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What Lies Beneath: Language Impairments in Children with Disruptive Behavioral Disorders (What You Can Do)

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ASHA Conference 2017, Los Angeles, Presentation by Maryellen Rooney Moreau and Linda Lafontaine, MindWing Concepts, Inc.

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What Lies Beneath: Language Impairments in Children with Disruptive Behavioral Disorders (What You Can Do)

  1. 1. What Lies Beneath: Language Impairments in Children With Disruptive Behavioral Disorders (What You Can Do!) Maryellen Rooney Moreau and Linda Lafontaine
  2. 2. Maryellen Rooney Moreau, M.Ed. CCC-SLP, President & Founder, MindWing Concepts, Inc., Springfield, MA Financial: Maryellen has ownership interest in MindWing Concepts, holds intellectual property rights and patents. Maryellen is employed as president of MindWing Concepts. In that capacity, she writes books, creates materials, consults, trains and presents. Nonfinancial: No relevant nonfinancial relationships exist. Linda M. Lafontaine, M.A. CCC-SLP, Speech Pathologist and Principal at The Curtis Blake Day School at Children’s Study Home Financial: Consultant for Mindwing Concepts, Inc., Springfield, MA Non-Financial: Linda has been a friend and colleague of Maryellen Moreau, owner of MindWing Concepts, Inc. for 20 years. Disclosures
  3. 3. “Oral language competence is a key competency that needs to be acquired early in life, so that important interpersonal, academic and vocational goals can be achieved in pro-social ways and the risk of offending behavior can be reduced.” Background Information Snow, P & Powell, M. (2012). Youth (in)justice: Oral language competence in early life and risk for engagement in antisocial behavior in adolescence. Trends and Issues in crime and criminal justice, 435. Australian Institute of Criminology.
  4. 4. “Youth offenders… marginalization from the mainstream begins in early life, particularly in the classroom, where they have difficulty both with language/literacy tasks and with the interpersonal demands of the classroom. Underlying both sets of skills is oral language competence – the ability to use and understand spoken language in a range of situations and social exchanges, in order to successfully negotiate the business of every day life.”  Snow, P & Powell, M. (2012). Youth (in)justice: Oral language competence in early life and risk for engagement in antisocial behavior in adolescence. Trends and Issues in crime and criminal justice, 435. Australian Institute of Criminology.
  5. 5. “A recent meta-analysis of studies of language deficits in children ages 5-13 years diagnosed with emotional behavioral disorders found an estimated prevalence of previously unidentified language deficits around 81%” Hollo, A. Wehby, J. & Oliver, R. (2014). Unidentified language deficits in children with emotional and behavioral disorders: A meta-analysis. Exceptional Children, 80, 169-186. Westby, C. & Culatta, B. (2016). Telling tales: Personal event narratives and life stories. LSHSS. 47 (260-282).
  6. 6. “These language disorders are pervasive compromising expressive and receptive language skills across all domains – vocabulary, narrative ability, to understanding figurative language.” Snow, P. (2014). Prevalence of different types of speech, language and communication disorders and speech pathology services in Australia. Monash University.
  7. 7. “Children with EBD (Emotional Behavioral Disorders) may have fewer opportunities to interact with other children, due to frequent alienating and antisocial behaviors, and – like children with LD – fewer communicative tools to participate appropriately in interactions with peers and adults” Suggestions (among others): •  Recognize and use feeling words to describe personal feelings. •  Recognize and label feelings of others by making an inference about a person’s nonverbal cues. •  Consider the perspective of another person. Cited by Armstrong : (Hyter, et al. (2001). Pragmatic language intervention for children with language and emotional/behavioral disorders. Communication Disorders Quarterly, 23(1), 4-16. Armstrong, J. (2011). Serving children with emotional/behavioral and language disorders: A
  8. 8. Personal narratives and fictional narratives are analyzed by some form of macrostructural analysis: Story Grammar (Stein & Glenn, 1979) or High Point (McCabe & Bliss, 2003). Westby and Culatta cite the levels of story grammar analysis: •  Descriptive sequence (before 4 years): The child describes actions, scenes, or characters. •  Action sequence (before 4 years): The child describes a temporal sequence of actions or events. •  Reactive sequence (about 4-5 years): The child indicates causality between events, through terms such as because and so. Westby, C. & Culatta, B. (2016). Telling tales: Personal event narratives and life stories. LSHSS. 47 (260-282).
  9. 9. •  Abbreviated episode (about 6-7 years): The child refers to the goal of the main character but does not explain a plan or how the goal is achieved. •  Complete episode (about 8-9 years): The child refers to an initiating event and a goal, an attempt to achieve the goal, and a description of how the goal was or was not achieved. •  Elaborated episodes: Stories with obstacles to attempts, multiple sequential episodes or embedded episodes.
  10. 10. Stages of Narrative Development
  11. 11. Youth offenders in a study of personal narrative production (Noel, 2011), showed that they “expressed themselves in poorly organized, syntactically simple sentences using few dependent clauses to explicitly signal the temporal and causal relationships within their stories.” Noel, K. & Westby, C. (2014). Applying theory of mind concepts when designing interventions targeting social cognition among youth offenders. Topics in language Disorders, 34, 344-361. Microstructure Concerns
  12. 12. “Of their narratives, 51% did not have a plot, which would involve and character’s intention to accomplish a goal.” “References to thoughts and emotions, either their own or others’, were almost nonexistent.” Noel, K. & Westby, C. (2014). Applying theory of mind concepts when designing interventions targeting social cognition among youth offenders. Topics in language Disorders, 34, 344-361. In youth offenders…
  13. 13. “Language Impairment exists when you do not have sufficient expressive and /or receptive skills to verbally navigate through the business of everyday life at the expected developmental level.” Snow, P. (2014). The Language of language impairment. Roses by other names can still be thorny. The Snow Report.
  14. 14. Participants and Setting for this Study
  15. 15. Children’s Study Home History The Children’s Study Home was originally founded in April of 1865 as The Springfield Home for Friendless Women and Children. This organization was one of the first social service agencies in Massachusetts and was started by a broad group of religious leaders ‘to provide a temporary home for friendless and destitute women and children; and to give them employment and instruction with the ultimate design of providing for them a more permanent situation, or of fitting them to maintain themselves.’ (Agency Constitution, 1865)
  16. 16. Mill Pond School of the Children’s Study Home !  MA DESE Approved School Established in 1976 !  Grades K-12 !  Primary Disabilities !  Emotional !  Behavioral !  6:2 Teacher: Student Ratio !  Academic, therapeutic and recreational activities !  Follow MA Curriculum Frameworks !  Primary goal to reintegrate student back to home school district
  17. 17. Student Disability Types !  Primary (12 students) !  Emotional (Disruptive Mood Dysregulation Disorder)-8 !  Health (ADHD)-2 !  Developmental Delay-1 !  Intellectual-1 !  Secondary (8 students) !  Health (ADHD)-4 !  Specific Learning Disability-Reading-1 !  Emotional-1 !  Intellectual-1 !  Communication-1 !  Tertiary (3 students) !  Health (ADHD)-1 !  Neurological -1 !  Communication-1
  18. 18. Student Ages March 2017 September 2017 Elementary Classroom 7 to 10 years 8 to 10 years Middle School Classroom 9 to 12 years 10 to 12 years
  19. 19. Student Grades March 2017 September 2017 Elementary Classroom 1st to 4th grade 2nd to 5th grade Middle School Classroom 4th to 6th grade 5th to 7th grade
  20. 20. Related Services Speech-Language Therapy 2 x 30 minutes Occupational Therapy 2 x 30 minutes 3rd grader X X 4th grader X 5th grader X X 5th grader X X 6th grader X X 6th grader X
  21. 21. Timeline !  Baseline Narratives obtained March 2017 !  Elementary Classroom received 11 lessons from April to September 2017 !  Middle School Classroom received 9 lessons from April to September 2017 !  Final Narratives obtained end of September 2017 !  30 minute lesson
  22. 22. Narrative Protocol !  Student listened to taped story of “A Boy, A Dog and a Frog” from the Strong Narrative Assessment Protocol while following along with the picture book by Mercer Mayer. !  Student narrated story !  Narrative taped on digital tape recorder !  Narrative transcribed by second author !  Narrative scored by second author !  Narrative scored by first author
  23. 23. Narrative Instruction
  24. 24. Lesson Plan Outline !  Book talk !  Read book !  Summarized with SGM manipulative and/or magnets !  Summarized with Critical Thinking Triangle® magnets or Critical Thinking Triangle® in Action Tool !  Focused on mental state verbs !  think !  know !  remember !  realize !  Varied activities to conclude lesson
  25. 25. Universal Narrative/Expository Magnet Set
  26. 26. © Lafontaine & Moreau 2014 - www.mindwingconcepts.com - 888.228.9746
  27. 27. Mental State Verbs ! Think about the character’s thinking ! Know for a fact ! Remember from the past ! Realize from own experiences
  28. 28. TEACHING PHASE TEACHER BEHAVIOR LEARNER BEHAVIOR Demonstration •  Initiates •  Models •  Explains •  Thinks Aloud •  Shows “How to do it” •  Listens •  Observes •  May participate on a limited basis What does the Gradual Release of Responsibility Model look and sound like? Source: Routman, R. (2003) Reading Essentials, Portsmouth, NH: Heinemann. “I Do”
  29. 29. TEACHING PHASE TEACHER BEHAVIOR LEARNER BEHAVIOR Guided Practice •  Demonstrates •  Leads •  Suggests •  Explains •  Responds •  Acknowledge s •  Listens •  Interacts •  Questions •  Collaborates •  Responds •  Tries Out •  Approximates •  Participates Source: Routman, R. (2003) Reading Essentials, Portsmouth, NH: Heinemann. “WE DO”
  30. 30. TEACHING PHASE LEARNER BEHAVIOR TEACHER BEHAVIOR Independent Practice •  Applies Learning •  Takes Charge •  Practices •  Problem Solves •  Approximates •  Self-Corrects •  Scaffolds •  Validates •  Teaches as needed •  Evaluates •  Observes •  Encourages •  Clarifies •  Confirms Source: Routman, R. (2003) Reading Essentials, Portsmouth, NH: Heinemann. “YOU ALL DO” TEACHER HANDS OVER RESPONSIBILITY
  31. 31. TEACHING PHASE LEARNER BEHAVIOR TEACHER BEHAVIOR Application •  Initiates •  Self-Monitors •  Self-Directs •  Applies Learning •  Problem Solves •  Confirms •  Affirms •  Assists as needed •  Responds •  Acknowledges •  Evaluates •  Sets Goals Source: Routman, R. (2003) Reading Essentials, Portsmouth, NH: Heinemann. “YOU DO” TEACHER HANDS OVER RESPONSIBILITY
  32. 32. Thomas’ Snowsuit Thomas versus Mother and Teacher
  33. 33. Kat Kong by Dav Pilkey Mice perspective
  34. 34. Zomo the Rabbit What did Zomo know, remember and realize about the fish, cow and leopard?
  35. 35. Scaredy Squirrel makes a friend What are the similarities and differences between a fish and a dog from Scaredy Squirrel’s perspective?
  36. 36. Dogzilla Mice perspective-think, know, remember, realize about dogs
  37. 37. Something Else Discussed mental states of Something Else, the Creature, and his classmates.
  38. 38. Dr. DeSoto Perspectives of the DeSotos and the Fox
  39. 39. Wolf’s Chicken Stew
  40. 40. Too Many Tamales Question answering and question asking
  41. 41. Piggie Pie Mental states of witch, pigs and fox
  42. 42. Aunt Isabel Tells a Good One
  43. 43. Macrostructure Results Elementary March 2017 September 2017 Emergent Action Sequence Emergent Action Sequence Unscorable Heap Would Not Attempt Emergent Action Sequence Would Not Attempt Emergent Reaction Sequence Emergent Action Sequence Emergent Action Sequence Heap Emergent Action Sequence
  44. 44. Macrostructure Results Middle School March 2017 September 2017 Reactive Sequence Reactive Sequence Emergent Action Sequence Emergent Abbreviated Episode Heap Emergent Action Sequence Descriptive Descriptive Emergent Action Sequence Reactive Sequence Descriptive Descriptive
  45. 45. Macrostructure-Story Grammar Elements included in Post Narrative Classroom # of Students who included Feeling # of Students who included Plan Pre Post Pre Post Elementary 0/6 0/6 1/6 3/6 Middle School 1/6 1/6 5/6 6/6
  46. 46. Microstructure Elementary Increased Decreased No Change Cohesive Ties 5 0 1 Noun Phrases 2 0 4 Adverbs 2 0 4 Mental States 0 0 6 Linguistic Verbs 2 0 4
  47. 47. Microstructure Middle School Increased Decreased No Change Cohesive Ties 5 1 0 Noun Phrases 2 2 2 Adverbs 3 2 1 Mental States 3 0 3 Linguistic Verbs 3 1 2
  48. 48. March 2017 First Grade 7 years old Emergent Action Sequence Note first question and scaffolding Baseline Narrative
  49. 49. September 2017 Second Grade 8 years old Emergent Action Sequence Note less scaffolding, planning word, increased temporal cohesion Post Narrative
  50. 50. March 2017 Second Grade 8 years old No Level-would not attempt Baseline Narrative
  51. 51. September 2017 Third Grade 9 years old Emergent Action Sequence Note scaffolding needed at beginning Post Narrative
  52. 52. March 2017 Third Grade 8 years old No Level-would not attempt narrative retelling or questions Baseline Narrative
  53. 53. September 2017 Fourth Grade 9 years old Emergent Reaction Sequence Note lack of scaffolding Post Narrative
  54. 54. March 2017 Third Grade 9 years old Emergent Action Sequence Note only retold beginning of story and word retrieval difficulties Baseline Narrative
  55. 55. September 2017 Fourth Grade 9 years old Emergent Action Sequence Note retelling included entire story Post Narrative
  56. 56. March 2017 Fourth Grade 9 years old Emergent Action Sequence Note inclusion of macrostructure with temporal cohesion Baseline Narrative
  57. 57. September 2017 Fifth Grade 10 years old Emergent Abbreviated Episode Note inclusion of attempts, noun phrases, adverbs and mental state verbs Post Narrative
  58. 58. March 2017 Fifth Grade 11 years old Descriptive Sequence Note retrieval issues, unclear referents, minimal macrostructure, omitted middle of story Baseline Narrative
  59. 59. September 2017 Sixth Grade 11 years old Descriptive Sequence Note less scaffolding, increased macrostructure elements, included one action from middle of story Post Narrative
  60. 60. March 2017 Sixth Grade 12 years old Descriptive Sequence Baseline Narrative
  61. 61. September 2017 Seventh Grade 12 years old Descriptive Sequence Note “cliff note” beginning then increased scaffolding to elicit more details Post Narrative
  62. 62. Elementary Classroom Comprehension Questions 5 Factual March 5 Factual September 5 Inference March 5 Inference September 40% 80%/100% 50% 60% No Response 100% No Response 80%/100% 60% 80% 0% 0% No Response 80%/100% No Response 60% 50%/90% 100% 20%/40% 80% 40% 40%/60% 0% 20%
  63. 63. Inferential Questions-Elementary Question Number Story Grammar Element # of Students- Increase # of Students- Decrease No change 7 Plan 2 0 4 8 Plan 3 1 2 9 Feeling 3 0 3 10 Thought 2 0 4 No change- 12 of 13 no change responses were incorrect pre and post, 1 of 13 was correct pre and post
  64. 64. Middle School Classroom Comprehension Questions 5 Factual March 5 Factual September 5 Inference March 5 Inference September 100% 100% 70% 100% 80%/100% 80%/100% 90% 80%/100% 100% 100% 20% 60% 80% 60% 60%/80% 40%/60% 80%/100% 100% 100% 70%/100% 80% 100% 40% 80%
  65. 65. Inferential Questions-Middle School Question Number Story Grammar Element # of Students- Increase # of Students- Decrease No change 7 Plan 2 1 3 8 Plan 0 0 6 9 Feeling 0 2 4 10 Thought 2 0 4 No change- 13 of 17 no change responses were correct pre and post, 4 of 17 were incorrect pre and post
  66. 66. March 2017 First Grade 7 years old Factual 40% accuracy Inference 50% accuracy Baseline Comprehension Questions
  67. 67. September 2017 Second Grade 8 years old Factual 80%/100% accuracy Inference 60% accuracy Post Comprehension Questions
  68. 68. March 2017 Second Grade 8 years old Would not attempt Baseline Comprehension Questions
  69. 69. September 2017 Third Grade 9 years old Factual 100% accuracy Inference 80%/100% accuracy Post Comprehension Questions
  70. 70. March 2017 Third Grade 9 years old Factual 50%/90% accuracy Inference 20%/40% accuracy Baseline Comprehension Questions
  71. 71. September 2017 Fourth Grade 9 years old Factual 100% accuracy Inference 80% accuracy Post Comprehension Questions
  72. 72. March 2017 Fourth Grade 9 years old Factual 100% accuracy Inference 70% accuracy Baseline Comprehension Questions
  73. 73. September 2017 Fifth Grade 10 years old Factual 100% accuracy Inference 100% accuracy Post Comprehension Questions
  74. 74. March 2017 Fifth Grade 10 years old Factual 100% accuracy Inference 20% accuracy Baseline Comprehension Questions
  75. 75. September 2017 Sixth Grade 11 years old Factual 100% accuracy Inference 60% accuracy Post Comprehension Questions
  76. 76. March 2017 Sixth Grade 11 years old Factual 80% accuracy Inference 40% accuracy Baseline Comprehension Questions
  77. 77. March 2017 Seventh Grade 12 years old Factual 100% accuracy Inference 80% accuracy Baseline Comprehension Questions
  78. 78. September 2017 Second Grade 8 years old Word Retrieval
  79. 79. References !  Moreau, M., & Fidrych, H. (1994). How to use the Story Grammar Marker®: A guide for improving speaking, reading and writing skills within your existing program. Easthampton, MA: Discourse Skills Productions, Inc. !  Moreau, M. (1998, 2008). ThemeMaker. (An intervention manual devoted to expository text, the academic language required within it and advanced sentence structures required to communicate it.) Springfield, MA: MindWing Concepts !  Strong, C.J. Strong Narrative Assessment Procedure (SNAP). Wisconsin, Thinking Publications. (1998)
  80. 80. Copyright © 2017 • Maryellen Rooney Moreau • 1-888-228-9746 • https://mindwingconcepts.com/pages/presentations To access the slides from this presentation, please visit: Snap a photo of this slide with your phone
  81. 81. Maryellen: Toll free: 888.228.9746 mrmoreau@mindwingconcepts.com Linda: llafontaine@studyhome.org Come and see them at Booth #846! How to reach:
  82. 82. Connect with us! https://www.facebook.com/mindwingconcepts/ https://www.pinterest.com/storygrammar/ @mindwingconcept @storygrammarmarker https://www.youtube.com/user/mindwingconcepts/videos EMAIL list: http://mindwingconcepts.com/pages/contact

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