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Chavda P, Helsby L. (2003)
The advantages of bilingualism are such that a speaker's overall competency may be more than a sum of parts. This article reports that recognising and facilitating this in group therapy not only has benefits for the children concerned, but brings parents and other staff on board too. Language groups were run in Leicester for two groups, each with 7 boys, with a bilingual background of English and Gujarati spoken at home. At the start of the groups the parents completed a questionnaire which looked at their expectations and their understanding of language issues. The structure and activities of the therapy sessions and homework (translated into Gujarati for parents) are described. Children were encouraged to access and name items in both languages and to use home language outside the home setting.
Chavda P, Helsby L. (2003)
The advantages of bilingualism are such that a speaker's overall competency may be more than a sum of parts. This article reports that recognising and facilitating this in group therapy not only has benefits for the children concerned, but brings parents and other staff on board too. Language groups were run in Leicester for two groups, each with 7 boys, with a bilingual background of English and Gujarati spoken at home. At the start of the groups the parents completed a questionnaire which looked at their expectations and their understanding of language issues. The structure and activities of the therapy sessions and homework (translated into Gujarati for parents) are described. Children were encouraged to access and name items in both languages and to use home language outside the home setting.
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Chavda P, Helsby L. (2003)
The advantages of bilingualism are such that a speaker's overall competency may be more than a sum of parts. This article reports that recognising and facilitating this in group therapy not only has benefits for the children concerned, but brings parents and other staff on board too. Language groups were run in Leicester for two groups, each with 7 boys, with a bilingual background of English and Gujarati spoken at home. At the start of the groups the parents completed a questionnaire which looked at their expectations and their understanding of language issues. The structure and activities of the therapy sessions and homework (translated into Gujarati for parents) are described. Children were encouraged to access and name items in both languages and to use home language outside the home setting.
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SPEECH & LANGUAGE THERAPY IN PRACTICE SPRING 2003 +8
t has been well documented that group therapy for children is an effective way of working (Brigman et al, 1992). It allows par- ents to see their child in relation to other children and gain a different perspective so that, instead of solely focusing on their childs difficulties, they can begin to appreciate their strengths. However, when working in a busy community clinic, it is very easy to select children for group therapy on the basis of high caseload numbers, rather then looking carefully at individ- ual needs. This is particularly problematic for bilingual children and their families as, when selecting them for group therapy, their overall language competencies may not be taken into account. When a childs full abilities are not acknowledged, parents are automatically margin- alised and unable to participate fully in the group therapy experience. l The advantages of bilingualism are such that a speakers overall language competency may be more than a sum of parts. Panna Chavda and Laura Helsby find that recognising and facilitating this in group therapy not only has benefits for the children concerned, but brings parents and other staff on board too. Here, they tell us what they did and why they did it. you are pannng therapy groups have bngua cents want to measure eectveness Read ths The vibrant, multicultural City of Leicester has many minority ethnic groups represented, and a very high bilingual speaking community. We find bilin- gual children can be included in general groups with monolingual children where the aim is to improve areas such as social skills, attention and listening. However, we wanted to offer more targeted groups with a focus on the specific needs of bilingual chil- dren with language development difficulties. When planning our groups for a busy inner city clinic, we used the Malcomess (1999) decision- making loop (figure 1) to identify the clinical need, in other words the why of therapy. When we ask why we do things with clients - as well as what we do and how we do it - it enables us to focus on a more functional model of service delivery rather than just a diagnostic, medical model. It allows us to tailor care to individuals and to begin to look at the outcome of intervention. We then arrive at a care aim which leads to goal setting, interven- tion and review with a measure of effectiveness. We grouped individuals according to their care aims then identified care aims for the overall group. Our level of input included the planning phase (two weeks), running the groups (six weeks), and the post-group report writing, review and contact with schools (two weeks). We ran two language groups for children chosen on criteria of age, language difficulties, parental commitment and support. All came from a bilingual background with English and Gujarati spoken at home. The first group had seven boys aged 5-8 years, presenting with mainly moderate language difficulties across both languages. The second group also had seven boys, this time aged 7-10 years, with higher level language difficulties across both languages. Insight At the start of the groups the parents completed a questionnaire (adapted with permission from Hulme et al, 2001). We wanted to look at parents expectations of the language group and to gain insight into their understanding of language issues. The questionnaires were discussed with parents in Gujarati and, if needed, in English. Several themes emerged: 1. Many children with language 100% disagreed problems are simply lazy. All of the parents felt the difficulties their children experienced with language were genuine. Working with bilingualism: Panna Chavda Laura Helsby SPEECH & LANGUAGE THERAPY IN PRACTICE SPRING 2003 +, groups
2. Playing with your child is 100% agreed
important in learning language. 3. Parents play a vital role in the 100% agreed treatment of language disorder. While all agreed that parents as well as other mem- bers of the family play an important part in the treatment of language difficulties, some found it difficult to fully support therapy due to time restraints, lack of ideas and language barriers. 4. Language disorder is a 40% agreed, new type of a problem; it 40% disagreed, was not around years ago. 20% did not know Although some parents knew about language dis- order, over half did not know it existed. 5. Gujarati children have 70% disagreed, language problems because 30% agreed they have to learn to use or were unsure more than one language. Most parents related this question to their child. A small number felt that learning Gujarati and another language can initially cause confusion, and that a child may find it difficult. The majori- ty saw that the difficulties their child experienced were not due to learning Gujarati and another language. Comments included, It is the parents attitude that causes the problem not the lan- guage. Some parents reported that they had been advised to speak in English to their child, which gave them the impression that this would resolve the language difficulties. 6. Learning to speak more 70% disagreed, than one language causes 10% agreed and language problems. 20% were unsure Similarly, the majority felt that learning to speak more than one language generally causes no problem, and cited their own successful experi- ences. They acknowledged that it may initially take some children longer to learn two languages but in the long-term there are more advantages associated with it. They also noted the importance of learning the home language for bonding with the family members and for cultural identity. 7. Children with language 50% agreed, difficulties often have 40% disagreed and problems with their behaviour. 10% were unsure The majority who agreed with this related it to the children being unable to express themselves, leading to frustration. 8. Children with language 95% disagreed and disorder are stupid and will 5% agreed about have problems getting a the difficulty in good job when they grow up. getting a job The majority disagreed. They felt that, with enough help, their childrens language difficulties should not hinder them in the future, and they were opti- mistic about the children doing well. They felt the attitude of other people such as teachers, parents and employers would be important. 9. Attending the group 50% agreed and 50% will cure my childs felt it would help the language problem. language difficulty but not cure it. Half of the parents were hoping that attending the group would cure the language problem. Half did not feel the group would provide a cure but that it would help the child to learn and give ideas to parents on how to deal with the lan- guage problem and think differently. 10. Speech and language 100% disagreed and therapy does not work. felt it helped their child The majority were very confident that speech and language therapy to date had made a big difference in the childrens learning. A number felt that school had a vital role to play and that getting the right help at school was i m p o r t a n t . Parents said that they had more ideas on how to work with their childs language. They felt early detection of the problem was important. The questionnaire gave qualitative information about the parents perception of their childs lan- guage difficulty. Discussion with them during the completion of the questionnaire gave insight into the understanding of our role as speech and lan- guage therapists, and meant we could reinforce cer- tain perceptions and change others through the group. Closer bond The groups ran in a local clinic for 45 minutes once a week over a six week block with two bilingual English / Gujarati speech and language therapists. The group children who are statemented have school-based language support assistants. Holding the group over the school term from January to March enabled these assistants to attend without the burden of a larger time com- mitment. They observed the group dynamics and activities and got involved where appropriate. They were an extremely useful resource and helped to develop a very important closer bond between schools and the speech and language therapy service. In turn, the assistants reported how beneficial it was to have time to reflect and to practise the activities during the week. After the six weeks the remainder of the term time was given over to re-running the group tasks in school at the discretion of the language support assistants. The groups had a structure each week: A gelling game to encourage group cohesion (for example, (a) fruit salad - objects or pictures were given to each child, two items were called out, and the children with those items swapped places; (b) passing a ball with a verbal activity). Activities to develop attention and listening skills in a group setting via Sounds of the World listening tape (UNICEF, no longer available). The core of the sessions consisted of tasks based on themes. Examples of themes were advertising (for older children), countries and languages spo- ken, food and drink, animals, transport, shapes, Figure 1 Clinical Decision-Making Loop (Episode of care) Identify Clinical Needs Intervene Review goals and measure effectiveness Set goals for intervention Kate Malcomess, 1999 the aim of our care and training given so we take advantage of the rich possibilities offered by bilingualism and ensure that the children receive therapy appropri- ate to their clinical needs. Panna Chavda is Clinical Lead Speech and Language Therapist (Bilingualism) and Laura Helsby Chief Speech and Language Therapist with Leicester City West NHS Primary Care Trust. Address for correspon- dence: Childrens Speech and Language Therapy Service, Prince Philip House, St Matthews Health and Community Centre, Leicester LE1 2NZ. References Asian Book of Nursery Rhymes. Mantra Publishing. (ISBN 1852697016). Brigman, G., Lane, D. & Switzer, D. (1992) Teaching Children Success Skills. Journal of Educational Research 92 (6) 232- 329. Cummins, J. (1984) Bilingualism and Special Education: Issues in Assessment and Pedagogy. Multilingual Matters, Clevedon. Hulme, S., Rahman Jennings, Z. & Thomas, D. (2001) Alternative Methods. Bulletin of the Royal College of Speech & Language Therapists August, 10-12. Malcomess, K. (1999) Measuring Effectiveness. Workshop. (See Malcomess, K. (2001) The reason for care. Bulletin of the Royal College of Speech & Language Therapists November, 12-14.) Masidlover, M. & Knowles, W. (1979) Derbyshire Language Scheme. Derbyshire County Council. Sage, R. (2000) Class Talk. Stafford Network Education Press. Useful Resources * The Bilingual Family Newsletter is written by and for parents. See www.multilingual-matters.com, e-mail marjukka@multilingual-matters.com or write to Multilingual Matters, Frankfurt Lodge, Clevedon Hall, Victoria Road, Clevedon, England BS21 7HH. Online catalogue: www.bilingual-supplies.co.uk. SPEECH & LANGUAGE THERAPY IN PRACTICE SPRING 2003 o groups words from one language are used in a sentence in another language. So we said, I like baath for din- ner for I like rice for dinner. Positive and valuable The children needed to feel they could use their home language outside the home setting to help with their communication. This approach increased their confidence and self-esteem and enabled them to use both their languages in a positive and valuable manner. In addition, the language support assistants and parents saw first-hand, or through feedback in the homework discussion, how suc- cessfully both languages could be used to help bilingual children with language difficulties. Having parents taking part in the groups with feedback given in their home language ensured the positive aspects of bilingualism were conveyed, and allowed code switching and other normal fea- tures of bilingual communication to be reinforced.The language support assistants were able to understand the importance of using the childs overall commu- nicative abilities and to value the learning of the home. During each session, we kept a record our observations of the childrens language and interac- tion while completing the tasks. This information was used when we completed a communication skills rating questionnaire adapted from The Communication Opportunity Group Scheme (COGS) (Sage, 2000), which is used in Leicester to promote effective communica- tion in schools. We found it a very useful tool to measure baseline performance for bilingual children, and will be using it as an ongoing measure of change and as a basis for discussion with parents and teachers. The rating scale has four main areas: general skills, formal conversation, formal presentation (speech/writing) and non-verbal communi- cation. It is rated from high competency to no evidence of the skill on a scale of 1-5. The communication skills rating alongside conventional assessment provides a much more holistic picture of the childrens lan- guage strengths, weaknesses and progress, allowing the mapping of skills over time across both languages and along different parameters. Where there are fewer bilingual children it can be problematic to have bilingual groups for their specific languages but, for effective therapy, it is better to include children who have the same home language and English, rather than children of many different languages. In areas where there are no bilingual speech and language therapists, co-workers and interpreters should be accessed Do we seect cents or groups on the bass o ther need - or our need to get through our caseoad' Do we oer a servce whch takes account o the strengths o a cents background' Do we promote code swtchng, exca borrowng and namng n two anguages wth our bngua cents' Reectons
colours. We also had activities to develop giving
and receiving requests based on the Derbyshire Language Scheme (Masidlover & Knowles, 1979) and time sequences related to simple stories. Maps of the world, cross cultural food items (pic- tures and false foods) and advertisements from local community and high street shops were useful resources. Gujarati nursery rhymes (adapted from Mantras book of Asian Nursery Rhymes). Although we had the structure and themes to follow, there was flexibility for the pupils to intro- duce and lead a topic of their choice. Homework was given at the end of each session. This was translated in Gujarati and discussed with parents. This formed one of the most valuable aspects of the intervention as it allowed the par- ents to understand the what and why of the groups. Parents who were present during the group sessions benefited most from watching the strategies the speech and language therapist employed during the group, as they were able to try these out at home. The aims of the group and the homework set were, as a result, more thor- oughly understood, and compliance on complet- ing the homework was high. Cummins (1984) discusses the idea of a common underlying proficiency model in bilingualism. We know there is more than enough room inside our thinking quarters for two or more languages, and research also suggests there is transfer between languages. For example, a child taught multiplication and subtraction in one language does not need to have those concepts re-taught in the second lan- guage, only the vocabulary to reproduce it. We aimed not to do the tasks in one language then another, but to use the natural discourse of a bilingual speaker accord- ing to the situation to facilitate vocabulary and word finding. The session reflected the childrens natural bilin- gual use of language where code switching and lexical borrowing is a normal feature. All the tasks were therefore done in English and Gujarati, led by the bilingual Gujarati speak- ing therapists. In vocabulary work, for example with our food theme, we encour- aged the children to access and name items in both languages to build up semantic links and facilitate word recall. Code switching (for example, I have been to India, hu rikshawma beto meaning I have been to India, I sat in a Rikshaw) was used naturally through- out. Names of food items were used in conversa- tion as an example of lexical borrowing, where We aimed not to do the tasks in one language then another, but to use the natural discourse of a bilingual speaker according to the situation to facilitate vocabulary and word finding. Homework was translated in Gujarati and discussed with parents. This formed one of the most valuable aspects of the intervention as it allowed the parents to understand the what and why of the groups.