Page 39 - SEN113 SEN Magazine July-August 2021-V3

SLCN Using VERVE in schools Johanna Barclay explains VERVE video interaction therapy. About the author Johanna Barclay is a speech and language therapist, currently on a two year break from the NHS, working on the small island of St Helena in the South Atlantic. Speech, language and communication needs (SLCN) is the most common primary type of need for pupils on SEN support, at 23%. Johanna Barclay and colleagues evaluate the use of video interaction therapy to promote changes in children’s communicative participation. In 2015, Guy’s and St Thomas’ Community Speech and Language Therapy Service ran a pilot project offering ‘Video, Endorse, Respect, Vitalise, Eye’ (VERVE) contact (Cummins, 2015), with nursery practitioners using goal attainment scaling (GAS) as a measure of children’s progress. This project showed promising results and was well received by practitioners. In this article we present our 2016 follow up study. What is VERVE? VERVE is a form of video interaction therapy focusing on developing and integrating communication and learning abilities, with an emphasis on self-regulation and face watching. Parents or practitioners (usually teaching assistants) focus on their timing and skill in interaction, using moment-by-moment video analysis and reflection. Several adult child interaction (ACI) approaches have developed over the past decades (for example, ‘Parent Child Interaction’ (PCI); Palin PCI; and ‘Pre-school Autism Communication Therapy’) with a growing evidence base (including Falkus et al, 2015; Fukkink et al, 2011). In practice, these are sometimes used without video, despite this being central to their effectiveness. McDonald et al (2015) found video feedback was key to increased use of communication-facilitating strategies by early childhood educators. Allen et al (2011) also showed that video interaction therapy could be successful with children with communication difficulties aged eight to 10 years. VERVE builds on the established ACI approaches, but emphasises the use of video to highlight the fundamental importance of self- regulation and face watching, drawing on neurological research, for example Porges (2011) and Siegel (2015). Project method After our initial pilot we wanted to investigate whether using VERVE with practitioners in schools leads to clinically significant gains in children’s communicative participation. Using the results of a questionnaire based on The Communication Trust’s ‘Speech, language and communication framework’, we identified five schools to include in the project. Twenty-one “VERVE is a form of video interaction therapy” primary school practitioners completed a four-week block of sessions, each paired with a different child from nursery up to Year 6 (age range 3 to 11 years). To track progress we used the ‘Focus on the Outcomes of Communication Under Six’ (FOCUS) (Thomas-Stonell et al, 2012) rather than GAS because of its breadth and established validity. The FOCUS is based on the ‘International Classification of Functioning framework: Children and youth version’ (WHO, 2007) to detect changes in children’s communicative participation. It rates 34 items (for example, ‘My client is comfortable when communicating’) based on observations. All practitioners completed an anonymous FOCUS for the child during the first session to provide a baseline and at a review session three to five months later. Video analysis The practitioners met with an SLT for a 20-30 minute introductory session. Following this they shared weekly paired sessions, facilitated by the SLT, over the four-week period. Each week senmagazine.co.uk SEN113 39