Developmental Language Disorder (DLD): Conversations in New Zealand

Thu, 16 Apr 2020 21:53:33 GMT

DLD: How far have we come with terminology, awareness, identification and diagnosis?

In 2012, with Professors Bishop, Norbury, Conti-Ramsden and Snowling, and Natalie Orringe our PR advisor, I set up the RADLD campaign (previously called RALLI). Our mission was to raise awareness of a hidden condition involving learning language, understanding language and use of language. The difficulty was first recorded in the literature in 1822, but despite being a common condition and despite impacts on classroom learning, literacy and mental health, language difficulties somehow remained under the radar of the general public and indeed the majority of professionals.

Our campaign was based around a series of short, accessible YouTube videos that prompted a step change in building awareness and led to a consensus project (CATALISE) led by Professor Bishop. The process brought academics and practitioners together to synthesis the research evidence and clinical issues, and to agree diagnostic terminology. Finally, after almost 200 years of confusion, an agreed diagnostic term ‘Developmental Language Disorder' (DLD) and a set of recommended criteria were established.

It was no surprise that an agreed term would help us build awareness. Further mobilisation of Speech and Language Therapists/ Pathologists around the globe followed, with the RADLD DLD Awareness Day gaining momentum each year since our first in 2017.

To facilitate discussions and encourage professionals to apply the new diagnostic criteria, I’ve recently delivered a number of workshops and presentations. Audiences have included speech and language therapy teams, Educational Psychology doctorate students, independent therapists and SENCos in the UK, and in December 2019, during a trip to New Zealand, a session with SLT colleagues and academics in Auckland.

Alongside those who attended Auckland's Massey University in person, the power of the internet enabled us to reach more than 80 professionals or groups using video conferencing. Click here to download slides and for a video of the presentation and subsequent conversation.

A few notes before you watch:
1) VIDEOS: Open the RADLD YouTube page www.YouTube.com/RADLD before watching so you can pause the presentation and watch RADLD videos as I refer to them in the presentation (Then skip through the presentation video for those bits).
2) LINKS: All the links mentioned in the presentation are in the slides.
3) AUDIO: You will notice some audio issues at the start, but the sound does improve shortly after the beginning. It is not possible to hear some of the questions at the end of the presentation. The questions / discussions were around: terminology in the early years; use of diagnostic label versus a description; social disadvantage; criteria in relation to standardised tests and the need for functional measures; Dyslexia and /or DLD; progress / prognosis - and how this may differ depending on the areas of difficulty; limited reliance on standardised testing; dependence on teacher/ parent report and children's language difficulties not being identified .
4) CUT-OFFS: Clarification point: The criteria used in SCALES involved the child scoring - 1.5 SD or below on 2 out of 5 the language composite scores used in SCALES.

We are still at an early stage in applying the criteria and at each workshop session, interesting and surprising issues come up for us to discuss, or to mull over and note for clarification. Many SLTs/ SLPs find themselves in a new position in terms of giving a formal diagnosis. It important to recognise the responsibility this involves and work together to develop our understanding of the complexities, whilst also recognising there will be still be grey areas and uncertainties to tackle. It may always be a challenging area, but I suspect this is the case with the details of any developmental diagnosis. With continued collaboration between professionals, and with the academics on hand to advise and carry out further research, I am very hopeful that progress will continue on a steep upward trajectory.

Tēnā koutou (thank you) to the New Zealand speech and language community for welcoming me, and to Professor Suzanne Purdy from the University of Auckland, Dr Elizabeth Doell from Massey University and Dr Jayne Newbury from the University of Canterbury for kindly hosting. Thank you to Sally Kedge from Talking Trouble Aotearoa NZ for initiating and organising the event and tackling all the technology. I look forward to hearing how the 'NZ DLD conversation' continues!

Contacts and links:
- To get involved in the NZ discussions contact Sally on sallykedge@talkingtroublenz.org or via the website www.talkingtroublenz.org
- If you have thoughts you’d like to share you can contact me on - becky@clarkslt.co.uk
- To support the global RADLD movement and get involved in the next DLD awareness day, please visit the RADLD website
- To link up on Twitter: @BeckyClark22 @RADLDcam #DevLangDis

How can speech & language therapy support your child?

Mon, 14 Oct 2019 00:00:00 GMT

'The five Ss'

Speech and Language Therapy can be a mystery to parents when it is first suggested for their child. The referral may be due to potential Developmental Language Disorder, social communication difficulties, or another type of speech, language and communication need. P arents often ask "Can you help?" or "What will therapy involve?". We also experience young people themselves questioning "..but how can you help me with that?".

Our 'Five Ss' graphic (below) demonstrates the ways we may intervene. SLTs work with professionals and parents to ' Support ' the child using shared approaches, and intervention may focus on ' Skills ' e.g. learning to understand and use specific new words. SLTs may work on ' Strategies ' e.g. developing individual strategies for learning words, and on ' Self Awareness ' e.g. the child learns that specific areas of communication are difficult for them, but that they also have many strengths.
See an example of this from Michael, who explains how SLT helped him in 'Speech & Language Therapy: Helping Michael' a film I created with RADLD ( www.youtube.com/RADLD ).

We aim for the young person to have improved skills, to build a set of strategies, and to be confident in their own strengths and difficulties. Our view is that ultimately these elements combine to achieve improved ' Self Advocacy '. This may have a range of important outcomes, from developing the confidence and skills to ask for clarification in the classroom - to having the ability to explain to an employer what adaptations they need in the work place. In this clip 'Alicia talks about DLD' one of our students describes how SLT has helped her use strategies to work around difficulties, how her confidence in herself has developed and about the difference this makes.

I believe it's important that intervention offers this combination of support. Children, young people and adults who have communication difficulties need to experience understanding from others, need to develop their own 'toolkit' of strategies, and need to have the confidence and ability to express their needs. Speech and Language Therapists are here to help.

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Developmental Language Disorder (DLD): Conversations in New Zealand

DLD: How far have we come with terminology, awareness, identification and diagnosis?

How can speech & language therapy support your child?

'The five Ss'