Makaton is a language programme which involves speech and gesture, eye contact, body language and facial expression. It is based on a series of basic everyday words and uses speech as well as gesture and/or signs. Children who may be experiencing difficulty with their speech often find it much easier to understand and communicate using gesture and/or symbols, thus helping prevent frustration and opening up new ways for children to communicate with others.
Makaton was developed in the 1970s to help children with learning disabilities to communicate. Its use has spread however to many other children too who may, for a wide range of reasons, be experiencing difficulty communicating for short or longer periods of time.
Makaton is introduced in stages, beginning with basic words and progressing to more complex words and concepts. In every case it is recommended that the choice of core or supplementary vocabulary be personalised according to the experiences of the individual child.
Further information can be obtained from the Makaton Charity website. Here there are links to training resources and also information about the (truly excellent!) award-winning BBC television series Something Special whose presenter Justin Fletcher (now a patron of the Makaton Charity) was awarded the MBE for his services to children’s broadcasting in 2008.
From a SLT angle, I tend to look for patterns of listening and patterns of words that are less-easily recalled for speech (or writing). We see a learner who may recall a word, but gets stuck with it ‘on the tip of their tongue’, or who uses words from a semantic group interchangeably, or who says most words clearly but with a small group of them in a rather mumbled or blurred way. Perhaps the word wasn’t ‘specified’ clearly by the student when learned, so was not distinctive enough for recall: this could be due to perception of the sounds within the word, the sensations of making the sounds, or being sufficiently clear about the meaning of the word. So I look for patterns: is there a group of words affected? Nouns? Verbs? (you could go mad and look for verb types…or verb semantics…) Perhaps they are people’s names: OK, so what are the circumstances where the learner is told the (e.g. names) – there are loads of mnemonic strategies here to make the information richer.
Maybe the learner relies more than most on the social demands being low for them to grab new information: so meeting new people is a particularly demanding time for them, or learning in group discussion, or while in the middle of a shared activity. Or the reverse might be true. Maybe this learner benefits more than most from written support. Similarly, if the words are from one subject area, it’s possible that they are sitting in a noisy part of the class, or the subject-teacher tends to be particularly pacey, or there is a just a general need for more repetition for that learner with word-finding difficulties. Also, it’s possible that they ‘switch off’, anticipating failure with vocabulary learning in one or two subject-areas as a result of previous experiences, attributing their performance to the subject, rather than to a particular, less-helpful, way of presenting the material that they came across in the past, probably when teaching staff weren’t aware of their liability to
The other pattern I look for is what type of input makes the most difference to secure word-finding. I make a list of low-frequency words (looking for words new to them, so the list varies) and teach some with the emphasis on repetition, others emphasising written support, others heightening visual sense of the word, perhaps using a cartoon or diagram, others presenting the word in its different morphological forms, or its syllable structure, or its sounding closely (dangerously) similar to other words, others in several sentences, and some with attention to the physical making of the word in the mouth. Actually, it’s usually pretty obvious that some of these can be discounted straight away, and just home in on a couple of approaches.
Then note the words that can be recalled after a week or two, or even longer if you both have the endurance and time, and match to the input method. The learner then knows what they can most effectively do to learn words for recall. Is it 100% and done in the twinking of an eye – no. This is why 6 sessions of SLT turns out to be insufficient – but that’s another story. Of course, this sort of thing isn’t the exclusive domain of SLTs, either!
Other SLT approaches make use of the initial phoneme of the targeted word, or increasing use of gesture, or making more use of ‘thing’, ‘that thing you use to…’ or similar descriptions of function or distinguishing features. My experience is that students don’t like having to do these things, but actually do them in practice quite a lot, so may have benefited not so much from the suggestion as from its ‘endorsement’.
In adult dysphasia and aphasia, there are all sorts of patterns, some of them amazingly precise in the types of words affected…in a young person, word-finding difficulties will often signal a language disorder of some kind and it will clearly have an impact on learning and using language as well as participating in rich language activities. An adult might have a discrete ‘dysnomia’, though the terminology probably varies depending on the professionals involved and their clinical interests
- Teach prepositions one at a time, perhaps using visual reinforcement.
- Use gestures, repetition and choose words at the child’s level of difficulty.
- Talk to pupils as much as possible, using slower speech rate, shorter remarks, simpler sentences, repetition, exaggeration and gestures.
- Choose questions carefully giving pupils opportunities to use language; how? Why? If – then … Avoid closed questions with yes/no answers.
- Encourage games which use the senses.
- Play games that talk about making mistakes, then “fixing them”. E.g. If I said “I want a baw” I would have to fix it and say, “I want a ball.”
- Reinforce self-corrections. i.e. if a child makes a mistake and corrects it himself, then praise him and say, “Well done, you fixed that up by saying ‘ball’”.
- Use labelled praise. E.g. “You read that well. I really heard the ch sound in cheese.”
- Make modelled corrections. E.g. child says, “Look at the bat cat”. You respond by saying, “Yes, a black cat, a dark black one.”
- Don’t ask the child repeatedly to say the correct word over and over. Just say it yourself several times so that the child will notice.
- Verbalise thoughts and actions as they happen.
- Use role play to give children opportunities to work in pairs where they take turns at being speaker and listener
- Encourage an atmosphere where children are not afraid to ask for clarification.
- Try to find a ‘buddy’ for the child with speech difficulties – very often children can communicate better through each other.
- Use carefully graded reading books. Oxford Literacy Scheme publish a list of commonly used books and have graded them according to difficulty.
- Play listening games where children have to listen for the sounds around them. You could also record common sounds and ask children to identify them.
- In science use containers with different contents and get children to identify them by shaking.
- In music have children close eyes while teacher taps out a rhythm. Children can try to count the beats or can repeat pattern back.
- With closed eyes try to teach children to discriminate between near and far sounds, loud and soft sounds, high and low sounds.
- Play find the sound where a ticking clock or a music box is hidden.
- Teach vocabulary through examples and demonstrations.
- Keep instructions simple.
- Prepositions are best taught one at a time.
- Encourage children to speak by asking open-ended questions such as How? and Why?
- Verbalise actions as you do them.
- Have short role plays where child takes alternate parts in turn.
- Use gestures to help child understand your instructions.
- Talk to the child in short simple sentences.
- Encourage children to explore through their senses and talk about what they see, feel, hear etc.
Sample Phonics Lesson
Prepositions worksheet 1 (for young children)
Preposition worksheet 2
- Think about using a picture exchange system. Take photographs of the child doing the activities he/she likes to begin with and also drink and items he/she would like to eat for break. This would be a starting point for helping him/her to communicate some choices. When he/she chooses the activity make sure she gives it to a member of staff who will say what is in the picture and encourage the child to do likewise.
- If the child can read, could she read the book onto a tape on her own and bring it back for you to listen to? Then you will hear the voice but not directly.
- Sometimes a child can be encouraged to read with partner onto tape and then in small group again onto tape. Plays were good for this.
- Talk to the child and alternate with talking to a puppet! Get the puppet to answer . After a while the pupil hopefully will take the puppet away and converse with it. In time the hope would be that the child will converse with a puppet held by an adult with the adult talking through the puppet. Another idea is to have a bring small pets day and encourage the child to talk to a pet!
- Another idea to try is having a small group of pupils sitting in a small comforting circle and saying easy things out loud round the circle eg counting a number each. You may be able to recite rhymes that had already been done with your whole class etc,
- What about passing a soft toy as you say numbers, rhymes etc, emphasis on toy not what they are doing. Rewards can be given for even a slightest utterance e.g. clips which child then hooked together; again emphasis on doing something rather than correct production of language. A puppet for each person in group is another idea. (Ideas from Anne Stockdale, SENCO forum)
- When trying to assess these pupils for oral examination you are going to have to be creative; You need to choose the best environment for him/her. Consider using a phone between pupil and examiner. Could you tape the questions and get the child to listen to and respond at home?
Communication Plan – Reflexes, Learning & Behaviour; a window into the child’s mind, by Sllay Goodard. This book includes an article by a 17 year old talking about the difficulties of elective mutism.
Causeway Trust (Tel. 028 2766 6600) in conjunction with NEELB and Homefirst Community Trust (Tel: 028 2563 3700 have produced a booklet, “An Introduction to Coping with Speech and Language Difficulties in the Classroom” (March 2000).
- Try to have the classroom as quiet as possible.
- Make sure you are facing the child directly when speaking to him/her or the class including him/her.
- Try to encourage the child to speak in short phrases.
- Give him/her enough time to say what he/she wants to.
- If you need him/her to repeat words, make it easy by just asking for the one word you didn’t hear/understand? e.g. You want to go where?Encourage him/her to use gestures etc. to help him/her explain what he/she is trying to say.
- Encourage him/her to take his/her time when speaking.
- Don’t keep at him/her to make all his/her words clear. As long as he/she communicates the basic message give praise..
So you’re teaching a child with Asperger’s Syndrome?!
The first thing to remember is not to panic! Although children with Asperger’s Syndrome have certain needs which you will soon discover, there are also many positive aspects to consider (see article on Asperger’s Syndrome). When children with Asperger’s Syndrome are interested in a topic area, they will often make very committed, enthusiastic and conscientious learners. Indeed they will often keep you on your toes as a teacher with their keen eye for detail in a subject of interest to them. Here are some tips to help you…
- The main thing you should try to ensure is consistency, structure and routine. Where you know that there will be a change to the routine, you should always give a pupil with Asperger’s Syndrome as much warning as possible and consider the possible implications for them (e.g. if you need to move to another room to use the computers, tell the class the period before and consider having a classroom assistant (if available) help the pupil with Asperger’s Syndrome find their way to the new classroom).
- The need for structure is important, but often pupils with Asperger’s Syndrome will struggle to organise themselves. You should create a list of tasks to be done, breaking larger tasks into more manageable chunks. Ensure that homework is noted carefully by older pupils, or consider emailing homework details to the pupil (to access later at home).
- Try to include lots of visual learning in your lesson. A visual timetable can also be very helpful for a pupil with Asperger’s Syndrome.
- It is important to remember that many of these pupils live with a very high level of anxiety. Managing behaviour requires defusing this. Human and gentle coaxing can work well. Here there is nothing better than getting to know your pupil: you will quickly learn what the pupil with Asperger’s Syndrome finds especially stressful. Asperger’s Syndrome is often accompanied by sensory processing difficulties, so children may experience particular sensitivity to loud noises, unexpected noises, bright lights etc.
- Consider teaching the rest of the class to understand the child’s difficulties. A worksheet for primary schools and a fact sheet for post-primary pupils is available from the National Autistic Society. This should be done in collaboration with the pupil and parents. There are some parents who still prefer not to have their child’s peers know about Asperger’s Syndrome.
- Consider how you speak to the child; do they understand what I am saying? do I need to give more information? am I explaining things clearly enough?
- Try to ensure you only give information/instructions when you are giving him/her your full attention and they are listening; don’t shout instructions across the class or give them when the child is doing something else too. Don’t change the instruction half way through. Make sure that homework instructions are not shouted out at the end of the lesson as the bell rings and pupils are packing up to leave. This works for no-one, but least of all for pupils with Asperger’s Syndrome.
- If you find you are regularly giving the same information, you could write it down and then refer the pupil to the list each time he/she asks.
- Don’t use ambiguous terms. Words like ‘silly’ and ‘naughty’ don’t mean anything to many pupils with Asperger’s.
- Avoid needless use of idioms. Telling a pupil to pull their socks up, for instance, will often lead to them literally pulling their socks up. Children with ASD will have to learn idioms individually, and this can take time.
- Realise that when the pupil says something strange or improperly personal etc. that he/she is not doing this deliberately, he/she just does not understand the rules of conversation.You may need to deliberately teach this. Role play can teach pupils how to react when they meet someone.
- If a pupil is doing something wrong, tell him/her what they should be doing instead, e.g. Stop banging that ruler; you should be writing.
- Pupils with Asperger’s have a need for structure in their lives so provide ways of structuring break times etc. for them, e.g. provide crossword puzzles, a quiet area in school for them to read or arrange for them to have a walk around the school grounds with a ‘buddy’. Anything unusual that is going to happen should be explained to the pupil in advance.
- Sometimes pupils with Asperger’s have a history of lashing out and hurting other children even when unprovoked. This can make integration, particularly at play times, very difficult and it may be that he/she will need to be supervised by a classroom assistant. The child must be told that if he behaves unacceptably he or she will be taken away from the other children. However, it is essential that the classroom assistant is sensitive enough to know when to intervene and when to let ‘natural’ play occur. A classroom assistant could provide a structured programme of activities for all the children under her supervision. By having a routine game for each day, the child with Asperger’s will feel more confident. He may feel more included if he/she gets a say in who plays the game.This is positive because play is supervised and a circle of friends is created. The child gets some recognition and some of the chosen friends will become friends for the child to play with later on when the scheme is phased out day by day.
- Avoid sarcasm and humour: pupils with Asperger’s Syndrome will often fail to understand either.
- Where possible allow opportunities for the pupil to explore and exploit their special interests. Where this coincides with your subject, allow the pupil the chance to talk or present about their interest. They will most likely have a very detailed understanding. Ensure however that this is timebound (an egg timer may work here) as people with Asperger’s Syndrome can talk at great length with little awareness of others’ waning interest.
- Pupils with Asperger’s Syndrome often find navigating a large building (e.g. a secondary school) very difficult. If there is no classroom assistant to help, consider giving them a map which could be colour coded.
- Homework can create a lot of stress for pupils with Asperger’s Syndrome who will often want to spend hours on work which is not intended to last that long. In consultation with parents, it is useful to set limits, for instance 20 minutes per homework.
- Finally, enjoy the experience of teaching pupils with Asperger’s Syndrome. Although there can be challenging moments, there are also many rewards!
Teachers’ Questions and Answers
Teaching Older Children with Aspergers
Teaching Pupils with Aspergers
Suggestions for Teaching with Aspergers
The Australian Scale for Aspergers Syndrome extract from ASPERGER’S SYNDROME A GUIDE FOR PARENTS AND PROFESSIONALS Tony Attwood, PhD
A School’s guide to Asperger Syndrome
Pupils with autism very often have unusual fixations on parts of objects; they focus on objects as though through a tunnel. When using a computer this can mean they are able to focus totally on the screen and to block out all distractions around them.
Using a computer can provide a very secure, comfortable environment for them as they feel less threatened, more in control of their surroundings, less likely to fail and they can choose whether or not to communicate with others. http://www.asilesp.com/
It is possible to buy software which can help an autistic child with social concepts such as learning to understand facial expressions. http://ccoder.com/GainingFace/
Use the digital camera to help reinforce correct behaviour, e.g. take a photo of the child behaving as you want, for example, putting his/her hand up for attention. Put this in his/her book with a caption such as, “I will remember to put my hand up when I want something”. Read this regularly with the child at the appropriate times.
ASD and ICT
Speech and language difficulties usually fall into three categories, (though there may be other speech/language disorders such as those caused by physical deformities, e.g. dysarthia); expressive disorders, receptive disorders and phonological difficulties.
A child with an expressive disorder finds it difficult to express his/her thoughts and feelings through speaking and writing. He/she may find it hard to recall the right word. He/she may try to communicate using gestures and sound effects. When he/she does speak it will often be in short phrases or sentences which may show incorrect grammar or tense. A child with this problem is likely to be very quiet in class.
Children with auditory processing difficulties find it hard to process what has been said. They find it hard to make sense of what they hear and have difficulty distinguishing between syllables, words and sentences. Sometimes these children are particularly upset by loud or sudden noises or noisy environments. He/she may have difficulty following directions and may seem disorganised and forgetful. In maths problem type calculations may be particularly difficult for the child and he/she may have difficulties following a conversation.
Children with a receptive disorder have problems understanding certain aspects of speech. The child can hear words but can’t always make sense of them, e.g. they may confuse a bell and a ball. His/her response is better if a visual clue or a gesture is accompanying the instruction. The child may be slow to respond to questions and instructions; he/she may have limited vocabulary and may have trouble working out what a story was about. He/she may confuse prepositions and may also have difficulties with spatial and temporal relationships.
Elective mutism is considered to be a speech disorder, although it is not so much that the child can’t speak but that he or she chooses not to speak in certain situations. This can be accompanied by other withdrawal activities.
It is possible that children can have one or more of the conditions and may well have difficulties which also fall into other special needs categories also.
People who can help: SENCO/Resource Teacher; Speech & Language Therapist
This condition is a weakness of the muscles used for speaking.
What to look for:
The child might speak in a whisper, have slurred speech or appear to be talking through his nose. There may also be other physical problems related to their being unable to control their muscle movement. Children with cerebral palsy often have dysarthia.
People who can help: SENCO/Resource Teacher; Speech/Language Therapist
- Autism is a medical diagnosis. The conditions involves a range of disorders affecting the way a person communicates and relates to people. There can be huge differences in the way it affects individuals and each child will need an individual approach to learning.
- Usually shows up within first three years of life; some children may appear to be developing normally for the first year or two while in others the signs are present in the first year.
- Remains with child throughout life but with training most able people can learn to manage the condition and live independently.
- Autism can occur at all levels of general ability although about a quarter of people with the condition have mild learning difficulties and about half have severe learning difficulties.
- Sometimes children and teenagers with autism can have serious difficulties sleeping and this can have further detrimental effects on their education. Information can be found at http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=367&a=3376
- Many children with autistic spectrum disorders tend to walk on their toes and this can lead to a need to have an operation to cut the tendons.
What to look out for:
The child seems to have difficulty making sense of the world around him/her and lacks imagination and understanding for others’ feelings, thoughts and needs. This results in a restriction in their social activities and a tendency towards a narrow, repetitive pattern of activities which take up all of their attention. The child can become obsessively interested in one subject. The child may have little use of language and may seem to be ‘in a world of his/her own.’ Activities which require turn-taking are difficult for children with ASD.
Repetitive behaviour can include spinning, rocking and making noises. Changes in routine can upset and confuse children with an ASD.
Sometimes these children can have extremely high levels of ability in a narrow range of activities but lack of appropriate language or difficulties with planning and organization can mean it is difficult for them to express their understanding.
This condition can occur alongside other conditions, notably ADHD.
People who can help: SENCO/Resource Teacher
Autism Tish Balfe, InTouch November 2000 (may be requested from www.into.ie)