Language and communication problems, and their relation to non-language difficulties – In Conversation with Dr. Hannah Hobson

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In this podcast we talk to Dr. Hannah Hobson, Lecturer in Psychology and Researcher at York University, and head of the Emerald Lab (Emotional and Mental Health Research in Autism and Language Disorders).

Hannah discusses language and communication problems especially their relation to non-language difficulties including social and emotional problems. She talks about why many children with language needs go undetected, and some camouflage, plus what can be done.

Hannah discusses her work as head of the Emerald Lab, plus her aims for her newly created Special Interest Group to gather ideas on the topic of language, communication and mental health.

Hannah is passionate about multi-disciplinary working and stakeholder engagement, explaining why this is crucial and ways to take this forward. Plus how this evidence based research can be used to impact on policy, and ultimately help children.

Dr. Hannah Hobson
Dr. Hannah Hobson

I have studied and worked in Oxford, KCL and Greenwich. In addition to my research activities, I have an active interest in reproducibility in psychology and the biomedical and social sciences. My research considers language and communication problems, especially their relation to non-language difficulties, including social and emotional problems. I have conducted research with a range of populations who have developmental or acquired communication problems, including autism spectrum disorder, developmental language disorder, traumatic brain injury and stroke.  My research has also considered imitation abilities and neural systems that underlie imitation, particularly focussing on how we measure activity in the human mirror neuron system using EEG. I also have an active interest in reproducibility in psychology and the broader biomedical sciences. Bio and image via University of York

Transcript

Interviewer: Hello. Welcome to the In-Conversation Podcast series for the Association for Child and Adolescent Mental Health or ACAMH short. I’m Jo Carlowe, a freelance journalist with a specialism in psychology. Today I’m interviewing Dr. Hannah Hobson, lecturer in Psychology at the University of York. Hannah’s research considers language and communication problems, especially their relation to non-language difficulties, including social and emotional problems. If you’re a fan of our In-Conversation series, please subscribe on iTunes or your preferred streaming platform. Let us know how we did with a rating or review and do share with friends and colleagues.

Hannah, thank you for joining me. Can you say a little about yourself by way of an introduction?

Dr. Hannah Hobson: Well, thank you so much for having me. So I work at the Psychology Department at York University. I’m a lecturer and my background is in research. I started off my research career in my PhD with interest in autism and a condition called Developmental Language Disorders. Developmental Language Disorder is a neuro-developmental condition in which children’s language abilities do not develop properly. There’s not a known reason for why that might have happened. So historically when a diagnosis of Developmental Language Disorder has been made, people have been looking to sort of rule out reasons for why a child might DLD.

So a known genetic condition, so like Down’s syndrome. You wouldn’t then also diagnose DLD on top of that. Now, one thing with DLD is their language problems might not always be really, really obvious. So often when people, so imagine a child who’s got a language problem, I say what you think that child might appear like? People often say they sound different, their words will sound strange. What people tend to describe is more like a speech problem. Now speech problems can be quite obvious and more able to be picked up.

With Developmental Language Disorder these children can have comprehension difficulties as well, so difficulty understanding other people. Those are less easy to pick up just from talking to a child. You have to do some digging to really understand that that’s what’s going on, particularly if you consider that children might be camouflaging their communication needs. Like all human beings, children with DLD don’t want to feel like people think they’re stupid. So they are going to camouflage and mask their needs potentially. Particularly if they don’t know that they’ve got DLD themselves, and just also to add that DLD is not a rare condition. It’s estimated that between seven to 10% of children meet the criteria of DLD, roughly one in every classroom.

And I was really interested in the skills that these children have in imitation, but while doing my PhD, collecting the data, working with the children, trying to get them to imitate things, verbal and non-verbal imitation, I became really interested. I mean, really in them to be honest, and then I’d tell them what their long-term outcomes are going to be. So after finishing my PhD I took a post-doc to work with Geoff Heard at Kings at the time, looking at something called alexithymia which is about recognising and communicating your emotions, and from there I’ve really gone to explore topics related to language communication, emotion and wellbeing and the links between these things.

Interviewer: Before we go into more depth into the topic, can you tell us a bit about your lab, the Emerald Lab? What is its main focus?

Dr. Hannah Hobson: Since moving to York in 2019 I set the Emerald Lab up and Emerald stands for Emotions and Mental Health Research in Autism and Language Disorders. So there’s at least some of the letters that they may make up Emerald in those words. We have quite a broad remit in our lab, but our core question really is about what is the relationship between language and communication and social emotion abilities and mental health and wellbeing outcomes, and that covers quite a broad range of more specific questions.

So some of the things we’ve looked at recently, we’ve looked at Developmental Language Disorder and how well these children can recognise their own emotions, how they score on some measures of alexithymia. We’ve looked at the experiences of autistic women getting their diagnosis and how that’s interacted with their wellbeing. We’ve recently completed a project looking at parents’ experiences, getting mental health support for their children and language needs, and currently I’m looking at how people perceive and judge children and young people with language needs. So quite a broad range I would say.

Interviewer: When you say how people perceive and judge children, are you talking about professionals or the public in general?

Dr. Hannah Hobson: A mixed share actually. So one project that we’re currently writing up was a mock jury perception project. So what we did is we created a written scenario about a young man who’d gotten into trouble with the police, and we developed the story with a team of forensic speech language therapists so that we knew we had a story that really reflected their clinical experiences without getting into maybe some ethical issues or legal issues, of actually drawing on a real case. So we developed this story and we got over 140 members of the public who were jury eligible.

And we asked them to decide whether they thought this young man was guilty. How long should he be sentenced for? How likeable he was? How honest he seemed? How cognitively able he seemed and how blame worthy he was, and we also asked them to give us some justifications for why they were giving the answers they were giving. Within the story half of our participants got told that this young man had a diagnosis of Developmental Language Disorder and a little bit about what that was, and half of them didn’t, but they had exactly the same story otherwise.

And we found the presence of the Developmental Language Disorder diagnosis affected ratings of blameworthiness, honesty, likability, and so on. So there does seem to be an impact on how we view people if we do or don’t know that they’ve got language needs. That does seem to alter our perceptions of people. We’re just going through some of the open text responses at the moment but a lot of our participants were responding to how he was appearing to talk in the story. So some people commented they thought he seemed quite rough.

I mean, we haven’t really included anything about this young man’s background, but that was how people were perceiving him based on how he was speaking.

Interviewer: Knowing the diagnosis did that make the young man appear more or less blameworthy?

Dr. Hannah Hobson: It made him a bit less blameworthy. It didn’t translate into an effect on whether they thought he was guilty or not. So they had to give a guilt, no guilt answer and the diagnosis didn’t matter there, but people did say he was less blameworthy if he had this diagnosis. Part of the reason we probably didn’t get the guilt effect was the particular story we’ve gone for it was quite a light crime. There was no violence involved, nobody was really hurt by it. So I think most people, even if they didn’t have the diagnostic information, felt it was a bit harsh to sentence him.

So we’re going to be trying it again with a few modifications to see what we find. This was just a first look. So I’m quite keen to try it again, but that’s one example of a project where we’ve been looking at the perceptions of language disorder. Another one that we’re again currently writing up is a project looking at camouflaging. So some of your listeners might have come across camouflaging relation to autism. So this is where children and young people with autism might do things or have certain strategies that help mask the fact that they have the social communication needs. It’s been something that’s been particularly kind of associated with autistic women, although autistic men do have that as well.

My interest really was looking to see whether we get a similar phenomenon in developmental language disorder, and part of this came from where I was about to do one of my tests in my battery and I always started off with, like a fairly simple non-verbal IQ test. It was a nice kind of task to kind of warm the children after I’ve just met them and I was working with a little boy who I knew had developmental language disorder. So it wasn’t that I didn’t know that he had a communication need and I explained the task as I normally do, and said to him does that all make sense to you?

Yes, yes, yes, yes. You know what you have to do? Yes, yes, yes. Lots of nodding, yeses and smiling and then as soon as we started the practice items, so very simple item, you know, pattern matching. It was clear he really didn’t know what we were doing and what he was supposed to do and that always really stuck with me because I knew that child had a language need. It wasn’t a particularly difficult task. I had already had experience working with children with language needs by this point, and I really thought he knew what he was supposed to be doing.

So that is one example of sort of camouflaging behaviour really. Just saying yes and nodding and smiling and not saying sorry, I have no idea what you’re saying or you’re talking way too fast. So we’ve been doing a project where we’ve been interviewing speech and language therapists and also parents of children with DLD, developmental language disorder, about do they think they see camouflaging? What does it look like and what’s the impact of that and it’s been so interesting. So in a nutshell, yes, there is camouflaging. It’s very, very varied.

Some of the examples of camouflaging we’ve heard have been really sophisticated. So we have one example were an SL team is saying she worked with a little boy who he behaved like a much younger child than he was. What she observed is that when he did that adults in the environment, because they treated him like a younger child, they talked to him in a more simplified manner, which was probably more accessible for him. Now there’s no way, well I don’t think that we have a conscious understanding of that’s what he was doing, but because he was physically quite small and because when he did it his life was a bit easier. That kind of way of being that behaviour is almost being reinforced.

So that was a really interesting one, but one that wasn’t going to work forever. He was getting ready to go to secondary school. It was all going to start to get a bit creepy quite soon. So children might have certain camouflaging and techniques or strategy for things that they do that mask their language communication needs, but some of those are time sensitive and they’re not always going to work and some might even be quite maladaptive, and it does seem that quite similar really to the work with autism. This camouflaging, although it might allow children to, I suppose smooth over some of their communication problems perhaps to fit in with the social group and not feel like they are being told they’re stupid or whatever.

Although that might be useful some of the time the camouflaging does seem to come at a bit of a cost. Interestingly, when talking to parents a lot of them said that when the children got home they were very, very tired. They’re very, very irritable and some parents felt that the children had really a sort of persona at school and that they were working really hard to fit in, to mask, to get along and that, you know, much like a Coke bottle that has been shaken up all day at school and then when they get home they kind of explode all over the place.

That is again, it sort of fits in I suppose with the theme of my work at the minute which is how we perceive young people with developmental language disorder and maybe what some of the things are that they do that maybe help those perceptions along. So I don’t think the children with DLD are consciously doing a lot of these behaviours, but it’s something that if the language needs aren’t picked up or recognised and become reinforced.

Interviewer: Hannah, you recently put together a Special Interest Research Group to gather ideas for future research on the topic of language communication and mental health. What are the aims of the group and what kinds of topics do you hope to explore?

Dr. Hannah Hobson: So the group is really there to generate new questions for researchers to focus on. So the Special Interest Research Group is funded by Emerging Minds which are essentially research charity with an interest in young people’s mental health, children and adolescent mental health, and we pitched to them this idea that perhaps we should be looking to do more research on the relationships between language communication and mental health. So we’re really scoping for ideas, questions, things people would like to know the answers to. So we want to hear from clinicians.

We want to hear from educational professionals, families and the young people themselves about what they wish people knew about language needs and mental health, and the idea at the end of the process is that we’ll be able to have like a go to list of ideas for research that different groups of people have told us they want to see more research on. This project is also a chance for us to think about the ways we could facilitate research into the area. We already know, actually, that there’s a large proportion of children in mental services with language needs.

So the question then becomes like, well, why hasn’t any research been done yet that’s really looking at what that does to services. Why are some children more at risk? Are there protective factors? What could be done to work with this problem? So we’re also interested in what are the barriers to this research? What’s getting in the way of us asking these questions and getting the answers, and are there different ways of working or things that we should invest in that could help get more research done on this topic?

Interviewer: How do people contact you then if they want to get involved with that?

Dr. Hannah Hobson: Best thing is to email me to be honest. So I’m at hannah.hobson@york.ac.uk. So please feel free to email me. So I help coordinate the special needs research group and I can then add you onto our mailing list for the Special Interest Research Group and make sure you’re kept up to date. There is also a few workshops and some surveys coming up or that are open. So we have a workshop on the 20th September where really what we’re doing is we’re giving people a first look at what we’re hearing, what ideas are coming up, and we want to kind of have workshops to discuss those and refine them and get some input from people.

So if you’re a mental health practitioner, speech language therapists, work in a school, if you’re a parent of a child with language needs, or if you consider yourself attached to this topic in any other way, feel free to email me and we can make sure you’re able to come that virtual workshop. Then we also have an open survey where you can literally just tell us what are some ideas you wish researchers would be working on in the future. You do not need to have a working knowledge of language disorders to contribute to that.

So if you are a mental health practitioner listening to this and you’re thinking, well, I’ve never heard of developmental language disorder before today. Please don’t count yourself out. We really want to hear from you. What are some of your observations? What are some of your gut feelings, even if you don’t work in a neurodevelopmental service? Please don’t feel that’s a prerequisite either. Everybody is welcome to contribute their ideas.

Interviewer: The Special Interest Research Group it’s very timely because despite evidence that many children receiving support for social, emotional, and mental health needs have language difficulties. There’s been very limited research on prevention, intervention and identification. Why is that do you think?

Dr. Hannah Hobson: It’s a really good question and it’s something that we have discussed in our Special Interest Research Group so far actually, is what’s the issue? What’s the blockage in the research? So some of the things that people have suggested about why this might be the case, some of it’s to do with the professions involved and the fact that there’s multiple different professional backgrounds that surround this question. You’ve got speech language therapists, you’ve got mental health practitioners, you’ve got educational professionals and educational researchers as well and all of these bring different perspectives and different training with different terminology that might create barriers between these professional groups working together.

I mean, I’ve not I should say, I have not had clinical training myself. I’m very boring. Straight out of academic researcher, but from speaking to colleagues in clinical psychology and mental health practitioners, my understanding is they get very limited coverage of language difficulties and that I think can make it difficult for them to spot in their caseloads when it comes up. Now, I can totally appreciate that from a mental health practitioner’s point of view their job is not language disorders. Their job is something else and they might see that topic as something for speech and language therapist.

But the problem is it takes someone to notice the language need for a speech language therapist to become involved. So I think some of it is around those sorts of professional barriers and I should say the other way as well. Speech language therapists they can and they do work with children with social, emotional, mental health needs. It is a specialism for them, but I think a lot of speech language therapists would see mental health as something for mental health practitioners. So I think there’s some gaps here where we’re losing the topic between, sort of between the gaps, between these two professions.

And I do worry that mental health practitioners consider language to be the problem, and speech language therapists consider behavioural problems or emotional problems to be the issue of mental health practitioners. Other comments we’ve had from our Special Interest Research Group is that perhaps historically language and communication might have been considered quite a niche topic. So when researchers have applied to say, you know, we want to look at this question of language and mental health, please give us money. So they might be told well that’s a very specific problem. I mean, in reality most mental health treatment rely on oral language to some degree.

If you’re talking to children and young people about their thoughts, their behaviours, their feelings, if you’re using metaphors, if you’re using analogies, if you’re trying to extract from somebody a narrative about what’s happened to them, even non-verbal communication as well is going in there. So language and communication has a big role in mental health settings, but I don’t think that’s always been recognised and appreciated, and the sort of final barrier I think is the complexity of the question. So mental health is very complex. Measuring mental health is normally quite complex in children, but I think particularly if you’re concerned about language ability and how accessible some of our mental health measures are for children, if you’re at all worried about their ability to respond in a valid way.

Again, just speaking from my own experience of gathering data from children one of the measures I was using was, kind of, [inaudible]. So a measure that’s all about recognising your own emotions and communicating them. One of the items on that questionnaire is you ask the child, do you know what’s going on inside you?

Meaning do you understand the emotions you’re having? This child very bluntly responded, well I haven’t studied the organs yet which as a researcher the alarm-bells go off and you go oh, my gosh. How many children have said no to this because they thought that was making a question. So I think there’s a lot of reasons why we might not be seeing this research come through yet. I think some of it is the gaps between professional backgrounds. Some of it is about perhaps the perception that language and communication is a niche topic and some of it is about perhaps how scary the problem is and how many more problems opening this Pandora’s Box might stumble out.

Interviewer: Any thoughts about how to encourage more multidisciplinary working?

Dr. Hannah Hobson: I mean, this is really one of the big problems for our Special Interest Research Group. So working with these clinical groups everybody’s a very busy clinician. Everybody desperately wants to help the children they’re working with. So it certainly isn’t that people don’t want to help. I think if we could carve out some space physically and in time for speech language therapists, mental health practitioners to have really good communication with each other. Share case studies. If we have joint conferences where we really set up environments where these groups can talk to each other.

I think they have so much to share with each other. That was sort of one of the aims really of our Special Interest Research Group. I would say we’re doing it, but I think currently we’ve really struggled to get mental health practitioners into our process. We’ve had some, they’ve responded to our survey. It’s been really difficult to get them to come to the online workshops. So I think there might be something around how this topic is kind of approached. I worry that mental health practitioners see the word language and they think oh that isn’t for me.

I think there would be a lot to say and I think teachers and educational professionals as well have lots to add, that it’s finding the space and the time and the energy to get everybody into one space I think.

Interviewer: We also know that many children with language needs go undetected. You’ve already talked about camouflaging, and I’m just wondering what the other common reasons are that so many children get missed.

Dr. Hannah Hobson: Some of it might be to do with the nature of language problems themselves. We do know from some research that generally outcomes for children who have just specific speech problems are better, and I suspect that’s because a speech problem is more likely to be picked up. Again, I think the camouflaging project is giving us some ideas that where particularly if you’ve got a comprehension problem those are not that easy to detect. To really understand if a child has comprehended something you’ve asked or you’ve said you need to do some detective work. You need to kind check their understanding, and in a busy classroom that could be really challenging.

Some of the things our parents have said to us in our interview studies is that, well, they said my child could read so that they’re probably fine. Well, actually a child being able to read out loud is not to say they’ll be able to understand what they have read and that takes a bit more digging.

Interviewer: Some children with language difficulties have good mental health and I’m wondering, Hannah, do we know what factors are protective for these children, and on the flip side do we know what factors make mental health difficulties more likely?

Dr. Hannah Hobson: From what we know from previous research that’s been done, the extent of the language problems doesn’t seem to predict the extent of mental health problems interestingly. So where studies have got sort of continuous measures of expressive or receptive language problems, it doesn’t seem to be the case that the worst your expressive and receptive languages, the worse your symptoms of anxiety and depression are, of example. So although there’s this group difference between children with language disorders and children without in terms of their mental health problems, it’s not a clear, straightforward linear relationship, it seems, which in itself probably demonstrates that we’ve got some protective or some risk factors operating here.

So one candidate would be relationships and peer friendships. Umar Tosseb who is a researcher here with me at York has done some interesting work on this about, kind of, pro-social behaviour and friendships and relationships. It’s clear that some children with language needs have good friendships, and actually these friendship groups can really act as a buffer to mental health problems. However, some children don’t develop good relationships and their communication problems may interfere with their ability to build good friendships. We know from, there’s not been many, but some studies that have looked at peer ratings of children with developmental language disorder, for example. Those children tend to be down rated by their typically developing peers.

So basically, typically developing children say that they don’t really want to play with children with DLD or they’re not very popular. In our own interview studies for some parents the lack of good friendships were sort of their dominant worry in relation to their children’s wellbeing. So they were worried that their children were lonely and that they weren’t being supported in school to develop good friends really, and that’s not the sort of superficial friends who will sit next to you at lunch time, but people they can really be their genuine selves with.

So definitely peer relationships is one. Another risk that’s come up in our Special Interest Research Group conversations is this idea of a genetics risk. So this idea that mental health issues and language issues might have some shared genetic risk factors to them. I think it’s an interesting idea. It doesn’t really give you much by way of what to intervene on, but it’s an interesting one. So potentially there might be overlapping neurobiological risk factors between language needs and mental health.

Interviewer: Your Special Interest Research Group, as you mentioned earlier, you plan to consult with affected families and young people, plus the clinicians who support them and researchers in the field. You’ve already mentioned how people can get in touch with you. What can participants anticipate from their involvement?

Dr. Hannah Hobson: So if you come along to our workshop you’ll be asked basically to give your expertise on some of the ideas we’re developing so far. So we’ve got research themes at the moment that we’re developing and you’ll be asked, kind of, what do you think about those. At the workshops there will be some group discussions. So you might be talking to a clinician from another field. There might be a parent of a child with language needs there. There will be some academics as well, and potentially some teachers. At the end of the whole process, at the end of the special interest research group, we will release a report that basically summarises all we have heard from our stakeholder groups.

And the idea would be that it’s going to be a great document to have if you’re writing, say a research bid and you want to say, you know, the community have said they would like more research on this. So if you are a clinician and you would like to contribute and have some input into what researchers might do in the future this is a really good way to do it.

Interviewer: Can you explain why stakeholder engagement of this kind is so important and how can it be encouraged?

Dr. Hannah Hobson: One thing that really I often come back to when I’m thinking about stakeholder engagement is when I was still a post graduate there was a report released by Liz [inaudible] and colleagues who did a piece of work looking at what research questions were being funded and what research questions were prioritised by the autism community. So that’s autistic people and their families, but essentially the main message of the paper was there was lots and lots of money, research money going into biomedical research for autism but actually what the community really wanted was things like social support and employment and, you know, what we needed research into how to support autistic people to live well and to tackle the really awful health discrepancy that people with autism actually live with.

And that always really struck me because my original background was very much in biomedical and behavioural science. I still am to a large extent, but it really made me feel that it’s so important that we as researchers look at our research portfolios and think about community priorities and do that alignment exercise where we try and make sure that how we’re spending our time and our energy is going towards something that matters really to end users of our research. So that’s why it’s important. I think it does make the research better overall as well, because I think if you have got community engagement you normally then get people giving you really good ideas on how to improve your research and to make it more impactful.

In terms of how to encourage it, I mean, I think always being open to conversations with a potential end users of your research, be that clinicians or families or teachers, I think being open with those conversations is really important. I think part of being open does mean having a bit of a thick skin and you’ve got to be prepared for your research question to be well, questioned really I suppose. If you’re presenting something as like, what do you think about me spending three years doing this and somebody says I can think of a better way that you could spend those three years.

Well, that is part of the process. So I think being open, having a thick skin. Most universities these days do have teams or members of staff whose job it is is to try and do this process of what we’d call PPI, so patient and public involvement. So it’s worth finding out who those people are at your institutions. If you’re an academic researcher and making use of them and asking them to help you find people who would be willing to listen to your research ideas.

Just in my own field of autism and language disorders, Autistica are really good at this. So Autistica have got a system by which they can support researchers to get feedback on their research ideas from the autism community and Engage in DLD is a new platform really that’s been set up by Michelle St Clair and others to help with this in DLD research as well. So there are even, kind of, organisations out there to help.

Interviewer: Hannah, what other research projects are you working on that you’d like to mention?

Dr. Hannah Hobson: So you might have got the impression from before, I’m all over the place. We’ve got lots of really interesting things that I love. I think probably the project that’s likely to be most of interest to your listeners is a project we’re just writing up on the experiences of parents trying to get help for their children’s mental health for their children who have got language or communication needs. So as a brief summary, we did this in two stages. So we did a survey. There was parents with children with what we call speech language communication needs. So that’s a very broad umbrella. It includes autism, it includes DLD, it includes other things like deafness as well.

Then we did a follow-up interview with nine parents of children who all have developmental language disorder, and from our survey it was clear many parents had concerns about their children’s mental health, and when we asked them about their experiences of getting help the picture voiced that they often really struggle to get help. So they often had referrals rejected from CAMHs and when they did get to work with the clinician they found they didn’t really know much about their children’s communication needs. Some parents were told to sort out their child’s language use first and then the mental health problems would resolve, that is not appropriate or likely to be honest.

So I think that’s one myth that’s worth busting is that where a child’s has got mental health needs and language needs that resolving the language problems will sort out mental health problems. That’s unlikely to be true. So what was happening for these parents is there was not really a clear service for them to go to. Many parents basically got stuck at a dead-end. From our interviews of parents with children with DLD a few things tipple out and I think here would be there were some concerns from the parents about how their children’s distress is communicated and how mental health problems might be detected.

So we have one parent who was taking their own child for medical appointments and they were very anxious, that it wasn’t clear how extremely anxious this child was until much later, which was very upsetting for both the child and the parent. We also had parents who were concerned that their children were maybe being bullied but weren’t really able to share this with other people, and this obviously led to them being concerned about their children’s future. So if they happen to find themselves in trouble in the future, would they be able to articulate that they recognise that there was a problem and needed to get help?

So concerns around distress. Another theme that we developed from our interview analysis was this idea that traditional approaches to mental health treatment in children might not work for this cohort. So we’re kind of at the moment our notes call them armchair discussions. So this idea that you go into a room and there’s two armchairs and you sit on one and the therapist sits on the other and you kind of talk through what’s going on. Those sorts of settings can be quite intimidating for children with communication needs. So you’ve to bear in mind that a child going into the office has had a long history by this point of having difficult conversations, so they haven’t been understood.

People haven’t understood them. They don’t understand that’s going on. So these sort of face-to-face armchair discussions might not be very welcoming. More positive examples from our parents included things like talking while walking or where therapists took the time to build rapport with children by craft or activity sessions. One boy made a bow and arrow with his clinical psychologist apparently, and quite a few of them mentioned play therapy and said, I’d be interested in play therapy. They’re a bit old now, but it would be that kind of setting that they felt their child would do better in because it was perhaps less verbally demanding.

Whereas we had some parents who gone for parent CBT training. So they’ve done parent classes to learn some CBT techniques to help support their child if their anxiety fled up again and the parents reported that a lot that content isn’t really going to work for their child. The terms were too abstract. Everything is going to need quite a lot of modifying. So thinking about how to deliver these mental health interventions for children with language needs. The delivery and also how to simplify the content and make it accessible, I think, would also be really important going forward.

Interviewer: I mean, given that, given the less positive factors that you’ve highlighted from your findings, how can evidence based research of the type you’ve described be used and effectively disseminated to impact policy?

Dr. Hannah Hobson: I think for policy, I think it’s about really gathering together the evidence that we already have about how much of a problem this is. There are a lot of organisations that are really trying to champion this issue of language, communication and mental health. The Royal College of Speech and Language Therapists has done a lot. The Communication Trust is a kind of consortium of different charities involved in language needs. I think really where the break-through needs happen is getting into some of the mental health organisations and those sorts of spaces to, kind of, really make it clear what the links are and lots of us are trying, lots of us are doing that work.

And I’m hoping that, I think, it’s making the right connections to some extent, reaching out to clinical colleagues in good faith. I do think some of this translation is down to making things accessible and easy to read. As academics we can get really into our jargon. That’s not always very helpful. So I think also just making sure as an academic your findings are very easily accessible, easy to understand and you’re easy to get hold of I think it’s also really important, and it’s a marathon, not a sprint.

I mean, I’m really keen to see language and communication issues taken up in mental health settings and there being policies that really support those groups, but it does take time.

Interviewer: Hannah, is there anything else in the pipeline that you would like to mention?

Dr. Hannah Hobson: Yes, a couple of things. So one is sort of an initiative that I’ve been working on with a few colleagues who work in autism research. One thing I’m also interested in is open and reusable research. So making sure that our research findings are reusable, that our methods and our statistics are open. You know, that includes things like registering reporting, pre-registrations, open data materials and so on and it also, I think, should encompass qualitative research as well. So making sure that when we conduct qualitative projects, even if there’s no stats in them that the way those projects have been inducted should be transparent.

So there’s a small group of us who are interested in kind of digging up these enterprises in autism research. We have created a very small little website, which I can share in the notes, and we have an event coming up, the 8th September. We hope to do more events in the future as well, but the idea is basically to start connecting up autism researchers who are interested in the topic of open research and want to see it applied more widely in their fields and will have ways of sort of sharing expertise and thinking about the next steps and things.

Another is it’s DLD Awareness Day mid-October this year. So there’ll be lots going on in social media but the Emerald Lab are planning an event, especially for medical students of all stages. So if you are or if you would consider yourself a medical student and you’d like to attend an online session all about developmental language disorder then you’d be very welcome. It will include a parent with a child with DLD, speaking about their experience, a speech language therapist who works in an alternative educational setting. So basically children with behavioural and emotional problems, and we also have a medical student as well who will be giving her reflections too. So if you follow the Emerald Lab on Twitter we’ll be tweeting about it if you want to sign up.

Interviewer: Hannah, finally, what is your take home message for those listening to our conversation?

Dr. Hannah Hobson: My take home message would be think about the central role that language and communication has on your interactions with children and young people, be that in the clinic, in research, in the classroom. Language difficulties are not as easy to spot, as many assume, but they have a really lasting impact on children’s wellbeing if not picked up. So be a good detective, rather than asking children, have you understood that? Ask them, can you tell me what you have to do now? What do you think this word means, because many children will nod, smile and say yes if you ask them if they’ve understood something, because that’s what they think you want and what is expected of them?

Interviewer: Brilliant. Thank you so much. For more details on Dr. Hannah Hobson please visit the ACAMH website at www.acmh.org and Twitter at @ACAMH. ACAMH is spelt ACAMH and don’t forget to follow us on iTunes or your proposed streaming platform. Let us know if you enjoyed the podcast with a rating or review and do share with friends and colleagues.

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