Dear Kerry
I take account of Caroline's note about our topic here. But it seems
to me that speech should not be absolutely separated from language.
After all neither is naturally experienced without the other. And on
my reading of the literature and my own clinical experience, the rate
of co-morbidity across speech and language disorders is highly
significant. And delegates at the recent COST conference in London
seemed to take a correspondingly broad view of SLI - to include speech,
I can think of two cases both with what seemed like an across the
board problem with no speech or language where I now think the primary
issue was probably phonological, with the input wrongly parsed (in
different ways) and with nothing therefore on which to build the
syntax. From a minimalist program perspective, with a profound
redefinition of the phonological component, this seems to me to make
sense. But I did not see this at the time - many years before anyone
was thinking about minimalism.
That said, I have to confess that i have never succeeded in really
'selling' the signing idea to parents – despite some very hard trying.
Like you, I have never seen parents happily signing back and forth
with a hearing child who is not yet talking – or anything like that.
Nor have I found a well controlled clinical trial showing that signing
really is an effective stepping stone to spoken speech. Now I can see
what seem to me quite powerful theoretical reasons suggesting that
signing as a therapy is rather unlikely to have the sort of effect
that is sometimes claimed, that its main effect is to reduce anxiety
and frustration on all sides, and to give the parents a sense of
involvement in a child's future. All worthwhile things of course.
There are other sorts of augmentative communication of course apart
from signing. But any one such step is a big one, and in the light of
EBP, I wonder...
When I decided that I was just no good at selling the signing, I
wondered what else to do.
A few years earlier, in 1976 I was I think one of the last people to
work on the date from Huxley. Atkinson and Fletcher's Edinburgh Child
Language acquisition project in 1972, which had looked at four
children, plotting the emergence of their speech and language from a
weekly sample of 20 minutes or so. The phonetic transcriptions were
made very finely. So I was reasonably familiar with the literature and
the raw data. And as an SLT student I had plotted the speech and
language development of the child of two friends (both social workers)
on the same basis, visiting weekly with a bag of toys, a tape recorder
and a notebook. But because the parents were friends we chatted about
my observations. And every time i thought i heard something
significant the parents would say: ah yes, we heard something similar
a few days ago, and give me what seemed to me like an accurate and
entirely plausible record. Crucially they did not seem to regularise
the speech or language.
Of course 30 years ago the only practical way for an external observer
to watch and listen was by weekly sampling. But it occurred to me that
parents without any special training in linguistics and phonetics
might still be good and accurate observers.
So in relation to the clinical situation of seriously delayed language
in a child, I thought of my social worker friends and the diaries
which my partner had started of our two children's development. (Her
idea, not mine). For both children this recorded a very sudden
increase in various aspects of the language, in one about 15 months in
the other about 21 months, exactly in line with the literature and my
previous experience, but on opposite sides of the normal bell. Reading
the diaries it was clear that she was using a very definite set of
criteria to decide what to record. I thought that it could be more or
less captured by the idea 'new and interesting'. And it occurred to me
that it might be useful for parents to keep a diary to give me as a
therapist an ongoing plot of how a child's language was developing.
And I started asking parents to do this. What they mostly wanted to do
was to record what they heard as accurately as possible, attempting a
kind of DIY phonetics. This I now think was entirely correct and
appropriate.
To my surprise this seemed to work almost irrespective of the
educational level of the parents. The only time this didn't seem to
work was with a parent who had a very particular sort of scientific
training which led her to want to do something more scientific. One
parent who did not know how to use lower case letters or the
difference between know and no managed just fine.
I have no reason for thinking that parental diaries help to fix a
problem. But they do, I believe, mostly provide very accurate
information. I am fairly confident of this because sometimes I have
noted almost exactly the same observation, the same words in the same
kind of situation, by different parents of different children with no
contact between them. 'New and interesting' seems to be a reasonable
criterion. Keeping the diary involves the parents. It generally
provides sensitive and accurate assessment information, and does so
better than most standardised tests. Obviously this cannot show any
kind of fine phonetic detail. Nor can it provide a position on a bell
curve or an age equivalent. But it does show if there is progress, and
at least in broad outline what sort of form this is taking. And that,
it seems to me, is a useful basis for clinical decisions.
Eventually I turned the notes I had started giving to parents into
something printed, with very useful help on the design from the head
of the local art college. Writing this makes me realise that an aspect
of those notes needs to be updated.
Would you like me to share them with you?
Aubrey
Aubrey Nunes
PhD, FRSA, MRCSLT
52 Bonham Road
London SW5 5HG
0044 207 274 8892
[Non-text portions of this message have been removed]
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