Autumn 2011

Articles from the Autumn 2011 edition

Understanding Rhys

Leadbitter, K. (Autumn 2011)

A young man with Down’s syndrome helps train his support staff in the use of Makaton

Rhys is a young man in his thirties who has Down’s syndrome. He lives with two other men with learning disabilities, supported by a staff team. As the staff found his speech clarity poor, and he was finding communication frustrating, he was referred to speech and language therapy. Karen Leadbitter structured and monitored the impact of this episode of care using a Plan-Do-Study-Act cycle to assess the situation, offer and evaluate intervention, and agree next steps with Rhys, his parents, and the staff team. Reflecting on the process, Karen suggests that Rhys’s participation in training his own support staff in the use of Makaton appeared to improve the communicative confidence and competence of both parties.


Whose goal is it anyway? Part 3: The wheel in motion

Simpson, S. & Sparkes, C. (Autumn 2011)

The third of a four part series explores readiness to change and goal negotiation conversations

Sam Simpson and Cathy Sparkes focus on the client’s voice in goal negotiations, and how this should inform the nature and timing of service delivery. Firstly, they describe the 6 stages of a theoretical model of readiness to change, and the therapist’s role at each stage. They then outline practical steps and tools which assist with initial goal exploration and goal negotiation and elicitation.


New Pathways

Paterson, L. (Autumn 2011)

A literature review on parent training following a diagnosis of autism informs design and implementation of an evidence-based programme

When a child or young person receives a diagnosis of autism, parent information sessions may be offered. To ensure a new parent training programme was evidence-based and equitable and consistent across an NHS area, Lynsey Paterson undertook a literature review, linking her findings with ‘recommendations’ if the evidence was strong and with ‘considerations’ if it was less clear-cut. This review directly informed the design of the multiagency programme New Pathways, including its emphasis on parental involvement and mutual support.


 In Brief:

Supporting Communication with Signed Speech

Diana James summarises her case study of the effects of the use of Paget Gorman Signed Speech in supporting the communication of four pupils with specific language impairment at a Special School.

Out of the mouths of babes

Nicola Grove is amused to observe the changing course of her granddaughters’ talking about talking over a two year period.


Journal club 5: observational studies

Reid, J. (Autumn 2011)

The fifth in our series to take the mystery out of critical appraisal looks at articles based on observational studies

Jennifer Reid’s series aims to help readers access the speech and language therapy literature, assess its credibility and decide how to act upon their findings. The content is based on the critical appraisal education format which has evolved in Fife and is delivered through a series of small group journal clubs. This article considers observational studies, how they differ from experimental ones, and the importance of recognising that evidence of an association is not evidence of causality. Three observational designs (cohort study, case-controlled study, and cross-sectional survey) are discussed. Two separate 10 question critical appraisal frameworks accompany this article: one for observational designs in general, and one for surveys that use questionnaires.


Here’s one I made earlier…

Roberts, A. (Autumn 2011)

Our series of low cost, flexible and fun therapy suggestions for groups

Paper fortune tellers


Symbolic voices (2): a complex reality

Greenstock, L. (Autumn 2011)

Putting the practitioner voice at the heart of research into the use of graphic symbols in schools

In 2009 Louise Greenstock gave an interim report on her PhD research into the use of graphic symbols in schools, and reflected on the influence of her previous experience as a teaching assistant. In this update she shares her final findings from analysis of interviews with teachers, teaching assistants / nursery nurses and speech and language therapists, which included a thematic framework, theoretical model and a suggested series of practical strategies for improving children’s experiences of using symbols. The research also gave insight into clinical reasoning, ambiguity around professional roles and the complex reality of implementation.


Boundary issues 6: An exceptional case?

Broomfield, J. (Autumn 2011)

Boundary issues: Adhering to standard service provision or making exceptions?

Jan Broomfield provides the sixth response in our series considering everyday events which need to be on our ethical radar screen: ‘The department you lead has a recruitment freeze and you are struggling to keep up standards of service, including waiting times. A referral comes in from a GP, and you realise the child concerned is the son of the Trust’s Chief Executive Officer.’


How I manage acquired brain injury (1): Tuning in a new audience

King, L. (Autumn 2011)

Revisiting Melodic Intonation Therapy

Daniel was only 16 when he sustained a severe head injury. Three years later he was in supported accommodation and receiving regular therapy, but Lindsay King wondered if he could achieve more. Inspired by a presentation at an aphasia special interest group, she decided to revisit Melodic Intonation Therapy, an intervention she had assumed was out-of-date. Although it is not possible to isolate the contribution of Melodic Intonation Therapy to his progress, Lindsay says it appeared to give Dan a platform for speech and, in turn, for greater social participation and independence.


How I manage acquired brain injury (2): The local dimension

Flynn, L. (Autumn 2011)

This article is written in memory of Suzannah Pemberton, who died in February 2009, three years after a severe head injury. Before transferring to a specialist unit where she moved into a fully conscious state, Suzannah spent 18 weeks in the intensive care unit of a local hospital. Here, speech and language therapist Laura Flynn reflects on the challenges and rewards of drawing on the literature, national guidelines and informal telephone advice to provide the best possible service to a minimally conscious patient pending transfer to a specialist facility.


My Top Resource

Pelman, C. (Autumn 2011)

A resource to support the language of maths

Regular contributor Cynthia Pelman recommends Stern Structural Arithmetic as an approach to support work on the concepts and vocabulary of maths, and to find common ground between speech and language therapists and teachers.


On language, power and gobby-ness

Speech & Language Therapy in Practice editor Avril Nicoll looks back on a varied and thought-provoking British Aphasiology Society Research in Progress day (with a little help from a friend).