Melanie Cross is a speech and language therapist with many years’ experience of working with children and young people with communication problems. For the past fifteen years she has worked with young people in public care, at The Integrated Services Programme (ISP), an innovative independent child care agency based in England. She is also a clinical tutor on the speech and language therapy course at City University, London, and a Royal College of Speech and Language Therapists (RCSLT) Advisor in Mental Health (Paediatric).

In this interview, Melanie explains why behavioural and communication difficulties so often occur together, what the negative implications of this are, and how those working with these young people can make a difference.

This month you will publish a new second edition of your 2004 book, Children with Social, Emotional and Behavioural Difficulties and Communication Problems. Can you talk about the motivation behind the first edition, and what is timely about the updated version?

My key motivation has always been to increase awareness of the potential communication problems in children and young people with social, emotional and behavioural difficulties (SEBD). I work with children and young people in care, who often have significant communication problems which have not been recognised. The scale of this still shocks me, especially because of the difference we can make once awareness is raised about communication difficulties.

2011 is the National Year of Speaking and Listening, with both the HELLO campaign and the Royal college of Speech and Language Therapists Giving Voice campaign aiming to raise awareness and offer resources. There is now a greater awareness of the issues raised in this book. This means there is also an increased need for up-to-date information on how to support and develop services for those with social, emotional, behavioural and communication problems (SEBCD). Initiatives responding to behavioural issues such as Restorative Justice are currently in the news. However, it is important to consider the communication skills of those taking part in order to ensure that any behavioural intervention is as effective as possible.

Why do you think communication difficulties in children so often go undetected, and what are the implications of this?

One reason that communication difficulties are undetected is because of limited education and awareness. If you have a limited knowledge of communication difficulties, or how to recognise them, you’re unlikely to spot them. Another reason why communication difficulties might not be identified, is because they can be subtle and easily mistaken for something else. Non-compliance might be due to not understanding what’s been asked and not knowing how to ask for clarification. What might be seen as a refusal to explain might be due to difficulties constructing coherent narratives. Conflict resolution and negotiation require high-level language skills and if these are lacking, then aggression can result. If adults do not recognise the underlying communication problems, the children and young people who experience them can be misunderstood and even misdiagnosed. It is also the case that many children and young people with SEBD face so many difficulties that things get missed or misinterpreted. Not everyone looks beyond the behaviour and recognises that communication problems could be at the heart of it, or at least a contributing factor.

What are some common obstacles professionals come up against when working with children SEBD and communication problems? How can this book help?

The first obstacle is that we need to consider not only our interaction style, but the language we use, and modify them in response to the young person with SEBCD. This is not always easy. It’s also important to differentiate any work or tasks we give them so they are accessible.

In addition to this, we need to provide opportunities for children and young people to develop their communication skills. This book helps to address these issues.

This new edition contains a chapter on unidentified and unmet communication needs in young people at risk of social inclusion. Why did you feel it was important to look specifically at this group?

Children and young people at risk of social exclusion are at additional risk of communication difficulties, but this is a factor which is rarely discussed. This applies to those who have been abused and neglected, children in public care, those excluded from school, as well as young offenders. Communication difficulties can further limit restricted life chances and increase the likelihood of social exclusion. Communication difficulties are both a product of and a cause of social exclusion. So helping children and young people develop their communication skills could increase inclusion; if their communication difficulties are not addressed their exclusion is likely to deepen.

You give lots of suggestions for things we can do to help children with SEBD. What would be your top tip?

Listen as much as you talk.

What do you hope the reader will take away from the book?

I hope the reader will have a better understanding of how communication, thinking and emotional skills develop together, which can help them understand the children and young people they work with better. They will also hopefully have more confidence in accurately spotting communication problems and lots of ideas about ways to increase the communication skills and thereby the active participation of children and young people.

Copyright © Jessica Kingsley Publishers 2011.

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