Articles from the Spring 2008 Issue
Do drop in
How a community clinic drop-in service can ease the pressures of large caseloads, waiting lists, late referrals and non-attendance
Maeve Guly has run a drop-in community clinic in Devon for six years. Parents bring children either of their own volition or following a recommendation from a health visitor or other professional. It provides an informal opportunity for the therapist to gauge what the communication difficulty might be and to offer advice and reassurance until further therapy can be arranged if necessary. This audit looks at 150 consecutive children, listing their sex, age at referral and primary finding. Maeve describes the challenges and practical aspects of running a drop-in service and lists useful resources. She also reflects on the benefits for clients and their parents and her own professional development.
Time for communication
Mike Harrison, Rosanne Lyddon, Cathy Harris & Yunus Hansdot
A three year Leonard Cheshire Disability Communication Project gives more clients the opportunity to access AAC
Almost half of Leonard Cheshire Disability’s residential service users have communication impairments associated with congenital or acquired conditions. With speech and language therapists in short supply, the charity is running a 3 year Communication Project to ensure its clients across the UK access the help they need. It has recruited 10 communication support officers who visit service users, staff and volunteers regularly to assist them in developing more effective communication methods and to make sure that speech and language therapy recommendations are put into practice. The communication support officers introduce low tech solutions where possible and promote choice and independence. Mike Harrison is the Project Coordinator, Rosanne Lyddon is a communication support officer, Cathy Harris is a specialist speech and language therapist in communication aids and Yunus Hansdot is a service user. Rosanne and Cathy discuss the benefits of the project as exemplified by Yunus.
A driving force
Nicola Clark & Sheena Nineham
Dissatisfied with their aphasia service, the Portsmouth adult speech and language therapy team formed an Aphasia Action Group
Inspired by Connect and the British Aphasiology Society, and dissatisfied with the quality, quantity and equity of local services for people with aphasia, the Portsmouth adult team formed an Aphasia Action Group. It aims to create a communication friendly healthcare culture, promote confidence and enthusiasm among therapists, provide an equitable service and to be respected locally and nationally. The article reviews how far this has been achieved through therapists developing resources, attending in-house workshops, running groups for clients and carers and hosting conferences. Future plans to maintain the momentum include increased opportunity for user involvement in service development.
Three years of a health promotion speech and language therapy post reviewed
Nicola Brooke is clinical lead speech and language therapist for health promotion for Southampton City PCT, a post created in 2004 to tackle a perceived increase in children experiencing delayed and / or impoverished language skills. Joint funding has enabled her to implement initiatives aimed at increasing knowledge among practitioners and families of how to encourage normal language development and make timely onward referrals. These include a training programme for practitioners working with preschool children, a magazine containing communication information and tips for families with young children, and similar information on culturally appropriate DVDs. Nicola lists the ongoing challenges of providing training for the right people at the right level, assessing need and evaluating outcomes.
The best laid plans…
Paula Leslie, Hannah Crawford & Heather Wilkinson
Seeking to understand the implications of percutaneous endoscopic gastrostomy (PEG) for adults with learning disabilities at end of life
PEG (percutaneous endoscopic gastrostomy) tube insertion is an effective way of providing nutrition, and its use with people with dysphagia is increasing. Concern is being expressed about the use of PEG tubes for people with end-stage dementia. With improved life expectancy for adults with learning disabilities likely to result in increased incidence of dementia, understanding indications for insertion of PEG tubes is vital. The authors describe attempts to undertake an exploratory, UK based retrospective review of closed files of adults with a diagnosed learning disability who had had a PEG tube fitted in the 12 months prior to their death. Data collection difficulties could not be overcome so the researchers held a multi-professional study day instead and have since continued to present on this issue and to explore other opportunities for research in this area.
Peter Tester offers tuition in information technology to learners with severe neurological difficulties as part of a project to enhance their quality of life.
Somerset College is a pilot site for Enhancing Quality of Life provision for people with profound / severe and complex learning difficulties. The linked curriculum service offered includes communication sessions, art, ceramics / pottery and information technology. Tutor Peter Tester describes the IT group content and process and explains how his own experience of an acquired brain injury gives him an insight into strategies which can be helpful to learners. He actively supports learners to find suitable hardware and software and is developing e-learning resources.
Assessments assessed (6)
Kathy Sherrit & Rachel McDermott; Susan Anderton
In-depth reviews of the Communication Development Profile and the Communication Disability Profile
- Communication Development Profile, Charlotte Child, Speechmark (Kathy Sherrit & Rachel McDermott find this a well organised and holistic way to describe a child’s communication and identify appropriate therapy goals.)
- Communication Disability Profile, http://www.ukconnect.org (Susan Anderton welcomes the freshness of an assessment that focuses on what a client with aphasia can communicate rather than what they can’t.)
How I meet my information needs
Avril Nicoll with Katie Cullinan, Rebecca Matthews, Kerry Wreford-Bush & Alison Hodson
Speech and language therapists and their clients have a huge need for information. This article considers how we can meet that need without experiencing overload.
Katie Cullinan gives priority to making face-to-face and telephone links with relevant people because sharing ideas and information makes for a better service to clients. Rebecca Matthews is mainly inspired by clients to find out more, but notices that the information can often reach her in a random way. Working in a very specialist post, Kerry Wreford-Bush welcomes the opportunities the internet offers for global links. Alison Hodson is solution focused and has a number of strategies to avoid becoming swamped with information. Avril Nicoll relates their experience to information behaviour as discussed by Case (2007) in ‘Looking for Information – A Survey of Research on Information Seeking, Needs, and Behavior’, Academic Press.
Are you getting enough? – (1) Supervision in context
Sam Simpson & Cathy Sparkes
Sam Simpson and Cathy Sparkes introduce a series of four articles on the importance of supervision
Sam Simpson and Cathy Sparkes are experienced supervisors and supervisees who offer non-managerial supervision to speech and language therapists and other healthcare professionals. They find supervision is not a static, defined set of skills and roles but a fluid relationship encompassing a wide range of skills and techniques which may include support, mentoring, coaching and action learning. A practical activity guides readers to reflect on their own supervision journey.
Alison Newton & Linzie Priestnall
A departmental prioritisation process to ensure adult inpatients receive a consistently fair speech and language therapy service
Communicating Quality 3 recommends that departments develop explicit prioritisation policies. This helps newly qualified therapists develop their skills, and more experienced therapists reflect on their decision making. Alison Newton & Linzie Priestnall led a process enabling therapists in the Heart of England NHS Foundation Trust to ‘think aloud’ their reasoning around prioritisation of adult inpatients referred to speech and language therapy. This evaluation process provided a qualitatively rich information template for building a policy, which was then strengthened through information from research papers, Trust policies and national guidelines. Alison and Linzie explain how the new policy works in practice and how it has since been successfully implemented in another Trust.
A quiet evolution
A gradual shift of services from clinics to schools for children from nursery age has dramatically cut the speech and language therapy failure to attend rate in Skelmersdale
Around 5 years ago Maggie Robinson was leading a team of four community clinicians in Skelmersdale who were frustrated by poor attendance in local clinics. They felt that by working more in schools they would improve access for children from nursery age. This was supported by schools and parents. Maggie describes the deliberately low key and gradual implementation which gave the speech and language therapy department time to make adjustments and learn from experience as they went along. The failure to attend rate has been cut dramatically and the department plans to start carrying out initial assessments in schools as well.