What does it take to make a practice change, #WeSpeechies?

Making a change in your practice – what does it take?

This is the theme for Twitter’s @WeSpeechies from 20th-26th April 2014, when I will be taking a turn to curate. An hour-long #WeSpeechies tweetchat on Tuesday 22nd at 8pm (BST) includes 5 questions to focus the discussion.

These questions come from work to date on my PhD, where I am exploring practice change in speech and language therapy. Making a change in our practice means integrating or replacing what we are used to doing with something different. We are familiar with how hard this can be from our efforts to support change in our clients’ communication skills and environments. But do we see our own behaviour or contexts in the same light? While there are countless changes we could make, only some will get off the ground, and still fewer will be sustained. Questions 1 and 2 are therefore:

Q1 What have you managed to do differently in practice, and why? #WeSpeechies

Q2 What in your practice has not changed, and why? #WeSpeechies

The research field of ‘implementation science‘ aims to make sure that practitioners can use research knowledge that will benefit their clients. It therefore looks for systematic ways to understand and support practice change. Some implementation studies use psychological behavioural change techniques such as incentives to encourage practitioners to adopt a different approach. Others draw on sociology, to take account of how a practitioner’s actions are always shaped and constrained by circumstances and other people. Whatever way a researcher chooses to investigate implementation, it is clear that changing practice is not a neat and tidy box-ticking event, but a messy and complex social process.  This leads us to the remaining questions:

Q3 Where do your new ideas for practice come from, and how do you share them? #WeSpeechies

Q4 Apart from your own motivation, what influences how you sustain or adapt practice? #WeSpeechies

Q5 How do you decide if a practice change is worth continuing? #WeSpeechies

If you are joining a chat for the first time, guidelines for #WeSpeechies’ Tuesday Chats are here. Just use A1, A2 etc at the start of tweets to show which question you are answering, and always tag your tweets with #WeSpeechies so that all following the chat can see them.

Posted in CPD, implementation science, PhD, Professional standards, Research, Resources, Service delivery, Speech and Language Therapy, Web/Tech | Tagged ,

Life is academic after speechmag

In 2011 it was time to bring Speech & Language Therapy in Practice to a close, and I was faced with the problem of what to do next. At a point where some rational decision making was probably called for, I instead took a leap into the unknown.

After many years in clinical practice and as a user representative in maternity services, my gut feeling was that experience of research might complete a circle. I therefore signed up for a full-time Masters by Research (Health). After completing it, I worked as a research assistant on two projects. One involved interviewing a variety of professionals about their use of alcohol brief interventions with young people. In the other I was tasked with recruiting people and nurses on acute hospital wards to complete surveys about their experience of care. I am now 6 months into an ESRC-funded PhD, through which I am exploring practice change in speech and language therapy.

The shift has been a culture shock, and I continue to find academia’s norms, language and expectations somewhat disorientating and in many ways rather odd. However – particularly when you are entering the murky waters between clients, practice and research – it is an advantage to be able to see situations in new ways that challenge deeply held assumptions. Moreover, I have realised that the lazy characterisation of academics as thinkers and practitioners as doers masks the reality that both roles require deep reflection and action. The challenge is in respecting and making the most of what each has to contribute.

Posted in CPD, PhD, Research, Speech and Language Therapy | Tagged ,

Preserving the Speech & Language Therapy in Practice archive

Speech & Language Therapy in Practice magazine came to a close at the end of 2011, but its legacy is a wealth of archive material reflecting the growth of the profession.

Being aware of the practical value of the articles – and knowing full well the blood, sweat and tears that go into writing them – I was keen to preserve the archive as a freely accessible resource. As a result, anyone can now access the magazine from 1997-2011, and all complementary material that was previously only available to subscribers via the speechmag website.

Saving and indexing all the articles has been a mammoth task, and there is still work to do. For example, although articles are available individually from 2002, the years 1997-2001 are only accessible at the moment as complete issues.

The archive is hosted on an external site called Scribd, which bills itself as the world’s largest online library. You can search the entire archive from within the Speech & Language Therapy in Practice profile on Scribd. We have also grouped some articles into ‘collections‘ – for example, My Top Resources, Winning Ways, Here’s one I made earlier, How I – to make it easier for you to explore them.

Please enjoy the archive, and encourage your colleagues to do the same. And if you are sharing any information about it via Twitter, use the hashtag #speechmag.

Posted in Books, journals and articles, CPD, Resources, Speech and Language Therapy, Uncategorized | Tagged

Ralli round to raise awareness of specific language impairment

RALLI-character"Ralli likes computer games, playing with her friends in the park, and smoky bacon flavoured crisps – BUT Ralli also sometimes finds talking difficult, and she doesn't always understand the words people say. Ralli wants to tell you what this is like and explain what happens."

If you haven't met Ralli yet, have a look at the Raising Awareness of Language Learning Impairments You Tube channel, and subscribe to receive new video updates. This campaign was launched in May by Dorothy Bishop, Gina Conti-Ramsden, Maggie Snowling, Courtenay Norbury and Becky Clark as a resource about specific language impairment for children, families and educators.

As is often the case, it is the young people themselves who provide the most compelling viewing as they explain what it is like to have a specific language impairment. The use of video also tells you a lot about context – for example the bookshelves behind the practitioners in the 'Signs of SLI' video hold an eclectic mix of material from joke books to textbooks on vocabulary and language development, to professional standards – a reminder of the everyday but complex process required to put theory into real world practice. 

Posted in Books, journals and articles, CPD, Professional standards, Service delivery, Speech and language development, Speech and Language Therapy | Tagged , , , , , , , , | Leave a comment

Life and times of a speaking wifie

Catherine Hollingworth may have been a visionary and steely pioneer of the speech and language therapy profession, but in the small Scottish town where she was born she was known straightforwardly as ‘the speaking wifie’.

As part of a drive to recognise and celebrate the achievements of ‘weel kent Brechiners’, Steve Nicoll of the Friends of Brechin Town House gave a fascinating talk on Catherine’s life, work and family history last week. Born in 1904, Catherine came from a family with a culture of high achievement and entrepreneurship, with one of her ancestors credited for taking a stand against the practice of body snatching for medical education in the 1800s.

Catherine’s independent income meant she was able to pursue her interest in drama through studying at RADA. She may have simply developed her drama teaching, but a road traffic accident in Kirriemuir in 1933 led her to use her learning to address the injury to her own speech. This ignited an interest in speech therapy at a time when speech therapists were self-taught and very thin on the ground.

In 1940, while another pioneer of the profession Lionel Logue was supporting King George VI in London, Catherine was appointed as the first Superintendent of Speech and Drama and Speech Therapy in Aberdeen. According to Steve Nicoll, who has spoken to a number of Catherine’s students, her attitude to teaching was disciplined, structured, hard but fair – and she was always right. However, the core values she sought to develop through drama teaching would not be out of place with educational thinking of today: confidence, communication, citizenship, civility, language, personal discipline and personal development. Significantly, Catherine was a great believer in the importance of peer learning, and kept the number of adults involved to a minimum.

In her later years, Catherine came out of retirement to do voluntary work in Dundee with people who had had a stroke. Although some of the specific methods were clearly of their time, it is telling that Catherine recognised the void when people with aphasia were ‘left’ at the end of speech therapy with no help, and she sought in a variety of ways to help re-build their confidence, self-esteem and social contact.

The profession has come a long way, but being aware of where we have come from can be as inspiring for the ‘speaking wifies’ of today as recognising where we are now and where we are going.

Posted in Aphasia, CPD, Dysarthria, Speech and Language Therapy | Tagged , , , , , , , , , | Leave a comment

Pam Enderby recognised for lifetime aphasia contribution

Pam Enderby2I was delighted to hear today that Professor Pam Enderby has been given The Robin Tavistock Award 2012 in recognition of her significant lifetime contribution to the field of aphasia. 

In announcing the award, the Tavistock Trust for Aphasia recognise that listing the extent of Pam's contribution and influence would be 'impossible'. However, they make a valiant attempt, giving particular mention to publication of the Frenchay Aphasia Screening Test, Pam's championing of new technology and development of Therapy Outcome Measures, as well as her pioneering work in establishing the Speech and Language Therapy Research Unit at Frenchay Hospital in Bristol. 

Beyond the evidence of specific achievements which have had a direct and sustained impact on people with aphasia, the Trust also try to capture what it is about Pam that makes her "a catalyst, who makes things happen and succeed". They mention her mentoring, capacity to bring people together, energy, compassion, generosity and sense of fun. To this I would add honesty, realism and high expectations of people's capabilities. 

Congratulations Pam – and lang may yer lum reek. 

Posted in AAC, Aphasia, Speech and Language Therapy | Tagged , , , , , , , , | Leave a comment

Family Action praise preventative Home Talk intervention for children at risk of language delay

Family Action have been in touch to let me know about some promising targeted work they are doing with late talking 2 year olds.

The charity provides over 100 community based services to disadvantaged and socially isolated families across England. This includes managing Children’s Centres in Mansfield where they work closely with local health visitors and speech and language therapists. As part of Nottinghamshire’s multi-agency Language for Life Strategy a Play and Learning Worker delivers the Home Talk intervention to parents of children at risk of language delay.

Children are identified by health visitors using a traffic light screening system devised by the children’s centres speech and language therapy service. While children with significant needs are offered referral to speech and language therapy, there are a range of other preventative options including Home Talk for those who may benefit from some targeted support. The Family Action Play and Learning Worker in West Mansfield has been going into homes of each identified child once a week for 6 weeks to work with parents to encourage communication around routines, play and the children’s interests. Over the past two years she has seen 30 children, and only 4 have needed further referral to speech and language therapy.

There has been increasing interest in primary prevention, and a number of areas with multi-agency strategies including Nottinghamshire (Language for Life), Sheffield (ESCAL) and Stoke on Trent (Stoke Speaks Out) were commended by Communication Champion Jean Gross in her final report, but such initiatives are under-represented in the research literature. An exception is the Babytalk Home Visiting service, a collaborative primary preventative intervention in Portsmouth. This has been written up in Child Language Teaching & Therapy and, following an encouraging evaluation, is due to have a controlled comparative study.

Posted in Books, journals and articles, Community settings, Service delivery, Speech and language development, Speech and Language Therapy, Voluntary organisations | Tagged , , , , , , , , , , , , , , , , , , | Leave a comment