Summer 2005

Articles from the Summer 2005 Issue


An integrated approach – in every sense

McCollum, D. & Teague, G. (2005)

Speech and language therapist Donna McCollum and occupational therapist Geraldine Teague on their joint sensory integrative group for preschool children with specific language impairment.

Do slings, scooter boards and climbing apparatus have a role in speech and language therapy?

Dr Jean Ayres initiated the concept of sensory integration, hypothesising that the development of the five senses (auditory, vestibular, proprioceptive, tactile and visual) and the integration of the information they receive is necessary before higher-level skills will develop normally. This means that sensory integration treatment should improve speech and language skills without specifically targeting language abilities.

Speech and language therapist Donna McCollum and occupational therapist Geraldine Teague summarise sensory integration theory and share the outcomes of their joint sensory integrative group therapy for preschool children with specific language impairment and sensory integration dysfunctions.


Enriching the early years

Sutton, C. & Sedgemore, J. (2005)

A joint strategic response to the increasing numbers of nursery aged children being referred with speech and language delay.

With increasing numbers of nursery aged children in Wolverhampton being referred with speech and language delay, managers from the service, a local education authority and a university college joined forces to ensure a strategic, coordinated response. This included training one member of staff from each of the nurseries involved to provide a communication rich environment for the benefit all children. The team also produced a quick screen and a detailed screen to help staff identify those children who needed extra attention and / or referral to speech and language therapy.


Yes or no – do we know?

Scrivener, L. (2005)

If you work with any client group where assessing capacity to consent is an issue, you need to be aware of new legislation and its implications for your practice.

If you work with any client group where assessing capacity to consent is an issue, you need to be aware of new legislation and its implications for your practice. Louise Scrivener looks at: legislation; consenting to medical treatment; consenting to social ‘lifestyle’ choices; and the assessment process, and makes recommendations for practice. The North Warwickshire Primary Care Trust ‘Consent process’ flow chart is also included.


Feature: Facing the fear

Nicoll, A. (2005)

Why do we fear breaking bad news, and how can we get better at doing it?

Arguably one of the most difficult aspects of a speech and language therapist’s work is discussing a diagnosis or the need for onward referral with clients, carers and parents. Editor Avril Nicoll asks why we fear breaking bad news, and explores how we can get better at doing it by being honest and open, listening well, encouraging the expression of feelings, following the client, carer or parent’s lead, and leaving the door open.

Speech and language therapists contributing to this feature are Geraldine Wotton, Angela Jones, Nibbhaya, Nicki Mason and Sam Simpson.


Winning Ways: The abundance key

Middlemiss, J. (2005)

Life coach Jo Middlemiss asks if you can see the abundance within?

Shona is a speech and language therapist in an influential promoted post. Although she used to love her work, she now feels frustrated and bored and is considering resigning. In the third of a series to encourage reflection and personal growth, life coach Jo Middlemiss asks Shona to see the abundance within and rediscover her passion for her work.


To taste or not to taste

Macleman, Y. (2005)

The evidence around the use of oral tasters with adults with learning disabilities who have a percutaneous endoscopic gastrostomy / jejunostomy.

To taste or not to taste? That is the question posed by Yvonne Macleman as she considers the limited and conflicting evidence around the use of oral tasters with adults with learning disabilities who have a percutaneous endoscopic gastrostomy / jejunostomy (PEG / PEJ). Further research is needed, but her interim answer lies in the client being at the centre of the decision-making process about when – rather than if – oral tasters are offered.

This article is based on an essay prepared for the Manchester Advanced (Level 3) Dysphagia Course, Adult Learning Disability Module.


How I review the literature to change practice

(1) – Finding the evidence

Kelly, A. (2005)

Clients benefit when therapists review and critically appraise the literature.

Annette Kelly’s enthusiasm for reviewing and critically appraising the literature grew out of a client’s query about the evidence base for his therapy following oropharyngeal cancer treatment. Training in search strategies was invaluable, and the evidence she then presented seemed to give her client the extra motivation needed to commit to an intensive therapy programme. Annette recommends journal clubs, expert training in search methods, using more than one of the databases that are most relevant and using a systematic search method.

Additional comment

Gamberini, L. (2005)

Clinical value of literature reviews.

A short comment on the importance of filling the gap in the evidence base for everyday practice through literature reviews. This has benefited Lorna Gamberini’s clinical work (topical anaesthesis for fibreoptic nasendoscopy; the effect of reflux on the voice).

Additional comment

Oliver, R. (2005)

Making a case for evidence based treatment.

Rita Oliver finds the evidence to justify developing a videofluoroscopy clinic for people with learning disabilities.

(2) – Improving study design

Young, M. (2005)

A literature review ensures a robust study design to assess the necessity for the Modified Evan’s Blue Dye Swallowing Test for patients with a trachestomy.

Margaret Young reviewed the literature to ensure that her study design would prove whether or not the time-consuming and invasive Modified Evan’s Blue Dye Swallowing Test is necessary for people with a tracheostomy over and above a single clinical assessment. The research results mean the adult team in Walsall now assess tracheostomy patients using a clinical swallowing assessment without the aid of blue dye, which allows patients with only minimal or no dysphagia to commence diet and fluids after only one assessment procedure.

(3) – Matching practice to theory

Hales, P. (2005)

The gag reflex and its relationship to swallowing.

Some speech and language therapists continue to assess the gag reflex, although basic dysphagia courses teach that it is not related to swallowing. Some doctors continue to refer to speech and language therapy based on an absent gag reflex. Pippa Hales reviews the literature to try to sort out the fact from the fiction, and finds marked inconsistencies across every area of the topic reflecting the quality of the research undertaken. She concludes that until this is done there is insufficient evidence to support the inclusion of the gag reflex in dysphagia assessments.


My Top Themes: NAPLIC conference

Nicoll, A. (2005)

Themes from the NAPLIC 2005 conference ‘Speech, language and communication needs: current trends in theory and practice’.

NAPLIC is the National Association of Professionals concerned with Language Impairment in Children. Editor Avril Nicoll’s themes from the 2005 conference ‘Speech, language and communication needs: current trends in theory and practice’ are: prediction / risk; auditory therapy; working with schools; supporting parents; changing need means changing provision; honesty is the best policy; the future.