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Grundtvig Learning Partnership, 2012-2014

« Creative Learning in Education United »

 

Table of contents

  1. PROJECT DESCRIPTION
  2. PROJECT OBJECTIVES AND STRATEGY

2.1. Concrete objectives

2.2. Subjects and problems

2.3. Approach to achieve objectives

  1. PARTNERS OF THE PROJECT
  2. FRANCE: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Eurl Aristote

4.1. Health system

4.2. Social system

4.3. Educational system

4.4. Disability categories

4.5. Legal system regulating the integration of disabled people in the school system

4.6. System of integration of the disabled into the school system in France

4.7. CREATIVE LEARNING APPROACHES

a) Workshops with local partners

b) Books about the learning of speech disorders

c) New methods about the learning of children with speech disorders

5. TURKEY: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Kutahya Valiligi

5.1. Special Needs Education in Turkey

5.2. Education of Children with Disabilities or Learning Difficulties

5.3. Special educational needs: assessment and diagnosis

5.4. Educational Institutions

5.5. Background and justification

5.6. References

  1. ITALY: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Association COAT

6.1. People with disabilities in Italy

6.2. ICF- International Classification of Functioning, Disability and Health in Italy

6.3. National Healthcare System in Italy

6.4. Facts about Disabled pupils in Italy

6.5. Disabled students education specific characteristics

6.6. References

6.7. Creative learning approaches (workshops with local partners)

  1. United Kingdom: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by TELLUS group

7.1. Children and Families Act England and SEND Reforms

7.2. Key Changes

7.3. Health and Social Care System

7.4. Disability categorisation and link to education

7.5. Educational implications

7.6. Speech and Language Impairment

7.7. Creative learning approaches (workshops with local partners)


  1. PROJECT DESCRIPTION

 

The project is designed for parents, grandparents, specialists (speech therapists, special pedagogues), teachers who are in contact with children affected by speech disorders. The project also aims to educate and learn through creativity. During the meetings of the partners, art, music and theatre activities will be used to develop the children’s creativity on a scale of motor facility, sensitivity to touch, imagination and verbal expression.

During the meetings, there will be discussions on applicable artistic methodology and IT interfaces to educate children with speech disorders in different countries. During the workshops, the partners will experience and study new methods. Many children affected by speech disorders are from low-class families and recipients of social welfare. They have minimal knowledge of what is required for children affected by speech disorders.

During the project, the teachers, the speech therapists and special pedagogues who have acquired knowledge about speech disorders will help adults to deepen their knowledge and abilities with the aim of helping their children. The whole delegation from European countries will get experience using the newest methods, learning from partners living in other countries and getting a chance to think about their working practices; working with other colleagues will open up the possibility of sharing the newest and most up-to-date methodologies.

During the project, the creation of a website will facilitate the sharing of good practice. Moreover, it will be a way of expounding the knowledge and educational methods acquired during the project on a wider scale.

 

  1. PROJECT OBJECTIVES AND STRATEGY

2.1. Concrete objectives:

  • Sharing of good practice, learning methods and special IT interfaces for learning.
  • Development of new methods and their adaptation in the countries of partnership through seminars and workshops.
  • Meetings between teachers and parents where parents will be introduced to methods as to how they could help children who have speech disorders at home.

2.2. Subjects and problems:

  • The old methods used by teachers and designed for children affected by speech disorders.
  • The limited number of parents interested in the newest methods that could help children affected by speech disorders.
  • The minimal collaboration between the teachers and the parents.
  • The absence of accessible and cutting edge information for the public on the newest methods designed for children affected by speech disorders.

2.3. Approach to achieve objectives:

  • Sharing of knowledge and good practice, selected and reflected new teaching methods during the international meetings.
  • Meetings will be organized between teachers, parents and workshops to familiarize them with the newest methods.

 

3. PARTNERS OF THE PROJECT

Eurl Aristote, FRANCE

Coat, ITALY

Kutahya Valiligi, TURKEY

Tellus, UNITED KINGDOM


  1. FRANCE: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Eurl Aristote

4.1. Health system

In France, “the social care of children with disabilities is based primarily on writing medical certificates issued by doctors”[1]. Regardless of nationality, every disabled child living in France benefits from the social health insurance scheme. In this case, the management of health care costs is 100 % and “this includes medication and other treatments, specific plans, hospital stays, transportation costs related to health care and technical aids.”[2]

Health care does not include specific treatments not acknowledged by the state ; in that case, the cost is paid by the family or relatives and is not reimbursed. Moreover, speech therapists can recommend unconventional methods not recommended by the state, these treatments are then paid by the families, and many treatments are deemed expensive and hence prohibitive for parents. Health care is linked to the social system.

4.2. Social system

Each child at their birth receives a social security number; they are then placed on their parent’s card till they are 16 years old. Every medical consultation or treatment is reimbursed by the health care system. But for the children affected by speech disorders or disability, the health care system has a way of providing for the families.

Indeed, anyone who provides care for a disabled child or young adult under 20 is entitled to an education allowance for disabled children (AEEH). This law depends on the severity of disability of the child that is enjoined by the Human Rights Commission and the autonomy of people with disabilities (CDAPH). To qualify for this family benefit, the child must have a disability of at least 80%, or between 50 and 80% if placed in externship or semi internship in a specialized institution. The basic amount of AEEH amounts to 129.21 euros per month and can reach 1000 euros per month depending on several factors such as: a possible termination of the parents’ occupation, higher spending incurred because of the health condition of the disabled child etc…

4.3. Educational system

“School integration of children with disabilities is governed by the disability law introduced in February 2005. The goal is to keep children with disabilities in regular schools whenever possible.”[3] Each disabled student has a personalized education plan that has the objective of coordinating the flow of his schooling, sometimes a specialized help is there to provide support for the child and the teacher. The major difficulties of the 2005 law is that the teachers were not sufficiently informed on the subject of speech disorders. The law had managed the integration of children with speech disorders, yet there was no real training for the teachers who got a disabled child in their classes. Since then, efforts have been made on the dissemination of the information on speech disorders by the media and the internet, but also by the ministry of Education and Health.

In France, instruction is mandatory for every child till they are 16 years old, and that includes home-schooling. Yet “before six years, young children with disabilities are not subject to compulsory education, in contrast to able-bodied children. They can be accommodated in facilities and hospitality services: childcare, daycare centres”[4]. At school, the disabled student can integrate CLIS (class inclusive education) while in college/high school’s enrollment takes place within ULIS (localized for inclusive education units). For some forms of disability, the use of specialized institutions is sometimes necessary. This is the case for some severe intellectual disabilities or communication disorders.

 

  • Disability categories

Within the meaning of Law No. 2005-102 of 11 February 2005 on equal rights and opportunities, participation and citizenship of people with disabilities “is a disability, any activity limitation or restriction of participation in social life suffered in its environment by a person because sustainable substantial, or permanent one or more physical, sensory, mental, cognitive or psychological, of a multiple disability or disabling health condition”[5].

Built on the initiative of the World Health Organization (WHO), the International Classification of handicaps is to allow a satisfactory description of the consequences of diseases and related health problems to. “It has three dimensions that reveal many components of disability. These concepts are: impairment, disability and disadvantage.

  • Deficiency:

“In the field of health, impairment is any loss or abnormality of a function or a psychological, physiological or anatomical structure.”

  • Failure:

“In the field of health, disability is any restriction (resulting from an impairment) of ability to perform an activity in a normal manner or within the range considered normal for a human being.”

  • Disadvantage:

“In the field of health, social disadvantage of an individual is the injury resulting from impairment or disability that limits or prevents the fulfillment of a role that is normal, given the age, gender and cultural factors.””[6]

Generally, there are six categories of disability are as follows:

  • The motor disability.
  • Visual impairment.
  • Hearing impairment.
  • The mental disability (neurosis, psychosis, etc.).
  • Intellectual disability.
  • Debilitating diseases (diabetes, haemophilia, AIDS, cancer, hyperthyroidism, etc.).

On the education of disabled students in France the following categories have been established:

  • TFC: cognitive disabilities or mental functions (with specific written language disorders and speech).
  • TED: pervasive developmental disorders (including autism).
  • TFM: disorders of motor function (including dyspraxia disorder).
  • TFA: abnormal auditory function.
  • MVT: disorders of visual function.
  • TMA: multiple disorders associated (multi – disability or disabling condition).

The law of 11 February 2005 establishes the principle of a single place to facilitate the efforts of people with disabilities. In each department, House Disability (MDPH) is created and provides a unified access to rights and services provided for persons with disabilities. The House departmental disability exerts a home mission, information, support and advice for people with disabilities and their families.

 

Disabilities in France (How many disabled, where are they educated? How many disabled people are in school?)

According to the Ministry of Health, there were in 2010, “5 million people with disabilities in France, of which 2 million people with reduced mobility”[7]. Of the 5 million disabled , 1.7 million are recognized as such by the authorities.

Disabled population by sex and age in 2007Source: Dares, complementary investigation to the investigation Employment in 2007.[8]
in %
  Population with an administrative1 recognition Population with a disability defined under LARGE2 Total population from 15 to 64 years old
Men Women Men Women Men Women
15-24 years 3 4 9 9 19 18
25-39 years 20 17 29 27 31 31
40-49 years 27 30 25 26 22 22
50-64 years 50 49 37 38 28 29
Total 100 100 100 100 100 100
Employees (in thousands) 998 815 4 415 5 180 19 470 19 920

1 Persons with administrative recognition of disability.

2 Persons with administrative recognition or declaring a health problem for more than 6 months experience significant difficulties in moving in daily activities, vis-à -vis the work or have had one or more accidents in the last year.

“The budget for the disability was 32.6 billion euros in 2005 against 41.3 billion (estimated) in 2011, an increase of 25.5%. Approximately 100,000 adults with disabilities are accommodated in medico- social structures 000 and 110 help centres at work. 800,000 people are beneficiaries of the allowance for Disabled Adults (AAH) and more than 500,000 people receive a disability pension. A third of the disabled assets is unemployed and nearly 100,000 companies are subject to the employment obligation of 6%”[9].

“Other figures of disability in France

  • More than 5 million people over 75 years, including 1.2 million 85 years or more.
  • 850,000 people suffer from Alzheimer’s disease and 225,000 new cases occur each year.
  • At 80 years, nine out of 10 people live in their own homes .
  • In 2020, 2 million people will be over 80 .
  • The number of people with motor disabilities is estimated at 7.4 million.
  • 2 million people over 16 years report both one or more disabilities, restricting their activity.
  • There are currently about 7500 students with disabilities.
  • 4,092,000 people suffer from hearing loss with 80,000 practising sign language.
  • 600,000 deaf people wear hearing aid.
  • 207,000 people are blind or severely visually impaired .
  • The life expectancy of people with trisomy 21 has increased in 15 years from 25 to 49 years (in 2002) and their longevity increased by 1.7 years per year.
  • 80 000 people are autistic.”[10]

The education of students with disabilities

The law of 11 February 2005 on equal rights and opportunities, participation and citizenship of disabled people increases the action for the education of disabled students. It affirms the right of everyone to education in mainstream schools closer to home, in continuous and adapted schooling. Thus, in 2011-2012; 210,395 children with disabilities were educated in schools and institutions under the Ministry of National Education: 130,517 in the first degree and 79,878 in the second degree.

 

4.5. Legal system regulating the integration of disabled people in the school system

The evolution of French disability legislation includes several steps:

  • The 1970s : national obligation for the integration of the disabled:

Without neglecting the two post- war laws aimed primarily at regulation of disabled workers ( Law of 2 August 1949, which generalizes the reintegration assistance to all severely disabled by setting the allocation of compensation for severely disabled workers and the Act of 23 November 1957 defining the status of disabled workers and promoting their placement ), the first step towards integration of people with disabilities start with the publication in 1967 of the report ” Study of the general problem of maladjustment of people with disabilities.”.

This text paves the way for the law 75-535 of 30 June 1975 on social and medico-social institutions. It regulates the conditions for the creation, financing, training and status of institutional staff and services sector. It also sets the legal framework for public policy: the importance of prevention and detection of disabilities, educational requirement for children and adolescents with disabilities, access for people with disabilities open to all institutions of the population and maintaining each whenever possible in an ordinary working environment and life. The law says the recognition of disability departmental commissions distinct: for youth 0 – 20 years (CDES: Departmental Committee on Special Education) and for adults (COTOREP: Technical Committee of vocational guidance and reclassification from 20 years).

  • Late 1980s : the integration of persons with disabilities is available in several pieces of legislation:

July 10, 1987 Law No. 87-517 for the employment of disabled workers for companies with more than 20 employees must employ 6% on a full- or part-time basis. This law established the creation in 1988 of the Association for Management Development Fund professional integration of disabled persons (AGEFIPH).

December 11, 1996 Law No. 96-1076 relating to autism. Autistic people should receive multidisciplinary support taking into account their needs in the context of an educational, educational, therapeutic and social approach. The law of 30 June 1975 was repealed by order of 21 December 2000 on the legislative part of the Code of Social Action and Families Now, the provisions of the law are mainly scattered in seven different codes: code of Social Action and Families, the education Code, the Code of social Security, the new code of public health, the Labor Code, the rural Code, the building Code and the housing.

  • 2002: Start of work updating the 1975 Act

January 10, 2002 following a ministerial meeting and the mobilization of associations and medical sonographers, the National Assembly adopted on first reading, the draft law on national solidarity and compensation of congenital disabilities which contains a government amendment stating that “no one can claim a loss only of his birth.”.

April 30, 2003 promulgated the law on education assistants, educational assistants perform tasks help to home and school integration of students with disabilities receive special training to ensure their functions.

  • The overhaul of the disability policy since 2005[11]

February 11, 2005 adopted the law on equal rights and opportunities, participation and citizenship of people with disabilities. This law focuses on education and recognizes any child carrier disability entitled to be registered in the mainstream, at the nearest school to his/her home. The nearest school or home school is the establishment of reference of the child. It is only with the consent of their parents or legal representative that can be enrolled in a school or a school other than the establishment of reference if they need a device that does not exist in establishing the closest.

Art. L. 112-1 : “Every child , every teenager with a disability or disabling condition of health is enshrined in the school or in one of the institutions […] closest to his home , which is the establishment of reference.”.

The right to enroll in school any child with a disability is one of the fundamental changes in the law. It recognizes the responsibility of Education vis-à -vis all children and adolescents. The law also recognizes that children with special needs have the right to receive appropriate support. Facilities and services of medico-social sector complement the regular school system. The law provides that parents are closely involved in the policy decision.

Art. L. 112-2: “Based on the results of the assessment, it is proposed that every child, youth and adult disabled person, and his family, a training course that is the subject of an individual education plan matching adjustments necessary to promote, whenever possible, training in mainstream schools.”

The law of 11 February 2005 also guarantees equality of opportunity for disabled candidates by providing a legal basis for the development of test conditions.

Art. L. 112-4. – “To ensure equal opportunities for candidates, accommodation conditions for the award of oral, written, or practical examinations or continuous monitoring of competition in school education and higher education, made ​​necessary by disability or disorder incapacitating health are provided by decree. These facilities may include the provision of such additional time and taken into account in the conduct of trials, the presence of an assistant, a communication device adapted the provision of suitable equipment or use by the candidate of his/her personal equipment.”

4.6. System of integration of the disabled into the school system in France

“From the age of 3 years, at their family’s request, disabled children can be enrolled in kindergarten. Each school is intended to accommodate children within its catchment area. To meet the special needs of disabled students, an individual education plan organizes the education of the student, together with the accompanying measures adopted by the Human Rights Commission and independence of people with disabilities (CDAPH). Schooling can be individual or collective, in mainstream or nursing home[12].

 

  • Individual education:

The conditions of individual education of disabled students in an elementary school or a school in the second degree depend on the nature and severity of the disability. Depending on the situation, the school may take place either: without any special help,

  • Have improvements when the student’s needs require.
  • The use of support by school carer for individual assistance (AVS- I) or a school carer for help pooled (AVS- M) and adequate teaching materials combine to make possible completion of schooling.

Creating Pass (accompanying pole schooling for deaf) can educate deaf and hard of hearing students in the mainstream, regardless of the mode of communication chosen by the family.

  • Collective schooling:

At school: classes for inclusive education (CLIS): in elementary schools, classes for inclusive education (CLIS) welcome children with a mental disorder, auditory, visual or motor and can benefit from integration into regular schools. Students receive instruction appropriate within the CLIS, and share some activities with other students.

In middle school and high school: localized for inclusive education units (ULIS)
In the secondary, where the requirements of individual schooling are not compatible with their disabilities, students with disabilities may be enrolled in a school located for inclusion (ULIS) unit. Supervised by a specialist teacher, they receive a suitable education that implements the objectives set by the individual education plan.

At the start of 2011, there were 2297 ULIS. The implementation of these units for inclusive education is organized so as to leave no area out of reach of students, taking into account the reasonable constraints of transport. This movement continues particularly in vocational schools. The ULIS are encouraged to work in a network, especially to meet the needs of professional training for students with disabilities.

Enrolment in nursing home[13]

Source: Interdepartmental committee of disability

Social and medico-social institutions include 36 000 and social services and community health. In all cases where the circumstances of the child or young person require referral to a nursing home which is the solution to offer free schooling support, educational and therapeutic adapted. It is always part of the individual education plan (MAP) for the student. The individual education plan coordinates the running of the school and all educational activities, psychological, educational, social, medical and paramedical, which complement the academic training and are required to ensure consistency and continuity of schooling. Parents are closely involved in the development of a customized project for the Child and the policy decision taken by them in accordance with the Human Rights Commission and independence of people with disabilities (CDAPH).”[14]

 

What staff welcome the disabled in France?

“In September 2008, 2,000 teaching assistants – AVS – i (school carer for individual aid) were recruited and trained. In March 2009; 9,728 teaching assistants jobs -AVS -i (individual) and 2,083 teaching assistants jobs – AVS. Joint (collective) were occupied. To complete the intervention of AVS – i, the staff were recruited on ancillary contracts in employment (CAE) or on future contracts (CAV), more than 12 679 people (7454 equivalent full time). In the 2010 school year, 57,067 students were subject to individual coaching. There were 21,800 full-time and AVSI 2166 FTEs AVSco equivalents.

In the structures of collective education (LCIS or ULIS), the heterogeneity of the groups and the complexity of the educational and pedagogical actions necessary for successful project completion may make it desirable for teachers that another adult is present: it is a carers school “collective” which perform this task .

Regarding individual assistance, human rights commission and the autonomy of people with disabilities (CDAPH) may decide, after needs assessment by the multidisciplinary team, to assign individual human assistance for the education of the handicapped student: a school carer for individual assistance ( AVS- i) ensures that mission. Similarly with pooled, a school carer for pooled aid ensures that mission. This allows us to offer assistance to students who do not require constant attention and continuous flexible support is available in close proximity according to their needs.

According to the 2005 law, all auxiliary school life, whatever their status, should receive training closer to taking office.

Art. L. 112-5. – “The teachers and management staff, hospitality, technical and service receive during their education and training, specific training for the care and education of students with disabilities and includes in particular information on disability […]”[15]

The proportion of teachers who are dedicated to the education of students with disabilities increased by 16.2% in six years. There are 13,948 full-time equivalents in 2011-2012. For institutions within the national education system, the increase was 28.3%: there are 8676 full-time equivalents in 2011-2012[16].”[17]

 

The integration of the disabled after the graduation, integration into the workplace

The disability law affirms the principle of non-discrimination and gives priority to work in the mainstream, by focusing on encouraging employers. Companies must take appropriate measures to enable disabled workers to get a job or keep a job corresponding to their qualifications or training that meets their needs. All or part of the expenses incurred as such by the employer may be offset by aid.

Since 1987, companies with more than 20 employees are required to fulfil their job requirement with at least 6% of people with disabilities. The law of 11 February 2005 reaffirmed this obligation and extends it to new categories of disabled persons: disability card holders and the Allowance for disabled adults (AAH)[18].

“The 2005 Act also created a fund for the professional integration (Agefiph) in the Public Service which will be powered by the contributions of ministries. Local authorities and public hospitals do not comply with the obligation to employ 6% of disabled workers. The contribution to the fund by the companies that did not meet the employment requirement of 6% is strengthened: it increases up to 600 times the minimum interprofessional salary schedule growth (SMIC) for disabled and non-employee worker up to 1 500 times the hourly minimum wage by disabled workers not employed for companies that have not taken any action on the employment of disabled workers within three years.

In the private sector : 65% of reporting institutions directly employed at least one disabled worker in 2009 against 53% in 2006, the number of institutions contributing to Agefiph has been steadily declining since 2006.

In the public sector between 2007 and 2011, the number of employers contributing to the fund for employability decreased by 13 % over the same period , the annual number of hiring people with disabilities more than doubled, from 6 000 to 14 000 .

In 2011, 44,458 companies had contributed Agefiph (funds for the employment of people with disabilities). This is less than the previous year, with 47,520 companies had then contributed to the fund. However, at 22%, the unemployment rate for people with disabilities is more than two times higher than the French average.”[19]

Employment and unemployment of people with disabilities in 2007Source: Dares, complementary investigation to the investigation Employment in 2007[20]
in %
  Pop. receiving adm. recognition Pop. disabled defined under LARGE Population 15 to 64 years
Activity rate 44 70 71
Employment rate 35 65 65
Unemployment rate 19 7 8
Employees (in thousands) 1 813 9 595 39 390

 

Those in work are most often employed in low-skilled sectors. 80% of workers with disabilities recognized by COTOREP are either workers or employees, against 57% of total assets, only 3% are managers against 11 % of assets.

 

Has the system integration of disabled people in the school system been positive or does it have flaws?

Very ambitious, the said “disability” law intended to cover all aspects of the lives of people with disabilities. This cross-sectional approach is its strength but also its weakness because requires a significant steering and implementation that, eight years after its adoption, is not yet complete.

“The conclusion is unanimous: the 2005 law has a real opening of the school of the Republic on the world of disability movement. Proof is the one-third increase in the number of children with disabilities in mainstream schools since 2006; 55,000 additional children were welcomed.

However, these good results must be qualified because the number of children with disabilities seamless enrolment is estimated at 20,000. This figure, however, must be taken with caution since there is no national statistical tool to precisely quantify the number of school-age children with disabilities. It is clear that quantitative advance was not accompanied by a qualitative improvement of the same magnitude.

Thus, we observe:

  • A great diversity of situations faced by families in the departments: weekly time enrolments are very random.
  • The existence of breaks in the course of schooling because of the difficulty in continuing education in mainstream schools in the second degree and a still very limited access to higher education.
  • Failure of the accompaniment to mainstream: the growing use of school assistants (AVS), which are insufficiently trained and recruited on temporary contracts, does not respond appropriately to the needs.
  • Inadequate teacher training on disability, which often makes them feel helpless faced with a student’s disability.
  • A lack of cooperation between the medical and social and educational institutions, which is characterized by a partitioning and damaging the quality of care pathways.[21][22]

 

4.7. FRANCE: CREATIVE LEARNING APPROACHES

a) Workshops with local partners

  • “Turbulences!”:

“Turbulences” is a centre for autistic adults, they work in an environment adapted to their needs and they are paid the minimum wage for their work. There are various workshops: creation and management of shows, multimedia/communication, maintenance/economy, catering/waitressing, sets and costume creation and tailoring.

http://www.turbulences.eu/http://www.turbulences.eu/Prestations-de-l-ESAT-Chapiteaux-Turbulents_a115.html

They are a company which offers many services to other companies or schools: catering, creation of web designs, tailoring. Every activity includes autistic adults who are professionals. The services are paid like in any other companies and since the state has offered a diminution of taxes for companies who employ people with disabilities, they are constantly called to perform their jobs. The sewing workshop makes cushions, aprons and other clothes for sale, the multimedia and communication design websites or advertisements for companies, the ‘live arts’ present shows performed by the artists of “Turbulences!”: they dance, sing and act for the audience.

 

turbulences 1The Burn’s Supper (01/24/2009)[23]

Concert with the Gospel Band “Ananias” and Turbulents[24]

turbulences 2 turbulences 3

Turbulents’ cushions[25]

The company offers a safe environment for autistic persons: they are autonomous but also accompanied by educators who are there to help them flourish through creativity and a working environment.

  • Avenir Dysphasie France – the Makaton language:

The association offers help to parents to interact and communicate with their children through the Makaton language. It is a program to help communicate and speak with a functional vocabulary used with speech, signs and pictograms.

http://www.makaton.fr/http://www.makaton.fr/article/quest-ce-que-le-makaton.html

The language was elaborated by Margaret Walker in 1973, it offers a visual representation of the language with signs and pictograms to improve comprehension and facilitate expression.

For instance: the sentence “The boy sleeps in the house” is introduced first by the more important pictograms: “boy sleeps house” and afterwards the other words are introduced to the child but every sign or symbol has to be spoken so the children are encouraged to speak when they sign.

Example of pictograms[26]

The association’s goal is to disseminate the Makaton language, an English website was created at the following address: http://www.makaton.org/. They propose training to learn the Makaton language.

  • Béatrice Sauvageot – Association “Puissance Dys”:

The goal of this speech therapist is to develop abilities through art and creativity for ‘dys’ children. She elaborated training for the children and the parents, they last one day or half a day. Her team focuses on methods that help children through creativity and art.

http://www.beatrice-sauvageot.com/page/association-puissance-dyshttp://www.beatrice-sauvageot.com/page/les-objectifshttp://www.beatrice-sauvageot.com/page/la-methodehttp://www.beatrice-sauvageot.com/page/de-la-dys-a-la-bilexie

The educators use a byslexic language elaborated by Béatrice Sauvageot’s team, the usual alphabet is used but in a different way: the letters are formed by their holes: instead of having the letters in black, the holes are black. They discovered that dyslexic people could easily read that language and they use it to help the non-affected people to understand how dyslexic people see the usual language.

The picture says “balançoire”, it means ‘swing’ in French[27]

Dyslexic people see their national language as a foreign language according to the team, the term ‘bilexia’ is used to explain that they are bilingual, they need to learn their national language as something else, they do not use the same language as the non-affected by speech disorders people.

 

  • Centre Simone Delthil:

The centre offers help for children affected by major speech disorders: they first propose a consultation with a hearing specialist and afterwards, they work with the children according to their capacities and needs.

http://www.centre-delthil.fr/article5/admission-sessadhttp://www.centre-delthil.fr/article11/accompagnement-sessad

The therapists and other specialists work in tandem with the families and the schools; the goal is to help the children do what they can, and not try to force them to do what they should be able to do according to the society’s norms. Their methods are based on a partnership with the children, they try to interact with them and afterwards work with them to develop their capacities: thus the therapists can go to the schools or study at home or at the centre with the children: they are adaptable to them and not the other way around.

  • Adrien Honnons: graphic designer who works on dyslexia, dysgraphia and other speech disorders in pictures and videos:

Dyslexia: http://vimeo.com/96010899

Dyspraxia: http://vimeo.com/12801116

Dysphasia: http://vimeo.com/12800677

b) Books about speech disorders

  • The Borel – Maisonny method “Bien lire et Aimer lire” : “Read well and like reading” – 2012.
  • FFDys : Fédération Française des Dys “Histoires 2 comprendre les Dys en entreprise” : “Stories 2 understand Dys disorders in companies”.
  • FFDys : “Histoires 2 comprendre les Dys” : “Stories 2 understand the Dys”.
  • The editor Tom Pousse, specialized in learning difficulties, with the method “L’âge de lire” et “Les 100 idées” : “The age of reading” and “The 100 ideas” : http://www.tompousse.fr/methodes-lecture.php.
  • The method “La planète des alphas” : “The planet of alphas” : http://www.lesalphas.net/
  • The Davis method “Le don de dyslexie” : “The gift of dyslexia”.
  • The Davis method “Le don d’apprendre” : “The gift of learning”.
  • De Weck and Marro “Les troubles du langage chez l’enfant” : “Speech disorders in the children”
  • Huron “L’enfant dyspraxique” : “The dyspraxia in children” – 2011 .
  • Jeannerod “La fabrique des idées” : “The Factory of ideas” – 2011.
  • Maillart et Schelstraete “Les dysphasies” : “Dysphasia(s)” – 2012.

c) New methods about the learning of children with speech disorders:

  • Method Borel – Maisonny.
  • Using computer equipment to help children at school.
  • Method « La planète des alphas » : “The planet of alphas”, acknowledged by the UNESCO.
  • Method Gattegno – La lecture en couleurs : Reading in colors.
  • Method Giasson – La technique de lecture répétée : The technic of repeated reading.
  • Method Crocolivre : Crocobook – Développement du lexique et travail systématique sur la morphologie : Development of vocabulary and systematic work on morphology.
  • Method Beatrice Sauvageot – Progresser et développer par des ateliers : To progress and to develop in workshops.
  • Method Davis – La pensée en images et la représentation en 3 dimensions : Images as a thought process and the representation in 3 dimensions.


  1. TURKEY: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Kutahya Valiligi

 

5.1. Special Needs Education in Turkey

Understand what assistance is available for children with special needs in specialist schools in Turkey, as well as in the mainstream public and private school systems…

Matters relating to people with special needs in Turkey are regulated by the Administration for Disabled People (TC Aile ve Sosyal Politikalar Bakanlığı, Özürlüler Dairesi Başkanlığı). This institution coordinates the government and non-governmental organisations providing services for disabled people.

In May 2009 Turkey adopted the UN Convention on the Rights of Persons with Disabilities. Although the government, municipalities and non-profit organisations have been working together to improve the conditions and facilities for people with special needs and encourage their full participation in daily life, access and the services available are not yet sufficient for the number of people with needs.

Some projects being managed by the Administration for Disabled People are explained in English:

5.2. Education of Children with Disabilities or Learning Difficulties

The fundamental policy is to educate children with disabilities in a way that allows them to interact with other children as much as possible, to support their integration in society. This applies to children with visual, hearing or physical impairment as well as children with behavioural, social or learning difficulties. If the disability allows, a child attends regular school classes.

However, depending on the level of their disability, education may take place in special classes.

The Ministry of Education (Milli Eğitim Bakanlığı, MEB) is responsible for providing children with special needs with education from age 3 to 14. The supervision of education of children with disabilities starts at birth.

5.3. Special educational needs: assessment and diagnosis

State educational support is provided to children judged to need special education services. Application is made to the Guidance Study Centre (Rehberlik Aratıma Merkezi) in the district of residence; a hospital-issued disability health report (özürlüler için salık kurulu raporu) is required.

Using various tests, the Guidance Study Centre evaluates the physical ability, personal development characteristics and the academic competences of the child and provides recommendations on education. It also gives the family guidance and counselling on the care and treatment of a child with special needs.

Documents required to apply for special education:

  • Residency certificate
  • Written application by the parents to the school administration
  • Personal development report of the child (if already registered)
  • Child’s health report from the hospital

Benefits

The Ministry of Education funds some of the expenses of a child’s special education; a report issued by the Special Education Evaluation Council (Özel Eğitim Değerlendirme Kurulu) is required to qualify.

5.4. Educational Institutions

At present, special education is provided for sight impaired, hearing impaired, mobility impaired and chronically ill children.

A nationwide educational integration programme is being extended and work is in progress to allow students with disabilities to study at regular schools.

All the schools and associations for visually impaired children are listed on the web page of International Council for Education of People with Visual Impairment.

The website of the Disabled and Elderly Services Directorate General (in Turkish) has information relating to students with disabilities.

5.5. Background and justification

One of the most important indicators of the contemporary education is inclusion of the disabled people in the society they live in and their active participation in every area of life like the non-disabled persons. Targets and regulations regarding inclusion of the disabled in society are emphasized in some international documents, also in EU policies documents.

At global level, Salamanca Declaration (UNESCO 1994) that has as its base the UN declarations on human rights proclaims the necessity and urgency of providing education for all children, youth and adults with special educational needs within the regular education system. It goes by saying that regular schools with this inclusive orientation provide an effective education to the majority of children and improve the efficiency and ultimately the cost-effectiveness of the entire education system. 4

The UN Convention on Rights of People with Disabilities that was adopted at the end of 2006 and signed in 2007 has the basis of protection and support of the disabled persons in education, health, work and in other areas and supports mainly the accessibility and education areas rights for their benefit with an approach of human rights basis. Accessibility area includes physical accession, accession to information-communication environment and work opportunities. Education area supports the efforts of including the disabled children, who had no chance to complete the primary education, into society as a productive power and also the efforts of changing the mentalities preventing accession to the education.

Equal opportunities and integration of people with disabilities into society have been issue in the European policy dialogue.

The most important resolutions regarding special education of the European Commission are summarised below.

Resolution of the Council and the Ministers for Education meeting with the Council of 31 May 1990 concerning integration of children and young people with disabilities into ordinary systems of education Some of the statements in this resolution are as follows:

  • The Member States have agreed to encourage integration of pupils and students with disabilities, in all appropriate cases, into the ordinary education system;
  • The work of special schools and centres should be seen as complementary to the work of the ordinary education systems;
  • Co-operation between all the bodies with an interest in and involvement with children and young people with disabilities should be encouraged (school education, preparation for work, leisure activities, health and the social services);

Council resolution of 5 May 2003 on equal opportunities for pupils and students with

disabilities in education and training

In accordance with the European initiatives of 2001 concerning the European Year of People with Disabilities 2003, this resolution calls on Member States and the Commission, within their respective competencies, to (among others):

  • encourage and support the full integration of children and young people with special needs in society through their appropriate education and training, and their insertion in a school system which is adapted to their needs;
  • facilitate proper information and guidance;
  • continue and, if necessary, increase the initial and in-service training of teachers in the area of special needs;
  • promote European co-operation between the parties involved professionally in the education and training of children and young people with disabilities.

This resolution also calls on Member States and the Commission to increase the sharing of information and experiences on these matters at European level, involving where appropriate the European organisations and networks specialising in this field, such as the European Agency for Development in Special Needs Education.

Social inclusion of the disabled persons was also emphasized in some other EU documents as mentioned below. 5

The European Social Charter that was adopted by Council of Europe in 1961 and revised in 1996 guarantees the right to vocational guidance including the handicapped (item 9) an

The European Social Charter that was adopted by Council of Europe in 1961 and revised in 1996 guarantees the right to vocational guidance including the handicapped (item 9) and the right of persons with disabilities to independence, social integration and participation in the life of the community (item 15).

Furthermore, The Charter of Fundamental Rights of the European Union that summarises the common values of the member states of the EU proclaims in item 26 under Chapter III.

Equality that the Union recognises and respects the right of persons with disabilities to benefit from measures designed to ensure their independence, social and occupational integration and participation in the life of the community.

Accessibility to education for all social inclusion have also been targets to reach the strategic goal of EU set in the meeting held in Lisbon between 23 and 24 March 2000 European Council that agreed on investment in human and combating with social exclusion in order to reach the goals they set until 2010. To ensure their contribution to the Lisbon Strategy, ministers of education agreed on three major goals to be achieved by 2010 for the benefit of the citizens and the EU as a whole:

  • to improve the quality and effectiveness of EU education and training systems;
  • to ensure that they are accessible to all;
  • to open up education and training to the wider world

As a candidate country, Turkey is going through the EU harmonization process for harmonizing the EU Acquis and implementing the EU rules and standards. Within the context of harmonization of the legislation with EU, from a legal and regulatory point of view, most basic principles governing the special education system in Turkey are consistent with those in EU Member States, such as equal admittance and equal opportunities.

The basic legislation regarding special education of Ministry of Turkish National Education is the Decree Equivalent to Law No. 573 on Special Education that was adopted in Turkey in 6th June 1997. This Decree was put into force by publication in the Official Gazette No. 23011 of 6th June 1997. In this Decree, mainstreaming education is accepted as the basis of special education. Another is the Regulations for Special Education Services for planning and implementing the special education services provided to the individuals requiring special education and for functioning of the institutions. It was put into force after updating by publication in the Official Gazette No. 26184 of 31 May 2006. Moreover, The Law No. 5378 on Disabled People and on Making Amendments on Some Laws and Decree Laws that was adopted in 1 July 2005 has been an important step for inclusion of disabled people in the society and for making necessary arrangements. These legislations and others under them have adopted that mainstreaming is essential in education of the disabled persons. However, negative attitudes and behaviours of parents of non-disabled children, teachers, administrators, and generally society make it difficult to implement these legislations.

2007 Progress Report states that as regards the rights of disabled people, several implementing legislation were issued following the entry into force of the Law on People with Disabilities in 2005. These cover areas such as workplaces and educational services for disabled people. More needs to be done to establish decentralized structures and services for disabled people and also to facilitate access to education of children with disabilities. 6

EU Member States take very different approaches to how pupils with special education needs are to be supported in education and training and how schooling can be better adapted to their needs. There are great disparities between EU Member States on allocation of additional resources for pupils with special education needs. Evidence also points to different approaches to training of teachers and others who need to be trained to teach in special education needs settings.

schools/institutions plan and fulfill the family education services related to students in need of special education and their families.

During the 2007-2008 school year, there are 4967 students in 48 primary education schools for hearing impaired, 1349 students in 16 schools for visually impaired, 442 students in 3 schools for orthopedically impaired, 8217 students in 171 schools for mentally handicapped and 692 students in 22 institutions for students with autism.

Children with handicaps are also often educated in regular schools; the choice for specialised or regular schools also depends on the parents’ preference as well as the educational diagnosis of the Guidance and Research Center.

The individuals with special education needs attend general and vocational secondary educational schools/institutions with their non disabled peers primarily through mainstreaming. There are also special education schools/institutions providing education for work and job for the individuals with special education needs. During the 2007-2008 school year, 6800 disabled students are trained in 17 vocational high schools, 126 work training centers and 64 work schools. The numbers of the disabled students who are mainstreamed in general and vocational high schools at the level of secondary education is 1792.

It’s essential that the individuals requiring special education to have vocational education make use of appropriate education settings in accordance with their interests, abilities and needs.

 

5.6. References:

1.http://ec.europa.eu/enlargement/pdf/turkey/ipa/2008/tr080105_strengthening_special_education-final_en.pdf

2.http://mebk12.meb.gov.tr/meb_iys_dosyalar/34/11/747096/icerikler/rehberlik-ve-arastrma-merkezinden-nasl-faydalanabiliriz_122933.html

3.www.meb.gov.tr

4.http://www.gonul.com.tr/ozel-egitim-ve-rehabilitasyon-literatur/dil-ve-konusma-bozukluklari-guclugu.html


  1. ITALY: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by Association COAT

6.1. People with disabilities in Italy

Italy has started in re-thinking the approach toward pwd (people with disabilities) during 70s: promoting a number of laws in favour specific groups (blind and deaf) and their work integration (as reserve list). In educational framework, this process understood a progressive closing of “special schools” and institutions for the education of disabled persons (in sense of confined location). These changes have to be seen as a general modification of the point of view of the italian society, which can be described as a “bio-psychosocial approach” to the concept of pwd.

It is possible to find two main conceptual models of disability:

–         the Medical Model deals with disability as a problem caused by diseases, injuries or health conditions which need medical assistance as an individual treatment by specialized professional figures;

–         the Social Model deals with disability as a complex interaction of conditions, many of which are related to social context and to environment of life.

Biopsychosocial model, which integrates the Medical model and the Social model, stressing the importance of all the components at the biological level, the individual level and the social level. The Biopsychosocial model gives a conceptual map to describe health condition of the person by the interactions among the following dimensions:

italu 1

Since the 70s, there is in Italy a gradual transition from the concept of inclusion in the integration of pupils and students with disabilities in public schools. The legislation reflects their various production steps with which it has developed a process to promote a process of inclusion and integration of people with disabilities in the school environment.

This process has had the objective of implementing a “right”, but above all implement tools, methods and services that might facilitate social participation and improve the academic performance of persons with disabilities.

Going through the main stages of legislation in recent years, we must remember the law n. 118 of 1971, which establishes the right to education in ordinary schools, and has measures to ensure the frequency, and the law n. 517 of 1977, which recognizes the importance of individualized educational interventions aimed at the full development of the personality of the students.

More recently, the law no. 104/92 “for the assistance, social integration and rights of disabled people “, aims to promote the full integration of people experiencing handicap in every area in which they can express their personality “in the family, at school, at work and in society “(Art. 1, paragraph 1, lett. a).

With regard to schooling, the above-mentioned law considers it a priority that the education of people with disabilities is fulfilled through their inclusion “in mainstream institutions schools of all levels and in the universities’ (Article 12, paragraph 2). The frequency in common classes constitutes an essential instrument for the achievement of the “development of … potential of the handicapped person in learning, communication, relationships and socialization “(Art. 12, paragraph 3).

The law n. 104/92, also calls for the adaptation of ICT of school facilities and promotes, in addition to coordinated planning with other of the territory, operated by public or private entities, including the training and retraining of teaching staff and support (Art.13-16). By Law no. 17 of 1999, which amends the law framework, are guaranteed to university students with disabilities both technical and educational subsidies, and tutoring services specialized and individualized treatments on the occasion of the university examinations and the presence of a teacher responsible for coordinating, monitoring and support of all initiatives on integration as part of the university.

Also as part of the Framework Law no. 104/92 is also introduced the instrument’s “Profile Dynamic Functional” (PDF) useful for defining the level of development that “the pupil in a state of handicap “can be reached in a short time (six months) and in the medium term (two years). The Functional Profile is prepared on the basis of Functional Diagnosis (DF), which consists in an analytical description of the functional impairment of the physical or mental condition of the student [compiled by Public Health system]. Both instruments defined above possible to develop the Individualized Education Plan (IEP), which is a document that descriptions of the interventions, projects didactic-educational, rehabilitation and socialization individualized and the modes of integration between school and extracurricular activities.

The Education Plan is prepared by operators of Local Health Units and staff specialist teacher of the school, with the psycho-pedagogical teacher participation operator identified in accordance with criteria established by the Ministry of Education, in collaboration with the parents of the disabled person (Article 12, paragraph 5).

A tool that should facilitate further integration is the Regulation on school, approved by the Council of Ministers on 25 February 1999, in that it emphasizes the need to consider each individual in its diversity (including those relating to a disability) and provides “education interventions, training and education aimed at the development of the human person, adapted to different contexts, the question of the families and the specific characteristics of the subjects involved “(Article 1, paragraph 2).

“The basic assistance to students with disabilities is a fundamental part of the process of school integration and its practical implementation will help achieve the right to education guaranteed by the Constitution ”

(Note no. N. 3390 of 30 November 2001 “Basic care for pupils with disabilities”) is therefore the responsibility of each school to create the conditions so that all pupils are offered the services more suitable. Basic care is handled by schools and educational activity with the lives teaching and is an important figure in the school employee. “Given the sensitiveness of the related to assisting students with disabilities are organized training courses, as provided for by Article CCNI 1998-2001. 46, relating to additional functions, identifying one or more school employees for each of the schools with the presence of students with disabilities “(note prot. n. 3390/01). In this way, each school autonomous is able to acquire a group of school staff capable of fulfilling the duties laid down by the assistance of the base. Remarkable is also the figure support teacher, which should be fully involved in educational programming and should participate, on an equal footing teacher of the class, the preparation and verification of the activities pertaining to the advice of teachers. For years it was maintained a ratio of 1 support teacher for every 4 students with disabilities (as provided by Law no. 270 of 20 May 1982 Article 12). By Law no. 449 of 1997 and the Decree of the Minister of P.I. n. 331/1998, has detached the organic support the number of students with disabilities: the places of support are now calculated at the provincial level, based on the ratio of 1 seat for every 138 pupils, disabled and non-disabled.

 

6.2. ICF- International Classification of Functioning, Disability and Health in Italy

The recently introduced ICF standards as a common “language” for all the agents of the society

ICF ( International Classification of Functioning, Disability and Health, 2001) is a classification of health and health related aspects, developed by the World Health Organization (WHO).

It represents a revision of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) which was first published by the World Health Organization for trial purposes in 1980, focussing more on the consequences of a disease. The new version describes body functions and structures, activities and participation, which are classified from body, individual and societal perspectives.

ICF is much more accentuating the aspect of health not only from the restrictive side but also highlighting the positive aspects.

The actual ICF classification makes a clear difference between body structure and function on one side and activities and participation on the other side. We can describe Disability as a global term regarding limitations due to the physical impairment but also as limitations by doing some activities and participation at the community, societal life. So it is related to the limitations as resultant by the combination of physical/intellectual impairments and the environment (physical and societal) the person is living in.

 

 

ICF introduces “a positive view that deals with health and functionality in a complex, systemic and interrelated perspective, that focuses attention to environmental and personal factors, to a language shared by different professionals, putting them in communication and helping them collaborating”.

At present, italian goverment is pushing the utilisation of ICF as a descriptive tool of person profiles through: educational system, employment services, health and assistance services, welfare and social security services. DIN – Disability Italian Network has developed purposely designed educational courses for professionals involved in al public services. Some public available websites provide some help in classification and characteristic extraction (see http://www.openicf.it ).

 

6.3. National Healthcare System in Italy

Since 80’s Italy provided a universalistic approach to healthcare provision: assuring healthcare access to all residents in Italy. It is funded by national and regional taxes (nowadays the responsibility of healthcare and social services). The public part is the national health service (SSN- Servizio Sanitario Nazionale) which is organized under the Ministry of Health and it’s administered on a regional basis.

The aim of the SSN was to create an efficient and uniform health system covering the entire population, irrespective of income or contributions, employment or pre-existing health conditions. The SSN provides free or low-cost health care to all residents and their families plus university students and retirees (including those from other EU countries) and emergency care to visitors, irrespective of their nationality.

In 1998 the SSN was separated from the INPS and funded directly by central government via the IRAP tax ( Imposta Regionale Sulle Attività Produttive), which is paid by employers on behalf of employees; the self-employed pay for themselves through their taxes.

he SSN is largely under the control of regional governments and is administered by local health authorities ( Azienda di Sanità Locale/ASL – often referred to by their former name Unità Sanitaria Locale/USL). The SSN provides hospital accommodation and treatment (including tests, surgery and medication during hospitalisation), visits to family doctors (GPs), specialist medical assistance provided by paediatricians, obstetricians and other specialists, discounted medicines, laboratory services, appliances, ambulance services and free services at a local health unit ( consultorio).

Family doctors are entirely paid by the SSN, must offer visiting time at least five days a week and have a limit of 1500 patients.

Prescription drugs can be acquired only if prescribed by a doctor. If prescribed by the family doctor, they are generally subsidized, requiring only a copayment that depends on the medicine type and on the patient income (in many regions all the prescribed drugs are free for low-income people

Visits by specialist doctors or diagnostic tests are provided by the public hospitals or by conventioned private ones, and if prescribed by the family doctor require only a copay.

Surgeries and hospitalization provided by the public hospitals or by conventioned private ones are completely free of charge for everyone, regardless of the income. For the planned surgeries waiting times can be up to many months, especially in the big cities.

6.4. Facts about Disabled pupils in Italy

The reported statistics are representing most recent and trusted data (ISTAT- Institute of Statistics of Italy and MIUR-Italian Ministry of Education) about the prevalence of disabled students in Italian school system. It should be noticed that the numbers are referred to “diagnosed” pupils, leaving out a number (that should estimated of the same order) of situation defined with the concept of “Special Educative Needs”. This typology (recently introduced in Italy) is including al border-line cases which are referred to cultural and material disadvantages, attention and hyperactivity problems, low-income families, special barriers to education (including religious).

italu 2

Number of pupils with disabilities in Italy (MIUR)

italu 3

Distribution of disabled students in school grades (MIUR)

The distribution of disabled students is confirming the “pyramidal” distribution of access to education: the higher schools are losing disabled students (at the end of the obligation period- 16 years).

The distribution per type of disability is based on a rough distinction between the psychophysical and sensory impairment. The first category is a large space including motor and mental/cognitive problems such as cerebral palsy exitus, autism, down syndrome…

  Type di disability
Year Psycophysical impairment Low-Vision and Blindness Ear Impairment/Deafness Total
2003/4 151.67294,1% 3.3442,1% 6.1433,8% 161.159
2009/10 189.94794,8% 3.7481,9% 6.7693,4% 200.464

(Source MIUR-ISTAT)

The support teacher is intended as help for all the class (where the student with disability is included), it depends on the number of “assigned hours” for the support teacher which is covering just a part of the weekly school hours.

Year Support Teachers Disabled students Disabled student per support teacher
2002/03 75.000 142.000 1,9
2006/07 90.000 170.000 1,9
2009/10 89.000 181.000 2,0
2010/11 95.000 189.000 2,0

(Source MIUR)

Distribution of ratio disabled student/support teacher in different regions of Italy (source Istat)

 

6.5. Disabled students education specific characteristics

Family-School relationship

The educational project is intended as part of a personalised-customised approche for all pupoils with disabilities : ita ha sto be shared with relatives in order to involve them in terms of objectives and modalities (pathway). Each school has and internal GLH (Gruppo di lavoro sull’handicap – Handicap Working Group) to realize this objective: it involves teachers (curricular teachers), support teachers, relatives and sometimes the students themselves.

In primary schools, GLH meets more frequently (montly), in secondary and higher schools it happens less frequently: there are consistent disparities between the institutions in northen and the southern part of Italy, where north is normally performing a better integrative practice demonstrating more attention to disabled students.

In all type of schools the support teacher is meeting a family member montly, discussing behaviour and performance of the student.

 

PEI – Individualized Educational Programme

It is prepared as a document where expected outcomes and modalities are described in integrated and harmonized way. Starting from diagnosis and Functional – dynamic profile (PDF – profilo Dinamico Funzionale), it is matching achievable goals and educational strategies (didactics and pedagogy) also with the help of specific tools and aids. It is shared among health and school responsible and family members.

 

Accessibility Barriers

At level of physical accessibility the architectural barriers are still a problem for most of school institutions: once again the difference between the north and the south is privileging the north: for instance 35% of primary schools in north have external paths accessible, against 21% of south.

 

Technology as facilitator

ICT and technology based solutions are in general great resources for inclusion of students in educational context. Hw and Sw are introduced as technological aids for various types of disabilities. Specific ICT Workstations are provided for primary and secondary schools: they are equally distributed in south and north (30%), with a less favourable percentage in central regions (27%). A problem is constituted by the adequacy of support teacher curricular w.r.t. the technologies: they are 14% in primary schools and 8,9% in secondary

Type of certifications

Disability/Handicap:

The handicap certification is following the law 104/92: it states the disadvantage situation coming from disability and/or impairment referred to the social context of the person.

Handicap is considered “severe” when the person needs of permament assistance: this type of certification gives the access to several allowances and rights.

 

Civil invalidity:

on the basis of the law 118/78 , it certifies the difficulty in performing typical functions linked to ADL (activity daily living) or communication/relation, caused by impairment or deficit at intellectual, sensory and motor level.

 

6.6. References

http://www.handylex.org- Italian collecting all laws about disability

http://www.istat.it – Italian Institute of Statistics

http://www.miur.it – Italian Ministry of Education

http://www.salute.gov.it – Italian Ministry of Health

http://www.lavoro.gov.it – Italian welfare ministry

http://www.disabili.com – Italian site on disabilities (news and information)

http://www.centriausili.it – Italian website of national network of counseling centres about educational and not-education aids

http://www.coatnet.it – COAT association (belonging to the Italian network of counseling centres) web page

 

6.7. Italy: Creative Learning approaches (workshops)

Autism daily centre: the behavioural approach and CAA with children with autism

The references of the regional reference centre for autism of the region (Dot. Pierini and Dott. Toccaceli) have presented the approach undertaken with a number of speech-impaired children.

The Pervasive Developmental Disorders, in their complexity, pervasiveness and persistence in the course of life, imposed to pay attention to the combination of needs and concerns expressed not only by the child or young person also by their families, by the school and health services themselves, to provide continuity and consistency in treatment programs, educational and supportive actions for their growth. Moreover there is the need to take account of the importance given to the gradually increasing “Evidence Based Medicine” even in the context of rehabilitative and psychosocial interventions.

Autism Daily centre outside

The opening of the Daily Centre for Autism (2007) has established an operational model that enhance the collaboration among families, social health services and social co-operatives, that means to improve the educational and rehabilitative activities addressed to children with autism through a network of actions synergistic implemented in different contexts and by different actors. This is achieved through the flexible of measures (developmental experiences) in different life situations (home, work and recreational soprtive, shops, cinemas, etc..) In continuity with what has been achieved by the family and the school as a single project (ref to Individualised Educational Plan in school).

The individual programs provide a one to one relationship between the educator and the child, the weekly time commitment for each participant varies from six to ten hours in total, distributed between 3 to 4 afternoons a week. In addition to these collective moments of variable duration, such as laboratory activities or aggregation (snack, relax etc..).

Inside the centre, the guiding principles are the psycho-educational work with the aim of integrating the cognitive-behavioral approach (TEACCH model) to the techniques of communication support provided by the AAC (Aumentative Alternative Communication) and those with special adaptations coming from the treatment of severe sensory deficits and linguistic disorders.

A structured environment is a comfortable and pleasant setting, stable and reassuring. It aims to give every child an experience of functional and predictable routines, which support socially adapted development. The structuring of the environment also facilitates educators in building and motivating real-life situations that promote the progressive adaptation of the child to the context: the educator helps him focus on the most important information for communicative exchanges and understanding of contextual indices (which make it appropriate or not a certain action at the place and time). The goal to achieve with this approach is to make children and young people with autism to experience a state of well-being that can help and support to deal with the skills to adapt to the social context and the community rules.

At level of AAC, some simple realization of Communication Books are given.

A Communication Book

 

COAT Association is collaborating with the centre in developing AAC solutions based on tablet technology. This experimental approach will assure a easiness in managing different communication contexts, allowing a number of symbol sets stored in the same (portable) device. On the other hand, a sound can be linked to each symbol reinforcing communication objective toward the environment as well as feedback for the user.

italu 4

 

Creative school activities for pupils with generic speech impairment

 

This meeting has been made with the teacher Stefania Imparati (primary school teacher): firstly she explained the framework of these activities/worshops as part of the integrative approach in Italy. The last positions of the Ministry for Education are recognizing “Special Educational Need” as a general category including mild disabilities/disturbs (dyslexia..) as well as cultural difficulties (i.e. for migrants) or emotional/affective disturbances.

She developed/applied creative methods for development of speech abilities for those pupils with defects in pronunciation, specific learning disturb, special education needs, language retardation, language difficulties (migrants). She proposed as additional activity (extra the normal timetable of school) a number of playful “games” mixing together sounds and drawing abilities, helping the participants to take confidence with their own capacity and developing the ability to overcome to specific problems by their own. This work has been developed in a social context where pupils coming from different classes met together to play under the stimulus/encouragement of the teacher.

This workshop has been organised in several phases:

Socialisation: where each participant has been invited to present him/herself creating a “music” with own name

(http://www.youtube.com/watch?v=shI1hEyhgYg&feature=youtu.be)

Elaboration of figured alphabet: sound of the letter linked with its graphical representation

Sing a nursery rhyme, enhancing personal ability to listen and repeat

Taking confidence with new words: by means of playful verses and games, their vocabulary is enlarged including also words and sounds difficult to pronounce (the music base is a great help: hip-hop, rap and pop are proposed)

Discovering the silence as a component of the spoken experience: represent it, respect time for silence, play with it

http://www.youtube.com/watch?v=RgcuEvaIbZc&feature=youtu.be

At the end, all the group has been invited to experience actively the games proposed in the workshop: it was a funny experience for all of us!

 

 

 


  1. United Kingdom: GENERAL PROVISIONS FOR SPEECH DISORDERS prepared by TELLUS group

The situation in the UK with regard to statutory provision is complex.

Government guidelines changed recently (July 29th 2014) and will be outlined below.

There may be unified guidelines but not a unified system operated by Local Authorities (LAs) in different regions. As with many other things in a time of pressure on funds there is a bit of a post code lottery, so where you live will affect the support you have access to.

Professional referral is essential for those affected and what may be termed lesser needs will tend to fall through the net.

Delivery of support may depend on or be dictated by associated disabilities.

For example, speech impairment may be compounded by issues around autism or special educational needs, which enhance the opportunity for professional support and funding.

Pressure from parents may well determine the action on part of professionals and LAs involved, which will tend to favour the better off and those with the knowledge to deal with systems and bureaucracy.

In summary, there are regional differences in provision with regard to funds available, level and quality of provision, type of provision and access to support.

Professional organisations associated with different disabilities and charitable organisations are commissioned to provide the services.

In the visit to the UK, partners had the opportunity to visit such organisations. Dame Hannah Rogers in Ivybridge and Seale Hayne in Devon offered a chance to look at a multi-disciplinary approach to very heavily disadvantaged children and adults with many on 24 hour individual care.

Whilst The Conquest Equestrian Centre in Norton Fitzwarren near Taunton in Somerset, demonstrated a relatively new technique involving work with horses and devised by a parent of an autistic child from his experience in Mongolia, Rupert Isaacson. The Centre is linked to the Horse Boy Foundation which is becoming a worldwide movement. The partners were able to experience personally the way it works.

The visit also benefitted with a visit from Jo Clay, Area Development Officer for Autism in the UK. Partners were able to discuss the situation in the UK and share experiences with someone working professionally to support people affected by autism and associated disabilities.

More detail on all of these aspects is available on the website created by Tellus Group Ltd to support the dissemination of the project.

What follows now is various reference points for parents and professionals and explanation of new guidelines for statutory provision. Paying attention to Health, Social and Educational systems as well as categorisation of Disabilities.

The final part of the report will focus on the project meeting in Plymouth and visits undertaken by the European partners:

Statutory overview

As of 1st September 2014 new guidelines have been issued by the Department of Education with regard to 0-25 SEND (Special Educational Needs and Disability) code of practice for:

  • Health care practitioners
  • Social care practitioners
  • School and alternative provision
  • Further education providers

This replaces the SEN code of practice 2001

 

 

 

7.1. Children and Families Act England and SEND Reforms

On 29 July 2014 the SEND Code of Practice was approved by Parliament. This is the statutory guidance designed for organisations who work with and support children and young people with special educational needs and disabilities.
The Code of Practice outlines guidance on duties, policies and procedures relating to SEND reforms contained within the Children and Families Act.  Approval of the Code of Practice marks an important step towards the implementation of the SEND reforms from 1 September 2014.

 

7.2. Key Changes
Some of the key changes from the 2001 SEN code of practice are:

  • The code now covers children and young people from birth until 25 years of age and includes disabled children as well as those with SEN.
  • The importance of involving children, young people and parents in decision making.
  • After compulsory school age (the end of the academic year in which they turn 16) the right to make requests and decisions under the Children and Families Act 2014 applies to young people directly, rather than to their parents. This will have implications for Gillick competence.
  • There is a stronger focus on improving outcomes for children and young people.
  • The code includes guidance on the joint planning and commissioning of services to ensure close co-operation between education, health and social care.
  • Statements of special educational needs and Learning Difficulty Assessments (LDAs) will be replaced by a co-ordinated assessment process and the new 0-25 Education, Health and Care plan (EHC plan).
  • There is a greater focus on providing support that enables children and young people with SEND to succeed in their education and make a successful transition to adulthood.
  • The role of the Designated Medical Officer (DMO) can be filled by a suitably competent qualified and experienced nurse or other health professional including an SLT, in which case the role would be called the Designated Clinical Officer (DCO).

 

Responding to changes
The RCSLT is also working on the development of new guidance and resources for members on the implementation of the reforms, including updating the existing position paper on Sharing Best Practice in the SEND Process. This will require the recruitment of a Lead Guidance Developer,  the establishment of both a core Guidance Development Group and wider reference group to ensure all stakeholders from the profession are involved.

 

Reference: Afasic supports parents and represents children and young people with speech, language and communication needs (SLCN).

Afasic Parents’ Helpline: 0845 3 55 55 77

 

 

 

7.3. Health and Social Care System:

How to find a speech and language therapist

If you think you, or your child or relative needs to see a speech and language therapist ask your GP, district nurse, health visitor, your child’s nursery staff or teacher for a referral.

You can also refer yourself to your local speech and language therapy service. You do not have to wait for someone else to refer you.

Ring your local primary care trust (PCT) and ask for the telephone number of your local NHS speech and language therapy service. Use your local phone book, the online directory of PCTs (below) or ask at your GP surgery to find the number of your local PCT.

Online directory of PCTs:

For England – As a short term measure, due to changes in the health system, please contact your local GP for advice.

 

What happens next?

 

This varies across the UK, because services are organised in different ways. In some places, demand for services is very high.

Some areas run a system where first referrals are sorted before appointments are made.

If you have this system in your area, a speech and language therapist or assistant may telephone you first to find out more about your situation.

At this stage ask what will happen next and how long you may have to wait for an appointment.

If you think you have been asked to wait too long for a first appointment or for treatment after the first appointment, contact the speech and language therapy department to ask what has happened. If you still experience difficulty, contact your PCT to discuss the situation

 

Social care

 

Some people need extra care or support – practical or emotional – to lead an active life and do the everyday things that many of us take for granted. The government is working to provide a social care system that provides care for those who need it, and which enables people to retain their independence and dignity.

 

 

The following good practice guidance has been written for CCGs (Clinical Commissioning Groups) to assist them to:

 Commission high quality, cost effective general and specialist health services for

people with learning disabilities;

 Jointly commission services for people who challenge services and those with complex

needs;

 Work with Local Authorities and others to address the social factors which adversely affect the health of people with learning disabilities.

1 Department of Health (2012). Department of Health Review: Winterbourne View Hospital. Interim report.

Emerson, E., & Robertson, J. (2008). Commissioning person­centered, cost­effective, local support for people with learning difficulties. London: Social Care Institute for Excellence.

CCGs need to give particular consideration to commissioning services for people with learning

disabilities because they experience poorer health than the general population, differences which

are to a large extent avoidable, and thus represent health inequalities.

2 Some health inequalities relate to the barriers people with learning disabilities face in accessing health care and health screening. These barriers are well documented in numerous reports including Death by Indifference, 3 which detailed the deaths of six people with learning disabilities while in the care of the NHS and the Disability Rights Commission’s report Equal Treatment.

4 The findings of the subsequent independent inquiry chaired by Sir Jonathan Michael are set out in Healthcare for All,

5 along with a number of recommendations for tackling health inequalities. CCGs will find it helpful to familiarise themselves with these reports and others detailed in the policy context section of this document as they have a key role in tackling health inequalities, including those found in general practice.

Recent events at Winterbourne View have also highlighted the importance of good quality commissioning for people who challenge services, and those with complex needs.

6 CCGs will have responsibility for commissioning services for people with learning disabilities detained under the Mental Health Act, and those deemed to be a health responsibility under NHS Continuing Health Care (CHC) criteria. They will also need to work jointly with Local Authority colleagues, providers and others to ensure that good local services are available to support people who challenge services and those with complex needs to prevent the need for expensive and potentially risky out of area placements. Good practice guidance such as Services for People with Learning Disabilities and Challenging Behaviour 7, first published in 1993, has been available for many years, and had this been implemented it is arguable that Winterbourne View would not have happened.

The guidance is separated into five broad areas and recommends some specific commissioning actions for CCGs, primarily related to the Health Self-Assessment indicators (see section 6) that will help achieve positive outcomes and cost-effective service delivery.

Health Self-Assessment (SAF) indicators relating to all services 8

 Quality, safety and safeguarding for people with learning disabilities are addressed via the commissioning, procurement or contract monitoring process with providers.

National Institute for Health and Clinical Excellence (NICE) guidance on adults with autism is available at: http://guidance.nice.org.uk/CG142/Guidance

The guidance recommends that the local autism multi-agency strategy group should include representation from managers, commissioners and clinicians from adult services, including mental health, learning disability, primary healthcare, social care, housing, educational and employment services, the criminal justice system and the third sector. There should be meaningful representation from people with autism and their families, partners and carers. Autism strategy groups should be responsible for developing, managing and evaluating local care pathways. The group should appoint a lead professional responsible for the local autism care pathway. The aims of the strategy group should include:

 developing clear policy and protocols for the operation of the pathway;

 ensuring the provision of multi-agency training about signs and symptoms of autism, and training and support on the operation of the pathway;

 making sure the relevant professionals (health, social care, housing, educational and

employment services and the third sector) are aware of the local autism pathway and how to access services;

 supporting the integrated delivery of services across all care settings;

 supporting the smooth transition to adult services for young people going through the pathway;

 auditing and reviewing the performance of the pathway.

The Joint Commissioning Panel (JCP) will be developing best practice guidance on Autism Spectrum Disorders in spring 2013. This work is being supported by the Department of Health.

 

5.Five good communication standards

Reasonable adjustments to communication that individuals with learning disability and/or autism should expect in specialist hospital and residential settings

 

Good communication underpins all these outcomes. Most people with learning disabilities have some speech, language and communication difficulties. These can be hidden or overlooked. Everyone needs to know what good communication support ‘looks like’ and what reasonable adjustments they can expect.

Failure to make reasonable adjustments to meet communication needs will mean people with learning disabilities will continue to be vulnerable to a range of risks. These risks include the continuing failure to design, commission and provide best practice services, alongside continuing health inequalities faced by individuals, in contravention of legal responsibilities.

To help providers of specialist hospital and residential services, the RCSLT recommends five good practice standards around speech, language and communication.

The five good communication standards: 

 

  • Standard 1:There is a detailed description of how best to communicate with individuals.
  • Standard 2:Services demonstrate how they support individuals with communication needs to be involved with decisions about their care and their services.
  • Standard 3:Staff value and use competently the best approaches to communication with each individual they support.
  • Standard 4:Services create opportunities, relationships and environments that make individuals want to communicate.
  • Standard 5:Individuals are supported to understand and express their needs in relation to their health and wellbeing.

 

Reference: Royal College of speech and language therapists

Educational aspects:

Segregation, Integration or Inclusion?

There are three approaches for educating children with disabilities:

The between integrated and inclusive education relates to access and quality. Save the Children notes that integrated education tends to focus more on children with disabilities attending school whereas inclusive education focuses more on ensuring children with disabilities are learning.

Save the Children argues that inclusive education is about restructuring the cultures, policies and practices in schools so that they respond to the diversity of students in their locality. This means that all children, including children with disabilities, not only have access to schooling within their own community, but that they are provided with appropriate learning opportunities to achieve their full potential. However, it is also essential that parents, children and communities are supported to change their attitudes and understanding of why inclusion matters, as this is what will sustain change.UNESCO’s policy guidelines for inclusion state that in order to move systems towards greater inclusion, there needs to be:

  • a recognition of the right of children with disabilities to education and its provision in non-discriminatory ways
  • a common vision of education which covers all children of the appropriate age range
  • a conviction that schools have a responsibility to meet

the diversity of needs of all learners, recognising that all children can learn. segregation, integration and inclusion.

Segregation children with disabilities are educated at special schools or at home Inclusive education schools where the whole system has been changed to meet all children’s needs Integrated education children with disabilities attend special classes or units in mainstream schools“

 

7.4. Disability categorisation and link to education:

Speech And Language Difficulties (Sp&LD)
When a child is noticeably behind their peers in acquiring speech and/or language skills, communication is considered delayed. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.

The causes of speech and language disorders may range from hearing loss, neurological disorders or brain damage to drug abuse, physical impairments such as cleft palate, or psychological trauma. Often, however, the cause is unknown.

Incidence of communication disorders

It is estimated that communication disorders (including speech, language, and hearing disorders) affect between 5 and 10 per cent of children in the UK. This estimate does not include children who have speech/language problemssecondary to other conditions such as hearing impairment or language disorders related to other disabilities such as autism, or cerebral palsy.

 

What parents can do

Early intervention makes a real difference…Communication disorders carry the potential to isolate individuals from their social and educational surroundings so appropriate timely intervention is essential.

 

Because of the way the brain develops, it is easier to acquire language and communication skills before the age of five. When children have muscular disorders, hearing problems or developmental delays, their acquisition of speech, language and related skills is often affected.

While many speech and language patterns can be called ‘baby talk’ and are part of a young child’s normal development, they can become problems if they are not outgrown as expected. In this way an initial delay in speech and language or an initial speech pattern can become a disorder, which can cause difficulties in learning.

 

7.5. Educational implications

Language development

Learning is done mainly through language, so it is critical that children develop a language for learning, through intensive and specialised help.

Specialist provision

Some children may require specialist assistance from a resourced school such as a language unit with speech therapy. Others may need a special school environment with a curriculum geared to children with severe communication difficulties.

Specialist equipment

Some children with speech and language difficulties may require alternative means of communication, such as sign language, symbols, or voice boxes.

Technology can help children whose physical conditions make communication difficult. The use of electronic communication systems allows those with no speech and people with severe physical disabilities to express themselves.

Speech and language therapy

Children may be referred for speech and language therapy for a variety of reasons, including:

  • mild, moderate or severe learning difficulties
  • physical disability
  • language delay
  • language deprivation
  • specific language impairment
  • specific difficulties in producing sounds
  • hearing impairment
  • cleft palate
  • stammering/dysfluency
  • autism/social interaction difficulties

 

Who can refer a child for therapy?

Parents, GPs, health visitors, school or early years staff can make a referral to a therapist.

If you have concerns, you may refer your child to a speech and language specialist without a referral from the GP or educational psychologist.

 

How does therapy help?

Speech and language therapists assist children who have communication disorders in various ways.

They work to assess, diagnose and develop a programme of care to maximise the communication potential of those referred to them; they may consult the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and they work closely with the family to develop goals and techniques for effective therapy in class and at home.

At the first session you will be asked for information about your child and the therapist will carry out a screening assessment of all aspects of your child’s communication skills. The results will be discussed with you, and the proposed therapy explained, including when it will be offered and the timescale.

Therapy varies, but usually involves individual sessions with the parent and child.

You will be expected to be involved in helping your child to practise and learn new skills so it is important to be clear about the aims and the results of each phase of therapy.

Sometimes a child will be placed on review – formal therapy sessions will be discontinued during this time; however, you should be told the reason for the review and what your child should be doing during the review period.

In some cases, perhaps where a child has a learning difficulty or where a severe and specific speech and language problem makes following the curriculum difficult, their education may be adversely affected. If this is the case for your child, ask the therapist who else needs to be involved, the expected procedures, timescales and what you can do to help.

Who is responsible for providing therapy?

Although the NHS provides speech and language therapy, it is often considered as an educational provision and may be provided or funded by the local education authority. There are many specialist areas within speech and language therapy, so if you feel your child’s needs aren’t being met by the therapist assigned ask to be referred to the specialist therapist for your child’s problem. If there is no specialist available or you want a second opinion, ask the therapist or GP to arrange this or contact one of the organisations listed below for help.

 

Useful strategies

Try to:

  • speak in clear, short, simple sentences
  • simplify instructions
  • support speech with visual prompts, signs or gestures
  • use pictures/symbols to aid understanding
  • ensure prompt referral to a speech and language therapist, or the provision of specialist speech and language intervention within the educational setting
  • encourage regular, constant reinforcement of skills introduced at speech and language sessions.

 

Strategies for or those with language impairment/delay

It helps to:

  • use simple sentences and instructions, reinforcing key words
  • ask a child to tell you in their own words what they have been asked to do
  • reinforce learning by repeating answers (from the child or others)
  • encourage ‘good listening’
  • encouraging the child to (learn to) read
  • use visual timetables/prompts gestures, signing eg Makaton or written instructions to reinforce the spoken word provide visual clues, don’t just talk about a cylinder, let them see it, feel it, play with it, find different cylinders
  • teach word association skills
  • teach the nuances of language, meanings of jokes, idioms, body language, facial expressions etc
  • make use of books, role play, drama, singing, social stories to explain social situations and develop social skills and understanding
  • play games that encourage listening and/or social skills
  • plan the careful use of computers and ICT to facilitate learning.

 

Types of disorders

 

Speech disorders

Speech disorders involve difficulties producing speech sounds or problems with voice quality. They might be characterised by an interruption in the flow or rhythm of speech, such as stuttering (which is called dysfluency). Speech disorders include problems with articulation (the way sounds are formed), or phonological disorders, or difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. Experiencing difficulty with some speech sounds may be a symptom of a delay, or of a hearing impairment. It can be difficult to understand what someone with a speech disorder is trying to say.

 

Language disorders

Language disorder is an impairment in the ability to understand and/or use words in context, both verbally and non-verbally. Characteristics of language disorders include improper use of words and their meanings, problems with sentence structure, inappropriate grammatical patterns, reduced vocabulary and inability to express ideas, or follow directions. One or a combination of these may occur in children who are affected by language-learning disabilities (such as dyslexia) or developmental language delay. Children may hear or see a word, but not be able to understand its meaning. Often, being unable to communicate frustrates them. The effects of language difficulties vary from mild and transient, perhaps requiring some short-term specialist intervention, to severe and long-term, requiring continual specialist input. Some children have specific language problems others have additional difficulties such as hearing impairments.

Reference: http://www.goodschoolsguide.co.uk

 

7.6. Speech and Language Impairment

‘How can I teach English to a learner who has difficulty speaking and understanding their own language?’[28]

As teachers we know that good communication is vital for successful learning, so it is not surprising that this is a worry for English language teachers across the world. Communication skills help children to understand and explain the world around them, share their ideas and feelings and make friends. Good language skills enable a child to reason and learn. They also help to develop a sense of self and the feeling of belonging to a group or community.

If we discover that there is a learner with speech and language difficulties in our class we might wonder how to help them to get the most from our lessons. By understanding the different kinds of speech and language impairment and knowing some useful teaching strategies we can really make a difference to these learners and help them to experience enjoyable and successful learning.

What is speech and language impairment?

Speech and language impairment varies from person to person and can range from mild to severe. A learner may have difficulty with speaking, ‘expressive language’ or understanding, ‘receptive language’. They may have problems expressing feelings and interacting with others. This can cause low self-esteem and frustration, and may lead to behaviour problems in the class. As speech and language problems are not always obvious, we have to think about what lies behind the behaviour and the need the learner may be trying to express.

Most children with speech or language impairment are of average intelligence, but may have other specific learning difficulties such as dyslexia, dyspraxia or ADHD. Speech and language impairment is sometimes linked with conditions such as hearing loss, Down syndrome, cerebral palsy or autism. Chronic ear infections may also be a cause. Some learners have difficulty with both language input and output and need to be taught the communication skills that other learners learn automatically.

Expressive language difficulties

Some learners have problems with the muscular movements needed to form words. They may have trouble producing certain sounds and simply leave them out, or substitute one sound for another. This can make them difficult to understand and result in delayed or unclear speech.

Expressive language difficulties can also affect the ability to put words in the right order in a sentence and tell stories with the events in the right sequence. Their speech can be jumbled up and hard to understand. Sometimes the learner will use inappropriate grammatical structures and their speech may sound immature for their age. They may also have trouble with learning and accessing vocabulary. These problems occur in their own language and will also appear when learning English. Having trouble explaining and describing things makes it hard to join in class discussions.

Receptive language difficulties

Some learners have problems with the way they hear and process language. This can impact on the ability to understand what others are saying and respond appropriately. Learners with hearing impairment have a physical barrier to understanding speech, but there are can also be ‘pragmatic language’ difficulties where, although the learner can hear what is being said, they do not understand the meaning. They may not know how to use social language and lack an intuitive understanding of social cues and conventions. There can also be problems understanding ‘figurative language’, which includes the use of irony, humour and metaphor. This can lead to a tendency to take things too literally. A learner with receptive language difficulties may have trouble in one or more of these areas.

  • Following instructions
  • Understanding abstract concepts
  • Concentration
  • Understanding stories, both written and spoken
  • Understanding metaphorical language
  • Making friends
  • Listening to others

Teaching and learning strategies – how can we help?

  1. Encourage and accept all forms of communication

Learners with speech and language difficulties are often lacking in confidence and shy about speaking in public, so avoid asking them to repeat mispronounced words or finish their sentences for them. It is better to model the correct form in your response. Concentrate on the message the learner is trying to communicate rather than the grammar. Allow alternative ways of communicating like gestures, writing or drawing.

  1. Be conscious of your own communication style

Make sure your language is clear and direct and face the class so that learners can see your expressions and read your lips if necessary. Give instructions one at a time in the order you want them to be carried out, using visual cues and gestures to support them. If you say the learner’s name before asking them a question they will know you want their attention. Try to avoid ambiguous language and always be prepared to repeat anything the learner does not understand.

  1. Teach active listening skills

Explain to the whole class that it is important to be attentive and look at someone when they are talking to you, and not to interrupt. You can teach turn-taking by having a special object which is the ‘speaker’s token’. The holder of the object is the only person who may speak. When they have finished they pass it on.

  1. Give time to think and respond to questions

All learners can benefit from this. Using the ‘think, pair, share’ model in class provides the time needed to process information and organize thoughts before having to answer.

  1. Use sound discrimination exercises

We know that phonemes are the building blocks for language. You can help learners who have difficulty recognising and decoding phonemes through multisensory activities like clapping and stomping out syllables in new vocabulary or colour-coding the different groups of phonemes. Rhyming bingo and card games where the learner can match the same sounds can be really helpful.

  1. Help with sequencing and word order

If the learner has difficulty explaining things or telling stories in the right order, just ask them to give bullet points of what they want to say and put them in the correct sequence on a timeline. It is also helpful to cut up stories so they can practice putting them in order – you can use pictures for younger learners.

  1. Build vocabulary

Use pictures, objects and photos to help understand and remember new vocabulary. Encourage learners to use their visual memory by making a personal vocabulary box of key words on picture cards.

  1. Help build self-esteem

Make sure to notice and praise good interactions and speech. Describe what they do well and identify and work with their other strengths, such as creativity and physical talents.

  1. Help learners to make their needs known

Always check that the learner has understood the task and clarify any misunderstandings. Encourage them to let you know if they have not understood by using a pre-arranged signal.

 

0:00“WHAT IS SPEECH AND LANGUAGE THERAPY?” [29]
‘Speech and Language Therapy’ is commonly used to help people with language or communication difficulties, although it can also be used to help individuals with difficulty swallowing, eating or drinking.
If the problem being experienced is related to another difficulty such as Autism this is called a ‘secondary’ impairment. If the problem does not stem from any other disorder, for example, if a child finds social interaction problematic, it is termed a ‘primary’ impairment. Whatever the cause a speech and language problem can present a considerable obstacle to a person’s development.
Speech and Language Therapy Terms

Professionals may differentiate between the terms ‘speech,’ ‘language’ and ‘communication’ and so it is useful to define these terms. Speech relates to the ability to clearly enunciate the sounds necessary to speak; language concerns the comprehension of words and their utilisation to make sentences and; communication concerns the use of language in a constructive way, allowing for interaction with others.

“WHAT DOES A SPEECH AND LANGUAGE THERAPIST DO?”

The Speech and Language Therapist is trained to assess and treat speech, language and communication problems in people of all ages to enable them to communicate to the best of their ability. They may also work with people who have eating and swallowing problems and work directly with the child and provide support to them and their carers.
Speech and Language Therapists will work with people who suffer the following problems: a stroke, learning disability, physical disability, neurological disorders, cancer of the mouth and throat, head injury, hearing loss and deafness, cleft palate, dementia and psychiatric disorders.
Speech and Language Therapists work in a variety of settings. These include hospitals (both inpatients and outpatients), community health centres, mainstream and special schools, assessment units and day centres and in clients homes.
“HOW DOES THE THERAPY WORK?”

In a case where communication is the problem the aim of the therapist is to aid the child to communicate as best as they can. In order to do this the therapist first assesses the extent of their problem by considering factors such as how they produce sounds and whether they are able to comprehend spoken language. Once the therapist has made a diagnosis a programme of care is developed for the child in conjunction with their family, and other individuals such as teachers and social workers and other healthcare professionals.

 

“ARE SPEECH DIFFICULTIES ALWAYS A SPEECH DISORDER?” 

It is to be noted that if a child is experiencing difficulties in speech it may not be that they have a ‘Speech Disorder’ but that they have a ‘Speech Delay’. The former refers to unusual or abnormal development whereas the latter concerns children who are not developing as fast as they should be. However it is not always easy to determine which category a particular child falls into and professionals may not even make a rigid distinction between the two.
“WHAT ARE THE CATEGORIES OF IMPAIRMENT?”

In regards to communication a number of different forms of speech and language difficulties may be identified. These may affect the ‘receptive language’ of an individual (their ability to understand language) or their ‘expressive language’ (their ability to form coherent sentences). For instance a person may be unable to control the muscles needed for speech or have a problem with semantics.
“HOW DO I KNOW IF MY CHILD NEEDS SPEECH AND LANGUAGE THERAPY?”
A number of factors may be identified in order to determine whether or not a particular child requires this form of therapy. For example in the case of a child between the ages of 1 and 2 the following factors would suggest that Speech and Language Therapy may need to be considered:

 

  1. There is no development of speech or only very slight progress in this regard
  2. They do not seem to understand what is said
  3. They have underdeveloped listening skills
  4. They are not playing as a child of that age usually would[30]

Reference for this section:

 

 

Book references:

RCSLT—Clinical guidelines- Sylvia Taylor-Goh (2005)Communicating quality: v3: RCSLT’s Guidance on Best Practice in Service Organisation and Provision-K l Williamson(2008)

Speech and Language therapy: the decision making process when working with children-Myra Kersner and Jannet Wright (2012)

Speech and Language therapy: issues in professional practice—Carolyn Anderson (2005)

50 Best Games for Speech and Language Development—Maria Monschein (2008)

Speech Therapy for kids: techniques and parent’s guide for speech therapy—Nancy Smith (2014)

Workbook of voice therapy exercises—Alison Behrman & John Haskell (2008)

The reason I jump: one boy’s voice from the silence of Autism—Naoki Higashida et al-(2014)

Ten things every child with autism wishes you knew—Ellen Notbohm (2012)

The autism discussion page on anxiety, school and parenting startegies—Bill Nason (2014)

101 Games and Activities for children with autism,asperger’s and sensory processing disorders—Tara Delaney (2009)

Early Intervention Games; fun, joyful ways to develop social and motor skills in children with autism spectrum—Barbara Sher (2009)

Powerpoint reference for the Conquest Equestrian Centre:

 

 

 

 

 

 

 

7.7. CREATIVE LEARNING APPROACHES (workshops with local partners)

 

[1] http://medidacte.timone.univ-mrs.fr/webcours/Comite-etudes/ItemsENC/sitelocal/disciplines/niveaudiscipline/niveaumodule/Item51/leconimprim.pdf

[2] http://medidacte.timone.univ-mrs.fr/webcours/Comite-etudes/ItemsENC/sitelocal/disciplines/niveaudiscipline/niveaumodule/Item51/leconimprim.pdf

[3] http://www.cemea.asso.fr/multimedia/enfants-medias/IMG/DOSSIER_handicap.pdf

[4] http://www.cemea.asso.fr/multimedia/enfants-medias/IMG/DOSSIER_handicap.pdf

[5] http://www.legifrance.gouv.fr/affichTexte.do?cidTexte=JORFTEXT000000809647&categorieLien=id

[6] http://www.sanitaire-social.com/centres-pour-handicapes/d%C3%A9finition-du-handicap/m3/7

[7] http://www.sanitaire-social.com/centres-pour-handicapes/Le-handicap-en-chiffres/m3/7

[8] http://www.insee.fr/fr/themes/document.asp?ref_id=T11F037

[9] http://www.handicontent.fr/handicap-au-travail.html

[10] http://www.handicontent.fr/handicap-au-travail.html

[11] The law mentioned above is available in its entire text on the website: http://dcalin.fr/textoff/loi_2005_handicap.html

 

[12] http://www.education.gouv.fr/cid207/la-scolarisation-des-eleves-handicapes.html

 

[13] http://www.senat.fr/rap/r11-635/r11-6354.html

[14] http://www.ted-caetera.fr/avsi-c22746843

[15] http://dcalin.fr/textoff/loi_2005_handicap.html

[16] For more information, consult the website: http://www.education.gouv.fr/cid207/la-scolarisation-des-eleves-handicapes.html

[17] http://www.ted-caetera.fr/avsi-c22746843

[18] All dispositions in relation to the employment of disabled persons are available on title IV, chapter 2 of the law on the disabilities of 2005: http://dcalin.fr/textoff/loi_2005_handicap.html

[19] http://www.humanite.fr/social-eco/emploi-et-handicap-un-parcours-encore-seme-d-embuc-514378

[20] http://www.insee.fr/fr/themes/document.asp?ref_id=T11F037

[21] Rapport of information n° 635 (2011-2012) « Disability Law : real improvements, insufficient application yet »: http://www.senat.fr/rap/r11-635/r11-635_mono.html

[22] http://www.senat.fr/rap/a12-570/a12-5701.html

[23] http://www.turbulences.eu/photos/Burn-s-Supper-24-01-2009_ga27336.html

[24] http://www.turbulences.eu/photos/DSC0815-jpg_gp1407642.html

[25] http://www.turbulences.eu/photos/Atelier-Confection_ga26344.html

[26] http://www.makaton.fr/article/les-signes-et-les-pictogrammes.html

[27] http://www.beatrice-sauvageot.com/page/de-la-dys-a-la-bilexie

[28] Reference: Article by Sally Farley: http://www.teachingenglish.org.uk/article/speech-language-impairment

[29] http://www.specialeducationalneeds.co.uk/speech-and-language-therapy-salt.html

[30] http://www.specialeducationalneeds.co.uk/speech-and-language-therapy-salt.html

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