Speechmag

Comic Relief, stammering, and the real irony

Humour can be difficult to get right - but last night Lenny Henry and the BBC got it very wrong.

My children have been very moved by the various TV programmes leading up to Comic Relief, in particular one involving Lenny Henry in Kenya. On their own initiative they set themselves challenges and got sponsorship. Their questions have led us to discuss politics, culture and the use of humour to highlight inequalities, injustice and our own inconsistencies.

It beggars belief that Comic Relief would open with a spoof of The King's Speech which involved absolutely no irony, hidden message or clever humour. All it said was - it's OK to roll your eyes and laugh at people who stammer, to interrupt them, to hurry them, to make fun of them and to finish their sentences. What sort of signal does that send out to young people who stammer and to their peers who are so crucial to their self-esteem and acceptance?

In a strongly worded complaint Leys Geddes, chair of the British Stammering Association, said, "Thousands of children are teased and bullied every day simply because they stammer. By doing stuff like this, you give other children permission to continue this foul treatment and encourage adults to snigger and turn a blind eye...In your drive for audiences and edge, you trample on the very vulnerabilities you claim to dispel."

The BBC recently showed an excellent programme about young people attending a course at the Michael Palin Centre for Stammering Children. Comic Relief spends considerable sums on anti-bullying projects. It's a pity that no-one involved in the production or showing of the opening sketch seems to have spotted this real irony.

Shopping habits, risky decisions and getting to grips with statistics

I’m sure Jen Reid didn’t intend to improve my shopping habits when she conceived the ‘Journal Club’ series on critical appraisal for Speech & Language Therapy in Practice – but that has been one outcome.

I picked up a pack of four leeks yesterday emblazoned with ‘Special offer! Only £1.70!’ But I paused as a little voice in my head said, “Check the figures and think about it. It’s up to you, not the shop, to decide if this is the best deal.” The loose leeks had a tiny little sign saying ‘£2.75 a kilo’. The four nicely packaged leeks weighed 500g. I did the maths - and swapped them over.

A new Cochrane Systematic Review concludes that people – whether health professionals or consumers – may make different decisions depending on the way risk statistics are presented. There are the usual caveats about more research being needed (and I won’t claim to have studied the whole review), but check out how the example given in the plain language summary (p.2) changes your own perceptions:
“You read that a study found that an osteoporosis drug cuts the risk of having a hip fracture in the next three years by 50% [relative risk reduction]. Specifically, 10% of the untreated people had a hip fracture at three years, compared with 5% of the people who took the osteoporosis drug every day for three years. Thus 5% (10% minus 5%) less people would suffer a hip fracture if they take the drug for 3 years [absolute risk reduction]. In other words, 20 patients need to take the osteoporosis drug over 3 years for an additional patient to avoid a hip fracture [number needed to treat].”

The authors conclude their findings suggest that “the formal education and training of health professionals apparently has no effect on their handling of statistical information” (p.26). It certainly doesn’t come easily to me but, as a teacher said at my older son’s parents’ evening, “He is used to being able to do things so, when they don’t come naturally, he just thinks he can’t do it. I tell him to take his time and to think it through, because he can. And then he does.”

I will keep trying to understand statistics because, when we are asking people to trust us to give them appropriate, evidence based information, an ability to look behind the headlines matters.

Jennifer Reid’s Journal Club series in Speech & Language Therapy in Practice has so far taken the mystery out of appraising expert opinion articles (Autumn 2010), qualitative research (Winter 2010) and systematic reviews (Spring 11). In Summer 11 she will tackle intervention.

Reference
Akl EA, Oxman AD, Herrin J, Vist GE, Terrenato I, Sperati F, Costiniuk C, Blank D, Schünemann H. Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database of Systematic Reviews 2011, Issue 3. Art. No.: CD006776. DOI: 10.1002/14651858.CD006776.pub2.

Music, Melodic Intonation Therapy and Giving Voice

"We found music provided an opportunity for people to express themselves and interact in a poignant way...This has given us food for thought about the link between communication, music and movement."

So say the speech and language therapy team for people with learning disabilities at Yourhealthcare, while reflecting on their Signsational training in the Spring 11 issue of Speech & Language Therapy in Practice (pp.28-29).

Another speech and language therapist, Lindsay King, has been pondering the link between singing and speech. Having heard about the resurgence of interest in Melodic Intonation Therapy (which I reported in 2007), she introduced it to a young man with a brain injury with promising results.

Lindsay wrote this up as a case study which will feature in the Autumn 11 issue of Speech & Language Therapy in Practice. Her Trust then asked her to write a summary of the approach in its new Cumbria Partnership Journal of Research, Practice and Learning (freely available online and well worth a read). With interest in speech and language therapy fuelled by The King's Speech, journalists picked up on her contribution at the Journal's launch, and her client was delighted to be interviewed and photographed for his local paper.

This is a really good example of the same 'story' being presented in different ways to suit the needs of different recipients. It also shows the advantages of therapists and clients working together to tell the story, as is being encouraged by the Giving Voice campaign. So go on, express yourself!

Spring has sprung at Speech & Language Therapy in Practice

Mailing of the bumper Spring 11 issue of Speech & Language Therapy in Practice is now complete and, as always, it is blooming with practical and inspiring articles.

We have a new arrival, Whose goal is it anyway?, a series for 2011 on goal negotiation from Sam Simpson and Cathy Sparkes. Journal club continues with a look at critically appraising systematic reviews, Editor's choice is on stammering, and Boundary issues is back with the ethical minefield when work and home life meet.

Other articles are on:

• putting people with learning disabilities in control of where they live and with whom
• introducing TOPICC (Targeted Observation of Pragmatics in Children's Conversations)
• reducing the risk of choking in adults with learning disabilities or mental illness
• training people with aphasia and their carers to communicate effectively beyond therapy
• resources for being an effective national specialist adviser.

And, as you would expect, we have fantastic reader offers (for NDP3 Speech Builder, Grow Words, and Independence Through Communication) as well as reviews of books and resources and more low cost ideas for groups in Here's one I made earlier.

New subscribers to Speech & Language Therapy in Practice should note that, in addition to the 4 issues for 2011, they will get a free copy of the Winter 10 issue.

Happy reading!