Summer 2008

Articles from the Summer 2008 Issue

Informed refusal?

Moira Wares

An investigation of food refusal in adolescents with complex physical and learning needs

Looking back on five years of managing a dysphagia caseload in a special school, Moira Wares became concerned about an emerging pattern of adolescent clients with complex needs starting to clench their teeth together and turn their head away when offered food. She decided to investigate the literature to help her plan how to approach future cases. Moira considers the influence of oral-motor problems, acute events, gastroesophageal reflux, nausea, constipation, dental problems, medication and reduced endurance as well as psychological issues such as negative feeding experiences, mental health problems and fear. She sets out her plans in light of the evidence and questions her previous view of gastrostomy.

The Maytor, the Shorpine and the Traigol

Helen McGrane & Linda Armstrong

Exploring whether optimal learning approaches might improve the effectiveness of aphasia therapy

In spite of a range of available resources, many questions about whether – and how – aphasia therapy works remain. Helen McGrane and Linda Armstrong share some findings from Helen’s research project, which considered one possible cerebral mechanism by which people with aphasia might be able to benefit in therapy – new linguistic learning using optimal learning approaches such as errorless learning. Helen created 20 mythical creatures for the research, so both the word forms and the word meanings were new. All 12 participants learned some new linguistic information, even those with significant language impairment. The detailed response of one client, who had severe aphasia, is described. Helen and Linda argue that the findings justify direct work on language with people with chronic aphasia, and consideration of an individual’s learning style when planning therapy.

Rise and sign

Polly O’Callaghan

A strategy to establish Signalong as part of a total communication approach in a special needs school

In recent years the learning, communication and behaviour support needs of pupils at Pield Heath House School have become more complex. The speech and language therapy department has implemented a variety of low and high tech AAC solutions for many of the pupils, and the school is committed to a total communication approach. Polly O’Callaghan explains the departmental and school strategy to introduce key word signing to extend the range of AAC available to pupils. This included choosing the system and selecting a tutor, setting up the training of all staff, publicising signing around the school and raising the profile of signing through clubs, assembly songs and motivational certificates. Polly reflects on the success and challenges of the strategy, in particular the extra support many staff need to use the signs they have learnt during everyday activities.

Are you listening?

Elaine Crighton, Isabel Forsyth & Lois Cameron

Making a respite unit, Tayavalla, an inspiring inclusive communication environment

Respite presents communication challenges as the children and young people are away from their familiar communication partners and environments. However, this also provides a huge opportunity because of the emphasis on individualised care and fun. Tayavalla is a residential short break unit in Falkirk. A partnership project between NCH Scotland, Falkirk Council and the speech and language therapy service saw the appointment of a Communication Development Worker to develop Tayavalla’s communication environment. The two key areas identified for attention were the children and young people’s communication and staff development needs. Methods used by Elaine Crighton, Isabel Forsyth and Lois Cameron included a before and after questionnaire, a training plan and communication support plans. The project has been so successful that it won a Scottish Care Accolade Award in 2007.

Listening and learning

Mariela Angulo & Amy Wolfenden, introduced by Avril Nicoll

The first of a new series on user involvement focuses on a speech and language therapy service to children’s centres

Editor Avril Nicoll introduces this new series by explaining her very personal reason for wanting to see the user involvement aspiration put into practice.

Mariela Angulo and Amy Wolfenden then describe a user involvement project to evaluate the services provided by speech and language therapists working in children’s centres in Bradford. They explain how they gained the views of children, children’s centre staff and teachers, parents and carers, and speech and language therapists. Finally they reflect on the difference this has made to their practice and to the service as a whole.

Are you getting enough? (2) Supervision models and barriers

Sam Simpson & Cathy Sparkes

The second of a series of four articles on supervision explores approaches and beliefs

There are many ways of offering and receiving supervision, and each relationship will benefit from an array of styles depending on circumstances. Sam Simpson and Cathy Sparkes summarise three models of supervision – a functions model, a developmental model and a tasks model. They then consider barriers to supervision and why, even when conditions are optimal, it can be difficult to access it. Finally they reflect on the history of supervision in the speech and language therapy profession and the need for a cultural shift to embed it in practice.

Talking hands

Amanda Baxter

Baby signing in an Early Start context to enhance carer-child communication skills

While gesture is part of natural communication and official signing systems are an established part of the speech and language therapy toolkit, the profession is divided on the issue of formal signing with babies in the absence of an identified need. A year ago when she began running baby signing ‘Talking Hands’ groups as part of ‘Early Start’ in Newham, Amanda Baxter was sitting on the baby signing fence but now, having seen the effect of signing as a means to enhance early communication skills, she is a convert. The ‘Talking Hands’ groups teach and use a range of signs that reflect early language development and environmental language use. Signs are introduced with objects, songs and stories, and sessions enable discussion of early communication and positive carer-child interaction.

Joining in as never before

Liz Skilton

The impact of inclusive poetry and drama workshops with Keith Park at the Globe Theatre on teaching and learning at a district Special School

While most definitions of literacy refer to reading and writing text, Liz Skilton argues for a broader understanding which includes people with severe learning disabilities. She invited interactive storytelling guru Keith Park to work with staff at Milestone School to challenge the conventional notion of literacy. Keith provides group activities at the Globe Theatre to students with severe and profound and multiple learning disabilities that enables them to understand the rhythm and atmosphere of literature such as Shakespeare using call and response, even if they cannot understand the words. Liz describes the impact of the workshops on students’ communication skills and on staff, which was boosted by a follow-up whole school training day.

My top resources – adult stammering

Carolyn Cheasman, Jan Logan, Rachel Everard, Sam Simpson, Paul Harris, Blanche Keaveney, Jamal Muse, Joanna Puzey, Danny Smith & Flora Swartland

The courses and philosophy that make Speech Therapy at City Lit a special services for adults who stammer

Speech Therapy at City Lit, a centre of excellence in adult stammering therapy, was recently awarded the prestigious Queen’s Anniversary Prize. In these top 10 resources, therapists and students and therapists describe the courses and philosophy that make this service so special. ‘Stammering therapy: an integrated approach’, ‘Interiorised stammering’, ‘Block modification’, ‘Communication skills for people with learning difficulties who stammer’ and ‘Mindfulness meditation for people who stammer’ are given particular mention.

Hook, sign and linker

Grace Windle & Jenny Henton

Two Sure Start therapists answer parental requests for a baby signing group to ensure the focus is on early communication skills 

Through their work as Sure Start speech and language therapists, Grace Windle and Jenny Henton were being approached more and more by parents asking them to provide baby signing courses. Recognising this as an opportunity to promote underlying principles of interaction, they decided to offer ‘Makaton Signing for Babies’. They were concerned that, if they didn’t, another provider would step in who may not offer the crucial complementary focus on early communication or diagnostic skills. Grace and Jenny describe how they publicised, organised and evaluated the impact of the group. They discuss what they have learnt as therapists from the experience that they will bring to future groups.

Once upon a time in Harrow…

Nicole Goldstein

Summer narrative groups give a mainstream schools team the chance to work with children and each other in a different context

The mainstream schools team in Harrow has run week long summer groups based around narrative for the past 6 years. Nicole Goldstein explains the format for the 2007 groups, which was revised based on previous experience. This included broader entry criteria, a prioritisation process, and a questionnaire to school staff about useful targets. A timetable guide, the themes chosen for different age groups and examples of activities are included.