Winter 2010

Articles from the Winter 2010 Issue

‘Best of PALS’

Crow, J. & Finley, D. (2010)

The PALS (Parents, Aspergers/Autism, Language and Social Skills) programme for parents of older children

Judy Crow and Diana Finley have used the Hanen ‘More Than Words’ programme successfully with parents of younger children with autism spectrum disorders. Having identified the need for a similar resource suitable for parents of children aged between 6 and 12 with a complex social and communication difficulty, they developed PALS (Parents, Aspergers/Autism, Language and Social Skills). Here, they report on two pilot programmes reaching 28 families in Northumberland. Information on course content, style of presentation, skill mix, timing, optimum number of attendees and evaluation is included.

In Brief:

(1) Pat Brookes on how a speech and language therapy department is working with service users to become more ‘stammer-friendly’ by developing web-based information and referral (2) Amy Jensen explains why she is an enthusiastic member of the networking organisation Communication Therapy International which emphasises the needs of countries where there is a shortage of resources for people with communication disabilities.

‘Who’s next?’

Allan, N. & Cahoon, C. (2010)

A two stage tool for making daily priority decisions in an acute dysphagia service

When demand exceeds supply, prioritisation of new referrals and existing clients is a challenge. This is particularly when services have variable staffing levels, a high workload and a responsibility to support new graduates. Inspired by Newton & Priestnall’s ‘Decision time’, Nicola Allan and Claire Cahoon produced their own prioritisation tool for their acute dysphagia service. The draft evolved over 10 months through everyday use by the team and the end result is a two stage Prioritisation Tool for Dysphagia Assessment, which can also be used as a record of decision making. Stage 1 is an initial screen, and Stage 2 provides additional important factors to consider if further prioritisation is needed. The tool, along with an exercise conducted to evaluate it, is included and a critical friends peer review comment is provided by Alison Newton.

‘Are we having fun yet?’

Park, K. (2010)

In this exploration of the use of humour, Keith Park hopes to inspire you to spread a little happiness as you go by…

They say laughter is the best medicine, but how often in our working lives do we remember to take and to offer it? Keith Park is an advisory teacher, poet and performer who works with children and adults with multi-sensory impairments in a variety of educational and community settings. In this article he reflects on real life situations in which he has used interactive storytelling, pantomime, Cockney rhyming slang and stories from the Brothers Grimm, Shakespeare, Hans Christian Andersen, Homer and Chaucer as well as AAC devices, poetry ambush, and knock knock jokes to introduce laughter as well as language into the working day.

Here’s one I made earlier

Alison Roberts with a low cost, flexible and fun therapy suggestion, Vocabulary workbook, best done in a one-to-one session.

‘Journal club 2: qualitative research’

Reid, J. (2010)

The second in our series to take the mystery out of critical appraisal looks at articles based on qualitative research

Jennifer Reid’s series aims to help readers access the speech and language therapy literature, assess its credibility and decide how to act upon their findings. The content is based on the critical appraisal education format which has evolved in Fife and is delivered through a series of small group journal clubs. This article explains the difference between quantitative and qualitative research. It explores the value of qualitative research for exploring and creating meaning from participants’ subjective experiences, and for gaining insight into phenomena that are ill-defined or poorly understood. This strength (validity) is also the source of a potential weakness (reliability) as generalisation cannot be assumed. Jennifer presents a 10 question appraisal framework for considering articles which are based on qualitative research. The downloadable version of the framework is available alongside the article.

‘Let’s CHAT’

Orr, N., MacLean, C., Richie, L. & Cairns, D. (2010)

The impact of the Whole Nursery Narrative Approach on language development and school readiness in areas of disadvantage

The Communication Help and Awareness Team (CHAT) has been operating for 7 years in areas of disadvantage across three Scottish local authorities. Its ultimate aim is to promote literacy and communication skills through enabling those involved with children in the early years to work together on their language and social development. This article considers how well it is working.

The authors report on two studies using the Whole Nursery Narrative Approach, a targeted 10 week intervention adapted from Carey et al. (2007). They describe how they selected and matched the groups of children, the structure of the groups, and pre and post assessment. A session plan example is included. The authors conclude that the approach does improve narrative and language skills in preschool children, that 10 weeks of the approach plus attendance at nursery enhances language skills more than nursery education alone, and that the approach can be replicated successfully. A senior early childhood educator adds her thoughts on the impact at Cornton Nursery where the Whole Nursery Narrative Approach is now embedded in the curriculum.

Through the second study, the authors aimed to find out if the approach makes an impact on school readiness. They report that, following participation in the 10-week groups, between 77.7 per cent and 100 per cent of the children made improvements in their language and communication skills and school readiness.

If funding continues, the CHAT team wishes to track these children through the early years of their primary education to assess longer-term benefits of the Whole Nursery Narrative Approach.

Reference

Carey, J. et al. (2007) Nursery Narrative (2nd edn). Keighley: Black Sheep Press.

‘How I encourage community participation (1): Any volunteers?’

Pearl, G. & Jackson, G. (2010)

A pilot study of the Personal Development Programme suggests we can engage and support people with aphasia to do more through volunteering

Although speech and language therapists aim to increase community participation by people with aphasia, their exclusion is still highly prevalent. Volunteering is one meaningful way of participating in communities, and has potential advantages for skill development, confidence, self-esteem and quality of life. Gill Pearl is chief executive of Speakeasy and Gill Jackson is chief executive of Dyscover, both specialist aphasia charities. In this article they describe how they used a conceptual model developed from earlier research as the basis of the ‘Personal Development Programme: Doing more with aphasia’ group discussion resource. The resource has three sections: 1) philosophical issues around disability and the contribution of the group leader, 2) the practicalities of group discussions when the members have aphasia, and 3) the structure for the six sessions. The outcomes of a pilot study suggest the resource has the potential to encourage successful volunteering as well as a wider range of life activities.

‘How I encourage community participation (2): “Actions not words”’

Allwood, R. & Terry, J. (2010)

How a client, Colin, embarked on a journey back to work in spite of aphasia through support from a speech and language therapist, occupational therapist and the Wheelbase charity

Returning to work is often a long-term goal for younger people who have had a stroke. Speech and language therapist Rebecca Allwood and occupational therapist Jane Terry work for a Community Stroke Team in Nottingham. Working with partners in other agencies, the team supports people to return to or undertake new activities, including paid or unpaid work if this appears to be realistic. This article focuses on Colin (63) who had a stroke shortly after being made redundant from his job as a welder. In the months following his stroke his aphasia improved and he returned to independent living.  During a discussion around long-term goals, Colin expressed an interest in returning to work. Rebecca and Jane discuss how they worked with Colin to structure targets towards achieving this goal, and the support they provided to Colin, the Volunteer Agency and the Wheelbase charity. This included direct therapy, a communication profile, goal setting sessions and training. They also reflect on the benefits for all involved.

‘My Top Resources: collaboration and change’

Krawczyk, K. (2010)

Collaborating with other colleagues and professions in rehabilitation, management and lecturing

Karen Krawczyk’s top resources and career path show her interest in collaborating with other colleagues and professions: in addition to resources for dysphagia, Karen discusses transferring evidence into practice, tools to aid understanding, individual change, different perspectives, listening skills, 7 habits and shifting perspectives.

Go forth and influence

Speech & Language Therapy in Practice editor Avril Nicoll reports on the innovative practice showcased at the RCSLT (Royal College of Speech & Language Therapists) Scotland Study Day in Perth on 26 August 2010, where delegates were also urged to give voice to people with speech, language, communication and swallowing needs.

Communicating ethics

Faced with the following scenario, Jois Stansfield and Jane Handley explore how an ethical framework can help speech and language therapists and students negotiate a path to what feels like the ‘right’ outcome for a given situation at a given time: You have been asked to provide a second opinion for the parents of a five year old boy who has profound physical and cognitive disabilities.