Public health nurses and language assessment in children at 2 and 4 year consultations.

The need to explore, experiment, absorb and learn, along with the pleasure of interacting with others, forms the basis for a normal language development. When mother, father and other caregivers puts words on what happens in different interaction situations, the child gets the best prerequisites for acquiring a large vocabulary and a good language (Sosial- og Helsedirektoratet 2006).


In the general health screenings at the child health centers in Norway, systematic observation of communication, language understanding and spoken language is recommended. The parents' assessment of the child's language is also essential. The public health nurse will refer the child to further language examination if there is suspicion of delayed language development or language difficulties. The Department of Special Needs Education at the University of Oslo, has prepared mapping materials for use at the health center's 2 and 4 year consultation. SATS and LANGUAGE 4 is used by the public health nurses for more systematic observation of children's language.

A normal language development at two years is characterized by a good language understanding. Regarding the spoken language, the normal variation is much greater.


SATS (Screening of Two-year-olds Language) focuses primarily on the child's language understanding, and consists of ten known objects from the child's everyday life (teddy bear, sock, bed, etc.), charting form, parental form and a guide. In the observation, the children are asked to play with the objects in different ways. In addition, interaction with the parents and environment are to be considered. If the child at the two-year consultation shows signs of linguistic delay, poor understanding or inadequate interaction with the environment, the child should be admitted to a new observation after a couple of months. The same applies if the parents express concern about the child's language development. In case of suspected linguistic abnormalities between the ages of 2.6 and 3 years, the child should be referred to further examination.


LANGUAGE 4 is a systematic observation that reveals significant features of four-year-old's language skills. LANGUAGE 4 consists of a simple picture folder, a tutorial and a mapping chart to be followed according to fixed procedures at the health center.


One of the most basic needs of a person's life is understanding and being understood. A delay in early language development may affect the child socially, emotionally and intellectually. It can also be a symptom of more complex difficulties, which can increase the risk of later reading and writing difficulties, learning disabilities and psychosocial difficulties.



Referanser
Sosial- og Helsedirektoratet (2006). Nasjonal faglige retningslinjer IS-1235. Retningslinjer for undersøkelse av syn, hørsel og språk hos barn.


Helsedirektoratet (2019). Nasjonal faglig retningslinje for det helsefremmende og forebyggende arbeidet i helsestasjon, skolehelsetjeneste og helsestasjon for ungdom. Tilgjengelig fra:https://helsedirektoratet.no/retningslinjer/helsestasjons-og-skolehelsetjenesten/seksjon?Tittel=helsestasjon-05-ar-3952. Nedlastet 13.03.19.

Written by Elisabeth H. Hansen

A weekend with stuttering in focus: Scott Yaruss visiting Oslo

Mid-March, the well-known professor Scott Yaruss travelled from Michigan to Oslo. The national organization for speech language pathologists (Norsk logopedlag, NLL) and the national stuttering interest group (Norsk interesseforening for stamming og løpsk tale, NIFS) collaborated on inviting Scott to two conferences that were held by the respective organizations that weekend. Also, the EST-team was very lucky to have a day discussing our project with him when he was here.

The topics Scott presented on the conferences was how to address bullying in children who stutter, treatment for school-aged children and treatment for all age groups. To sum up, it seemed that everyone, including parents of children who stutter, people who stutter “speechies” and the EST-group were amazed by Scott’s knowledge and dedication to enhancing treatment for people who stutter. He focused on making us SLPs more confident in how we assess and treat stuttering and how to address the challenges of living with a stigmatized difference. Through vivid story telling, examples, questions and exercises he enhanced the audience's understanding of the behavior and feelings that arises during the feeling of loosing control.

Scott emphasized that treatment success is much more than enhancing fluency and the importance of aiming to enhance acceptance of stuttering. One of the messages that I took home with me was that the gift of fluency has been wanted so badly by teachers, SLPs and parents that stuttering treatment has focused on teaching the children put much time, training and effort into using very difficult and unnatural techniques. Many children go through years of speech therapy focusing on learning to master techniques that they seldom use. SLPs should therefore not overpromise the effect of fluency techniques, but rather communicate that fluency techniques does not always work. Just as an umbrella in a heavy storm does not cover you from the rain, in some challenging situations fluency techniques will not work. Also, children have to learn that what they say is more important than how they say it. This does not mean that fluency techniques should not be included in stuttering treatment, but rather that stuttering treatment is much more than learning fluency techniques. One quote by Scott sums it all up: “treat the DISORDER, not just the BEHAVIOR”!

One of the EST-groups collaboration partner is the national interest group (NIFS). During the conference, they made a short video of Scott summarizing his presentation at the conference. If you want to look at this great video, click here: https://www.youtube.com/watch?v=_7ngc8uWu-w

Also, for all Norwegians, have a look at their web page and keep updated on all the activities they are arranging: http://stamming.no/

Inclusion criteria, design and assessment tools discussed over coffee and chocolate covered cherries from Michigan and Norwegian milk chocolate at the lovely Tøyen Hovedgård.

 
To Scott, thank you so much for your inspiration to do our very best as speech language pathologists working with people who stutter and researcher investigating stuttering treatment!