Articles from the Summer 2010 Issue
Helen Page & Viki Baker
An ambitious programme of cultural change for adults with learning disabilities
The speech and language therapy team for adults with learning disabilities in Sussex was frustrated that basic communication needs of clients were not being addressed by other services. They felt this would only change if local Commissioners and the Learning Disabilities Partnership Board made communication a higher priority. This article charts an ambitious programme of cultural change, beginning with a successful application for funding for venues, resources and speech and language therapy time for a project to ‘Kick Start’ things. Working in partnership with users, carers, voluntary organisations, advocacy services and local authority and policy officers, the project started with practical road shows which showed how simple ideas could make a big difference. It continued with the addition of new training initiatives and speech and language therapy drop-ins. Funding has been secured to ensure further development of support and information for families, the learning disability workforce, employers and the general public. A booklet and DVDs have been produced and an online package is in progress. The article ends with detail about a ‘Festival of Togetherness’, an exciting specialist road show targeted at clients with high support needs and limited communication skills.
Alison Roberts with ‘Older or younger?’, a low cost, flexible and fun therapy suggestion for groups.
Introducing the Enneagram, and how personality plays a part in therapy
The Enneagram is a psychodynamic system, supported by online resources and training, which offers insights into our own and others’ characters. Nine basic personality types are identified, all using head / heart / body to a greater or lesser extent to deal with the world. Eric has found five ways in which the Enneagram may be useful to speech and language therapists: self-knowledge; resolving workplace conflict; modifying behaviour to establish better rapport; professional development; helping clients to change. Three case examples and Eric’s self-assessment are included.
Claire Butler & Roger Newman, with a comment from Jo Middlemiss
Overcoming fear and doubt to present at ASHA’s Annual Convention
ASHA is the American Speech-Language-Hearing Association, the professional and ‘credentialing’ body for speech-language pathologists, audiologists and speech, language and hearing scientists in the USA. Its Annual Convention attracts expert speakers and well-known names from around the globe. Claire Butler and Roger Newman were both invited to present at ASHA 2009. They describe how the invitations came about, how they felt, and how they went about preparing for it and finally got through it in spite of terror, doubts and competing work and family priorities. They hope their experience will encourage others to accept such opportunities of a lifetime when they come along. Life coach Jo Middlemiss adds a comment on dealing with fear and risk.
Samantha Procaccini & Paula Leslie
Evidence based debate: is instrumental assessment required for all people referred with acute dysphagia?
This is the sixth in our 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 is that clinicians should complete an instrumental examination – videofluoroscopy or fibreoptic endoscopy – on all acute care patients referred for swallow evaluation. They argue this would provide the external evidence needed to achieve the highest quality patient care. The Opposition points out that the clinical swallow evaluation serves a wider range of purposes than detecting aspiration, and one of its aims is to establish whether there is a need to conduct an instrumental examination. Universal use would be a pure act of paternalism and violation of the ethical principles of autonomy and informed consent. The authors Samantha Procaccini and Paula Leslie conclude that, while instrumental assessment has an integral role, it must not be over-used and that the clinical swallowing evaluation should be comprehensive and followed up with instrumental assessment if required.
What the experience of early speech and language therapy pioneers in Kenya can teach us in the UK
Kenya has a population of 37 million with a maximum of eight speech and language therapists working in pressurised and isolated circumstances. Lois Cameron lived in Nairobi as a child. In 2009 she returned for the 3rd East African Speech and Language Therapy Conference, running two training sessions in Talking Mats. Delegates came from a wide variety of professions and included speech and language therapy representation from Uganda and Ghana. Lois outlines factors around awareness, training, funding, culture and attitudes that affect people with communication difficulties, their families and services. She then considers how we can apply this knowledge to professional work in the UK, in particular through questioning our attitudes to diversity, training, sustainability and working with others.
Sheina Stockton shares some ‘wonderful treasures’ for working with teenagers in groups.
Boundary issues: Do speech and language therapists have a role in promoting smoking cessation?
Roger Newman provides the second response in our ethics series considering everyday events which need to be on our ethical radar screen. You are working with a client / parent of a client who smokes heavily. Whether you feel you want to mention it – or feel very strongly that you don’t – to what extent is such lifestyle choice and information the responsibility of a speech and language therapist?
A critical look at use of assessment tools for specific language impairment
Assessment is a time-consuming and complex process. When you first see a child whom you suspect has specific language impairment, you will naturally carry out an assessment. But what tools do you choose and why? Rena Lyons reports on an audit of practice in Ireland, from phase 1 (establishing steering group, distributing surveys) to phase 2 (focus groups covering the assessment process, assessment tools and influences on the choice of assessment tools). The results are related to the available literature, and suggestions are made for improving our assessment practice.
Favourite resources for making the most of Solution Focused Brief Therapy
Kidge Burns, author of the book ‘Focus on Solutions – A Health Professional’s Guide’, lists ten items she wouldn’t be without, including the miracle question, scales and supervision.