Chatting about screen use on WeSpeechies

This week I am the lighthouse keeper on @WeSpeechies, a twitter handle for those interested in issues to do with the speech and language profession.  WeSpeechies is focussing on a topic I have been interested for some time - the debate around children's use of screen based technology and child health, wellbeing and development.  It's a topic that arouses much opinion so I think it will be keeping me busy!

To find out more about WeSpeechies you can read about them here.  To find out specifically about this week look here.  For this page I have written a background to the week with editing support from WeSpeechies founders Caroline Bowen @speech_woman and Bronwyn Hemsley @BronwynHemsley.  For ease I have copied it below.  Just 2 hours after taking over as lighthouse keeper the debate around this issue is well underway, and I'll update this blog with a summary of issues raised throughout the week.  There'll also be a twitter chat on this issue on Tuesday 12th May from 8.00-9.00pm Brtish Summer Time.  Tune in and get involved!

Topic: Screen time and child development: Exploring the impact of audiovisual and interactive screens from all angles

There is no doubt that we live in a time of rapid technological advances. Travelling on a London Underground train recently, I estimated that around 70% of passengers were using smartphones. The screen has exploded out of cinemas and living room TVs and into people’s back pockets. In addition, small screen based technology has provided a platform for many other uses, including, but not limited to social networking, audio-visual communication (such as Skype and Facetime), education and gaming.
The widespread adoption of the small screen is said to be changing behaviours (Ley, et al., 2014) and questions have been raised about the effects of screen time on child development (Ebbeck, et al., 2015). This is no new phenomenon; indeed the effect of the television on children’s development was questioned by Meerloo, back in 1956. Concern was raised in 2005 when a UK survey reported 20% of young children had a television in their bedrooms. Nowadays, many children have regular access to up to five screen based devices in their own homes (Kesten, et al., 2015).
Over the years screen use has been reported to be associated with both a range of positive and negative developmental outcomes. Across the research to date, the variety of aspects examined obviously makes it impossible to generalise findings from different studies to all screens, all media and all user behaviour.  None-the-less, certain trends emerge.
There are of course advantages associated with the availability and use of screen technology for communication, learning, and social connectedness. Applications have been developed to support child development, and social media platforms may facilitate networking for children with their peers, families, and many other people. By contrast, there are potential risks to children’s privacy, safety and mental health that may result from unsupervised use of Internet based apps on the small screen (Broughton, 2005).
As speech-language professionals, we face many decisions about how much to recommend or use ‘screens’ in our work with children and families. We must take account of all of the evidence, not only the representations made in the mainstream media. On @WeSpeechies this week, I will challenge all taking part in discussions, and reading along, to consider the role of speech-language professionals in providing reliable advice to parents on screen use and how we might adopt screen use in our own clinical practice.
References
BROUGHTON, D. D. 2005. Keeping kids safe in cyberspace: Pediatricians should talk to patients, parents about Internet dangers. AAP News, 26, 11-12.
EBBECK, M., YIM, H. Y. B., CHAN, Y. & GOH, M. 2015. Singaporean parents’ views of their young children’s access and use of technological devices. Early Childhood Education Journal. ABSTRACT
KESTEN, J. M., SEBIRE, S. J., TURNER, K. M., STEWART-BROWN, S., BENTLEY, G. & JAGO, R. 2015. Associations between rule-based parenting practices and child screen viewing: A cross-sectional study. Preventive Medicine Reports, 2, 84-89.
LEY, B., OGONOWSKI, C., HESS, J., REICHLING, T., WAN, L. & WULF, V. 2014. Impacts of new technologies on media usage and social behaviour in domestic environments. Behaviour & Information Technology, 33, 815-828. ABSTRACT
MEERLOO, J. A. M. 1956. Technology invades our minds. The rape of the mind: The psychology of thought control, menticide, and brainwashing. Cleveland, OH, US: The World Publishing Company.

Are speech and language therapists too "nice" for robust peer review on the internet?

This is a sensitive post that explores the issues around debates that take place on social media. Whereas with other blogs I have attempted to source third party information, due to the sensitive nature of the story told, parts of this blog will remain anonymous.  Some readers will be aware of specific events I have referred to from Twitter, but as the role of this blog is to explore the themes and principles necessary to learn about professional development through social media, individual names and tweets will not be repeated here.

Social media has burst into the professional arena over the past few years and is increasingly being used to network with colleagues, share information and reflect on practice.  In my last blog "Healthy skepticism in clinical practice" I recommended Twitter as a forum to share critical thinking in order to develop robust practice.   The past few days, however, have been rather heated in the Twittersphere with allegations of cyberbullying and individuals being requested not to use certain professional networking hashtags as a result of their previous tweets.

The twitterstorm originated from one user challenging a speech and language therapist who had hosted a guest post about psychological astrology on a professional blog.  Requests were made to remove this post with the argument that it did not adhere to the principles of evidence based practice.  A lively discussion followed on twitter which extended to discussion around evidence based practice and blogging in general.  Shortly after this, however, the originator found themselves the subject of allegations of cyberbullying from several users of the professional hashtag.  Allegations included using an inappropriate tone in tweets, "obsession with EBP", and fostering negativity on the hashtag.  The originator was asked by these users to stop requesting that fad therapy posts be removed, stop asking for evidence for interventions and to stop using the professional hashtag.  Whilst there may be differences in opinion over the hows and whys of the discussion that had taken place, was it necessary to jump to public allegations of cyberbullying?  And was it appropriate to request another user to stop tweeting and to veto them from a professional network hashtag?

This incident has raised a few issues that as a profession we need to explore. Discussed in more detail below they are: a; the nature of pre peer review publication, b; conduct on social media concerning peer review and c; professional standards in the world of social media.

The nature of pre peer review publication
Before the emergence of social media most professionals communicated through peer reviewed journals or edited professional magazines.  These media give should give the reader confidence that the reports and views of the author have been reviewed and given approval for publication by other professionals in the field. (That assumption has recently been in dispute in one case, as described by Bishop, but largely holds true).  Whilst professional magazines (such as the RCSLT's Bulletin) are not peer reviewed, the editorial process provides some protection to the reader against outlandish or rogue opinions.  Magazines also often give an opportunity for readers to respond to articles through a letters page.

Things on the internet are different.  Individuals may freely publish articles on blogs without any peer review.  Opinions can also be tweeted without checks and balances on twitter and can reach thousands of people very quickly.  This has benefits and disadvantages.  One of the benefits of these forms of media is the democratisation of opinions.  You don't have to be an established figure or authority to have a voice, and anyone can comment on information.  Another benefit is the speed and degree to which information can be shared amongst professionals.  Through tweets and blogs news gets out very quickly and can be disseminated widely.  I believe I am better informed in my area of practice (early language development) than I would be if I were not on Twitter and did not read other professionals' blogs.   Social media also gives an international perspective for things, so as a UK speech and language therapist I am learning from professionals in different countries and different health economies. In her keynote speech to the RCSLT 2014 conference, Caroline Bowen proposed that Twitter was useful for generation and dissemination of news, engaging in discussion, asking and answering questions, inspiring, encouraging and supporting others, participating in professional learning networks, and connecting and collaborating with groups. Disadvantages of social media, however, include the ease in which cod science and quackery can be distributed and the unpleasant interactions that can result from this unregulated environment (both of which I have alluded to above).

Two blogposts with guidance for academics on Twitter and Blogging have been written by Dorothy Bishop.  This guidance may be equally applied to clinical professions, such as speech and language therapy.  Bishop also discusses the role of blogging in post publication peer review here. The value of peer critique on social media extends beyond post publication review of peer reviewed journal articles. I would argue it is not only of huge benefit to our profession but is essential in the presence of pre-peer reviewed publications, such as professional blogs and websites.  It is the post publication review (via comments on a blog, tweets and shares) that takes place within social media that helps the wider community interpret and understand the validity of what is published.  Put simply, if you blog or tweet, you need to be open to critique of what you are saying.  If we seek to stifle or subdue opinion, that is to the detriment of our profession.

Conduct on social media concerning peer review:
Given the unregulated environment of social media, and its relative youth in terms of a medium for human communication it is not surprising that things go wrong.  There are many examples in Twitter of where things have got nasty and personal.  Trolling on Twitter happens and we need to be aware of it. There are steps you can take to protect yourself from this, including blocking and reporting offensive tweeters.  The extreme reaction to this is not to be on Twitter, or not to tweet what you really think.  Whilst I always advocate 'thinking before tweeting' and not being offensive or personal, it would be such a shame if our desire to always be 'nice' or 'positive' resulted in a muting of the debate.   Our profession could consider a code of conduct when communicating with others on Twitter.  There are several questions that such a code might address.  First, what is the right way to critically appraise someone else's work?  How might someone whistle blow if professional misconduct is observed on social media?  How should we decide what is the appropriate use of a hashtag?  I would argue that it would not be appropriate to dictate who can or cannot use hashtags as that goes against the democratic nature of social media.  It seems reasonable, however, to have explicit agreed rules over how a hashtag may be used.  #WeSpeechies, for example has a rule that the hashtag is not used for promotion or advertising of commercial goods and services.

Professional standards in the world of social media:
Another issue that this incident raised is the extent to which we are free to publish or post what we like on a professional blog or website.  A clinical standard which all speech and language therapy professional bodies now expect, for example, is adherence to the principles of evidence based practice.  Our clinical practice falls along a continuum regarding levels of underpinning evidence and I would doubt anyone would advocate too strict a policy regarding what level of evidence is required for services.  It could be argued, however, that it is not appropriate for our profession to promote services that would be considered 'rogue' or 'outlandish', however, or services where there has been clear evidence of non-effectiveness.  Given that many speech and language therapy professionals now use the internet to promote services, I suggest that our profession would benefit from professional standards on blogging and other publication on the internet.

Update 6th March:
Thank you to those of you who responded to a request for information regarding current guidelines. In the UK the RCSLT does not have its own standards, but refers all enquiries to the HCPC which has guidelines on social media here. Speech Pathology Australia have guidelines here and please see Caroline Bowen's comment below for guidance on use of the #WeSpeechies hashtag. If you are aware of any other professional bodies across the world with guidelines or standards for publishing on the internet, please do get in touch with me and I'll update this blogpost.

Conclusion - are we too nice?
The internet is the 'wild west' of our professional practice.  Currently unregulated and with no code of conduct it appears that anything goes.  This can be refreshing and liberating but it also has its consequences.  While we do develop our practice in this arena, however, I challenge the reader to consider the priorities. When working towards a better, more clinically robust service for the benefit of our clients (who I would hope should always be the priority), let's not close down discussions for fear of not being 'nice' enough.  We need to be robust and stand up to critique, especially those of us who publish on the internet.  Try to be nice on the internet, but not too nice not to keep the debate open for the benefit of everyone.

3rd March 2015 PS: Further to my request for information on guidelines from different professional bodies I have received comments from readers with information.  I am waiting to hear from others, after which I will update this blogpost.  In the meantime please do read the comments below where you will find more information on professional guidelines for social media and internet use.

Healthy skepticism in clinical practice.

I’m a bit of a stargazer, so I was exited to learn that we would be able to see the International Space Station passing over the UK last Christmas.  My family and I stood outside in the cold and watched in wonder as what looked like a bright star majestically passed directly over our house.  A couple of days later another astronomy tweet did the rounds claiming that on January 4^th 2015 we would all experience some weightlessness due to an unusual planetary alignment in our solar system. Thanks to Phil Plait – astronomer and blogger, this claim was debunked shortly afterwards as being completely false (Plait, 2014).  This saved me from the social embarrassment of jumping up and down on January the 4^th yelling to the kids “can you feel it?” for no good reason! Aside from astronomy, however, Plait’s blog caused me to reflect on the importance of healthy skepticism within our profession.

What is skepticism?

A skeptic questions the truth or value of a claim.  Not to be confused with religious skepticism, scientific skepticism is fundamental to the advancement of knowledge.  A skeptic will endeavor to base beliefs on the accumulation of evidence and is prepared to modify beliefs in the light of new scientific findings.  It is also not the same as intelligence, Plait noted that intelligent people are sometimes taken in by false beliefs.  This is more likely if the belief is either widely held or championed by an authority figure.

In the workplace, effective skeptical practice does not stop with questions but seeks evidence to either support or reject assumptions.  This may result in a conclusion of ‘we don’t know yet’, but that is better than a false assumption that we do know.   

Why is skepticism important for speech and language therapists?

We might consider that a skeptical approach to our work is not so important, because we are already underpinned by evidence-based-practice.  Alternatively we may believe that we are already skeptical enough.  A skeptical approach to work, however, is needed more than ever for the following reasons:

1.  Professional integrity

A huge amount of information is now available at the click of a mouse.  I recently carried out  a google search using the search term ‘speech therapy’ and it yielded over 18.5 million results.  Not only is the quantity of this information overwhelming, much of it will not be reliable and clients may find a vast range of cod science and quackery surrounding their clinical need.  As a protected profession we are trusted as experts and our message should be reliable. New trends that overlap with our therapy practice emerge regularly that claim efficacy but are not grounded in adequate or reliable evidence (examples in my field of practice include brain gym and baby signing).  Some advice even extends to the ridiculous, with one speech therapy blog hosting a guest blogger promoting astrology for children with communication needs!  Whilst most practice does not extend into the realms of the ridiculous in this way, we do need to be aware of the grounds on which claims of efficacy are made.   As we know, no evidence of effectiveness is not the same as evidence of non-effectiveness and therapists are entitled to be open-minded about new initiatives.  We should, however, be aware of the level to which different approaches are evidence-based, and in turn be honest with clients about this.

2.  Myths and legends. 

We may be tempted to believe that we are no longer subjected to myths and legends as in times past, however, there are still many stories that abound concerning communication and language that need to be debunked.  Recent mainstream news articles in the UK have blamed forward-facing buggies and ipads for damaging child development.  Neither claim is underpinned by any evidence (for an analysis of the iPads article see this Guardian post, and for forward facing buggies read my blog here).  Whilst as a profession, we generally follow principles of evidence-based-practice it can be tempting to run with stories such as these because in doing so we can promote our own messages (for example, a carer-facing buggy promotes face to face interaction).  I believe we have a duty, however, to be more robust with our professional advice instead of dressing up our messages up in popular opinion.

3.  Conflicts of interest. 

Sources of evidence that we are presented with may be influenced by bias due to conflicts of interest.  These may be financial but may also be for other reasons.  For example, ‘investigator allegiance’ refers to a particular intervention being championed by one person, who may be seeking to enhance their own reputation (Bernstein-Ratner, 2006).   This, as well as other conflicts of interest may lead to a bias towards positive results in the literature, known as a positive publication bias. Aware of this bias, there is now an expectation that negative findings of evaluation studies or trials are published but this still does not routinely happen.  Ben Goldacre highlighted this issue very clearly in the case of drug trials in this talk.  We need to be aware that a similar bias may also occur in our own field of practice concerning trials of interventions.  As a profession, we need to keep up with these results too, so we are aware of what is likely not to work for clients as well as what is likely to work.  Loff (2011) highlighted that if evidence suggesting an intervention does not work is not shared then ineffective practice can continue, grow in popularity and become part of the folklore of the profession. As I stated earlier, myths that are widespread are more likely to be believed.

What should we be skeptical about?

Skepticism should not just be limited to questions concerning effective therapy approaches. Our profession can benefit if we question all aspects of our practice, from theory underpinning our decisions through to discharge planning.  We should even question assumptions about evidence-based practice itself.   As we all bring different perspectives, collective and constructive skepticism can help to move the profession forward.

How can we exercise healthy skepticism?

We can’t all be experts on everything, so it is important to be skeptical collectively.  Make the most of specialists and regularly update care pathways in line with recent evidence.  Clinical researchers are skeptics in practice, so if there is a research active clinician or a researcher in residence in your team, use them to inform the questions you ask and the way you go about answering your questions.  They should be aware of the most up to date guidelines that are in place to inform the quality and clinical relevance of evaluation studies and trials. 

As well as researchers, use the tools now available to support evidence based practice decision making, including the What Works Website, SpeechBite and the Evidence-Based Clinical Decision making tool (Joffe and Pagnamenta, 2014). How about a regular “What’s the evidence?” feature in the non peer reviewed professional magazines, such as the RCSLT's Bulletin, where different contributors write an analytical article on the current evidence for a particular therapy?

Another great source for collective skepticism and a way to keep in touch with evidence based practice is to maintain an active Twitter account.  As well as my Twitter account @clarrysmith there are many ,champions for evidence based practice in the Twittersphere.  These include, but are by no means limited to @vjoffe, @SusanEbbels, @deevybee, @lilacCourt, @avrilnicoll, @speech_woman and @BronwynHemsley, as well as professional networking and organisational Twitter handles, including The Cochrane Library, WeSpeechies and EBPChampion.  Twitter also enables me to maintain an international perspective.  As well as my own professional body, the RCSLT, I am also able to follow other speech and language therapy professional bodies such as ASHA and SpeechPathAus.  I appreciate I am probably preaching to the converted here, if you have read this blog then it may be because you're already on Twitter.  If you benefit from Twitter in the way that I do, however, why not share this blog or your message with your colleagues via email and spread the word.  The more clinicians we can network with via Twitter, the greater our collective wisdom.

Reflective practice and clinical supervision are opportunities for disciplined skeptical thinking.  Reflective practice is a great opportunity to question your own practice and assumptions.  Within group supervision healthy skeptical conversations can be encouraged at work.

Skepticism can be seen as a negative trait but if harnessed constructively, it can help us to grow as a profession.  As we experience more commissioning of services, a team that enables open and constructive skepticism supports staff in developing robust services that they are proud to deliver.

References:

BERNSTEIN-RATNER, N. 2006. Evidence-based practice: an examination of its ramifications for the practice of speech-language pathology. Lang Speech Hear Serv Sch, 37, 257-67.

JOFFE, V. & PAGNAMENTA, E. 2014. Evidence-based clinical decision making. RCSLT Bulletin. London: RCSLT.

LOF, G. L. 2011. Science-based practice and the speech-language pathologist. Int J Speech Lang Pathol, 13, 189-96.

PLAIT, P. 2014. No, a planetary allignment on 4th January 2015 won't decrease gravity. Bad Astronomy [Online]. Available from: http://www.slate.com/blogs/bad_astronomy/2014/12/24/zero_g_day_nope.html [Accessed December 2014 2014].

We need a positive culture of music for our children.

I originally wrote this commentary last year, inspired by the Channel 4 series "Don't Stop the Music". The comments are still valid but I have updated the blog very slightly. This year a fantastic project called TenPieces has been produced by the BBC, which aims to introduce primary school children to ten well known pieces of classical music in a dynamic and interactive way.  It's a great project and my son's school has been using it as a basis for music lessons with really positive outcomes.  My son has come home singing classical pieces he has learned and he also is able to talk about the composer and the structure of the music.  I experienced a real joy the other day when he commented "I really like classical music, in fact some of my favourite tunes are classical music!"

To find out more about Ten pieces click on this link, or follow #BBCTenPieces on Twitter.

Last year Channel 4 produced a short series called 'Don't stop the music', featuring James Rhodes, a concert pianist with a mission to revolutionise music teaching in Britain's Primary Schools.  You might be forgiven for thinking - 'oh no, not another mission campaign programme', following hot on the heels of the likes of the highly admirable Jamie Oliver, Hugh Fearnley Whittingstall and Gareth Malone, but perhaps yet another expert moralising about what we need?

After watching the series, however, James Rhodes appeared to have got this right. First, it is apparent that  the state and status of musical teaching in primary schools in the UK is dire.  As a developmental language therapist I've been banging on about this for years so James Rhodes is a man after my own heart.  Our children are currently being denied access to quality musical education in primary school - the early, formative years when it really matters.  And I believe the root of this problem lies with a lack of a positive musical culture in school and at home.

Why do we need to develop a culture for music?

Do you like music? - seems like a pretty stupid question doesn't it, because we all enjoy some form of music or other. Music is part of our everyday experience. And yet, many people are unable to participate in music beyond singing along to the radio or watching the X factor. What if our children could do more than this? Beyond getting skills for working life, what is education for, if not to expose our children to the wider world and to instruct them so they can be active participants in life?  This is especially valid for music, where some skill is needed to support participation.  Most people would agree that they enjoy music,  and those of us that have had the privilege of playing music with others are testament to the life enhancing experience that it is.  What is more, as James Rhodes pointed out in the first episode, we have a multimillion pound music industry in the UK, which will need future talent.  Schools do their best with the limited resources they have, but apart from a once weekly general music class (often taught by unqualified staff), any other musical training is usually an optional extra that comes with a price tag for parents. Because music is not adopted as an integral part of the culture of schools, children are left to 'go it alone' when it comes to the discipline required with practicing an instrument (especially if their parents are not musical themselves).  I think this is why so many children give up if they do start to learn an instrument.  

This lack of a musical culture in schools is further exacerbated by the (in my view, wrong) opinion that music is not a high priority subject at school or home.  The educationalist Ken Robinson highlighted this problem clearly, when he described the 'hierarchy of subjects'  - maths and literacy at the top of the hierarchy, with many hours and resources dedicated to these subjects, and music and art at the bottom.  Of course our children need to learn to read and write and add up, but this dilemma is so extreme, that school reports and SATs largely ignore subjects beyond literacy and numeracy in primary school (the sciences and humanities are paid lip service but very little more).  This is problematic for so many reasons.  Why do we need literacy and maths?  Surely partly to engage in wider learning!  Also, this approach carries the assumption that literacy and maths can't be learned outside of literacy and maths sessions!  I would argue that children could gain literacy and maths skills by engaging in music (and the arts in general - there is much to be said for drama and dance, but that is another blog!!).  Aside from the obvious lifelong pleasure to be gained from playing music with others, learning an instrument has so many benefits for academic achievement (there is evidence for impacts on language, maths, literacy etc).  Too often I hear parents saying that their children 'want to give up' an instrument after they have got over the initial excitement and are having to face the challenges of regular practice.  Funny how we never hear the narrative of wanting to 'give up' maths or reading!!!

The purpose of this blog is not to undermine or negate in any way the fabulous work that is already done by the unsung musical heroes in our schools music services, and the scores of talented and inspiring music teachers up and down the country.  Also it is important for me to point out that our local primary school has done a fab job of encouraging music with the limited resources it has.  But more is needed.  Like James, I believe all children should be encouraged to actually learn to play an instrument.  This blog is about supporting those who work towards supporting music, and positioning their role firmly as an essential component of learning in a musically active school culture.  Musical development is hugely beneficial for children and if nurtured in a positive culture, where music is an accepted and prioritised aspect of school life, I believe children would rise to the challenge of learning to play.  

Developing a musical culture in our communities.

Developing a culture means we all get involved.  Children are led by example, and if they see adults (teachers, parents and friends) engaging in and enjoying music, they are more likely to get on board.  This means that, as much as we are able, we should try to develop a musical culture at home too.  Perhaps we might enjoy it along the way!

Playing at a local festival 

There are many ways parents can encourage their children with music.  In 'Don't Stop the Music' James Rhodes has called an amnesty on all the unplayed instruments sitting in peoples' attics,  but before you give it up,  perhaps you might think about starting to play it again?  This would do wonders to encourage your children.  Join a musical group or form a band with your friends.  I learned to play the double bass after both my children had been born and were at school.  I'm no expert, but have fun playing with friends who have also either learned later in life or who have picked up an instrument once learned then forgotten.  Our children see us having fun and are encouraged to join in.

With friends round the bonfire on a camping holiday

The kids joining in with the music

Experiencing the thrill of the Royal Albert Hall

Another way to foster a musical culture at home is going to see live music.  The wider the range of genres, the better.  As a family we have recently been to a pop concert, our local festival, a classical concert at the Royal Albert Hall and a Royal Marines band concert.  Concerts can be expensive, but if we cast our eyes beyond the big stars the price tag comes down.  There are also often free classical events taking place regularly in churches, and in our home town there's always a gaggle of buskers on busy shopping days. This is a great way of democratising music, and helping our kids to see that you don't have to be a big star to play music (and there are more instruments than the guitar!).

A culture leaves a legacy

The British successes in the 2012 Olympics demonstrated that by building a culture for sport, people got inspired, and that encouraged participation and excellence.  Credit to James Rhodes for his part in developing a music culture for children.  We can all be part of this.  Not only will our children reap all the known benefits for learning music, but just think what legacy that might leave!

Can Big Data help research into language development?

Last Monday I attended an event at Cambridge University organised by the Cambridge Big Data Strategic Research Initiative (CBDRI) entitled "The vocabulary of Big Data".  I am cognisant of the fact that I am not a specialist in this area and, just as the title of the event suggested, I went along to dip my toe into this increasingly more useful approach to data analysis and gain at least a basic vocabulary.  Could embracing Big Data increase the possibilities for research into language development? Travelling up from the South Coast of England it was a fair distance, and I wasn't sure whether the event would be appropriate at all for me, an early career researcher with roots in clinical practice and one randomised controlled trial under my belt.  I wasn't entirely sure what Big Data even meant, perhaps it might be something to do with astrophysics, or analysis of Twitter use, or perhaps there might be other applications, such as language analysis, something I have used in my research.   This was a free event shared on Twitter and, not one to miss an opportunity, I went along.

There were 8 speakers in total, giving talks on Big Data from a range of perspectives. In this blog I am going to focus on just a few of those talks and the key aspects I learned from the event.

First we were introduced to the concept of Big Data, and why it was relevant today and in the future.  We live in a time where very large amounts of data are being produced, far more than ever before.  Social networking, genome sequencing, brain imaging, images, text and many more examples were given of the data generated.  It was also highlighted that this data generation is predicted to grow, and in 5 years time, the data we have access to now will appear as a drop in the ocean to data generated in the future.  By acquiring a vocabulary of Big Data we can begin the journey of learning how to tap into and benefit from the data that is produced.

The first talk by Professor Zoubin Ghahramani was an introduction to Machine Learning. In this talk we were introduced to the vocabulary of machine learning, which stems from the field of computer science and statistics.  Machine learning is a way to make sense of and manage large amounts of data.  An algorithm or model is created and built using the data which is input into the system.  That model can learn from new data and consequently is able to make predictions based on the data.  There are a range of different approaches used in machine learning, which include artificial neural networks, clustering and Bayesian networks.  These different approaches enable analysis and predictions in different ways.  We also learned about different applications for machine learning.  A well known example is that of the company Netflix, which used machine learning to more successfully predict consumer preferences.  Other applications of machine learning include object or photo recognition, speech recognition and natural language processing.  The benefit of machine learning is that, as it is able to learn from data it does not rely on a fixed predesigned algorithm to start with.

A real case example of the application of Big Data was presented by Dr Richard Gibbens who described how Big Data was used for road traffic modelling, demonstrating how the large amount of information gained from motorway sensors was used to predict and manage traffic flow on Britain's motorways.  He highlighted that this data was already collected for another purpose and was therefore available but through analysing the data his department were able to provide the Highways Agency with really valuable information about traffic flow, which is now contributing to road safety.  Whilst traffic data isn't something we're likely to be mining in the field of language and communication, the case study highlighted that a Big Data approach can exploit data that has already been generated for another purpose to answer questions.

A problem with handling Big Data is just that; it is big!  The issue of handling large amounts of data were addressed by Dr Anders Hansen, Dr Eiko Yonkei and Dr Jan Lellmann.  Through their talks we were introduced to the storage and processing issues encountered when dealing with Big Data.  We were introduced to the concepts of compressing data. We were shown two images of earth, one with all the data and one with the data compressed.  To the naked eye, it was impossible to see the difference between the two, and this highlighted the fact that most of the information held in a data sample may be gleaned from a small percentage of that data.  We were shown how this approach can be used in brain imaging to provide a high level of focus on an area of interest, such as a lesion, without significantly increasing the amount of data processing.  The ways in which large amounts of data are stored were also addressed. In part, Big Data can now be stored effectively thanks to the ability to use multiple servers and cloud technology.

The event ended with a case history of natural language processing presented by Dr Paula Buttery.  She showed how natural language processing could be used to gain information from large sources of text using algorithms, and how the syntax of language could be used to make predictions.

This event really did give me a basic vocabulary of Big Data and an awareness of how it might be useful in language development research.  Undoubtably, Big Data approaches will already be employed in the field of genetic research and the neuroscience of language development.  I believe Big Data may be employed in the same way concerning environmental influences on language development.  Having spent my last research project transcribing hours upon hours of parental talk to children I am very interested in how we may embrace both new technologies of data capture and the discipline of Big Data analysis to make progress in this academic field.

A Review of 'Brainstorm' - a whirlwind encounter with the teenage brain

I love science and the communication of science in new and interesting ways.  My daughter and I love theatre.  I am a developmental speech and language therapist, researcher and parent.  My daughter is a teenager.  Islington Community Theatre's production 'Brainstorm', a youth theatre drama explaining the neuroscience behind the teenage brain and teenage behaviour looked set to tick all the boxes.

Brainstorm is a collaborative production with Islington Community Theatre, Park Theatre, the Wellcome Trust and the National Theatre Studio.  The result of 2 years of creative theatre making and workshops and with the involvement of leading neuroscientist Professor Sarah-Jane Blakemore (UCL), this looked like an exiting and innovative production.

Each of the teenagers made their entrance onto the stage with a typical teenage exclamation or grunt and proceeded to play with their mobile phones.  We were reminded that many people think of teenagers as a 'crap version of an adult'.  This production was to show the audience that it is not really like that.  Right from the first scene, the importance of the teenage brain in this story was given centre stage.  How the brain develops during the teenage years explains why they behave the way they do.  Members of the audience were informed that teenagers' behaviour is part of their development and is just the way it should be.  The performers pointed out that their brain is 'not broken' but 'beautiful'.

The setting of the production was the teenagers' own bedroom, which acted as a metaphor for many features important to teenage development; an expression of emerging independence and identity, a sanctuary and an illustration of the brain itself.  Another key prop in the production was the mobile phone, a device to which this generation of teenagers appears to be permanently attached.  Images from the cast's mobile phone screens were projected up onto the wardrobe to illustrate parts of the message.  This was an innovative way of communicating the story through a medium which is a fundamental part of the modern western teenager's identity.

The cast did a great job of explaining the neuroscience behind the teenage brain, behaviour and development.  Our brains are made up of no less than around 85 billion brain cells called neurones, which are connected together with synapses.  Teenagers have many more connections than adults so everything is connected together.  This was illustrated in the drama as the teenager's own bedrooms, messy and chaotic, full of everything.  As we develop, the connections or synapses that we use are reinforced and the ones that we don't die away, a process known as pruning.  The bedroom analogy was used again to illustrate pruning in the brain as the teenagers found a special place for their really useful or loved items, and cleared the less useful stuff away.

Other features of brain development also explained teenage behaviour.  The prefrontal cortex 'just behind your forehead' is the part of the brain responsible for reason and rational behaviour.  This part of the brain takes a long time to develop and is not fully developed in the teenage brain. The limbic system, that is the part of the brain responsible for emotions, risk taking and reward, is highly sensitive during the teenage brain.  The performers illustrated this as the limbic system shouting at them to take risks and handing out sweets, while the underdeveloped prefrontal cortex whispers in the background 'can you hear me?'

The production explored key aspects of teenage life, hopes and dreams for the future, relationships with friends and parents and the teenagers' emerging sense of self; 'you want me to be you but I am not you'.      The performers gave a candid account of themselves and their experiences which was both life affirming and moving.  A particularly powerful scene was introduced as 'brain scan', and involved the performers answering questions about themselves by turning on a lamp.  The anonymity of responses the randomly placed lamps gave enabled the teenagers to be open in their answers to challenging questions such as 'have you lied to your parents today?', 'does the thought of sex scare you?' and 'have you ever been drunk?'

The confidence, energy and potential of the teenager was demonstrated through the voices of these young actors.  Their vulnerability and need for understanding and support from their parents was also clearly communicated, particularly in the final scene where each performer shows a written message of love to their parents, something that they 'could never say'.  One key theme that was reinforced throughout the play was that brain development is not a 'one-off'' event, like starting your period.  It takes a long time.  'That's important.'

This production was a truly unique way to communicate the neuroscience of the teenage brain to a wider audience.  Using the voices of teenagers themselves made it even more powerful.  They understood and owned the science behind their own development.  The combination of these two aspects of communication resulted in a clear, powerful and relevant message.

I have always had an interest in the theatre and how it can be used to inform and educate.  I am also very interested in exploring ways in which scientific discoveries can be communicated to a wider audience (for more of this see my previous blogs on my experience of the Cheltenham Science Festival).  Living on the south coast my family is a long way from   Finsbury Park in North London.  I wanted to see this production for myself, but given that my daughter loves drama, I thought it might be an opportunity for her too to be exposed to a new field of science through a medium she loves so she and I travelled to North London for the Saturday matinee performance.  Brainstorm did not disappoint, in fact it far exceeded expectations.  I was surprised by the sheer energy of the cast, young people aged between 13 and 17, giving graphic, emotional but authentic portrayals of their experiences as teenagers.

It would be amazing to see such an innovative performance given a wider audience, perhaps at a major UK science festival such as Cheltenham or the British Science Festival.  Whatever the future of this venture, however, one thing is clear; Islington Community Theatre should be proud of a truly unique production.

Debunking parenting myths: The tale of the incompetent parent, the fiendish forward facing buggy & the developing child.

The poem 'This be the verse' by Philip Larkin starts with "they f*&!k you up, your mum and dad, they may not mean to but they do". It is true that parents are going to get some things wrong, but are they really messing things up quite as much as the media would have us believe?

Last week the UK's Daily Telegraph - education section published an article claiming that child communication development was being damaged as a result of parents' use of forward facing buggies.  The argument followed that forward facing buggies do not facilitate face to face interaction and conversation.  The claims were made by Gail Larkin, president of the National Association of Head Teachers.  You can read the article here. This might be worrying were it not for the fact that there is no evidence that these claims are true. 

In my fifteen year career as a speech and language therapist and now as a researcher into early language development these scare stories blaming parents are not new.  This article could well have been written back in 2005 when the National Literacy Campaign authored a paper entitled Why do many young children lack basic language skills? as part of it's "Talk to your Baby" campaign.  Or it might have been written back in 1995 after a groundbreaking study by Betty Hart and Todd Risley in the United States highlighted the relationship between parental talk to children and child language development.  Similar articles expounding the failings of parents were written in June 2003 , August 2003 and 2004.

It is valid to be concerned about child language development.  Communication through language is a vital skill, necessary for successful social, emotional, academic and ultimately economic wellbeing.  It is also valid to question what influences child language development and seek to optimise the environment children grow up in to support their acquisition of language.  We do know that there are a significant minority of children who genuinely need support due to difficulties with learning to communicate.  The sad fact is that despite this being a fascinating and valuable area of study, some newspaper articles such as the latest in the Daily Telegraph appear to be interested in going no further in this debate than blaming parents for the problem.  In this particular case, to make matters worse, the claims were not valid and were not based on a shred of credible evidence.

Following a brief discussion with other professionals interested in child development on Twitter I felt it necessary to debunk the myths in this latest article that have been reported as fact.  In order to make the claim that forward facing buggies are damaging child language development you need to establish a number of factors based on evidence; first, you need to agree there is evidence that children's communication skills have deteriorated over the last decade, second, that child language development is caused by parents not talking to them enough, third you then need to establish that parents are talking less than they used to, fourth and finally you would need to establish that forward facing buggies cause parents to talk less, and this effect is large enough and lasts for a long enough duration to have an overall effect on parent input to children.

In this blog I have explored these questions with reference to the evidence we currently have;

1.  The article claims that, in general, children's language has deteriorated.
I have heard this concern consistently throughout my clinical experience, and yet there is no empirical evidence to support it.  In areas of social deprivation there does appear to be a higher prevalence of language delay than in more affluent areas (see for example Locke et al; 2002 and the Hart and Risley study cited above), but this factor should not be generalised to a blanket concern about all children, and there is no evidence of change over time.  The only way to be sure that language skills have deteriorated is to compare cohorts of children at different points in time and there have been no such studies reporting a deterioration of language skills.  In fact, in 2003 in response to this very same concern an article in the UK's Times Educational Supplement uncovered 2 unpublished cohort studies, which indicated that, if anything, children's language levels had improved over that previous decade (you can read this article here).

Given this factor, the two further claims in the article that I challenge below are in essence moot points.    Let us explore the claims, however, to see if they might shed light on how we can help children who do present with language learning difficulties.

2.  The article claims that parents are having fewer conversations with their children.
Gail Larkin postulates that, in addition to forward facing buggies, this is because parents are spending too much time talking on their mobile phones or chatting to friends at the school gate.  This issue needs to be broken down to two distinct questions, a; are language learning difficulties caused by a lack of parental talk? and b; are parents actually talking less to their children than previous generations?

a; Are language learning difficulties caused by a lack of parental talk?
There is evidence that children from different families do experience a wide variety in the quantity of language that they hear from their parents.  This has also been found to be related to the child's language development (again see Hart & Risley, and Hoff and Naigles; 2002 for examples of this research).  It is also generally established that the language children hear forms part of the language learning mechanism and so as a clinician I would always advise parents to talk to their child through everyday routines to support child language acquisition. How effective this advice is is a topic for another blog, however, and whilst there is a relationship between parent language input and child language learning, Dorothy Bishop (Professor of Developmental Neuropsychology; University of Oxford) highlighted recently in her blog that as these studies on parent talk and child language learning are based on correlations a cause and effect relationship has not been established.  It may be that a third factor is influencing both parent language input and child language development.  For a more comprehensive discussion on this matter, read Dorothy Bishop's blog here.  The point to be made in this discussion is that, attractive as the proposal may be, there is as yet no evidence that child language learning difficulties are caused by lack of parental talk.

I suppose professionally I find this the most difficult question to address.  Something is going on between parent talk and child language learning, and much more research needs to be carried out in this area, as it is clearly a potential area of value to the speech and language therapy profession.  It is important, however, to be aware of what we know and what we don't yet know, and not to jump to conclusions.  In any case, the argument put forward by the Telegraph does not rest on this fact alone.  If anything, it states the claim that parents are talking less to their children than previous generations.  Let's explore that question, therefore, in a little more detail.

b; Are parents actually talking less to their children than previous generations?
Whilst there is evidence of a wide variety in the amount of language children hear across a population, there is no evidence that the amount of language children hear has changed within a population over time.  On the contrary, the research I have carried out with families in Portsmouth city, UK, reveals a similar distribution of parent talk across the population to that carried out by Hart and Risley in the early 1990s. Other studies have also reported similar distributions over the years, including the Hoff and Naigles study cited above and a recent study of parents in the US by Weisleder and Fernald; 2013.  There is no evidence that parents in general are talking less to their children than previously.

3.  The article claims that forward facing buggies are to blame for the decline in children's language skills.
Again this is not a new concern but was raised in the noughties (around 2005) by the National Literacy Trust's (NLT) 'Talk to Your Baby' campaign.  The NLT commissioned a study at Dundee University exploring the effect of forward facing buggies on parent-child interaction.  The buggies were already being blamed, however, for poor parent-child interaction in a Talk to Your Baby Conference in 2004 before the research findings were reported (see page 3 of conference report here).  To see if there had been any further developments leading to the latest newspaper article I carried out a quick review of the literature.  It yielded 1 review in 2011 (Topping et al) and 1 subsequent empirical  study (Blaiklock; 2013).  The Dundee study was not published in peer reviewed literature but a study report was published by the National Literacy Trust.  No study provided any evidence of a negative effect on child language development.  Effects on parental interaction were at best inconclusive, sample sizes were too small to have any confidence in the outcomes.  The fact is, in terms of empirical evidence, we are a long way from any claim that forward facing buggies are damaging child language development.

To conclude; should parents be forced to fork out on expensive buggies on the grounds of the Telegraph article?  Furthermore, should the media continue to fuel parental guilt based on the opinions of one person?  Whilst debate is to be encouraged in order to support child language development, rather than basing judgement on opinion let's have an informed inclusive discourse based on evidence.

The daily Telegraph has a much wider readership than this blog ever will, so journalists have a duty to report a balanced view of a topic, and there are moves to report science more objectively through the efforts of Sense about Science and The UK's Science Media Centre.  Unfortunately much needs to be done in the field of child learning and development before poor parenting myths are put to bed.