Clinical Psychologist

The need for a psychologist in a special school is imperative. It is the psychologist who bridges the gap between the teacher-student and parent-student most of the time. The psychologist chalks out a plan for the student and executes its plan through counseling or behavior modification or sometimes a combination of both. The sessions held are meticulously planned and executed depending on the IQ as well as SQ levels.

During individual sessions, the most important element is rapport building as it helps in free expression through the session, thus carving a niche for a comfort zone. In group sessions held, an introduction of each student is undertaken so as to help in free expression as were as build self – confidence. Each student’s perceptual; and cognitive abilities vary and so the psychologist minutely notes down its observations. The psychologist also observes the students both, in the classroom and outside to check the confounding variables present and accordingly implement the technique.

Presently, there are two psychologists, whose main objective is to help and guide the students. Duration of each session is 30 minutes but varies depending on the attention span of the student.

What is the difference between educational and clinical psychologists?

One of the differences is the settings we work in. Educational psychologists are based within the educational system and work in schools. So where a child is presenting an emotional or behavioural difficulty within a school setting, the school will consult with their educational psychologist about what might be happening. Clinical psychologists are based within the NHS. We work in clinics, similar to where GPs work.

Clinical psychologists are interested in difficulties that children present that appear to be related to their life in general rather than specifically at school. So if a problem existed outside of school, or there was a strong feeling that the difficulties they were having were related to more global issues, then that would be where a clinical psychologist could help.

What can a clinical psychologist do to help a child?  

The starting point would always be a thorough assessment, which would include meeting the child and talking with them, depending on how old they are or where their verbal skills are at.

We would also want to talk to the people around the child who know them well - usually parents or carers - and we would contact schools to hear about how the child is doing there. It's all about helping us build up a picture of that child, what the difficulties are and where and how they present themselves.

Once we have a good understanding of what we think is going on, we can begin to think about the kind of treatment that needs to happen. This could be either:

Individually with the child – the clinical psychologist meeting on a one-to-one basis with the child, doing some therapy with drawing, playing or talking.

Involving other people – maybe sessions with families together or involving other people as well in doing what we call systemic (group) sessions looking at the whole system.

Based on what the assessment tells us we think about what interventions we might offer.

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COMMON QUESTIONS

WHAT DIFFICULTIES ARE TYPICALLY REFERRED TO SPEECH LANGUAGE PATHOLOGISTS (SLPS)?

1. Articulation
2. Auditory processing
3. Following directions
4. Word finding
5. Vocabulary and Speech grammar / syntax
6. Asking and answering “wh-” questions (i.e. who, what, where, when, why, how)
7. Listening and reading comprehension
8. Sequencing and Narratives
9. Fluency (i.e. stuttering / stammering)
10. Voice (e.g. hoarse, nasal)
11. Pragmatic skills (i.e. the use of language in social contexts including conversational skills, and the use of body language)
12. Feeding and swallowing

These difficulties could be due to:

1. Developmental conditions such as Downs Syndrome, Autism, Cerebral Palsy
2. Neurological conditions such  as Multiple Sclerosis, Parkinson’s Disease, Alzeimher’s Disease
3. Brain Trauma such as stroke, traumatic brain injury
4. Medical conditions such oro-pharyngal cancer, cleft lip & palate, pre-term birth

WHAT DO OCCUPATIONAL THERAPISTS WORK ON?

Occupational therapists evaluate kids' skills for playing, school performance, and daily activities and compare them with what is developmentally appropriate for that age group. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life.

Occupational Therapists work on:

1. Sensory Processing Disorder (more below)
2. Behavior: Teaching children positive ways to redirect their actions instead of acting out
3. Attention: To improve focus and concentration
4. Fine motor skills: To improve grasp and release of toys, gripping a pencil, cutting, sticking etc.
5. Hand-eye coordination: To improve play and academic skills such as hitting a target, batting a ball, copying from a blackboard, etc.
6. Activities of Daily Living (ADL): Bathing, getting dressed, brushing teeth, self feeding
7. Sensory Processing Disorder (SPD, formerly known as "sensory integration dysfunction") is a condition that exists when sensory signals don't get organized into appropriate responses.

WHAT KIND OF CLIENTS DO YOU WORK WITH?

We work with adults and children, many of whom are individuals with:

1. Autism
2. Attention Deficit Hyperactivity Disorder
3. Childhood Apraxia of Speech
4. Down Syndrome
5. Craniofacial anomalies
6. Cerebral Palsy
7. Aphasia (i.e. neurologically acquired language disorder)
8. Dysphagia (i.e. swallowing difficulties)

WHAT IS THE DIFFERENCE BETWEEN SPEECH AND LANGUAGE?

Language refers to one’s understanding and expression of ideas including: the form (i.e. word structure and order), content (i.e. meaning), and use (i.e. functional and social application).

Speech refers to the verbal means of communication including: articulation (i.e. the way in which sounds are produced), voice, and fluency (i.e. the flow of speech). A child can have trouble with speech skills, language skills, or a combination of both.

HOW EARLY SHOULD I BEGIN SPEECH THERAPY?

This depends on the communication milestones that are expected at every age. We can begin working with children as early as 12 months of age for communication skills. However in the case of feeding/swallowing issues, we provide intervention as early as a few weeks to a month of birth.

HOW MANY SESSIONS ARE REQUIRED PER WEEK?

Greater frequency of sessions leads to more effective progress. However the frequency of sessions also depends on the type and severity of the communication or feeding disorder and the age and attention span of the child. Children can attend therapy from 1-5 times per week.

In most instances however 1-2 times per week is an appropriate frequency to make optimal progress toward meeting set goals and objectives.

WHAT CAN I DO AT HOME?

Parents are encouraged to watch and participate in every speech session especially for younger children so that a language learning environment can be created at home. For older children and adults, parents or care givers are encouraged to discuss treatment plans and progress at the end of the session. Home practice worksheets and ideas are provided by the therapist.

DO AAC DEVICES IMPEDE SPEECH DEVELOPMENT?

Contrary to popular belief, recent research has shown that the use of AAC programs does not inhibit communication, but rather facilitates it. Augmentative and Alternative Communication (AAC) is a method of communication that does not involve direct speech from a person. It involves the use of gestures, facial expressions, sign language, writing, and/or electronic devices to communicate. AAC is used when speech is not developing typically, or is not likely to develop typically due to a pre-existing condition. Even when it is unclear whether or not a child will eventually develop typical speech, as is frequently the case, the child may still benefit from an AAC program.

There are several advantages of using an AAC program. It enhances a child's cognitive, social and academic abilities by increasing his/her communication skills. It also teaches functional communication; this is particularly beneficial to a child with severe disabilities who is unable to learn the early cognitive and social skills on which conventional communication is based. By providing the child with a socially acceptable way of communicating his/her needs and desires, an AAC program reduces frustrations and problem behaviors in a child, which may otherwise arise due to the inability to communicate.