Spring 2009

Articles from the Spring 2009 Issue


Changing you, changing me

Andrea Ruck

Video Interaction Guidance addresses attitudinal barriers of care staff of adults with learning disabilities

Andrea Ruck works with adults with learning disabilities. She became frustrated when traditional methods were not effective in getting carers to change their communication behaviours. At the same time she was looking to be more positive in her work. A colleague mentioned Video Interaction Guidance in 2005 and this has proved transformational for Andrea’s practice. The article describes the background to the approach, reasons why she finds it exciting and rewarding and the positive impact on her practice. Andrea also mentions limitations, offers two case examples and looks forward to developing her skills in Video Interaction Guidance as a supervisor and practitioner. This article is accompanied by a short contribution from Jane Young who uses the approach with parents of children with speech, language and communication needs.


Advocating partnership

Lois Cameron & Sally Boa

Talking Mats used by people with learning disabilities to collect and give feedback on advocacy services

‘Advocacy into Action’ provides independent advocacy services to people with learning disabilities in Clackmannanshire. The group worked in partnership with the AAC Research Unit at Stirling University to find a way to involve people with a learning disability in collecting and giving feedback to advocacy workers. They developed an interview tool, the Advocacy Talking Mat, during a six session training course for 10 people with learning disabilities. Talking Mats is a low tech communication framework involving a textured doormat and set of symbols. The authors describe how they organised the training, the level of involvement and change in participants and the project outcomes. They also consider what extra support may be needed to enable individuals to carry out successful interviews.


Here’s one I made earlier

Alison Roberts with two low cost, flexible therapy suggestions to promote friendship: ‘Friendship bands’ and ‘Fields of interest’.


If at first you don’t succeed… Part 1: When traditional techniques are not enough

Liz Ackroyd

Trophic electrical stimulation and Surface Electromyography with a client with severe oropharyngeal dysphagia

This article describes the symptoms of a man with severe oropharyngeal dysphagia and his speech and language therapy treatment. While part 2 goes into detail about the tools and resistive exercises used to improve tongue movement and lip seal, part 1 concentrates on Trophic Electrical Stimulation and Surface Electromyography. There was no perceptible improvement in the effectiveness or safety of swallow, and Liz reflects on why this may have been and how she would do things differently now. Additional insights are provided through peer review by specialist speech and language therapist Penny Gravill.


If at first you don’t succeed…Part 2: Tools of the trade

Liz Ackroyd

Tools and techniques used with a client with severe oropharyngeal dysphagia

This article provides more detail on the tools and resistive exercises used to try to assist a man with severe oropharyngeal dysphagia (see Part 1 ‘When traditional techniques are not enough’). More information is given about Trophic Electrical Stimulation, resistive tongue / lip exercises, compensatory strategies and Surface Electromyography.


A lot of hot air?

Deirdre Cosgrave with Jill Titterington

A preliminary audit to see if sucking and blowing games can improve phonology

The academic consensus is that there is little – if any – good quality research to support the use of non-speech oral motor and respiratory exercises in treatment of speech sound difficulties in children. Despite this, many clinicians use these as part of an eclectic mix of evidence-based and non-evidence-based approaches. This article reports on an audit of sucking and blowing exercises in a language unit as part of an eclectic approach to children with moderate phonological / articulation disorder. The results of the audit are analysed, limitations acknowledged and tentative conclusions drawn which include the possible benefit of selective use of blowing exercises.


In Brief:

Lynn Griffiths explains a child-friendly visual representation of speech / pace of speech.


Winning Ways: A timely consideration

Jo Middlemiss

Time management for speech and language therapists

This is the first in a series of articles from life coach Jo Middlemiss written in response to a survey of reader concerns, top of which was time management. Jo encourages us to have a calmer, more elastic perspective on time and suggests four Ms to assist: meditation, mediation, manipulation and minimisation.


This House Believes in Botox

Kendrea Focht & Paula Leslie

Should clinicians advise clients with adductor spasmodic dysphonia to receive botulinum toxin injections?

This is the first in a new series of articles set out like a debate, with the Proposition required to prove its case and the Opposition aiming to show why the Proposition is wrong. The Proposition case considers studies which have shown significant improvements in participants’ quality of life after receiving botulinum toxin injections for adductor spasmodic dysphonia. Their Opposition contends there is a lack of evidence that Botox really works. The authors draw a conclusion for clinical practice based on the available evidence.


How I put learning into practice (1): View from a Welsh mountain

Dawn Leoni

Insight into communication difficulties through immersion in Welsh

Before starting a new job in North West Wales, Dawn Leoni was supported to attend a 10 week intensive Welsh course. This process gave her some insight into how it may feel for many clients who are struggling to communicate effectively with limited speech and language, and the strategies which may help. She presents twelve learning points for supporting adult client in rehabilitation.


Our Top Resources: head and neck

Eryl Evans, Jodie McCord & Ruth Best

Working in ENT and head and neck cancer

The authors consider their top ten resources for working with people with voice disorders and head and neck cancer. Five of the ten resources refer to people while the others cover a range of equipment, technology and educational items.