Echolalia Mac OS
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Watch the full interview or read the transcript below and let us know what you think!
I might be back here at Famly HQ but we’ve still got loads of great interviews for you from Nursery World. This next one is with Wendy Usher from Inclusion Training For All. We talked all about the importance of inclusion, how you can make sure you’re being inclusive even when you’re on a budget and she gave so many great examples about how you can think more inclusively in your practice. Hope you enjoy!
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- 2018-12-09 00:23:57.
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Mac Os Catalina
I think it’d be lovely if you could just tell us a little bit about your history with early years and who you are. My name’s Wendy Usher and I run a company called Inclusion Training For All and that’s only been running for a couple of years, but prior to that for the last ten years we’ve had a business called The Play Doctors where I was actually physically designing and manufacturing resources for children with cognitive disorders so autism, dyspraxia, dyslexia and so on. All of that was actually based on 35 years of experience of working both within in early years within education, and then I also ran and managed a number of voluntary organisations prior to starting up my own business. All of that experience led to me writing my first book and I’m 13 down now so the 13 books I’ve written around autism, behaviour, inclusion, supporting language and development of communication. So yes, I’ve got a lot of history within the sector. But I think one of the most important things for me is that actually I’m a mum and I’ve got two children who are grown up. I have a 33 year old, and my 33 year old happens to have autism, dyspraxia, dyslexia, learning difficulty, epilepsy, sensory integration disorder. So it’s a combination between professional and personal experience that I come at it from real life I’m not a theorist I’m a practitioner and I’ve been there, so I understand some of the difficulties that a lot of the practitioners here are facing. So that’s where the real passion for it comes from as well because you’ve dealt with it firsthand. Yeah I’m one of those people, if I was a stick of rock and you cut me in half, I’d have inclusion written all the way around!
What do you think, ‘State of the Union’ style what do you think the state of provision is in the UK at the moment for inclusion and for children?
It’s getting better, recognition is getting a lot better and people really have a heart and a desire to be able to support inclusion. I think the difficulty is the same as it always has been and always will be with funding and being able to find the right resources. But true inclusion truly doesn’t have to cost the earth, it’s actually thinking out of the box. I’ve got a really favourite phrase of mine and my phrase is “behaviour itself is a form of communication” and if that’s the case, what’s the communication behind the behaviour? With inclusion if we’re taking a person-centered approach, then what you need to do is to be able to recognise where the children are and what they need and then thinking about making reasonable adaptions can be so simple. It could be in the use of our language, so instead of using too many words, what I advise people is they think about how to sign the phrase so say for instance it was going to be time for dinner and they were signing it, you’ve only got two words. Instead if you’ve got a child who’s got cognitive processing difficulties and you’re saying to the child “hey come on Ben, gotta sit at the table because it’s time for dinner now. If you don’t have dinner you’re not going to play football afterwards” and it’s too much but if we’re thinking about it from the child’s perspective, how can we simplify things down and there’s an acronym I use a lot which is ‘KISS’ and ‘KISS’ our children very simple to remember but it just stands for ‘Keep It Super Simple’. The world doesn’t have to be complicated. You know we don’t need masses of equipment and masses of resources. If you’ve got a pen and a piece of paper to be able to visualise something to help the child have a cue or a clue into what you’re trying to communicate, then actually the world is a different place.
That’s brilliant, that simplicity it’s just about making sure that we communicate things in the way that is appropriate to that child, whether it’s signs or us signing or or visual cues etc.
It’s around for me, knowing about the child or the young person as much as we can garner. You have you’re all about me record so you’ve got things about the doctors, about the diagnosis maybe about likes and dislikes. But things that perhaps aren’t there that need to be considered are going to be things like does the child have any sensory needs? Are there any sensitivities that you are aware of? What kind of calming do you use at home? Is it kind of head shoulders knees and toes is it a bubble tube, or is it something where in actual fact it’s a hypo-sensitivity if you have a sensory need, and you have hyper and hypo: so hypo is low and hyper is high. One of my granddaughters has hypo-sensitivity which means that her body craves stimuli. If she’s walking along the road, she doesn’t get the same level of sensory input unless she is running or if she’s swinging on a swing she has to be the one upside down holding on by her toenails with her hair swinging on the ground to gain that same level. So to calm Retendo, what you need to do is to be able to take her out into the playground you put hand on her head and you say go for it Ro, and she spins 20 times in one direction, 20 times in the other direction. She’s self stimulating which actually gives her body sufficient stimulation to come back in to the room and then to be able to concentrate. So unless you know that, unless you find out about the individual children that you’re working with you could take Retendo over into a corner, give her a quiet area give her a book to read, none of that is actually going to help her unless you’re responding to her individually. Taking a person-centered approach for me is really important.
I think that’s a great example of a time when what we traditionally do for children who might be having behavioural problems, or they are acting out as you might say, that normal approach is completely the wrong thing to do.
Yeah, the acting out thing, I’ve got a story. When I was working within early years, I’ve got a young gentleman that seemed to be attacking his worker on a regular basis, but nobody could work out exactly why and I was asked to go and do some observation. After a period of time I noticed it was only ever happening on the days when the worker was wearing a bright red fleece. Now the child didn’t have the ability to say “I’m terribly sorry, but could you possibly take that red fleece off it’s really annoying me.” So instead he tried to take it off her which was then deemed to be an attack. So if we hearing the child’s voice, then we need to have a stand back and we need to observe to be able to listen to what their individual needs are, to learn more about them, but you’ve got to have your mind in inclusion just to be able to open the box and be willing to actually think in a very lateral way and that you’re going to get different approaches for different children. So again we’re back at that same thing of behaviour being a form of communication, how do you compile this knowledge about a child – well you think deeply about their behaviour and then you can understand what it is that they might be trying to tell you by doing so. I think that the behaviour itself, not solely behaviour obviously, there are going to be other traits that you’re going to be looking for so say for instance with autism within early years, you might see tippy-toe walking or you might see very stiff fingers, or you might see repetitive behaviour. Have you come across echolalia? Echolalia; echo is copy, lalia is language so can I just get you to repeat everything I do? So “hiya!”, “you alright?” “time to tidy up now”, “okay?” So I’ve walked away believing that you’re gonna tidy are but the reality is, is that all you’ve done is to copy what I’ve said. Therefore actually I am assuming that you understand but the reality is not quite like that. So it’s not just around behaviour, there may be specific traits that you’re seeing, but behavior to me is actually a form of communication as I’ve just said. So it’s getting behind that to be able to actually focus and to find out how you’re going to be able to support the child. So the child with echolalia as an example, obviously language isn’t going to be the easiest thing to use with them, but instead if you’re going to use something that is going to be a visual image to help them understand, or an object of reference, or you’re modelling the behaviour that you are asking the child to be able to copy what you’re doing and then you stand back observe, check that that’s going on and once you’ve checked and you know, then you can walk away and leave a child to it but our role as practitioners is enablers. Our ultimate is to be able to bring young people to the best of their potential, and if we’re not thinking around inclusion and we’re not making reasonable adaptions in the way we’re working, then we’re not doing our job because we’re not actually going to allow these children to excel as much as they can.
I think that makes again the point so lucidly that it’s about understanding the different aspects and how we can pull that together. I guess a good question is, let’s imagine I’m a new practitioner or a new manager into a setting and I want to understand my children better perhaps I have a new cohort coming in, what are some of the steps that I can take to really deeply understand those children’s needs beyond just my all about me form or the kind of existing conversations I’ve had?
I think observation for me is a key and observing the child right at the very beginning including the environment. Where do they go within the environment? Which areas do they like going? Map what their transitions are where they’re actually moving to be able to talk to the child, if they’ve got the cognitive ability to do that or even English as a Second Language. Don’t just assume that you know, actually the child is there and the child has a voice. Sometimes what I see with new practitioners is that they’re so keen to be able to get all of their attainment targets dealt with and to be able to set the child up to be able to achieve, the setting up actually isn’t the way that the child learns. So another key principle to me is actually considering the child’s learning style. I know there’s a debate at the moment within early years as to whether audio, visual or kinesthetic actually makes a difference in how a child learns, but over 35 years worth, I really do believe that the majority of children once they come into early years, then they’re going to be moving on from mouthing from kinesthetic into visualisation. I have found that visualisation is actually a really good way to be able to support. So if I was advising a worker who was coming into a setting, then I would say have your eyes open, how can you hear the child’s voice? Be aware of what you know about the child, but also be aware of what you don’t know about the child. What might you need to know and who holds that information so parents are really important. A plea from a parent of a child or an adult with disabilities, don’t allow your parents to do that walk of shame when they come to the setting. When my Ellie was young, then it was walking across the playground and waiting for that, “Oh Mrs Usher could I just have a quick word please?” Or parents actually thinking oh yes that’s the mum of the child who bit mine, that’s the mum of the child who makes all of that noise. All of that is actually really, it’s a situation where as a parent why should you have any more understanding as to your child than anybody else? Sometimes parents have low self esteem and low confidence levels because actually they’re no more prepared than anybody else. So just as a practitioner, as a new practitioner be able to think about the positives. What can that child do what can you praise them? If the child is a constant fidgeter or a constant jumper or constantly running, then you could introduce a subject and say “hey do you know your Ben is the best jumper that we’ve got in the whole of the setting?” So the parent says “Yeah he jumps at home, he jumps from the top of the stairs to the bottom of the stairs!” Then you can say “yes actually today he jumped off a brick wall straight onto the headmaster’s car bonnet!” Just think about how you’re actually having a conversation, because that walk of shame is really hard for a parent as well and if you are a new practitioner, if you’re feeling out of your depth, or you’re not too sure what you’re seeing or what you’re looking at, don’t be ashamed to ask advice. There are other people out there that are going to be willing to help. Don’t feel that because you’ve done your training that you’ve got to deal with it all on your own, be prepared because actually it helps you grow to be able to find out other people’s thoughts as well.
That makes a lot of sense I think it’s often practitioners as you’re saying perhaps sometimes rely or expect to rely too much on the parents for knowledge and for reporting and you have to know the level of understanding the parent has as well, rather than just expecting them to have everything at their fingertips
Yes that’s what I was saying that if you are a parent, why should you know more than anybody else and in fact parents will have that expectations that practitioners have had training so therefore they’re going to be able to give advice. It’s actually working through it together, and planning together, and meeting together, and being honest and open and chatting. One of the ways that if I’ve been working with a parent who has barriers, either that they don’t want to know that their child might be having difficulties of some description, or that they don’t want their child to be labeled in any way or form. Then rather than actually having a conversation where I am facing a difficult situation with a parent, then sometimes I’ll say as a practitioner, “can I just ask your advice on this situation that we’ve, what do you reckon, what do you think we might be seeing?” Not asking what we should be doing about it but what do you think we might be seeing and then the parent actually feels as though they’re involved and they want to be involved because they want to improve things for their child rather than the parent feeling that they are being judged as a bad parent for whatever behaviour you’re seeing.
That makes a lot of sense and I think maybe just to kind of finish up, here at Nursery World you’re talking about autism spectrum disorder and enabling environments. Super interesting topic I think, how should we maybe change our understanding of enabling environments when it comes to children with ASD and and yeah how can we consider them more if we have **children in our setting?**
I think that if you do autism awareness training then it will set you up and it will give you an understanding but every single child is going to be an individual so in 35 years I’ve never come across a child who behaves in exactly the same way. So when you’re thinking about the environment and setting them up in the environment, again it goes back to needing to know more about that individual child. A really quick story, I was asked to go into a nursery environment where I’ve got a child who wouldn’t participate in any messy play whatsoever and I went to do some observations and I stood at the edge of the room and I saw two children walking down and as I did I saw one child just bring his hand to his eyes as they came parallel with a messy play tray. So I thought, gosh if that child’s not even looking at the messy play how am I going to get them engaged? But then within the environment as I was observing, I noticed anything he chose to play with whether he was picking up a book or a train, or whether he was doing Lego bricks, he would take them to the darkest area within the room. The following day, I got the tray moved because where the trays were there was a window above them and I got the trays moved into the darkest area of the room and the following day he was up to his arms in sand and water. It was nothing to do with the messy play at all, it was that he actually had a sensory sensitivity to the light coming through the window. So we need to actually observe children, to hear their voice. I know it’s something I’ve repeated during this interview, but for me it’s so important how can we know our children when the child has very little in the form of their own voice particularly if they’re nonverbal. So to be able to support the environment, generally, make it clear as in not clear of resources but make it clear what the child is meant to be doing. So give them some rules and some boundaries, make things visual work within the child’s own framework, so have a look and see if the child is more of a visual learner or an audio learner or a child who is a kinesthetic learner, use those kind of tools to be able to help during transition so it might be that a child is a kinesthetic learner and loves DUPLO bricks, so to get from one room to another give them a DUPLO brick and when they get into the other room they can already put it onto a DUPLO model that’s there so that there’s a reason for going, so this is working with the child and using things that the child is interested in rather than fighting against it just by actually deciding and planning your own environment and this is what we’re doing without making reasonable adjustments.
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Question
At what age should echolalia no longer be used or observed in a child's speech?Echolalia Mac Os Catalina
Answer
Echolalia Mac Os Catalina
Developmental stages are often used to characterize early language gains made by infants and toddlers. One taxonomy is often used to describe such stages according to descriptive categories with associated age ranges. The examiner (1-6 months), the experimenter (7-12 months), the explorer (12-24 months), and the exhibitor (3-5 years) captures the nature of normal language development (Owens, 2005).
During the examiner stage, infants begin communication through responses to their environment through crying and pleasure sounds, babbling, altering vocal pitch and volume, imitation and experimentation of sounds. They become quite social with caregivers and use their motor and cognitive attainments to focus, look at people and objects, and reach and hold objects. Imitation of some movements and sounds begins to develop at 5 or 6 months.
At about 8 or 9 months of age, within the experimenter stage, infant social skills increase and they comprehend some words they hear regularly. The also begin to develop variety in communication strategies through the use of imitation of gestures, variegated babbling, jargon and echolalia. Thus, the period between 8 and 12 months is called 'the echolalic stage.' During this stage, infants produce short utterances spoken by others exactly. They use the same words, but also imitate the prosodic patterns. As you might imagine, this display of linguistic knowledge is very appealing to parents and other caregivers, thus the youngster using echolalia often receives much attention. And, since echolalia occurs within the experimenter stage, most youngsters try their newly found skills on all who might listen. As children enter the one word stage and beyond, echolalia decreases and is replaced by the child's own creative utterances.
The use of echolalia beyond the experimenter stage was thought to be noncommunicative behavior arising from comprehension problems. However, research within the past two decades has revealed much about the nature and functions of echolalia, as well as intervention strategies. Echolalic characteristics occur along a continuum of exactness, degree of comprehension, and communicative intent. Thus, it is necessary to understand the verbal behavior in the context of the child's cognitive, socioemotional, and communicative environment. Prizant and Rydell (1984, 1993) and Prizant (1987) discuss the functional uses of delayed and immediate echolalia and provide suggestions for intervention.
Dr. Kathleen Fahey has 28 years experience as a speech-language pathologist. She is a professor in the Audiology and Speech-Language Sciences program at the University of Northern Colorado. Her areas of expertise include normal and disordered language and phonology.