- Identifying accessible interventions and adapting resources.

- Focusing on positive communication to address behavior.

- Providing training to parents and carers.