overview - fua€¦ · expressive language targeted observation of pragmatics in children’s...

20/11/2015

1

The Social Communication Intervention Project (SCIP)

An evidence-based intervention for school aged children with pragmatic language

impairment

Jacqueline Gaile Clinical Lecturer in Speech and Language

Therapy University of Manchester, UK

Website:

http://www.psychsci.manchester.ac.uk/scip

Email:

[email protected]

13 November 2015 University of Copenhagen

Overview

• The Social Communication Intervention Project summary

• Assessment for children with PLI /SCD

• SCIP assessment to intervention mapping

• The three Phases of SCIP Intervention

• Metacognitive content of SCIP Intervention

• Discussion


The Social Communication

Intervention Programme (SCIP) Trial A randomised control trial of intervention for children with

pragmatic language impairment

Catherine Adams and Elaine Lockton

Funded by the Nuffield Foundation

RCT (N=88) of effectiveness of SLT for children with PLI /SCD (aged 6-11)

International Journal of Language and Communication Disorders: Vol 47:3 (2012)

& Vol 48:1 (2013)

Acknowledgements Researchers & assistants:

Jenny Freed

Jacqueline Gaile

Gillian Earl

Kirsty McBean

Jenny Gibson

Anna Collins

Ruth Wadman

Rachel Stevens

Catherine Bird

Vivienne McKenzie

Sibyl Havers

Collaborators:

Dr Catherine Aldred

Dr Janet Baxendale

Professor Jonathan Green

Dr Marysia Nash

Professor James Law

Dr Andrew Vail

Advisory committee:

Bonnie Brinton

Martin Fujiki

Geoff Lindsay

Sue Roulstone

Thanks also to

Nuffield Foundation

Greater Manchester and

Edinburgh NHS SLT Services

Parents and children in Edinburgh

and NW England

University of Manchester

undergraduate and postgraduate

SLTs


Social Communication Intervention Project

• Randomised controlled trial

• Manualised SLT intervention

• Children with pragmatic language impairment

• Aged 6-11 years old

• Mainstream schools in NW England and Edinburgh region of Scotland

• SLTs and Assistants




mailto:[email protected]

20/11/2015

2

Aim of SCIP study

• Ascertain the effectiveness of an intensive social communication therapy (SCIP), compared to treatment-as-usual, for children who have PLI

• On standardised language assessment functioning

• On functional pragmatic ability and broader social communication as rated by parents and teachers


85 children who have PLI

57 Children Intervention group

28 Children Control

Intensive intervention in one school term

20 sessions

Delivery by therapist or

trained assistant

Continue therapy with local services


SCIP intervention

protocol

Up to three, one-hour therapy

sessions per week (up to a maximum of

20 sessions)

Delivered in school by specialist

therapist or trained assistant

One-to-one sessions, provision of whole class and

home based activities

Parent/teacher/LSA attendance and input solicited

throughout

Manual of intervention

Complex individualised intervention


Time 1 Pre-intervention/control assessment

outcome measures and baseline assessments

Intervention or control phase

Time 2

Assessment on outcome measures immediately after therapy

Time 3 Follow-up assessment on outcome measures

Study phases


CELF 4 = standardised language test, receptive and

expressive language

Targeted Observation of Pragmatics in Children’s

Conversation (TOPICC)

Pragmatics and Autism Communication lists from

Children’s Communication Checklist CCC-2

SCIP Parent ratings of social communication

SCIP Teacher ratings of classroom listening and

communication

Outcome measures


Masked or

not masked?

Intervention effect?

Standardised language test

CELF-4

Masked No

Ratings of conversational skills

change TOPICC

Masked Yes

Parent ratings of pragmatic skills

CCC-2 lists

Not masked Yes

Parent perceptions of

improvements in social communication and related skills

Not masked Yes

Teacher perceptions of change in

classroom listening skills

Not masked Yes

SCIP Main Outcomes Summary


20/11/2015

3

Conclusions from trial

Preliminary non-definitive

evidence of effectiveness

Non-specific effects on

pragmatics

Small effect sizes and

heterogeneity

Not everything measures what it

claims to measure

Qualitative study adds to essential

information

Importance of participation measures


Bishop (2000) proposed pragmatic language

impairment (PLI) as a descriptor of the

communication profile within this overlap = “an

intermediate condition”

Kjelgaard &Tager-Flusberg (2001) Children with

ASD “exhibit language profiles of grammar,

vocabulary, and phonological processing similar to

children with SLI = “co-morbidity”

Theories of the impairment


Main pragmatic and language impairment features

observed in PLI

From Adams C (2013) Pragmatic language impairment in F. Volkmar (Ed.) Encyclopedia of Autism, Springer: New York.

Pragmatics

Responsivity

Initiations

Turn-taking

Verbosity

Topic

Presupposition

Reference

Language impairment

Non-literal language

Inference

Word meaning

Narrative


Social features related to ASD

Unusual or stereotyped intonation

Abnormalities of non-verbal communication

Social interaction difficulties

Difficulty with peer relations

Secondary behavioural difficulties

Anxiety and other co-occuring mental health problems

Lack of flexibility


SCIP

Theoretical

rationale

Social Understanding Social Interpretation

Pragmatics Language

Processing


Assessment for SCIP

• Comprehension of spoken language: sentence level

• Comprehension of spoken language: above sentence or discourse level

• Expressive syntactic competence

• Receptive and expressive vocabulary

• Oral narrative skills

• Observation of pragmatic ability in formal and informal settings

• Report of social communication ability from carers and teaching staff


20/11/2015

4

SUSI components PR SUSI 1 Understanding social context cues

HSS CCC-2 PR TR SUSI 2 Understanding emotion cues

SUSI 3 Increasing flexibility

CCC-2 HSS PR SUSI 4 Understanding thoughts and intentions

CCC-2 MIPO SUSI 5 Understanding friendships

Assessment or

Parent/Teacher Report

show identified need

Maps to SCIP Intervention Components

Prioritised aspects shaded


PRAG components PR TOPICC PRAG 1 Working on conversation skills

CCC2 TOPICC PRAG 2 Understanding information

requirements

PR TOPICC PRAG 3 Improving turn-taking skills

CCC2 TOPICC PRAG 4 Managing topic change and drift

PR TR PRAG 5 Improving and expanding discourse

styles

Assessment or






Assessment or





LP components WS* RS * CCC-2 LP 1 Vocabulary and word-finding interventions

FS* ERRNI LP 2 Improving narrative construction

ACE NL TR LP 3 Understanding non-literal language

CFD * WS * USP* FS * LP 4 Improving comprehension of discourse

CFD * TOPICC TR LP 5 Enhanced comprehension monitoring


SCIP Intervention

• Developmental approach

• Emphasise comprehension monitoring

• Language scaffolding

• Therapeutic techniques – Role-play, role reversal

– Sabotage, problem-solving

• Phased approach

• Integrate skills across components


Metacognition in speech and language therapy for children

with social communication disorders

Jacqueline Gaile SLT and Clinical lecturer

University of Manchester

University of Copenhagen 13 November 2015

Overview

University of Copenhagen

• Background to this research

• What is metacognition?

• Data

• Method of analysis

• Results

• Discussion– the SCIP therapy process

13 November 2015

20/11/2015

5

SCIP Intervention

SUSI

Social Understanding and Social

Interpretation

PRAG

Pragmatics

LP

Language Processing



PRAG

PRAG 1.1

Enhanced listening skills

PRAG 1.1.1

Listening for content

PRAG 1.1.2

Understanding looking in listening

PRAG 1.2

Understanding

speaker roles

PRAG 1.3

Giving

Information

PRAG 1.4

Understanding reciprocity

PRAG 1

Conversation skills

13 November 2015

Why study SCIP intervention?

• RCT evidence of effectiveness of new intervention (Adams et al. 2012a & b)

• Unique experience as Research SLT on RCT

• Frequently used components

• Parents and teachers valued comprehension monitoring and reported change in academic engagement (Baxendale et al 2013)


Aims of research


• To determine which aspects of metacognition can be identified in speech and language therapists’ interactions during therapy with children with SCD.

• Develop a method of coding metacognitive content in the therapeutic interaction between speech and language therapists (SLTs) and children with PLI

• Conduct a thematic analysis of the identified metacognitive content of SCIP intervention

13 November 2015

Exploratory study

• Metacognition is important in SLT but implicit (Law et al. 2008)

• Therapy tasks are – Skills acquisition or

– Metacognitive

• Theory of therapy – Form and Process

(Byng & Black 1995)

• Mixed inductive deductive analysis

• Develop theoretical perspective on data

• Constrain the analysis

• Limit influence of tacit knowledge / beliefs


What is metacognition?


Flavell (1979)

Metacognitive knowledge

• Person knowledge

– the knowledge one holds about one’s own learning,

• Task knowledge

– the design and demands of tasks

• Strategy knowledge

– How to select and apply the right strategy to succeed

13 November 2015

20/11/2015

6

What is metacognition?


Veenman et al., 2006

• WWW&H Rule

– the what, when, why and how rule

13 November 2015

Metacognitive monitoring and control


Lyons & Ghetti, 2010

• Monitoring one’s mental processes

• Taking action to ensure success on a task

13 November 2015

Thematic analysis

• Mixed inductive and deductive analysis

• Iterative process of analyis

– Define actions with the data at different stages of analysis

Fereday & Muir-Cochrane 2006

Whitebread et al 2009

Bryce & Whitebread 2012


Data

• Existing data set of SCIP video recordings

• Ethical procedures – NHS Ethics

– Local R&D approval

– Consent

• Sampling procedure – Typology to gain representative sample of SCIP cohort

– Purposive sample

• Critical case (Patton, 2001)


Data selection criteria

• Clinical profile of SCIP cohort

– +/- ASD; +/- Language Impairment

• Therapy content

– 3 sections in SCIP Manual (SUSI, PRAG and LP)

• Time point in each child’s therapy

– Spread over 20 sessions

• SLT and SLTA

– Sessions from each member of the team


Data set

Case Age CELF-4 CLS SCQ Clinical profile

1 71 56 21 PDD-NOS + Language Impairment

2 123 67 14 Non-ASD + Language Impairment

3 102 87 37 ASD + normal limits language

4 94 90 15 PDD-NOS + normal limits language

5 109 62 11 Non-ASD + Language Impairment

Mean 99.8 72.4 19.6

Range 71-123 56-90 11-37

SCIP Mean

100.5 72.6 20.3

SCIP Range

71-128 40-114 2-37


20/11/2015

7

Data set


Case no

SCIP session number

RSLT or ThA

SCIP Intervention content: Section and activity numbers

1* 1 RSLT PRAG 1.1.1

PRAG 1.1.2 LP 5.1.1 LP 5.1.2

SUSI 1.1.1 LP 2.1.2

1 8 RSLT SUSI 1.4.1 LP 1.2.1a LP 4.2.1 LP 4.1.1

2 11 ThA SUSI 2.5.1 SUSI 2.5.2 SUSI 5.1.1 PRAG 5.3.1 SUSI 4.2.1

2 18 RSLT LP 3.1.2 LP 1.1.6 LP 4.2.3 LP 1.5.2

3 14 ThA SUSI 2.2.1 SUSI 2.5.2 SUSI 4.2.1 PRAG 5.3.1

4 16 ThA LP 4.2.3 LP 4.2.2 LP 4.2.4 PRAG 5.1.4 SUSI 4.2.1

5 15 RSLT SUSI 3.1.1 SUSI 3.1.2 LP 4.2.4 PRAG 1.5.3

5 4 RSLT SUSI 1.3.1 SUSI 1.4.1 PRAG 1.4.4 LP 2.2.1 LP 2.3.1

13 November 2015

Selecting the critical case


• Integration of SCIP intervention activities

• Included all three areas of SCIP Intervention, i.e. LP, PRAG and SUSI goals

• Included activities on comprehension monitoring LP 5 and metapragmatics PRAG 1

13 November 2015

Planned method for analysis


• Development of the initial metacognitive coding framework (MCF) using the critical case

• Use of the MCF to code transcripts of therapy sessions for the selected sample

• Thematic analysis of the data to determine the nature of metacognition in SCIP therapy content and delivery

13 November 2015

Initial Metacognitive Coding Framework

1. Literature Review: metacognition terminology

2. Transcribe critical case; familiarisation

3. Examine each utterance; create a list of codes

4. Review and emphasise metacognition

5. Search for patterns and relationships

6. Create the initial Framework

7. Verify the MCF against the critical case


Initial Metacognitive Coding Framework Steps in analysis Contribution to developing the IMCF

1. Literature Review: metacognition Search for terminology and key concepts

2. Familiarisation Repeated viewing, transcription, accuracy checks Add notes on context & initial thoughts on the metacognitive content

3. Examination of each utterance Interpret utterances in metacognitive concepts Create a list of codes using metacognitive terminology

4. Review of the list of codes with the transcript

SLT content and aims reconsidered in terms of metacognitive concepts and terminology

5. Search for patterns and relationships between codes

The codes were grouped into categories of super-ordinate and ordinate terms.

6. Framework compiled using code numbers (e.g. 1.1.2)

Codes were allocated to the IMCF in the order in which they were observed in the critical case

7 Verify the MCF against the critical case

The transcript of the critical case was coded using the initial MCF. Illustrative examples were added to the MCF for each category and sub-category. University of Copenhagen 13 November 2015

Step 3 – metacognitive interpretation


• Terminology from SLT practice re-coded using metacognition terminology

• ‘feedback’, ‘praise’, ‘correction’ and ‘reinforcement’

• ‘reinforcement’ coded to represent its metacognitive function, i.e. ‘feedback on using a strategy’

13 November 2015

20/11/2015

8

Iterative process

Case 1 • Coded using Initial MCF

Case 2 • Add new

codes as needed

• IMCF_V2

Case 3 • Code using

IMCF_V2

• Add new codes as needed


Making analysis explicit


• Thematic charts – Data from all the transcripts allocated to the same

code are separated from their original context and collected together in one chart.

– Patterns within and across cases

• Thematic maps – represent the hierarchical relationships between codes

• Potential themes – Links between potential themes

• Main themes

13 November 2015

Results


• Metacognitive coding framework • Metacognitive knowledge

– Person – Task – Strategy

• Metacognitive skills of monitoring and control • SCIP therapy process • Task design and demands

– Controlled by SLT – Adjusted the metacognitive content

13 November 2015

Metacognitive coding framework


• Category 1: Talking about tasks

• Category 2: Talking about prior knowledge

• Category 3: Talking about strategies

• Category 4: Talking about monitoring

13 November 2015

Metacognitive Coding Framework

Category 1: Talking about tasks

Code and sub-code with reference numbers Example to illustrate

1.1 naming

tasks

1.1.1 using specific names

for tasks

And what you and I are going to do today,

we’re going to think about good listening

1.1.2 the non-specific

names for tasks

We’re going to do lots of nice things today,

shall I tell you what we are going to do?

1.1.3 CHILD names a task Child: Good listening


Metacognitive person knowledge


• Mental state verbs taught (LP 5)

• Explicit in discussion

• Explicit discussion about other people’s knowledge, thoughts and feelings

13 November 2015

20/11/2015

9

Monitoring person knowledge


• Comprehension monitoring strategies to reflect on knowledge and aid comprehension

• Benefit of using a strategy was made explicit (LP, PRAG and SUSI)

• Explicit links between using the strategy (or not) and mental and feeling states

13 November 2015

Metacognitive task knowledge


• Demands, materials and strategies

• Steps explained alongside a demonstration

• Task design

– Role-play and role-reversal

– The child’s actual experiences

– Include rule breaks: error-detection and problem-solving

13 November 2015

Using real events in therapy


Ok, so let’s drive. I think I saw your mum this morning. Child: Yeah, she always drives. So there’s the car, [drawing] and in the back, there’ll be you Child: No I’m not in the back, I’m in the front. Are you? [drawing] There’s mummy in the front driving, and you on the other side and your sister is in the back. Anyone else? Child: No. After discussion about the child’s actual routine a fictional problem is introduced for him to solve. I know, that’s your routine, that’s right. OK, so once you get in the car, you always drive the same way. But, one morning, [drawing] there are some road works. Child: No! We don’t have road works at my school.

(Case 5 session 15 SUSI 3.1.2) 13 November 2015

Metacognitive strategy knowledge


• Strategy names – explicit and implied

• The steps in strategies were:

– discussed

– modelled through role play

– represented using drawings and symbols

• Strategies were demonstrated to the child correctly and incorrectly

13 November 2015

“Thinking about the work”


• [Arranges puppet to look at the story] So I need you to think about the work • Child: yeah • How the cat purred and how the witch grinned, as they sat on their

broomstick and flew though the wind • Child: phew phew [actions for wind swooshing] • But how the witch wailed, and how the cat spat

• Child: I • when the wind blew so wildly it blew off her hat • Child: I got four toys in my pocket

• Were you thinking about the work? [points to icon on chart] You were thinking about something else.

• Child: nods and smiles • You were thinking about toys in your pocket. So you missed the [shows

picture of hat to child] • Child: hat

(Case 1 session 1 PRAG 1.1.2)

13 November 2015

‘Play with other children’


Have you tried out playing with other people? Child: I did. You did? What did you play? Child: Um… football. … • The steps in the strategy are reiterated So did you go over? What did you say? Child: Do you want to play football? Do you want to play football? That was really good… because we talked about that last time, didn’t we? Going up to other people and saying, “Please can I join in?”

(Case 4 session 16 SUSI 5.2.1)

13 November 2015

20/11/2015

10

Making strategy use explicit


• Child: It’s in a café

• It is in a café, isn’t it? So what are the clues that tell you where it is?

• Child: Cos there’s drinks, and people, order-taking people….

• Brilliant. So you are looking at the picture and you are doing some working out as well.

13 November 2015

Independent use of strategies


• If you have a strong feeling like being angry or upset or something,…what you could do is turn to a blank page in your book and you could draw the feeling, draw the big triangle

• Child: I remember I drew that • And have a think about what might make you feel

calm. • Child: I remember you doing that. • I did draw that didn’t I? But you’ve written nice and

quiet. (Case 5 SCIP session 15 SUSI 3.1.1)

13 November 2015


Sabotage and problem-solving


• Multiple examples in the data from all time-points

• All sections of the SCIP manual (LP, PRAG & SUSI)

• All cases

• SLT and SLTAs

• Materials – task design

• SLT/A made deliberate errors as part of task delivery

• Role play and role reversal

• SLT used the child’s errors as they arose

13 November 2015

Task materials


Task materials


20/11/2015

11

Sabotage- do not ask for help


• Can I have 5 guesses? • Child: Yeah • Is it a telephone? • Child: No • Is it a watch? • Child: No! • [SLT marking guesses wrong with an ‘x’ and draws a sad

face next to the ‘x’] Oh I feel a bit sad now. • Child: Yeah [looks at SLT with concern] • I’m beginning to feel a bit sad now because my guesses are

wrong (Case 1 session 1 LP 5.1.2)

13 November 2015

Role play plus sabotage


• Do you know that sometimes we have conversations with problems? And we sort them out. I’m going to be him and you can be her, OK, are you ready?

• Child: Pardon, excuse, hello • Can you just stop squashing me? [angry voice] • Child: Sorr – eee! [angry voice] • Was that a problem? • Child: [nods]

(Case 5 session 15 PRAG 1.5.3 within LP 4.2.3)

13 November 2015

Review actual attempts to use strategies


• And there were balloons, weren’t there? • Child: Yeah • Did any pop? • Child: once … near the door there was pop and it was close to my

mouth and I nearly cried. I didn’t…… • So you don’t need to feel a ‘big nervous’, do we? • Child: No • Just a ‘small nervous’ • Child: Yeah • Ok, so let’s see if next time there’s a party, see if you can, if you can

keep • Child: Calm

(Case 2 session 11 SUSI 2.5.2)

13 November 2015

Metacognitive skills in SCIP intervention


• Monitoring and control of listening skills

• Monitoring feelings in self and others

• Monitoring use of language strategies

• Monitoring social interactions self and others

• Self-monitoring in real time

– Using child errors on tasks to promote monitoring

13 November 2015

Monitoring and control of listening skills


• Monitoring a puppet using strategies for listening to a story

• Controlling a puppet to use strategies for listening • Self-monitoring listening to the same story

So well done, keeping your hands still. What were you thinking about? Child: I was thinking about listening You were, you were thinking about the work.

(Case 1 session 1 PRAG 1.1.2)

13 November 2015 University of Copenhagen 13 November 2015

20/11/2015

12

University of Copenhagen 13 November 2015 University of Copenhagen 13 November 2015


Monitoring feelings in others


• Role-play to monitor other people’s feelings • Comment on how people feel when others ‘make mistakes’ So we are going to look at their faces and see who is OK and who is not OK… And how close do you think she is standing to him? Child: Really close… Child: [reaches for pen] I want to do the face What is the face? What’s the feeling with that sentence? Child: [draws angry face] Oh, is that worried or angry? Child: Angry

(Case 5 session 15 LP 4.2.4) 13 November 2015

Monitoring feelings in self


• Shall we write that down in your book, under nervous?

• Child: Mmm, they’re like, [gesture hands over tummy] they’re like, you get a bit of sadness in your tummy. If it goes up you feel nervous.

• OK, so what do you do when you feel nervous?

• Child: Keep breathing. Keep breathing, yeah.

• What about when you are driving to the party … and you start to feel really nervous, and you’re breathing slowly and you still feel nervous

• Child: Yeah, it doesn’t work

13 November 2015

Monitoring use of language strategies


• Child: To the car do you know, what that thing, cross, crash-down truck, not like crash down.

• Not crash down, there’s another word instead, isn’t there? • Child: Oh, I forgot, what is it? • Do you know what it begins with? • Child: [shakes head no] … • How many syllables has it got? • Child: Three. Crash down truck [uses same gesture with fingers] ….. • Child: Break down truck! Aw, I know it! • And does thinking about the first letter help? • Child: Yeah, sometimes, but sometimes, I just don’t get it.

(Case 2 session 18 LP 4.2.3)

13 November 2015

20/11/2015

13

Monitoring social interactions in others


• Do you remember the two boys in our story and they were fighting about PlayStation, weren’t they?

• Child: PlayStation, yeah

• Can you remember we had a sad ending, because, look, how is everybody feeling here?

• Child: Angry

13 November 2015

Monitoring social interactions self


• Now we’ve got to draw a story that happened to you on Saturday….What happened to you at your house on Saturday? … Well I’m going to draw the same picture as we’ve got, one of these big pictures, and I know …

• Child: [interrupts SLT] Frustrated.

• Frustrated? Is that how you were feeling on Saturday?

• Child: [points to page] Freddie, my brother..

13 November 2015

Self-monitoring in real time


• How did we start talking about wrestling? • Child: By playing PS2 wrestling. • Because we were talking about noise weren’t we? Ok, and I said,

you didn’t like noise, but there was noise at Thomas’s party and you had a good time. And then, you started to tell me all about the game and how you were making the noise. I got a bit lost because I didn’t know what you were talking about.

• Child: Right The SLTA modelled and explained the strategy that will repair the problem. • So if you were going to tell me about the wrestling game on the

PlayStation you need to say, ‘The reason we were making lots of noise was this really noisy game’.

(Case 2 session 11 using a strategy from PRAG 4.2.1 in SUSI 2.5.2)

13 November 2015

Metacognition in SCIP therapy


• Manipulation of the therapy task

– Task demands

– Therapist actions

– Task materials

– Therapy goals

• Skills acquisition

• Monitoring use of skills

• Control of skills once acquired

13 November 2015

Design variables in SCIP therapy tasks


• Strategy use by SLT/A or child – Incorrect strategy use

– Correct strategy use

• Events in communication and interaction – Generic events to illustrate communication and

interaction

– Actual events in child’s attempts at communication and interaction

13 November 2015

The SCIP therapy process of modification of task design and delivery variables


Generic event Actual event

Correct strategy use

Incorrect strategy use

13 November 2015

20/11/2015

14

Q1:correct strategy use in generic

• GOAL- learning WHAT strategy to use and WHEN

• SLT ROLE – modelling correct use

• METHOD - Role play

• MATERIALS – visual representations of skilled use of strategy


Q2:correct strategy use in actual event

• GOAL- learning HOW and WHEN to use a strategy

• SLT ROLE – give feedback on use

• METHOD - Role reversal

• MATERIALS – visual representations of skilled use of strategy

• Self-monitoring skilled use


Q3:Incorrect strategy use in generic event

• GOAL- learning to monitor others’ strategy use

– WHAT, WHEN and WHY it is important

• SLT ROLE – modelling incorrect use (approximate child errors)

• METHOD - Role play plus sabotage

• MATERIALS – visual representations of error in others’ use of strategy


Q4:Incorrect strategy use in actual event

• GOAL- learning to monitor and repair own strategy use

• WHAT, WHEN, WHY it is important and HOW to use it

• SLT ROLE – give feedback on strategy use

• METHOD - Role reversal plus sabotage

• MATERIALS – visual representations of error in child’s use of strategy in actual event



Discussion


• Metacognitive Coding Framework

• Explicit explanation of metacognition in SLT

• Process of SCIP therapy – Skills acquisition

– Metacognitive

• Generalisation – flipped context (Timler et al 2007)

• Clinical education

13 November 2015

20/11/2015

15

Limitations


• Bias arising from extensive knowledge of the SCIP intervention manual content and delivery

• Small sample size necessary

• Reported the steps in analysis

• “Thick description” (Geertz, 1973)

• Written a reflexive account of research across

the research process

13 November 2015

What next?


• Can MCF be used to determine metacognition in SLT for other development language disordered populations? (cf Whitebread et al. 2005, 2009, 2012)

• Can metacognition be positioned within a theory of therapy alongside theories of impairment and development?

• Can this method of close examination of therapy contribute to our understanding of mechanisms of change?

13 November 2015

overview - fua€¦ · expressive language targeted observation of pragmatics in children’s...

Documents