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One way to develop these ideas is to make a concept map. Below is a sample of the student's concept map if they focused on knitting.
Now this particular student enjoys mysteries and crime shows, because they like to figure out who the culprit is. The student needs to write an informative speech, and decides that they could inform others on how to solve mysteries.
Since it is a very large topic, the student decides to focus on helping people solve mysteries by informing them on how to tell if someone is lying .
After narrowing the topic, evaluate your speech to see if it is a good fit for your assignment.
In our example the student’s evaluation would look like this:
: Lying - How to recognize if someone is lying. : To provide my audience with information about lying. | : Professor and other college students. : Yes, possibly in psychology and sociology journals. |
Write out your research question or thesis statement. Underline words that you believe best represent the main ideas.
How can we determine if someone is lying to us?
Second, create a list of synonyms for each word you underlined and use these terms to search for resources.
Lying OR lie-spotting Face perception Body language. Deception.
You can add additional terms as you survey what is available:
Lying OR Deception AND workplace or business Friendship or workplace or business
As you gather resources be sure to evaluate the resources!
Check out the Searching Strategies for Websites and Databases for more tips. Check out the Evaluating Resources page to avoid choosing bad sources for your projects!
There are lots of reasons to provide references to the sources that you use.
Your audience may want to know how to investigate your topic further. By providing your resources you are helping others who are interested in the same topic.
You also need to credit the people who did the research you are using otherwise you will be claiming it is your own (even if unintentionally doing so). Plagiarism is a serious offense.
Here is a definition of plagiarism:
“Plagiarism is appropriating someone else's words or ideas without acknowledgment. To understand plagiarism we must consider two questions: (1) How is plagiarism like or unlike theft— (2) Why is plagiarism considered wrong; why should we acknowledge the originator of an idea.”
(Encyclopedia of Ethics. London: Routledge, 2001. Credo Reference. 17 April 2009 <http://www.credoreference.com/entry/7915618>.)
Just like in college writing, speeches should provide your audience with verbal cues to the information you have used: the SOURCE where you found your information. (This might be an interview, scholarly article, book, or website, etc.); the AUTHOR, when available, and the DATE when your source was published or accessed (for web sources and interviews).
Here are three ways to incorporate citations for your speech:
For more information on how to cite sources, see the “Citation” page in this guide.
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Categories Psychology Education
One of the best ways to learn about psychology is to listen to some of the world’s greatest experts talk about their research. In this selection of TED Talks about psychology, the popular video lecture series designed to educate and inspire, we highlight just a few of the best psychology talks on subjects ranging from the nature of evil to the secrets of happiness.
Philip Zimbardo: The Psychology of Evil
Can good people really commit evil acts? Philip Zimbardo, known for his famous Stanford Prison Experiment, offers insight into the nature of evil and how nice people can be led to do terrible things. In this speech, Zimbardo talks about the atrocities committed at Abu Ghraib in Iraq and discusses the parallels between those events and his infamous prison experiment. But, he suggests, if people are capable of being transformed into doing bad things, then they are just as capable of being transformed into doing good things. Heroism, he claims, is something that can be taught.
Elizabeth Loftus: The Fiction of Memory
Elizabeth Loftus is a renowned memory expert perhaps best known for her research on false memories, or how we believe in memories that are mistaken, incomplete, or completely fictitious. In this TED talk, Loftus shares some of the astonishing things she has learned about false memory in her decades of research, including how surprisingly common such false memories are.
Oliver Sacks: What Hallucination Reveals About Our Minds
Noted neurologist Oliver Sacks takes a looks at a fascinating condition known as Charles Bonnet syndrome in which visually impaired patients experience vivid, lucid hallucinations. The cause, Sacks explains, is that the visual parts of the brain are no longer being stimulated by actual sensory information. They then become excitable and start to fire spontaneously, resulting in visual hallucinations. Listen to the rest of the talk to learn more about what this syndrome reveals about the brain.
Dan Gilbert: The Psychology of Your Future Self
Do you think that the way you are now is the ultimate, finished version of yourself? Psychologist Dan Gilbert refers to this tendency to believe that we are at our personal pinnacle as the “end of history illusion.” In other words, we mistakenly believe that who we are now is who we will always be. Listen to Gilbert explain why this idea is just plain wrong.
Tali Sharot: The Optimism Bias
Sharot explores our tendency to look on the bright side of life, even when it might be to our own detriment. The optimism bias, Sharot explains, is a type of cognitive illusion that 80 percent of the population experiences. It causes us to overestimate the likelihood that good things will happen to us as well as underestimate the likelihood that we will experience bad events.
Listen to Sharot explain the effects this bias has on our lives as well as the possible dangers this optimism might pose to our health and happiness.
Joachim de Posada: Don’t Eat the Marshmallow!
During the late 60s and early 70s, psychologists at Stanford performed a series of fascinating experiments looking at delay gratification. In the experiments, preschoolers were left alone in a room with some sort of treat (often a marshmallow or cookie). Prior to leaving the room, the researchers told each child that if they could go 15 minutes without eating the treat, they would be rewarded with two treats.
What the experimenters discovered is that those children who were able to delay gratification and wait for the second treat were more likely to do better academically later on in life. Learn more about a classic experiment on delayed gratification and what it might mean for future success.
Mihaly Csikszentmihalyi: Flow, The Secret to Happiness
In this TED talk, pioneering positive psychologist Mihaly Csikszentmihalyi talks about his theory of flow and what really makes people happy. He relates the story of how he first became interested in psychology after attending a lecture given by famed psychiatrist Carl Jung .
Csikszentmihalyi’s theory proposes that people experience moments he refers to as flow, or being completely absorbed in the moment. In these moments, time seems to sink away as people become so immersed in the activity that it seems effortless. People are more likely to experience flow when the activity offers enough of a challenge that the individual must focus their skills and abilities on completing the task.
Why is flow so important? Csikszentmihalyi suggests that these moments of flow can be critical to our happiness, so learning how to achieve flow experiences more frequently in our daily lives can be important.
Why Some People Compulsively Talk More Than Others
Speech is a part of how our brains are programmed to socially connect and survive. But some people may talk excessively. Excessive talking is the act of overtalking or compulsively talking. Someone who talks too much may have a mental health disorder, such as bipolar disorder , or it could simply be a behavioral or personality trait.
This article discusses the psychology of people who talk too much. Read on to learn which disorders can cause this trait, along with how to deal with people who talk too much.
Excessive talking can occur due to personality traits or characteristics.
People who are more extroverted will recharge by engaging socially with others in conversation, while introverts recharge by having time alone. Extroverts often think out loud, while introverts process more internally through deeper thinking.
To a more reserved, less talkative introvert, an extrovert may seem to talk excessively, when the issue could be due to a difference in personality traits.
Often, the person who is talking excessively may not know they are doing it. Excessive talking can be caused by the following mental health conditions:
Assessing a person's speech is a part of a mental status exam, which is a type of assessment that mental healthcare providers often perform during appointments. The quality of a person's speech can often give indications of their mental status.
The following are categories of excessive talking.
Pressured speech is rapid, urgent speech to the point that others may find it difficult to interrupt or get a word in. This can occur when someone is having severe anxiety, has schizophrenia, is under the influence of substances, or might be experiencing a manic episode, which can occur with bipolar disorder.
Hyperverbal speech is talking fast with an increased rate or number of words. This type of speech can indicate anxiety or that a person is currently experiencing a manic episode.
Disorganized speech moves rapidly from one idea to the other in ways that can be hard to follow.
Disorganized speech may also include ideas that do not connect to each other or are out of context. Disorganized speech can occur due to schizophrenia. Examples include the following:
Compulsive talking occurs when someone feels they cannot stop talking or they compulsively keep talking nonstop. This can occur for several reasons, including severe anxiety, the impact of substances, and ADHD.
With ADHD, the brain will jump quickly from concept to concept. People with ADHD already have poor impulse control, and they can often feel anxious enough to talk excessively, have difficulty taking turns in conversations, and frequently interrupt others.
Sometimes people talk compulsively because it's actually a way of avoiding painful emotions. They are so busy talking, they can push away their feelings to avoid dealing with the pain or anxiety that may come with the emotions.
People who talk too much may benefit from seeing a healthcare provider in order to explore the cause and find the best possible treatment options. But there are some management strategies you can try yourself.
Research indicates that up to 40% of a person's speech is about themselves. Talking about oneself can activate the reward centers of the brain. So while socially it may be necessary to cease talking excessively, it may be challenging to go against the wiring of the brain.
Here are a few strategies for managing excessive talking.
Excessive talking can create a burden on social interactions. Therapy may be beneficial as a treatment.
The following therapy options may help with excessive talking:
Here are a few tips for handling excessive talkers:
Excessive talking occurs when a person talks compulsively or excessively. Reasons that someone may talk excessively include mental health disorders, personality characteristics, and personality disorders.
Excessive talking can create a social burden for both the talking person and their listeners. There are things you can do to avoid overtalking, like setting a time limit on conversations, paying attention to social cues, or seeking the help of a mental health provider.
Weiner L, Doignon-Camus N, Bertschy G, Giersch A. Thought and language disturbance in bipolar disorder quantified via process-oriented verbal fluency measures . Sci Rep . 2019 Oct;9(1):14282. doi:10.1038/s41598-019-50818-5
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Washington D.C.; 2013. doi:10.1176/appi.books.9780890425596
Norris DR, Clark MS, Shipley S. The mental status examination . Am Fam Physician. 2016 Oct 15;94(8):635-641.
Patel KR, Cherian J, Gohil K, Atkinson D. Schizophrenia: overview and treatment options . PT . 2014;39(9):638-645.
Kaiser Permanente. Symptoms of schizophrenia disorganized speech and behaviors .
American Psychological Association. APA dictionary of psychology neologism .
Green BC, Johnson KA, Bretherton L. Pragmatic language difficulties in children with hyperactivity and attention problems: an integrated review: Pragmatic language and ADHD symptoms . Int J Lang Commun Disord . 2014;49(1):15-29. doi:10.1111/1460-6984.12056
Patel J, Patel P. Consequences of repression of emotion: physical health, mental health and general well being . IJPR. 2019;1(3):16-21. doi:10.14302/issn.2574-612X.ijpr-18-2564
Tamir DI, Mitchell JP. Disclosing information about the self is intrinsically rewarding . Proc Natl Acad Sci USA . 2012;109(21):8038-8043. doi:10.1073/pnas.1202129109
Strålin E, Thorell L, Szybek K, Lundgren T, Bölte S, Bohman B. Cognitive-behavioral group therapy for ADHD predominantly inattentive presentation: A feasibility study of a new treatment protocol . Nordic Psychol . 2022 Jan;74(4):325-339. doi:10.1080/19012276.2021.2020683
Reed-Knight B, Fischer S. Treatment of narcissistic personality disorder symptoms in a dialectical behavior therapy framework: A discussion and case example . In: The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments. 2011;1(1):466–475.
Depression and Bipolar Support Alliance. 8 tips on setting boundaries for your mental health .
By Michelle C. Brooten-Brooks, LMFT Brooten-Brooks is a licensed marriage and family therapist based in Georgia. She has been covering health and medical topics as a journalist for over 20 years.
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Introduction to psychology.
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Language is an amazing thing. How do we learn and use language in our everyday lives? How does the brain make this happen? This session explores the brain basis of language perception and comprehension, how language contributes to our understanding of our environment, and how we learn languages. : phoneme, speech, comprehension, hearing, writing, reading, phonology, syntax, evoked response potential (ERP), meaning, pragmatics, aphasia, language acquisition on Flickr (aka Markus Koljonen, ). |
Read the following before watching the lecture video.
View Full Video Lecture 12: Language View by Chapter Language Basics: Sounds We Hear and Distinguish From Sound to Meaning: Syntax, Semantics, and Comprehension Problems with Language: Aphasia and the Neural Basis of Speech Language Acquisition: Infants, Bilingualism, and the Case of Genie Video Resources Removed Clips Lecture Slides (PDF - 1.7MB)
Language is just incredible – think about how easy it is for us, as babies, to learn our native language effortlessly, and yet how hard it is, once we’ve already learned a language, to learn another… Read more »
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Supplemental reading | Crystal, D. . Penguin, 2007. ISBN: 9781583332917. [Preview with ] | An introduction to lingustics written for the layperson, recommended by the TAs. |
Blog | Covers language in current events, run by University of Pennsylvania phonetician Mark Liberman with multiple guest linguists | |
Web resource | Lewis, M. Paul (editor). . Sixteenth edition. SIL International, 2009. | Reference work on languages of the world, with web resources and preview pages of print edition |
Wikipedia | Example discussed at end of class. | |
Textbook supplement | Study materials for Ch. 8 “Language and Thinking: What Humans Do Best.” In , 3/e (Pearson, 2007) | Practice test questions, flashcards, and media for a related textbook |
Part 1: change your speech, change your mindset. it's so simple..
Posted October 8, 2020 | Reviewed by Lybi Ma
With everything going on in our country right now, I have decided to share a series on “Positive Speech.” People need more positivity right now. There is a slew of words people use in their everyday lives that are dis -empowering. My goal, with this series, is to get you to shift toward empowering speech.
One of my favorite quotes is by Henry Ford: Whether you think you can, or you think you can’t, you’re right . Repeat the saying to yourself and think about it for a minute. If you “believe you can,” you are optimistically looking at something, whatever it may be in that moment and, by simply saying “you can,” you will shift an “impossibility” to a possibility. However, if you “believe you can’t,” then, sadly, you just closed the door to the possibility of being able to or, at the very least, you have put up a formidable barrier to being able to accomplish whatever it is you are saying “you can’t” do. Either way, you are right. It’s that simple.
I have shared Henry Ford’s sage words with students on the firearms range, during therapy sessions, and with colleagues and friends when they have all been experiencing doubt. I tell them that by saying you “can’t” do something, you are already doubting yourself, throwing up the white flag, closing the door, and locking it. Why would you do this? Ugh. I get frustrated sometimes about this. It’s not that you can't . Even if you really and truly “can’t” do something (e.g. fly an AH-64 Apache Helicopter), there is always a different and more positive way to express that.
Confession. I have a visceral reaction when I hear someone utter, “I can’t” in any context. It literally makes me cringe or, more often, I close my eyes, shake my head, and or scrunch up my face. The word can’t is ugly, it’s disempowering, it’s defeating, and it’s not part of my vocabulary—at least, not since I recognized how negative it is.
And, it’s not just in situations when people are doubting themselves. People use “can’t” in response to everyday questions, such as:
It’s not that you can't ; you actually can do all of those things. However, instead of being honest, you choose the icky “I can’t” as your default answer. There are so many ways these questions can be answered in a more positive and/or honest way:
There is another perspective as well. Maybe you are just not up for the task or you are not willing to do the thing(s) being asked of you. It’s better to be honest about whatever is being asked vs. saying, “I can’t”.
Responding honestly, in a positive way, is not just empowering, it is freeing. Okay, so it might be uncomfortable at first for some of you but I promise it gets easier and it feels great.
The moral: Words reinforce your thinking. Positive thinking is reinforced by positive speech and vice versa. Your words create your destiny.
Today, remove the word “ can't ” from your speech. I am confident you can do this. Let me know how it goes.
Mary Beth Wilkas Janke, PsyD , is a former United States Secret Service Agent and currently teaches at George Washington University.
Sticking up for yourself is no easy task. But there are concrete skills you can use to hone your assertiveness and advocate for yourself.
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Annabel hancock.
1 Division of Psychology and Language Sciences, University College London, London UK
2 Division of Language and Communication Science, City University of London, London UK
3 Department of Psychology, University of York, York UK
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Data are available on request due to privacy/ethical restrictions. The data are not publicly available due to privacy or ethical restrictions.
While the relationship between speech, language and communication needs (SLCN) and mental health difficulties has been recognized, speech and language therapists (SLTs), and mental health professionals face challenges in assessing and treating children with these co‐occurring needs. There exists a gap in the evidence base for best practice for professionals working with children and young people (CYP) who experience difficulties in both areas.
To explore the views of SLTs and mental health clinicians about their experiences of working with CYP exhibiting co‐occurring SLCN and mental health difficulties.
Semi‐structured interviews were conducted with eight SLTs and six mental health professionals, including psychotherapists, clinical psychologists, play therapists and counsellors, with experience working with CYP with SLCN. Interviews were analysed using reflexive thematic analysis and themes were identified from the data.
Participants felt that SLCN and mental health difficulties frequently co‐occur. Participants described how CYP with SLCN and mental health issues commonly experience difficulties across and between the domains of language and cognition, emotional well‐being and challenging behaviour. Findings suggest that there are organizational limitations in the fields of SLT and mental health that have implications for the efficacy of assessment and treatment of CYP with SLCN and mental health difficulties. Traditional talking therapies were perceived to be inaccessible and ineffective for CYP with SLCN and mental health difficulties. Interventions blending behaviour and emotion programmes with language and communication interventions were considered potentially beneficial.
Future research should explore and evaluate current services and service set‐up in SLT and mental health. The findings from this study have important implications for the efficacy of treatments provided to this population suggesting that more research needs to be done into effective diagnosis and interventions for this population.
What is already known on the subject.
The relationship between speech, language and communication needs (SLCN) and mental health is interwoven and highly complex and often poses real problems for speech and language therapists (SLTs) and mental health professionals to understand, diagnose and treat. SLCN is a broad category that covers a wide range of conditions affecting speech, language and communication (Bishop et al., 2017 ). For simplicity and consistency, the term ‘mental health’ or ‘mental health difficulties’ will be used to refer to children and young people (CYP) with social–emotional and mental health needs, anxiety and depression.
The aim of this study was to explore the views of SLTs and mental health clinicians about their experiences of working with CYP with SLCN and mental health difficulties and, if identified by participants, to explore issues around language and social communication disorders. We begin by first reviewing the existing evidence on the links between language, communication and mental health.
There is extensive evidence that language and communication problems co‐occur with mental health problems, although the mechanisms behind this relationship remain unclear. Poor language skills are common in CYP with emotional–behavioural disorders. A 2014 systematic review reported that four out of five children with emotional–behavioural disorders had at least mild language difficulties that had not been previously identified (Hollo et al., 2014 ). Poor mental health can present as challenging behaviour, and is associated with disorders of social communication and language (Georgiades et al., 2010 ). In addition to externalizing problems, children with social communication difficulties (SCDs) are likely to experience anxiety (Moree & Davis, 2010 ). Cohen et al. ( 2013 ) and Wadman et al. ( 2011 ) reported that anxiety symptoms frequently occur in individuals with DLD in young adulthood. DLD can severely impact on mental health, and an increased risk for depressive symptoms has been consistently reported in this group. For example, clinical levels of depression range from 20% to 39% in children and adolescents with DLD compared with 14–18% in peers without DLD (Conti‐Ramsden & Botting, 2008 ). Difficulties with language and communication can affect daily living and extend across the lifespan to affect life outcomes. For instance, young offenders with language impairment are at a higher risk for mental health problems (Snow & Powell, 2004 ) and one of the biggest predictors of reoffending is unrecognized DLD (Winstanley et al., 2019 ).
It is possible that certain aspects of language and communication hold particular relevance for mental health. Van den Bedem et al. ( 2018 ) reported specifically more semantic problems in individuals with DLD and the contribution of this to the prediction of depressive symptoms. Children with pragmatic language difficulties also appear prone to emotional and psychosocial difficulties (Cohen et al., 2013 ). For example, in a community‐based longitudinal study, Sullivan et al. ( 2016 ) reported an association between poor pragmatic language in childhood and adolescent psychotic experiences, and that poor pragmatic language skills preceded early adolescent depression. Some children with pragmatic language impairments also show difficulties recognizing facial emotions (Merkenschlager et al., 2012 ), which may impact on their ability to respond appropriately to others and to form close relationships with those around them (Merkenschlager et al., 2012 ). Van den Bedem et al. ( 2018 ) suggested that children with social communication problems are more likely to adopt maladaptive emotional regulation strategies. These maladaptive strategies may contribute to the prediction of higher levels of depressive symptoms. Children with SLCN are also more likely to be the target of bullying and to experience emotional difficulties compared with their typically developing peers (Lloyd‐Esenkaya et al., 2021 ). SCDs are thought to predict social anxiety, and those who experience peer victimization are likely to present with SCDs (Pickard et al., 2018 ).
In clinical practice, those commonly diagnosed with SCDs and/or autism spectrum disorder (ASD) may also present with pragmatic problems. Research shows that CYP with ASD and SCDs meet the diagnostic criteria for co‐morbid diagnoses of depression and anxiety disorders (Hofvander et al., 2009 ). The prevalence of mental health disorders in ASD is high. For example, in an interview study of 54 young adults with Asperger syndrome, 70% reported experiencing one major episode of depression and 56% reported experiencing anxiety disorders (Lugnegard et al., 2011 ). Furthermore, children with SCDs as part of ASD experience attention and challenging behaviour disorders (Moree & Davis, 2010 ; Georgiades et al., 2010 ) and this may lead to poor mental health.
Another factor that may link language, communication and mental health is the role of emotions and the impact of language and communication upon emotional processes. The ability to effectively vocalize feelings and thoughts relies heavily upon robust language skills, especially in relation to gaining a sense of self‐expression, self‐control and emotional insight (Unsworth & Engle, 2007 ). Neuropsychological evidence also highlights that damage to classic language areas in the brain affects emotion processing. Computerised tomography (CT) scans of patients who had sustained a traumatic brain injury found that damage to the inferior frontal gyrus (i.e., Broca's area) was associated with increased alexithymia scores (difficulties identifying and describing one's own emotions) (Hobson et al., 2018 ). Similarly, communication problems of people who have had a stroke are associated with high alexithymia scores, even after accounting for depression and anxiety (Hobson et al., 2020 ). Such research has led to the proposal that the link between language and identifying emotions is intrinsic, and that language impairment could contribute to alexithymia and/or vice versa. This has been coined as the alexithymia language hypothesis (Hobson et al., 2020 ). While these studies reflect data from acquired language disorders (i.e., following traumatic brain injury or stroke), Hobson et al. ( 2020 ) suggests that individuals with developmental language problems are also likely to experience difficulties with alexithymia. Indeed, initial examinations of levels of alexithymia in DLD suggest that, at least according to children's parents, children with DLD have higher alexithymic traits and problems with recognizing and expressing their own emotions (Hobson & van den Bedem, 2021 ). If language problems lead to greater alexithymic traits, it would be expected that such emotional problems will increase the risk for mental health problems and impact on treatment.
There are clear links between language and communication problems and mental health, and plausible models for how these two domains interact. It is thus pertinent to ask: What can interventions do to help and are current interventions suitable for CYP with SLCN? The use of appropriately modified talking therapies for CYP with language and SCDs is lacking evidence. Nonetheless, deficits in speech, language and communication would be expected to negatively impact the effect of talking therapies as CYP with SLCN would have difficulties with understanding pragmatic and inferential language, understanding and using narrative language, and understanding and interpreting emotions. Furthermore, difficulties communicating abstract concepts in verbal and non‐verbal children have been identified as limiting factors to effectively access psychological therapies (Lang et al., 2010 ). Thus, social communication and language difficulties may reduce the accessibility and therefore efficacy of traditional talking therapies.
There appears little acknowledgement about the role of language and communication in modifications of talking therapies. The National Institute for Health and Care Excellence (NICE) guidelines for the use of psychosocial interventions with adults with ASD (NICE, 2013 ) recommend using plain English during therapy sessions and avoiding the use of metaphors. In addition, much of the research in this area has focused largely on the use of cognitive behavioural therapy (CBT) in children and adolescents and often with overt SLCN such as voice disorders, stammering and selective mutism (Bercow et al., 2016 ; Menzies et al., 2008 ). There is also a growing body of research on the use of adapted talking therapies for adults with SLCN. For instance, the Solution Focused Brief Therapy (SFBT) in Poststroke Aphasia SOFIA trial (Northcott et al., 2021 ) applied modified SFBT so that it was accessible to language‐impaired stoke survivors. There is no direct evidence for the use of adapted talking therapies in CYP with DLD or language impairments.
Without knowledge about the nature of the SLCN, suitable access to a talking therapy may be ineffective. For instance, individuals with ASD have more trouble understanding psychotherapy concepts than non‐autistic controls (Hall et al., 2015 ). Furthermore, differences in social communication may mean a lack of social chat, difficulties initiating and maintaining conversations and interpreting language literally, all of which would significantly impact upon effective accessibility to talking therapies (Bliss & Edmonds, 2008 ).
In summary, despite the evidence for a relationship between SLCN and mental health needs, there are considerable knowledge gaps in understanding the impact of SLCN on the efficacy and accessibility of treatments, and the role of SLCN in traditional talking therapies has been largely unexplored. Little is known about clinicians’ perspectives of SLCN and mental health difficulties. Therefore, to inform and build the evidence base, the current study explored the views and experiences of clinicians assessing and treating CYP with SLCN and mental health difficulties. The aim of the study was to explore clinicians’ experiences of working with CYP with SLCN and mental health difficulties. The study addressed the following research questions:
A qualitative research design using reflexive thematic analysis (TA) was chosen for this study in order to obtain a richness and depth to the data set that would appropriately answer the research questions. This approach facilitated an exploration of clinician experiences, observations and knowledge. A reflexive approach to TA was chosen due to the emphasis placed on the importance of the researcher's subjectivity as an analytic resource, and the reflexive engagement with theory, data and interpretation (Braun & Clarke, 2020 ). A reflexive approach is compatible with experiential qualitative research and was fundamental to the research questions. The approach adopted was an active and flexible process with the acknowledgement of theory. This process ensured a quality demonstrated in gold standard TA (Braun & Clarke, 2020 ). Interview questions were semi‐structured in nature; an interview guide and questions were constructed (see in the additional supporting information ) and followed from a flexible and dynamic perspective. The questions were designed to be open‐ended to facilitate flow of conversation with the aim to build rapport and encourage participants to talk about issues pertinent to the research questions.
This study received ethical approval from University College London (LCD‐2020‐10). This study involved 14 clinicians: eight SLTs and six mental health professionals (Table 1 ). Inclusion criteria were that participants should be qualified allied health professionals in the field of speech and language therapy or mental health. Participants had to have sufficient professional experience (at least one year post‐qualification) working with CYP. Participants were provided with an information sheet written in plain English regarding the research area, interview procedure and research aims. Informed consent was obtained before each interview and participants were given the opportunity to ask questions.
Participant characteristics
1 | Female | Speech and language therapist | Developmental language disorder and challenging behaviour | No |
2 | Female | Speech and language therapist | Deafness | No |
3 | Female | Speech and language therapist | Acute neurology, neurosurgery specializing in communication and dysphagia | No |
4 | Female | Speech and language therapist | Autism spectrum disorder | No |
5 | Female | Speech and language therapist | Youth justice team | No |
6 | Female | Speech and language therapist | Complex needs and early years preventative | No |
7 | Male | Speech and language therapist | Child adolescent mental health service (CAMHS)/mental health | No |
8 | Female | Speech and language therapist | Complex needs and behaviour support | Yes |
9 | Female | Play therapist | Mixed paediatric caseload specializing in attachment disorders | Yes |
10 | Female | Clinical psychologist | Learning disabilities and autism spectrum disorder | No |
11 | Female | Psychotherapist | School counselling: bereavement, anxiety, changes at home, social issues, challenging behaviour | Yes |
12 | Female | Counsellor | Anxiety, depression, ADHD concurrent with autism spectrum disorders, adjustment disorders, grief and loss | No |
13 | Female | Clinical psychologist | CAMHS/mental health | Yes |
14 | Female | Counsellor | School counselling: bereavement, anxiety, changes at home, social issues, challenging behaviour | Yes |
Interviews lasted for up to one hour and were conducted by the first author online via Microsoft Teams video conferencing software. Video‐audio data were collected. Online interviews were chosen for participant convenience and to ensure that the research could take place despite COVID‐19 pandemic restrictions. Each interview was recorded and transcribed verbatim by the first author and field notes were taken. Personally identifying information such as names and places of work were not transcribed to ensure participant anonymity. Video recordings were securely stored under encryption and deleted after analysis.
The transcribed interviews were subjected to an inductive thematic analysis. An inductive approach to thematic analysis was chosen due to the acknowledgement that epistemological assumptions would inevitably inform the analytic process (Braun & Clarke, 2020 ). However, the recognition that thematic analysis is a theoretically flexible approach was accepted and informed the analytic process. Therefore, the approach was descriptive but not wholly atheoretical. A flexible, active and interactive approach was central to the data analysis to support the process of theme generation, as opposed to theme emergence which could be deemed as not reflective of the data and the positionality of the researchers (Braun & Clarke, 2020 ).
NVivo 20 software was used to support line‐by‐line coding of all transcripts. A reflective diary was used to support the identification of themes from codes. Online team coding was conducted with two postgraduate research students and three senior researchers to support the process of reflexivity and refinement of theme generation. The first author presented raw data, identified codes and initial generated themes to the coding group; these were discussed, challenged and refined.
As reflexive TA captures the skills the researcher brings to the process (Braun & Clarke, 2020 : 6), it is necessary to consider the researcher's perspective. The lead author is a female clinical academic SLT specializing in paediatric ASD, DLD and challenging behaviour. She is also a solution‐focused therapist and practices hypnotherapy with children and adults. The current project formed part of the lead researcher's pre‐doctoral clinical fellowship funded by The National Institute of Health Research. The co‐authors are senior researchers with experience in the fields of speech and language therapy and psychology with research in aphasia and solution‐focused brief therapy, alexithymia and SLCN. Participants were informed about the lead researcher's occupation, background and research aims. The lead researcher's interests and aims were not shared with the participants, and the researcher attempted to maintain a neutral stance throughout the interviews in order to obtain a true picture of clinicians’ experiences and understanding of specific subtypes of SLCN and their relationship to mental health.
Four main themes were generated from the data: (1) boundaries around professional relationships, (2) knowledge of SLCN and mental health, (3) being misunderstood: how CYP are perceived by others and (4) blended interventions. These are summarized in Figure 1 . We unpack each theme and its subthemes below.
Summary of the main themes and subthemes [Colour figure can be viewed at wileyonlinelibrary.com ]
Note: SLT, speech and language therapy; MH, mental health; MDT, multidisciplinary team.
In addition, data were gathered regarding how participants characterize this population. SLCN and difficulties with mental health were identified by participants as frequently co‐occurring. These data are presented following a discussion of the four themes under Figure 2 : SLCN and mental health difficulties: typical difficulties reported in this population.
Speech, language and communication needs (SLCN) and mental health difficulties: typical difficulties reported in this population [Colour figure can be viewed at wileyonlinelibrary.com ]
This theme describes observed discrepancies in the identification of children with SLCN and mental health difficulties, and discrepancies in approaches to working with this population between mental health professional participants and SLT participants. Differences in service provision, professional practice and lack of multidisciplinary team working were cited by participants as contributing factors to the observed discrepancies.
One subtheme concerned marked differences in the organization of SLT and mental health services. SLT and mental health services were not only considered differently organized but also highly variable depending upon postcode, funding and service set‐up. How services were set‐up was construed to play a large part in the appropriate management, or perceived mismanagement, of children with SLCN and mental health difficulties. Service boundaries were identified as contributing to a range of difficulties working across and between disciplines. For example, SLTs discussed difficulties referring to services such as child and adolescent mental health services (CAMHS), often receiving referral rejections from CAMHS with limited or no feedback. Other examples cited by participants were related to limited feedback or acknowledgement to receiving patient reports, a physical distance between services, and difficulties identifying appropriate treatment pathways for CYP with SLCN and mental health difficulties, particularly in mental health services. ‘Lots of referrals get rejected, so many referrals that we really feel as a team need CAMHS support’ (participant (P)5: SLT).
Participants described how services are often entirely separate and working in respective isolation. This was interpreted to contribute to a limited or total absence of joint working, resulting in a lack of knowledge of each profession's discipline and of discipline protocols, for example, referral systems, use of screening for appropriate referrals and confidentiality policies. Service level differences were also cited as causing difficulties identifying which discipline should assess and manage CYP. ‘It was sort of, oh no, that has to be CAMHS, CAMHS has to deal with them, and if they were under seven, then CAMHS would say, oh no, that has to be speech therapy, speech therapy is dealing with them’ (P3: SLT).
A second subtheme was limited multidisciplinary team (MDT) working. An MDT is a group of health or social care workers and professionals who are members of different disciplines, each of which provides a specific service to service users (Hodder Education, 2021 ). Differences in service provision and service funding resulting in a separation of professionals, both at a geographic and organization level, was construed as a contributing factor to limited MDT working between mental health and speech and language therapy. Participants described how SLTs and mental health professionals are often not part of the same MDT and therefore have fewer opportunities to provide integrated care. SLT participants commented that their profession is often unaccounted for within acute mental health services, and one mental health professional considered her role under the safeguarding team as being cut‐off from the SLT's role which was under the SEN team. In addition, some participants attributed limited MDT working to policy level differences such as psychological services not sharing information with SLT due to confidentiality policies and differences in patient note systems:
‘we're often funded by different streams and funded by different people, we work in different health trusts quite often, and that actually has massive implications for the fact a) that you're not physically in the same building, so you don't get to see these people very often, but that even things about how we collect data, our electronic patient systems, we often use very different data technology that, that can make things very difficult in terms of information sharing’. (P13: mental health professional)
SLT participants also described a lack of approachability from mental health professionals which was seen as alienating and limiting from a diagnostic and therapeutic perspective, further contributing to limited MDT working, collaboration and cohesion between these professional groups.
‘because you've talked about an incident or challenging behaviour or something like that, certain psychology colleagues see that as inappropriate or you've overstepped a boundary because you're talking about a kind of emotion when that's something that they do, or they perceive themselves as doing quite exclusively’. (P7: SLT)
The first theme ‘Boundaries around professional relationships’ directly interacts with the second theme ‘Knowledge of SLCN and mental health difficulties’. A perceived lack of shared knowledge was seen to be related to limited opportunities for multidisciplinary experiences and the clinical service set‐up overall.
The first subtheme concerned the ‘visibility’ of SLCN. It was construed that potentially less immediately obvious SLCN, such as DLD, are less likely to be identified by mental health professionals than more visible SLCN, such as stammering and selective mutism. Visible SLCNs discussed more frequently by mental health professionals as opposed to invisible SLCNs. This discrepancy was described by participants as potentially contributing to unidentified SLCN and mental health difficulties within mental health services, and the lack of knowledge universally with assessment and treatment of this population.
‘I don't think that's typical for mental health practitioners (to consider language difficulties). No, I would definitely think I know my team, the teams that I've worked in, most people would not think about language, particularly language disorders in a young person as part of the part of their (psychology) assessment, unless a parent disclosed something like that, or unless they were very, it was very clear evidence that there were quite obvious difficulties’. (P13: mental health professional)
Difficulty teasing out SLCN from mental health issues (and vice versa) was also interpreted as contributing to a lack of knowledge regarding appropriate diagnosis of CYP with SLCN and mental health difficulties. It was construed that a lack of understanding of the relationship between SLCN and mental health often impacts upon which professional should and would assess and treat this population. Participants discussed how social skills historically have been explicitly taught by SLTs but that mental health professionals are increasingly using this approach as an intervention strategy. Participants discussed a general lack of clarity around role boundaries which could sometimes lead to perceptions of overstepping a professional role or boundary. ‘In my kind of experience, I find certain psychologists very much see emotion, or kinds of challenging behaviour as their domain and they don't like anyone stepping into it’ (P7: SLT).
Barriers to accessing talking therapies was the second subtheme. Knowledge around diagnosis was construed as relating directly to providing appropriate interventions for this population, particularly regarding talking therapies. Traditional talking therapies were interpreted as being potentially inaccessible and inflexible for individuals presenting with SLCN and mental health difficulties, particularly if language difficulties were unidentified. SLTs and some mental health professional participants viewed psychological therapies as language heavy, involving higher level language and concepts that CYP with SLCN would struggle to comprehend and verbalize.
‘I might go and observe a psychology session with them and then the language they're using is far too complex the, the psychological language, the therapy materials, they often use a metaphorical language, they're using kind of these images and symbolism, which is far too complex for the person in general and then they're not really understanding’ (P7: SLT).
Due to a perceived lack of knowledge, identification of CYP with less visible SLCN might be missed by mental health professionals and unaccounted for within traditional psychological therapies. SLT participants described how in such instances appropriate accessibility and efficacy of talking therapies for CYP with SLCN may be compromised. ‘I'm not sure how much they know about these particular children's language needs and like how therefore their intervention with DEAF‐CAMHS‐H [CAMHS for the hearing impaired] is delivered effectively’ (P2: SLT).
Both SLT and mental health professional participants construed CYP presenting with SLCN and mental health difficulties as misunderstood and often perceived negatively by staff, carers, parents and the wider environment. In particular, difficulties with challenging behaviour, dysregulation and disengagement were interpreted by participants as being misunderstood and perceived as ‘naughty’. Participants considered the high prevalence of behaviours such as disengagement, a distrust of professionals and school refusal as contributing to this perception. Participants interpreted this population as commonly using non‐typical social communication skills that may result in difficulties building and maintaining relationships with peers, staff, parents and carers, further contributing to a negative perception. Difficulties with understanding and expressing language were seen to be related directly to instances of challenging behaviour.
‘We tend to get a lot of young people who are presenting at school, with quite significant behavioural difficulties and we tend to find that being viewed as a behavioural child, rather than a child that's got underlying language needs that have been un‐diagnosed’ (P5: SLT).
The final theme concerns blended interventions. This theme describes participants’ descriptions of optimum interventions for CYP with SLCN and mental health difficulties. It was construed that working with the systems and environment around CYP is clinically useful for this population.
The first subtheme concerns working with the environment. The use of positive behavioural support systems, emotional regulation strategies and programmes, staff training, and the involvement of parents within interventions were deemed as clinically useful interventions for CYP experiencing SLCN and mental health issues. Parent–child interaction therapy (PCIT) is used by SLTs with the aim of improving interactions between children and their parents/carers (Falkus et al., 2016 ). Theraplay is used by psychotherapists to support healthy child/caregiver attachments (Institute of Theraplay, 2021 ). Both PCIT and Theraplay offer similar programmes where parents are involved as part of the intervention process. Participants discussed the potential of combining or utilizing such approaches in a more joined‐up manner for future targeted interventions. A functional approach to mitigating SLCN was also construed as beneficial for this population. Participants discussed how targeting specific aspects of SLCN may not be as beneficial as focusing on increasing overall functioning and well‐being of CYP.
‘So, I think in terms of delivering therapy, lots of it is about that environmental to therapeutics, so sort of, let's see if we can normalize the environment as much as we can in this environment and support behaviour through communication’ (P3: SLT).
The second subtheme concerned supports for communication. This theme was discussed universally by participants. The need to adapt language and consider therapist delivery within all diagnostic and therapeutic processes was seen as paramount for CYP experiencing SLCN and mental health difficulties. Using simple or no language to take the pressure off a requirement for verbal communication was interpreted as being necessary within any intervention for this population. Other visual supports, such as talking mats (Murphy et al., 2013 ) and communication systems, such as visual timetables and ‘now and next’ boards, were considered useful.
‘The use visuals, the use of visuals full stop. Whether that's visual or written timetable, even if the child has literacy so implementing a sort of routine on a timetable and consistent use of that across the day, I think works well’ (P4: SLT).
Play therapy or the use of play as a vehicle for access to psychological therapy for CYP with SLCN and mental health difficulties was considered a potentially useful psychological approach for this population due to the lack of emphasis upon verbal communication:
‘So, I think the use of toys and play can help bring their outer world about what's going on when, what they see inside and speech doesn't need to be, it doesn't need to be a part of that’ (P12: mental health professional). ‘I think the therapy it's different because I'm not expecting, they don't have to talk’ (P11: mental health professional).
Explicitly teaching higher level language was deemed an important intervention strategy, particularly in relation to comprehending and expressing emotions. One SLT participant described how they had combined a cognitive developmental theory of emotion and a psychotherapy model, with a vocabulary intervention directed through talking mats (Murphy et al., 2013 ) to facilitate communication. This was discussed and explored as a potentially useful way to develop emotion vocabulary comprehension and processing with this population.
‘You give people labels to understand what they're feeling physically, and then you move it onto more cognitive levels where that's the more kind of established sort of CBT, that kind of approach where they're thinking about their emotions and their thoughts … then you move on to the word level stage (of the vocabulary intervention) and that's very much around introducing kind of very basic semantic understanding of the word of the meaning and then you're building in the syntax and you're trying to get a really deep, you're trying to get there because they often have a vague notion of what certain words mean, but their understanding is very poor so you're trying to really reinforce a particular meaning or understanding of an emotion word’ (P7: SLT).
Merging interventions drawing upon practices from speech and language therapy and mental health was discussed. For instance, an SLT talked about how they had successfully combined shape coding (Ebbels, 2021 ), which is an established intervention used by SLTs, with social communication, emotional regulation, and transactional support (SCERTS), which is a behaviour intervention (Prizant et al., 2006 ). Participants also interpreted the use of relatable, non‐hypothetical language, and teaching how emotions look and feel in the body as being clinically necessary for this population. Participants advocated for the need to modify and adapt traditional talking therapies such as cognitive behavioural therapy and using an individualized approach. ‘Lots of more sort of explicit ways of doing things and using lots of examples from his own his own life and things that he would bring to the session rather than me coming up with example’ (P13: mental health professional).
In addition to the themes described above, participants generated discussion regarding how they characterize this population. In answer to the question ‘can you tell me about some of the difficulties these CYP experience?’, participants described a range of difficulties this population typically present with. This is not a diagnostic criterion; it is a set of descriptions used by participants to describe their experience of this population (Figure 2 ).
Participants felt that characterizing the overall presentation of this population is often problematic. Participants reported that it is difficult to determine what is specifically a SLCN and what is a mental health need. SLCN and difficulties with mental health were identified by participants as frequently co‐occurring. Key aspects of development were identified by participants as being typically delayed or disordered with CYP experiencing SLCN and mental health difficulties. Participants reported that CYP in this population would commonly experience difficulties across these areas. The first area identified was emotional well‐being. Participants felt that this population significantly struggle with feelings of self‐consciousness, low self‐esteem, and anxiety, often about the presence of a communication impairment, and the impact of their communication difficulty on their experiences with the world around them. Participants felt that difficulties with self‐esteem and anxiety could sometimes result in poor emotional resilience. One participant described how young offenders are at particular risk of developing low self‐esteem because of multiple exclusions from education and therefore a sense of rejection that they may experience throughout life. Another participant described how difficulties with SLCN could impact on their well‐being and levels of anxiety and distress and behaviour. ‘We definitely see those children, they're often very anxious and there is definitely an impact of some of their difficulties on their well‐being, self‐esteem and their mental health’ (P5: SLT).
The second common characteristic was challenging behaviour. Participants described this population as typically experiencing difficulties with engagement, staying on task, and finding it hard to comply with work in the classroom or, with other professionals. Typical behavioural difficulties were problems with emotional regulation and the presence of anger or aggressive behaviours. Participants described how CYP can be disruptive or conversely appear withdrawn and isolated in social situations. Other reported difficulties in this area were with attention and listening and with building and maintaining relationships, particularly with peers.
‘We see quite a lot of, we describe it as anxiety for the children that, that I work with and dysregulation is a term that I've been using much more recently, so that can present as very elevated, it can present us physical aggression, some self‐harm and behaviours, yeah, sort of, socially inappropriate behaviours in terms of removing clothes and smearing and that sort of thing’ (P10: mental health professional).
The final area identified as characteristic of this population was language and cognition. Participants felt that this category of CYP experience difficulties with general language comprehension, processing of spoken language and with their expressive language. ‘Verbally he (a patient) appeared to understand things very well or he had a good, he had a good vocabulary, but actually his understanding was limited so he could be quite misleading’ (P13: mental health professional).
Difficulties with executive function was also discussed, often in relation to CYP being able to appropriately plan and organize themselves. One participant cited how it is common for CYP to arrive late to lessons, getting lost en‐route and forgetting school equipment. Difficulties with verbal reasoning were also described as commonly present with this population. ‘They're breaking their curfews and they end up in trouble with the police and things because they can't tell the time’ (P5: SLT).
Difficulties with metacognition (thinking about thinking) was also highlighted by participants as a typical difficulty seen in these CYP. Difficulties with insight, being able to monitor their communication and planning how to approach a learning task were all discussed as typical problems for this population. ‘They may not have insight into their own language use or behaviour’ (P2: SLT).
‘Difficulties with higher order language and the use of sophisticated, abstract and emotional language was also reported. Participants reported CYP in this population often experience difficulties understanding and using emotion language, particularly labelling emotions. They don't know what it means when somebody uses those words (emotional words), or is sarcastic’ (P5: SLT).
The misunderstanding of negative constructions was discussed as being a barrier to understanding emotions:
‘You might conceive that someone's doing something to you because you can't understand negative constructions, for instance, you just you assume everyone's just doing things to you but you're the one who's not quite understanding like the word no, or negative things’ (P7: SLT).
Difficulties with being able to understand abstract language and using language in a more abstract way to make predictions, use hypothetical language and humour was also cited as a typical difficulty in this population. ‘He would struggle with transferring that knowledge from a discussion about a hypothetical person to himself’ (P10: mental health professional).
The current study explored the experiences and views of SLTs and mental health professionals working with CYP with SLCN and mental health difficulties. Discussion around CYP with SCDs such as ASD, and developmental language disorder (DLD) was of particular interest. SLTs and mental health professionals in this study perceived certain subtypes of SLCN to commonly co‐occur with mental health difficulties. Findings suggest that there are organizational and service set‐up boundaries between SLTs and mental health clinicians, which has implications for the efficacy of assessment and treatment of this population. Findings also suggest that this population is often misunderstood and misidentified. The current research indicates that combined approaches in SLT and mental health may be beneficial for CYP who present with co‐occurring SLCN and mental health needs.
The current research has also identified that distinct barriers exist between mental health clinicians and SLTs which has led to boundaries between these professional groups. The most significant barrier was found to be around service organization and set‐up. Participants described how, as professionals, they felt organizational difficulties led to feelings of ‘failing’ this cohort. Findings suggest that mental health professionals and SLTs are often not in the same MDT and that SLT is often not a recognised professional group within children and adolescent mental health services. SLT and mental health services appear to be functioning in parallel, working under different teams, services, NHS trusts, local authorities, and sometimes entirely different organizations. Service set‐up and organization limitations were deemed to result in fewer opportunities for MDT working which has a negative impact on the knowledge professionals have of CYP with co‐occurring SLCN and mental health difficulties. Within the United Kingdom there is currently an ongoing consultation process with The Royal College of Speech and Language Therapists (RCSLT) and CAMHS to recognise the role of SLT within mental services and to increase SLT roles within core CAMHS services.
The current research highlights how a lack of understanding of this population is a clinical concern and has been described by participants in this study as having implications for effective diagnosis and treatment. The current study also illustrates that availability of joined up and multidisciplinary services for this population is scarce. This has resulted in a lack of shared knowledge about this population, leading to challenges with diagnosis, particularly with CYP who exhibit invisible SLCN and mental health difficulties such as DLD. The current research highlights that CYP with co‐occurring SLCN and mental health difficulties may be undiagnosed or misdiagnosed by professionals. This may mean CYP in this population fail to receive appropriately modified and evidence‐based treatment. The current findings resonate with other recent investigations of parents’ experiences concerning mental health support for their children with SLCN. Parents have reported concerns that mental health treatments were not accessible for their children and lacked adaptations necessary for them to work for children with conditions such as DLD (Hobson et al., 2021 ).
Typical behaviours and characteristics of CYP with co‐occurring SLCN and mental health needs are often misunderstood by parents, carers and professionals resulting in this population being misinterpreted and often labelled as ‘naughty’. Behaviours that are typically misunderstood include anger or emotional outbursts due to difficulties with emotional regulation, disengagement, language difficulties and problems with building and maintaining adult and peer relationships. Participants reported that children in this population are frequently ‘angry’ or show aggressive behaviours, and experience difficulties with friendships, can be distrusting of professionals, and are likely to show poor school attendance. Participants observed that CYP in this population are also likely to experience school expulsion, attendance to pupil referral units, and in some cases youth offending institutions/team (YOT).
A key finding was that interventions used in both speech and language therapy and psychotherapy are perceived as clinically useful if combined. Other research (Bercow et al., 2016 ; Menzies et al., 2018 ) has applied mental health interventions to specific subtypes of SLCN such as stammering, selective mutism and ASD, but little in relation to DLD. Participants discussed how they have successfully blended behaviour and emotion programmes with language and communication interventions. Similarly, participants discussed how combining traditional talking therapies, such as CBT, with modifications to account for communication difficulties, such as using visual supports, can be beneficial.
Hollo et al. ( 2014 ) has called for the development of interventions to ameliorate the effects of these dual deficits. Findings from the current study show that some existing or modified interventions are anecdotally effective. A good starting point for future research would be with the exploration of adapted traditional talking therapies and psychological therapies combined with SLT. A preliminary finding from the current research is that play therapy could also offer a potentially useful psychological therapy for CYP with co‐occurring SLCN and mental health difficulties due to its child‐led nature and lack of emphasis upon language and communication. Interestingly, play therapy was also raised by parents of children with DLD in the study by Hobson et al. ( 2021 ) as an approach that they felt would be worth pursuing. This has yet to be directly explored in individuals with SLCN but could offer further direction for future research into interventions for this population.
Findings from the current research show that it is not typical for mental health clinicians to consider language and communication skills within their assessment and treatment processes. The potential impact of this omission was described by participants as limiting CYP with co‐occurring SLCN and mental health needs to therapies that would likely be inaccessible. The current study has found that traditional talking therapies may not be modified for this population, unless the CYP have an obvious or diagnosed SLCN. This has implications for the efficacy of treatments provided, highlighting that traditional talking therapies, if not appropriately modified, are likely to be suboptimal for this cohort. Participants felt that traditional talking therapies could be reasonably adjusted to be accessible to individuals with SLCN. In a recent intervention study where aphasic adult patients received SFBT, Northcott et al. ( 2015 ) concluded that modifying question forms of therapy enabled greater accessibility.
Clinicians identified that CYP with SLCN and mental health difficulties most commonly experience difficulties across and between the domains of language and cognition, emotional well‐being and challenging behaviour. Fundamentally, participants considered that it is typical for CYP to present with co‐occurring SLCN and mental health difficulties, that is, difficulties across speech, language and communication and mental health. Previous research reports that children and adolescents with DLD and ASD are likely to experience difficulties with anxiety and depression (Cohen et al., 2013 ; Hofvander et al., 2009 ; Wadman et al., 2011 ). Results from the current study reflect this, indicating that difficulties with language and social communication are likely to interact with mental health difficulties. In addition, participants felt that SLCN can profoundly affect a person's social and emotional well‐being, and this can lead to poor mental health.
Participants described how CYP typically experiencing difficulties with higher level language are likely to find understanding and expressing emotions challenging. This supports existing frameworks such as the alexithymia language hypothesis (Hobson et al., 2020 ) which proposes that because of the intrinsic relationship between language and emotions, CYP with conditions such as ASD and DLD may be more likely to experience co‐occurring difficulties with mental health.
A limitation of the current study was that some of the participants were recruited from the researcher's professional network. Thus, a convenience sample was used and therefore potential selection bias may have been present, resulting in a failure to capture important perspectives from hard‐to‐reach participants. However, it is important to note that the range of participant specialities, knowledge and skill set was heterogenous and diverse.
Clear directions for future research have been identified from the results of the current study. The service organization, set‐up and service provision for this population is problematic. Future studies could explore and evaluate current services, set‐up and structure across and between SLT and mental health. The findings from the current study have important implications for the efficacy of treatments provided to this population, suggesting that more research needs to be done in this area. There exists a large gap in the evidence base for intervention‐based studies with this population. Larger scale intervention studies could also provide evidence for the efficacy of psychological approaches with this population. Future studies could also explore the adaptability of traditional talking therapies, combining approaches drawn from SLT and psychological therapies and the exploration of play therapy. Intervention studies analysing the efficacy of psychological therapies in children and adolescents with SLCN should arguably be conducted in part with SLT to provide input regarding SLCN. Modifications to talking therapies in young people with SLCN are therefore necessary in order to reflect and treat the presence of SLCN and mental health difficulties. Research from Solution Focused Brief Therapy (SFBT) in Poststroke Aphasia SOFIA trial (Northcott et al., 2021 ) suggests that modifications to SFBT is a promising psychotherapy approach for adults with aphasia, and that it is possible to adapt a language‐based psychological intervention for people with language disorders. In addition, behavioural activation therapy has also been shown to be successfully modifiable for adults with aphasia (Thomas et al., 2013 ) but further evidence, especially in a paediatric population, is scarce.
The current study aimed to describe typical presentations of this population, clinician experiences treating this population and clinically useful treatment approaches. The findings present a picture of the problems CYP with SLCN and mental health needs commonly experience and has enabled the documentation of a range of clinician experiences and views to inform and build a limited evidence base. Findings suggest that there are distinct organizational and service set‐up limitations with implications for the assessment and treatment of CYP with SLCN and mental health difficulties. Interventions drawing upon SLT, and mental health approaches may be beneficial for this population.
Supporting Information
Annabel Hancock thanks The Owl Therapy Centre for their invaluable support and for making this project a reality. She also thanks her supervisors and The NIHR for funding this project as part of the Predoctoral Clinical Academic Fellowship. She is also grateful to the participants who took part in this project, without which this research would not have been possible.
Hancock, A. , Northcott, S. , Hobson, H. , & Clarke, M. (2023) Speech, language and communication needs and mental health: the experiences of speech and language therapists and mental health professionals . International Journal of Language & Communication Disorders , 58 , 52–66. 10.1111/1460-6984.12767 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
The NIHR funded this project as part of Annabel Hancock's Predoctoral Clinical Academic Fellowship.
Volume 55, 2004, review article, speech perception.
This chapter focuses on one of the first steps in comprehending spoken language: How do listeners extract the most fundamental linguistic elements—consonants and vowels, or the distinctive features which compose them—from the acoustic signal? We begin by describing three major theoretical perspectives on the perception of speech. Then we review several lines of research that are relevant to distinguishing these perspectives. The research topics surveyed include categorical perception, phonetic context effects, learning of speech and related nonspeech categories, and the relation between speech perception and production. Finally, we describe challenges facing each of the major theoretical perspectives on speech perception.
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Most cited most cited rss feed, job burnout, executive functions, social cognitive theory: an agentic perspective, on happiness and human potentials: a review of research on hedonic and eudaimonic well-being, sources of method bias in social science research and recommendations on how to control it, mediation analysis, missing data analysis: making it work in the real world, grounded cognition, personality structure: emergence of the five-factor model, motivational beliefs, values, and goals.
Publication Date: 04 Feb 2004
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Speech-language pathology is a growing field in which professionals work with children and adults who have communication and swallowing disorders. Speech-language pathologists (SLPs) work in educational, health care, academic and private practice settings. Across these settings, SLPs can:
An undergraduate psychology degree and its focus on understanding and evaluating human behavior in combination with foundational courses in speech, language and hearing sciences provides excellent preparation for future work in the field of speech-language pathology. This dual-degree program provides students with the opportunity to combine the undergraduate Psychology program with automatic admission to the M.S. in Speech-Language pathology program at SHU after meeting specific undergraduate criteria.
"An undergraduate psychology degree from Seton Hall was the perfect choice on my way to becoming a speech-language therapist. Through my courses, I gained insight into the various behaviors, learning difficulties and mindsets that a person could have. This allowed me to then treat each person for more than their disorder. The combination of rigorous course work and a dynamic faculty helped mold me into a well-rounded and versatile therapist." Megan (Mills) Pagano, ’10
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Developing & Writing a Speech. This guide was created to take you along a step by step process to develop a speech. It is mainly focused on helping you brainstorm, identify, and define a topic to research. This is a general guide, so it may vary from your classroom assignments. As always, refer to your professor and syllabus for your project ...
One of the best ways to learn about psychology is to listen to some of the world's greatest experts talk about their research. In this selection of TED Talks about psychology, the popular video lecture series designed to educate and inspire, we highlight just a few of the best psychology talks on subjects ranging from the nature of evil to the secrets of happiness.
Excessive talking can be caused by the following mental health conditions: Bipolar disorder: People with bipolar disorder may talk excessively with pressured (rapid and urgent) speech when their brain is in a manic state. Schizophrenia: Schizophrenia is a psychiatric disorder that affects the brain and often influences how someone talks ...
In psychology, some of the big questions about language have to do with language acquisition (both as babies and as adults); the brain bases of speech and language; and communication and language disorders, such as aphasia and dyslexia. Language is a huge topic, but we'll hit some of the highlights here. Demonstration
Part 1: Change your speech, change your mindset. It's so simple.
The current project formed part of the lead researcher's pre‐doctoral clinical fellowship funded by The National Institute of Health Research. The co‐authors are senior researchers with experience in the fields of speech and language therapy and psychology with research in aphasia and solution‐focused brief therapy, alexithymia and SLCN.
Contamination: fusing ideas into one another. Accelerated thinking: rapid flow and increased volume of speech. Flight of ideas: losing track of where a thought is going. Inhibited thinking: slow ...
Speech Perception. Randy L. Diehl 1, Andrew J. Lotto 2, and Lori L. Holt 3. View Affiliations. Department of Psychology and Center for Perceptual Systems, University of Texas, Austin, Texas 78712-0187; email: Boys Town National Research Hospital, Omaha, Nebraska 68131; email: Department of Psychology and Center for the Neural Basis of Cognition ...
Inner speech—also known as covert speech or verbal thinking—has been implicated in theories of cognitive development, speech monitoring, executive function, and psychopathology. Despite a growing body of knowledge on its phenomenology, development, and function, approaches to the scientific study of inner speech have remained diffuse and largely unintegrated. This review examines prominent ...
The intricate interplay between speech therapy and psychology has long been recognized as a dynamic approach to improving communication skills and overall well-being. Speech therapy, traditionally associated with enhancing speech and language capabilities, goes beyond the realm of mere linguistics.
Speech-language pathology (a.k.a. speech and language pathology or logopedics) is a healthcare and academic discipline concerning the evaluation, treatment, and prevention of communication disorders, ... New York: Psychology Press / Taylor Francis Group.
Speech disorders affect a person's ability to produce sounds that create words, and they can make verbal communication more difficult. Types of speech disorder include stuttering, apraxia, and ...
processing speed. memory recall. attention. association. If you're unable to retrieve the memory of a word, for example, it might manifest as long pauses in your speech pattern. Or, you might ...
B.S./M.S. or B.A./M.S. Psychology/Speech-Language Pathology. Speech-language pathology is a growing field in which professionals work with children and adults who have communication and swallowing disorders. Speech-language pathologists (SLPs) work in educational, health care, academic and private practice settings.