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exploratory research

Symbolic voices
Louise Greenstocks previous experience as a teaching assistant brings a very practical focus to her research into how graphic symbols are used in schools and her associated observations on collaborative working.

READ THIS IF YOU ARE INTERESTED IN GRAPHIC SYMBOLS WORKING COLLABORATIVELY THE PERSPECTIVE OF SUPPORT STAFF

ow can we understand the ways symbols are used in schools without any research documenting this? And how can we learn from good practice in the use of symbols when practitioners experiences are not shared? I am halfway through my PhD research journey, where I have the exciting opportunity of investigating the use of graphic symbols in schools in a small geographical region. My previous experience in particular working in schools has influenced the focus and conduct of my research. I hope by reflecting on this and on my early findings to encourage more effective use of graphic symbols and greater collaboration between speech and language therapists and education practitioners. As a psychology graduate, one of my first jobs was working as a teaching assistant in a mainstream inner-city Infant and Nursery School. I worked in the same foundation stage setting for three to five year olds for two years. My role was class-based, supporting the teacher and all the children in that class. While working in school, I used Makaton manual signs and graphic symbols. (Please note I will use the term symbols to refer to all graphic symbols.) In this school, signs and symbols were used to label the environment and resources, help children learn signs for songs and rhymes, symbolise displays and text, and encourage children to sign greetings and requests. The school also promoted the use of symbol-supported visual timetables. Children were expected to plan their day and select the activities they intended to do during the session by placing symbolised cards representing activities on planning boards. As a teaching assistant I used Makaton signs and symbols in these ways because this was what I was instructed to do. When I look back, I am surprised I didnt ask more questions and even request some training, but I didnt. At no point was training offered to me. Although there seemed to be an implied school policy about the signs and symbols used and how these were presented, this was never explained to me. At the time I was unaware of alternative representational systems or the reasoning and rationale behind selecting from the various sets. I was oblivious to the arguments for and against using one symbol set consistently. In this particular school strict adherence to the preferred symbol set was

enforced. Software was used to retrieve new symbols when they were needed. There was no clear definition of whose role it was to plan and prepare for the use of symbols. While the use of symbols in schools with children in the Foundation Stage later became the primary focus of my research, one of my secondary research questions is concerned with the related collaborative working that occurs when practitioners use symbols in schools. As a teaching assistant, I was aware of a number of practitioners from outside agencies such as speech and language therapy and educational psychology coming in to observe and work with individual children and small groups. It was frequently the case that practitioners would arrive in the unit without introduction or warning from anyone. This made collaborative working between myself and the practitioner concerned very problematic. Opportunity for discussion with them was non-existent and I was not informed of their objectives. I was unable to learn about symbols from the speech and language therapist who visited the school.

Curious

I felt a considerable amount of empathy for the practitioners coming in from external agencies because they were not introduced to school staff, nor given the opportunity to share their professional opinion about how best to support the children. Their expertise was not utilised to full effect. I had no understanding of the experiences of speech and language therapists working in schools and began to be curious about this. After two years of working as a teaching assistant, I found a faculty funded PhD opportunity addressing symbol use in schools. I was overjoyed to be offered the studentship by my two experienced supervisors. I spent the first six months exploring what I saw as the research areas surrounding symbol use: augmentative and alternative communication (AAC), symbolic and cognitive development, collaborative working, inclusion, speech, language and communication difficulties, and early years education. I found only one example of a piece of research conducted in the last five years in which the use of symbols in schools was explored (Abbott & Lucey, 2005). I realised that this was an under-researched area in

need of a well-designed piece of exploratory research. I felt that the best way to explore the current situation was to approach and interview practitioners in schools and to attempt to empower them by incorporating their experiences into the findings. I was influenced by Schratz (1993) who argued that the voices of practitioners in the field are not utilised enough in research. I knew from my own experience that there was a gap between research and practice for practitioners in schools and that research literature was often inaccessible. As a researcher I want to bridge this gap by generating accessible findings and disseminating these where possible. Having explored the research areas and identified a gap, I went on to define my research questions and outline my objectives. From an understanding of the literature and building on my own experiences, I felt these needed to address a number of aspects of symbol use: Who uses symbols in schools and in what ways? What experiences have these practitioners had of using symbols? What guides them in their use of symbols? How do they decide which children might benefit from symbols? Is their use of symbols planned? Do they liaise with other practitioners about the use of symbols? During my investigation of the literature relating to symbols, I encountered several areas of difficult terminology, for example, symbols / signs / pictures, and interprofessional / multi-professional / collaborative / inter-agency working. I began to recognise the challenges faced by practitioners in schools with so little consistency in the terms used.

Function

Graphic symbols are often defined as a graphical representation of a referent (Greenstock, 2007). The referent is the concept that is being represented. Although there is some debate about which referents can and cannot be effectively represented by a graphic symbol, most symbol sets range from concrete to abstract

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SPEECH & LANGUAGE THERAPY IN PRACTICE summer 2009

exploratory research

referents and transparent to opaque symbols. Most recognised symbol sets have a communicative function although symbol use is developing and spreading to other inter-related areas of learning and participation, including visual timetables, English as an additional language support and literacy. The majority of the existing literature around the use of symbols is in the field of AAC. It discusses their use in high and low tech systems. Symbols are a well-recognised way of supporting people with communication difficulties related to physical disabilities, learning difficulties and developmental disorders. Symbols are also recommended by the National Autistic Society as a way of making information clearer for people with autism spectrum disorder. Symbol-supported software (see figure 1 for examples) is developing fast.
Figure 1 Symbol software examples

Software Supplier Communicate: in Print Widgit Software Communicate: SymWriter Boardmaker Mayer Johnson Clicker 5 Crick Software The Grid 2 Sensory Software International Ltd When AAC systems are used in schools, this obviously requires the involvement of teachers and a range of support staff as well as speech and language therapists. There is guidance for practitioners working with AAC users on how to select communication aids and the symbols to go with them (Clarke et al., 2001; McCurtin & Murray, 2000; Millikin, 1997; von Tetzchner & Martinsen, 1992). Literature about use of symbols other than for AAC is rarer. In the context of existing knowledge about symbol use, I decided to explore the experiences and attitudes of a range of practitioners about the use of symbols in schools (mainstream and special) with children in the Foundation Stage. As I had an interest in the ways these practitioners worked collaboratively when they used symbols, I decided to interview three groups who work together: teachers, speech and language therapists and early years practitioners. I felt the term early years practitioner (Letts & Hall, 2003) would encompass the diversity of job titles for support staff in school settings.

My preparatory work demonstrated that very little is known about how symbols are being used in schools. For this reason I designed a piece of exploratory research, hoping to increase understanding of symbol use in its current condition. Due to my location, I selected a sample from a region within the East Midlands. After a rigorous and lengthy process of scrutiny for ethical approval from the University and the NHS, I recruited a sample of practitioners who worked in schools and had experience of using symbols. I conducted semi-structured interviews individually with 15 teachers, 22 early years practitioners (teaching assistants, nursery nurses), and 16 speech and language therapists. I transcribed and coded these interviews one by one individually. I used QSR NVivo2 qualitative data management software during the initial coding, and built models and frameworks representing the themes on which my theoretical outcomes are based. The analysis gradually moved to conceptual linking, during which I looked for relationships between the transcripts. I then began to gather evidence for the themes that were emerging. Although the analysis is not complete and any early findings will not necessarily represent the final themes resulting from the full analysis, there is already a considerable amount of interesting data to refer to: 1. Purpose Symbols are being used for a wide range of purposes. I have ordered these loosely from the most frequently mentioned: Visual timetables Supporting children with speech and language needs Focused work with specific children (including those with special educational needs, autism and English as an additional language) Helping children understand rules, choices and following instructions Labelling the environment and resources PECS (Picture Exchange Communication System) and developing exchange routines Supporting children with social, emotional and behavioural needs Literacy activities and creative work As part of various games. 2. Consistency Interviewees in all of the professional groups expressed opinions about the importance of

PCS (Picture Communication Symbols) used for illustrative purposes by kind permission of Mayer Johnson Inc (www.mayerjohnson.com). Clockwise: communication, team, listening, talk, teacher, speech therapy.

consistency in symbol use, some suggesting this was important and referring to consistent symbol use within the school. 3. Progression Interviewees in all of the professional groups expressed ideas about progression in the use of symbols, referring to childrens understanding of symbols and appropriate use of symbolic items, objects, photos and symbols. 4. Needs Interviewees in all of the professional groups expressed reasons for and against using symbols and often spoke about their decision to use them in isolation or with other resources, depending on the needs of the child(ren). 5. Training Many interviewees had not had any specific formal symbol training and many said they would like some. Those who had had training said it was brief. 6. Collaboration Some interviewees from all of the professional groups had experienced working collaboratively with other professionals when they had used symbols. Time was often given as a factor supporting or challenging this. 7. Relationships Working relationships between teachers, early years practitioners and speech and language therapists were largely positive 8. Recognition Teachers and early years practitioners supported the view that speech and language therapists have knowledge about symbols and bring this knowledge into school. Again, sufficient time is needed to maximise this.

Good practice

There were some encouraging accounts of good practice in the use of symbols and related collaborative working. Many interviewees were able to discuss their rationale for using or not using symbols with confidence. Many had an understanding of developmental progression objects,

SPEECH & LANGUAGE THERAPY IN PRACTICE summer 2009

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exploratory research

resources
The National Deaf Childrens Society freephone helpline now has extended hours: Monday 9.30-19.30, TuesdayThursday 9.30-17.00, Friday-Saturday 9.3012.00. Calls can be translated into over 100 languages. 0808 800 8880; www.ndcs.org.uk Crick Software has added SoundsLike technology to its WriteOnline software, so that students with very poor spelling can benefit from word prediction. www.cricksoft.com/uk/products/ WriteOnline/ For details of the Bristol Speech & Language Therapy Research Units latest projects, see www.speech-therapy.org.uk The Challenging Behaviour Foundation has produced an information sheet on Difficult sexual behaviour amongst men and boys with learning disabilities. www.thecbf.org.uk/chall-behaviour/more/ Difficultsexualbehaviour.htm ITV is making childrens stories available in British Sign Language and in text, pictures and sound, with the aim of improving the literacy of deaf children. www.signedstories.com/page/index.cfm Jeremy Fisher of Vocal Process has now produced a film to help you Build Your Own Tilting Larynx. A free template is available. www.youtube.com/watch?v=H1UEzPc3I2g The Novelty Warehouse sells sensory toys for children with special needs. www.thenoveltywarehouse.com Speakability has produced a Communication Board to assist people with severe aphasia and a Medical Passport to enable a person with aphasia to discuss their needs with their doctor on an equal basis. The charity also sells the ICOON wordless picture dictionary. www.speakability.org.uk A new guide from the Foundation for People with Learning Disabilities details how person centred planning and selfdirected support can be used by young people with autism and their carers when making the transition from school or college to adult life. We Can Dream, free from www. learningdisabilities.org.uk The Work Wise UK initiative supports organisations to adopt smarter working practices such as flexible working / condensed hours / mobile and remote working. www.workwiseuk.org

photos, symbols, words and ideas about the appropriateness of symbols for certain age groups and developmental levels. Some interviewees were also looking for evidence that children were benefiting from symbols, for example, the children knew what they should be doing, or developed symbolexchange skills. Many participants referred to effective collaborative working. There were some clear consistencies between the working conditions given in their examples: Good communication and support Team working Time to talk Sharing information two way feedback Speech and language therapists in school regularly Same speech and language therapist each visit Speech and language therapists available to give guidance Educational practitioners feeling able to ask speech and language therapists questions Speech and language therapists feeling respected and welcomed into schools Speech and language therapists given the opportunity to share knowledge about symbols with staff teams many therapists were involved in delivering training and this was frequently in schools. During the analysis several contradictions and debates emerged which I shall explore further in the full analysis: a) Should symbols be used with all children? b) Are children in the Foundation Stage too young for symbols? c) Should terminology be more consistent (symbols, signs, pictures)? There is currently very little documentation of how symbols are being used in schools. This means that it is difficult to learn from each other and develop good practice. It also means that resources, ideas and suggestions are not

being shared as much as they could be. My research to date suggests that symbols are widely used for various purposes. Some practitioners are using symbols without training and there are issues around their consistent use, even within the same school. There is confusion over terminology and lack of time causes a strain on all services. On the positive side, we can learn from examples of good collaborative practice. Speech and language therapists would like to spend more time in school and education practitioners would like to see them more. From my research, I have developed the strong impression that practitioners working in schools would like to know more about how others are using symbols and would welcome the opportunity to share ideas. There is a reasonable amount of information about symbols available on the web, in research literature, text books, and from the symbol developers themselves. Practitioners need to be signposted to this information and given the opportunity to browse and explore these sources themselves. I believe in empowering practitioners by documenting their experiences and enabling their professional development by sharing information as widely as possible. The ultimate goal is more informed and evidence-based use of symbols in schools and better access to symbols for children. Louise Greenstock is a PhD research student at De Montfort University, e-mail lgreenstock@dmu. ac.uk. Louise will be happy to share her final research findings when they are available. SLTP

Abbott, C. & Lucey, H. (2005) Symbol communiDo you wish to comment on the impact cation in special schools in England: the current this article has had on you? Please see the position and some key issues, British Journal of information about Speech & Language Special Education, 32 (4), pp.196-201. Therapy in Practices Critical Friends at Clarke, M., Price, K. & Jolleff, N. (2001) Augmentawww.speechmag.com/About/Friends. tive and alternative communication, in Kersner, M. & Wright, J. (eds.) Speech and Language Therapy: the decision making process when working with children. London: David Fulton, pp. 268-282. Greenstock, L. (2007) MPhil to PhD Transfer Report. Unpublished. Leicester: De Montfort University. Letts, C. & Hall, E. (2003) Exploring early years professionals knowledge about speech and language and development and impairment, Child Language Teaching and Therapy, 19, pp.211-229. McCurtin, A. & Murray, G. (2000) The manual of AAC assessment. Bicester: Winslow Press Ltd. Millikin, C. (1997) Symbols systems and vocabulary selection strategies, in Glennen, S. & DeCoste, D. (eds.) The Handbook of AAC. San Diego: Singular Publishing Group Inc., p.97. Schratz, M. (ed.) (1993) Qualitative voices in educational research. Buckingham: The Falmer Press. von Tetzchner, S. & Martinsen, H. (1992) Introduction to sign teaching and the use of communication aids. London: Whurr Publishers Ltd.

References

REFLECTIONS DO I SEEK TO INCLUDE SUPPORT STAFF IN TRAINING AND LIAISON SESSIONS? DO I ENCOURAGE OTHER PROFESSIONALS TO ASK ME ABOUT MY PRACTICE? DO I AUDIT CURRENT PRACTICE BEFORE INTRODUCING NEW DEVELOPMENTS?

Resources

Makaton see www.makaton.org/ National Autistic Society see www.nas.org.uk/ PECS see www.pecs.org.uk/

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