Winter 2000

My top resources.

Tuson W, Nicholson C, Nieuwoudt H, Charles D, Larkin M. Newham Community Health Services NHS Trust, UK. Speech Lang Ther Pract Winter 2000: pback cover

This article provides ten suggestions of resources related to augmentative and alternative communication that the authors have found useful across a range of care group settings. The majority of their clients have severe to profound learning difficulties.

How I . . . manage progressive neurological disorders. An ever changing story.

Freeman L. Dorset Healthcare NHS Trust, Royal Bournemouth Hospital, Bournemouth, UK. Speech Lang Ther Pract Winter 2000: p28

The last of this set of three articles suggests that adults with progressive neurological disorders benefit from a therapist who is prepared to be flexible with their time. Although caseload pressures limit opportunities to vary the pattern of involvement of SLTs, this can be addressed by planning ahead and involving other professionals and specialists.

How I . . . manage progressive neurological disorders. Shared care.

McCormick C. Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK. Speech Lang Ther Pract Winter 2000: p26-7

In the second of a set of three articles it is suggested that a regional centre offers the best facilities to children with progressive neurological disorders and their families. However, some intervention may be offered more appropriately and conveniently closer to home. The case example of a child with Kearns-Sayre syndrome is provided.

How I . . . manage progressive neurological disorders. Uncharted territory.

White M. Central Nottinghamshire Health Trust, UK. Speech Lang Ther Pract Winter 2000: p24-6

This is the first of a set of three articles concerned with the management of progressive neurological disorders. The author of this article works in an area with a higher than average incidence of progressive disease and advocates greater multidisciplinary and inter-agency working is the key to better services for diagnosis, maintenance, complex cases and palliative care.

Early goals bring a result.

Robinson R, Bailey K. Mancunian Community Health NHS Trust, Manchester, UK. Speech Lang Ther Pract Winter 2000: p20-3

To facilitate a child’s speech and language development, parents and professionals need consistent and timely information and the opportunity to share ideas. This article describes how the city wide referral of parents in Manchester to their early intervention group programme is benefiting children with Down Syndrome. The referral system across the city is now highly effective. Group intervention with parents, of six sessions on a monthly basis, begins after two home visits. The sessions focus on a variety of speech and language topics which are outlined in the article, including general principles, play, listening, turn taking, and making sounds. The concept of signing as part of total communication is also encouraged.

Pressures, priorities and pre-emptive practice.

Cantwell J. [Swindon & Wiltshire Healthcare NHS Trust] now Speech & Language Therapy,Gloucester Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK. Speech Lang Ther Pract Winter 2000: p16-9

As ‘bed-blocking’ puts pressure on acute services and the patients concerned, new initiatives strive both to keep people at home for longer and discharge them more quickly. This article describes the Collaboration in Dysphagia project, in which collaborative work with district nurses aims to improve timely access to dysphagia services by people living at home. A variety of learning methods were employed in joint workshops with district nurses which were organised in different locations. The results of questionnaire evaluations are discussed. These showed that the workshops were positively received and that knowledge of dysphagia and of the speech and language therapy service had increased. Improvements in the feedback from SLTs to district nurses about individual patients was requested. Joint visits to patients at home have been arranged although the numbers are small at present. The use of portable suction, responsibility for the procedure, and provision of the equipment are discussed.

The need for leadership.

Bowles H. Speech Lang Ther Pract Winter 2000: p12-4

Do we make too many assumptions about our own and other professions when we offer and develop training? This article reports the experience of training nurses in dysphagia screening, highlighting the need for change at a strategic level to improve ther effectiveness of cross-professional training. Training will not be effective without improved leadership and support. The reasons for training nurses in dysphagia screening, the training protocol, the type of training preferred and differences in responsibility across professions are examined.

The right things at the right time.

Hurd A, McQueen D. Faculty of Health & Community Care, University of Central England, Perry Bar, Birmingham, B42 2SU, UK. Speech Lang Ther Pract Winter 2000: p8-11

Speech and language therapists often despair at educational expectations for children who are unable even to sit and listen. Large numbers of children enter nurseries socially unprepared, with poor speech and few self-help skills. This article describes the Sandwell Accelerated Language initiative which has demonstrated that core skills and literacy attainment can be improved at the same time by incorporating the principles of prevention, intervention, and collaboration with nursery teachers and nursery nurses. The structured programme is delivered to small groups of up to ten children for twenty minutes per day over a a total of 100 days.

Flying by the seat of our pants?

Nicoll A, Taylor C+. Child mental health Learning Disability Service, St George’s Hospital, London, UK. Speech Lang Ther Pract Winter 2000: p4-7

In addition to the developmental delay and specific speech and language difficulties caused by fragile X, other characteristic features of the syndrome impact on communication skills. Highlights from two full day presentations by Dr Vicki Sudhalter on her researches into fragile X to the Fragile X Society Family Conferences are presented in this paper. This includes the idea that fragile X should be treated as a social phobia and that eye contact should be actively avoided in therapy. Additional ideas for intervention are suggested to unlock the communication potential of these individuals. It is important to foster relationships with typical peer children and to involve them in mainstream activities.

Whilst very little research has been carried out into intervention, difficulties with transitions, anxiety and behaviour problems can be addressed by careful preparation. The genetic basis for the syndrome and recent research findings are outlined.