By Charlene N. Rivera-Bonet | Waisman Science Writer
At a Glance:
- Children with language delays are at greater risk for experiencing trauma and vice versa. That trauma can influence how much support a child may need during early language learning.
- Integrating trauma awareness into how caregivers are supported by speech-language pathologists (SLP), can help SLPs better equip caregivers to support their child’s language learning needs.
- Supportive caregivers and trauma-informed support systems can be a buffer against the long-term negative effects of trauma in children.
Learning language in early childhood occurs through interaction between children and their caregivers. It is a foundational process that allows children to participate in social interactions, learn from the world, and develop other essential skills such as literacy.
Having a language delay or disorder is associated with greater risk for experiencing trauma and vice versa. Furthermore, children’s and caregivers’ trauma histories can impact their individual strengths and needs related to participation in early language intervention.
Research from Waisman Center investigator Rebecca Alper, PhD, CCC-SLP, assistant professor of communication sciences and disorders at the University of Wisconsin-Madison, seeks to understand and improve language and academic outcomes for children who have or are at risk for language delays and disorders. Alper has developed a framework to integrate trauma awareness into caregiver-coaching interventions for early language support, which was recently published in the journal Language, Speech, and Hearing Services in Schools. The framework involves two factors that protect against the negative effects of trauma: trauma-informed care and caregiver support.
The framework is meant to help speech-language pathologists (SLP) and other clinicians incorporate trauma-informed care into their work, as they guide caregivers on supporting their children’s language development.
Caregivers support on language development
Strong early language skills develop as a result of repeated, supported interactions between children and their caregivers. Although children are resilient language learners, some children need extra support to maximize their language outcomes.
Caregiver interventions, where the caregiver supports the child in their language development, is the preferred model of early language intervention from birth to three given the constant presence of the caregiver in the child’s life and the existing relationship.
Speech- language pathologists (SLP), experts in communication who evaluate, diagnose, and treat communication disorders, in addition to providing care to children, can coach caregivers in having the most supportive interactions with their children as they can. To do that, Alper says, they need to learn how to meet the child where they are at, and adjust their level of support to match the child’s specific needs. “What we’re trying to do, usually in caregiver coaching, is to understand and support caregiver’s knowledge, behaviors, and awareness around language to maximize the child’s early language learning environment based on what they need,” Alper explains.
Caregiving coaching as an early intervention tool allows for the intervention to be family-centered, culturally responsive, and in a naturalistic context. Caregivers can also provide a more comprehensive review of the factors that have an influence on the child’s developmental environment, including trauma.
Considering trauma in language development
Language development can be a dynamic and multifaceted process, and trauma has the potential to affect this process in different ways. Its repercussions can impact the child’s learning opportunities and environment directly, and it has the ability to change brain function in a way that impacts learning abilities. Additionally, difficulty with communications can increase a child’s risk of experiencing trauma, and decrease their ability to discuss it with others.
Children with disabilities, including those with communication disorders, are more likely to experience traumatic events such as abuse or neglect compared to their typically-developing peers.
Supportive caregivers and trauma-informed support systems can be a buffer against the long-term negative effects of trauma in children. Trauma-informed models of care recognize the impact of trauma in children’s lives, and provide trauma-sensitive and responsive services to foster patient safety.
Holistic intervention
Alper’s manuscript seeks to inform SLPs on how to incorporate trauma-informed care into their assessments and interventions, as they coach caregivers on early language interventions. “The idea is that there are existing early language interventions and there are existing principles of trauma informed practice, but those have not been integrated,” Alper explains. “What does it actually look like as a clinician to practice trauma-informed care while you are teaching someone how to respond to their child’s language needs?”
The role of a SLP is to come up with an intervention plan that considers the strengths and barriers of both the child and their caregivers, including trauma and its impacts. “Coming in to do caregiver coaching, while we as speech-language pathologists are not mental health providers, we do have to think about the whole picture, like what is going on with the family for food security and housing security and mental health and social supports and all of these things,” Alper says. “Because their capacity to implement what we’re asking them to do, or even just their ability to focus on that, if so many other things are challenging, is going to be impacted by all those external factors.”
Alper’s new article supports SLPs in doing that. It takes existing interventions that focus on trauma-informed practice and considers the many dynamic factors influencing child language development, and supplements them with other frameworks that identify the risk and protective factors that impact lifelong developmental outcomes.
This combination may guide clinicians to consider the caregiver, child, and family needs in the context of their environments, and support families through individualized services. “We integrated across all of those [interventions] to try to give clinicians some concrete strategies to use in direct clinical service provision, and then also in their interactions with other supports,” Alper says.
This article and tutorial was supported by the National Institute on Deafness and Other Communication Disorders Grant K23DC017763.