Q & A with Kim Griffin, OT.

Kim Griffin, occupational therapist, has written 2 articles for The Link magazine. In issue 14 Kim describes how she uses her OT sessions as an opportunity to enhance children’s language development ‘Exploring Language with Your Senses’.

We caught up with Kim and asked her some questions our readers have sent in:

Your article describes how you use the senses in your OT sessions to enhance children's language development and understanding. How likely are children, with a sensory processing disorder, to have speech and language difficulties also, in your experience?

I find there is a lot of cross-over with sensory processing and speech and language. I think that this is in part because most children with autism have sensory challenges and autism is a social communication disorder. There is still debate as to whether sensory processing disorder is a stand-alone diagnosis and it is currently not formally recognised in any of the diagnostic manuals. It is used to describe a set of sensory challenges but there is not enough research to identify it as a disorder in its own right. There is however evidence that children with Down's Syndrome, Fragile X, ADHD have sensory challenges and it is also common for these children to have speech and language difficulties.  

How did using senses to support speech, language and communication needs (SLCN) in your OT sessions come about - did this evolve during sessions as you realised that some children weren't fully understanding what you were asking them to do?

I think I was just really fortunate as a student to have a placement with an excellent multi-disciplinary team. We frequently did joint groups with the speech therapists and I understood from very early on in my career how intrinsically linked the two things were. Sometimes the OTs did regulation work with children before they went into speech therapy, and, in groups, we would use the senses and play to help support language. It was a symbiotic partnership that has stuck with me throughout my career.  

Did you know the children you were working with had SLCN already?

Yes, as Sensory Group came about when working with children who already had identified SLCN on their EHCPs.

Did an SaLT ask you to try and work on this alongside physical therapy?

Again, I've been really fortunate with the SaLTs I have worked with. We have usually been able to match our goals. For example, if they need help to support the child's attention, I will give regulation ideas. I have always found that physical movement and play help with children's understanding of physical space and prepositions. There is also some evidence in some cases that activating the vestibular system (movement) can really help with vocalisations and I have definitely seen this clinically.  

Is there a correlation do you think between SPD (sensory processing disorder) and SLCN? Do you believe that the way the brain does not interpret sensory messages they receive from their body effectively might be linked to the way the brain has difficulties understanding and using language in a child with SLCN?

Now that one I am not sure on the research. My own clinical experience would say yes there is a link, whether it is a correlation or not I don't know. The thinking neurologically is that children who experience sensory processing challenges don't filter and direct the messages efficiently in some parts the of what is called the lymbic system. These parts of the brain are responsible for directing and coordinating the inputs (sensory information including hearing) and the outputs (movement and speech). If a child has interpreted the information they receive incorrectly, then their output will likely be incorrect. If they find it difficult to process multiple sensory inputs their brains could be quickly overloaded. This leaves less capacity to then think about organising speech and language. Often the child's processing is slower. An added challenge is that people will often then repeat the question, giving the child more information to process, slowing them down further! 

The 'Extremes of Senses' section in your article was extremely interesting. Using their senses to establish what 'too hard' or 'too loud' is, really highlights to the child how their actions are perceived by others. Do you have any more ideas that schools could use when trying to teach their children to adjust their behaviour?

I genuinely think it is about teaching the extremes rather than expecting children to 'know’. If a child is using too much force it is often because to them it feels 'normal.' Or they need that extra input to understand the sense. So, letting them feel the extremes first gives them a clearer reference point. If you can then put some labels onto the reference points (e.g. numbers or size words) I find it's an easier way to help the child modify their behaviour. Also, I would highly recommend using positively phrased language to help a child change their behaviour. So if a child is being too loud instead of saying ’Stop Shouting!' or 'You're so loud!' link it to the reference points you have used. It might be that you as them to use a 'Level 2' voice or to use their 'inside' voice. However, there needs to be physical practice around what each of these mean rather than an expectation that the child will know. Visual prompts can also be helpful. I know some teachers use a speedometer-type scale and others have a hand sign which can help to reinforce the idea and be an easy way to give the prompt.  

Read Kim’s article in The Link magazine here.