Speechmag

Picture menu launched to help people with communication difficulties in hospital

No-one would choose to be in hospital but, if we have to be, the majority of us can at least read the hospital menu and choose our preferred dishes. Unfortunately people who have difficulty communicating - including those who have aphasia, or English as an additional language, or who find reading hard - don't have that luxury. As a result, they miss out on making choices for themselves, and may also miss out on nutrition.

Recognising the problem, speech and language therapist Karen Rodger started to explore the possibility of making an aphasia-friendly hospital menu around 10 years ago. In 2006 she wrote the article 'Some hae meat' about her project for Speech & Language Therapy in Practice. Today I was delighted to catch up with Karen as the Nutrition Standards Service Improvement Programme rolled out the finished product to the main hospital in her NHS area.  

High quality photographs of food choices on the hospital menu are presented in a large, durable ring binder. Copies are available in certain wards and through speech and language therapy and dietetics. Karen has worked with colleagues from dietetics and catering as well as with patients and carers to develop the resource. She is now hoping that the publicity surrounding the launch will make nursing staff aware of the availability of this simple but effective tool, and of the difference it can make to the lives of a variety of patients.

Identifying and supporting 'Other ways of speaking' to ensure everyone can have a voice

Gesure, signing, symbols, boards and books, adapted computers and Voice Output Communication Aids -  in the words of the Hello campaign, 'Other Ways of Speaking' that ensure everyone can have a voice.

My final year project 23 years ago was on 'Using computers with people with aphasia'. Technology has moved on unimaginably since then, and people with communication difficulties are benefiting as AAC (Alternative & Augmentative Communication) becomes ever more adaptable, portable and affordable.

Speech and language therapists have a crucial role in ensuring the 'other ways' are appropriate to the individual's needs and functional in real life situations. The difference matters between aphasia and dysarthria, a physical disability and intellectual disability, or a language impairment that may or may not involve comprehension, as does the age, personality and interests of the client. The right choice of 'other ways of speaking' and support to establish their use in everyday communication is vital.

Manufacturers of voice output communication aids are taking their role seriously. Euan Robertson is Clinical Application Specialist at DynaVox Mayer-Johnson. He says, "I strongly believe a manufacturer's job is not over when a device is sold. Implementation is the difficult part, and AAC manufacturers have a responsibility to help this process. As such, DynaVox have created the Implementation Toolkit and run free workshops across the country. Although DynaVox InterAACt software is demonstrated, the strategies can be used with any form of high or low tech AAC system."

The recently launched MyChoicePad is making impressive use of its website and social media to spread the word about appropriate and functional use through short videos. Developed with the full support and collaboration of the Makaton charity, 'chief juggler' Zoe Peden says, "The angle we've taken is not just that of a low cost AAC device, but more about building the skills for communication using symbols and signs."  

The Makaton charity has also been involved in the production of the free 'Other Ways of Speaking' resource, along with 1Voice, ACE Centre, ACE Centre North, Scope and Signalong, as member organisations of Communication Matters. Anna Reeves from ACE Centre North says, "It is imperative that the needs of children and young people who have difficulties speaking are identified at an early age. Finding the right method of communication can have a dramatic impact on a child or young person's life - helping them to express themselves, participate in decisions, and improve their self esteem, which will ultimately impact on their contribution to society at large."

For proof of this, you only need to watch this video, produced by the ACE Centre for Hello, as part of the National Year of Communication:

 

Communicating with young people about mental health and wellbeing



This afternoon I went to a twilight seminar for a range of professionals. We heard about the findings of a critical review of the literature on children and young people’s views on the factors that influence their mental health. One of the authors, Jenny Spratt, summarised the findings of the review’s 137 pages and we were then encouraged to reflect on how they relate to and can inform practice with young people, whether at school or in the wider community. The four most important influences for young people emerging from the review are all familiar territory for speech and language therapists:
- Social relationships
- A need to feel normal and fit in
- Transitions
- Control over choices.

One of the attendees talked about the challenges of finding the right language to use with young people to discuss their mental health and wellbeing. Jenny has found simple concepts such as ‘good’ / ‘bad’ can be the most effective.

By coincidence, earlier on today I had an order for a 2010 article by Yvonne Macleman. It examines how speech and language therapists can work with Child & Adolescent Mental Health Services using Talking Mats to facilitate accurate mental state assessments in young people with speech, language and communication difficulties.

Talking Mats is a low technology communication framework involving sets of symbols designed to help people with communication difficulties think about issues and express their opinion. Yvonne’s article included an example of their use with Greg, a young man with Asperger’s syndrome. She says his mother “spontaneously commented on two separate occasions that she felt the Talking Mat was an easier way for her son to express his thoughts and feelings around a difficult area.” A family therapy colleague also commented that he “thought the Talking mat could actually be ‘emotionally containing’ for both the young person and their family” (p.9).

Jenny Spratt talked about the irony that  children who are generally happy find it difficult to express the positive factors impacting on their wellbeing while, in contrast, the review says that “some of the most insightful thinking about ‘normal’ states of mental health in young people comes from those who feel they have somehow been tipped beyond this” (p.62). In a similar way, we know that work done with people with speech, language and communication difficulties gives lots of clues about the kind of language and supported conversation that is equally useful with young people who do not have such specific needs.

References
Macleman, Y. (2010) 'Talking Matters', Speech & Language Therapy in Practice Spring, pp.8-10.
Shucksmith, J., Spratt, J., Philip, K. & McNaughton, R. (2009) A critical review of the literature on children and young people's views of the factors that influence their mental health. Edinburgh: NHS Scotland.

Acknowledgement
Thank you to Sue Briggs, Senior Community Learning & Development Worker in Laurencekirk for inviting me to the seminar.

Summer 11 Speech & Language Therapy in Practice out now!

The Summer 11 issue  of Speech & Language Therapy in Practice magazine was mailed to subscribers on Friday and Saturday, so should be with you very soon.

As well as the second instalment in the new goal negotiation series and an 'In Brief' contribution that puts the accent on aphasia, we have an uplifting story of the evolution and impact of a total communication project across Devon. In 'Journal Club', Jen Reid provides a framework for critical appraisal of intervention studies, while 'Boundary Issues' looks at the ethics of new professional roles.

We hear about a collaborative project with a children's centre and library service in an area of deprivation, which seems to highlight the benefits of targeting training on selected individuals. We also get a glimpse into the speech, language and communication needs of prisoners completing community sentences.

The cover feature is on using the evidence in dysphagia management. Hannah Crawford and Julie Bake explain why they have moved away from previous practice and introduced oral taster programmes with people with learning disabilities who gain their nutrition via PEG, while Celia Harding and colleagues use a problem solving framework to support appropriate intervention for infants and children with early feeding, eating and drinking difficulties.

We have reader offers for Photosymbols 4, I CAN Secondary Talk narrative and a Grow Words resource set, as well as Editor's Choice, three pages of reviews and 'Here's one I made earlier' on encouraging clients to make their own books. As always it is good to the very last page, where Kate Balzer shares some of the ideas for working with people with dementia from a SIGDOM therapy swapshop.

Enjoy!

Shine a light to recognise good practice in children's communication and inspire others

I know from all the articles I receive that speech and language therapists put a great deal of thought, imagination and effort into providing the best possible service to clients in challenging circumstances, and that sharing their experience really inspires others. So I'm delighted that the Hello campaign is going to 'Shine a Light' on good practice for children and young people's communication with an extensive awards scheme.

The Royal College of Speech & Language Therapists is sponsoring Team of the Year for speech and language therapists, and there are other categories for outstanding achievement, communication friendly establishments, other types of team, communication strategy, commissing and employee support. You might also want to have a think about potential candidates for the Hello Young Person of the Year Award, open to children and young people up to 19 years with speech, language and communication needs.

Sponsor Pearson Assessment says, "We encourage you to apply no matter what size and scale you are working at. If you think your work is special and making a tangible difference that you can evidence, we want to hear from you."

Hello is the national year of communication, a campaign to increase understanding of how important it is for children and young people to develop good communication skills. Wendy Lee, Professional Director for The Communication Trust, says the awards are intended to recognise inspiring work and "enthuse and spur on others who, through the national year of communication, are starting to tackle this subject head on in a range of ways - from small grassroots projects through to larger area-wide initiatives."

To enter, visit the Shine a Light 2011 Hello campaign awards site. Entries close on 15 July 2011.

 

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!

4 bursary places at No Mind Left Behind conference to benefit cash-strapped speech and language therapy departments

You're hearing it here first! In recognition of the vital part that speech and language therapists play in the field of learning difficulties, Mindroom is offering the profession 4 free places at the forthcoming major international conference No Mind Left Behind.

The conference runs from 29-30 March 2011 in Glasgow. Delegates also receive access to the Virtual conference for up to a year. It will feature 52 international speakers from the fields of learning difficulties, autism, ADHD and other early onset neurodevelopmental disorders. They include a speech language pathologist from Sweden, Carmela Miniscalco, who will be speaking about her work on early diagnosis of autism.

The cost for professionals attending the conference is £495 + VAT, but Mindroom founder Sophie Dow decided to offer these bursary places specifically to speech and language therapists following my blog post about the impact of cuts on training budgets.

She says, "The offer is for 4 free places at both days of No Mind Left Behind. This includes the bonus of access to the Virtual conference for up to a year. In other words, it also offers fantastic in-house training opportunities for an entire department."

Interested speech and language therapists should contact Sophie (email [email protected]) as soon as possible. Successful applicants will be responsible for their own travel and accommodation.

What a brilliant CPD opportunity - good luck!

 

New 'Communicating ethics' article explores use of Seedhouse grid

There wasn't room for 'Boundary issues' in the Winter 10 issue of Speech & Language Therapy in Practice - but don't despair if you missed your ethics fix, as I have just published an online only article which explores the use of the Seedhouse grid.

'Communicating ethics' is a collaborative effort from Professor Jois Stansfield of Manchester Metropolitan University and Jane Handley, one of her former students and now a practising therapist.

When Jane was in her final year she found a series of workshops on a case-based approach to ethical reasoning very helpful. As she says, we frequently need to make decisions that "are often difficult to resolve because they present ethical dilemmas which cannot be reasoned out with logic alone. To achieve the best possible outcome, it seems that a moral judgement is also required." 

The article explores how Jane used David Seedhouse's Ethical grid with a hypothetical client, Bryan (5), who has profound physical and cognitive disabilities. His parents are looking for a second opinion, as they do not believe sufficient time is being allocated to his feeding in school or in respite. This was the first Manchester Metropolitan University speech and language therapy case to be presented in Seedhouse's Values Exchange, an online approach to ethical decision-making.

Therapy ideas - a collaborative web resource

While editing an article today, I went to check something online. I didn't find what I was looking for, but I did come across a really interesting blog and ideas-sharing website run by speech and language therapist Rhiannan Walton.

Rhiannan's blog very sensibly favours quality over quantity of posts, with topics including dynamic assessment, care aims in education, outcome measurement and how speech and language therapy is changing.

The website is also a free collaborative resource for sharing practical therapy ideas, the bread and butter of direct intervention. I expect this would be particularly useful to students and new graduates, or anyone keeping an eye out for a fresh twist.

'Benefit finding' and coping with head and neck cancer

ENT & Audiology News for Nov/Dec 2010 includes a summary review (p.132) of Morwenna White-Thomson's article 'How I support TEP closure: an open and shut case?' from the Autumn 10 issue of Speech & Language Therapy in Practice.

The Nov/Dec issue of ENT & Audiology News also contains a thought-provoking article by Sandy Cavell (pp.49-50), 'Head and Neck Cancer: quality of life and beyond.'

Sandy is a Health Psychologist in New Zealand. As she says, "quality of life assessment and further information on psychological factors are important in enabling the clinician to improve communication with the patient, to ensure there is a more informed choice regarding treatment options and that better health outcomes are achieved" (p.49).  

Health professionals are increasingly recognising the importance of qualities such as resilience, so I was particularly interested in her comments on 'benefit finding' and its positive association with effective coping strategies. Examples of benefit finding were where the person's experience "caused them to think differently about their relationships with family and friends, altered their worldview and their prioritising of life issues" (p.49).

Between its print publication and online presence, ENT & Audiology News says it aims to offer "an invaluable forum for the communication of news and information from every aspect of ENT and audiology". For subscription rates and offers, contact Pinpoint Scotland Ltd, tel. 0131 557 4184.