Speechmag

Penultimate issue of Speech & Language Therapy in Practice now out

The Autumn 11 issue of Speech & Language Therapy in Practice has been mailed today, so subscribers can expect it through their door very soon!

Cover star Dan sustained a severe head injury in 2007, and Lindsay King describes how revisiting Melodic Intonation Therapy has helped his recovery. Our second 'How I manage acquired brain injury' contribution comes from Laura Flynn in Jersey and is written in memory of another inspiring client, Suzannah Pemberton.

The client-centred theme continues with Karen Leadbitter's reflection on empowering Rhys, a man in his thirties with Down's syndrome, to participate in training his own staff. Lynsey Paterson also concentrates on training, using a literature review to develop parent training following an autism diagnosis.

In the well received Journal Club, Jennifer Reid tackles critical appraisal of observational studies, and subscribers can download two associated frameworks from the members' area of www.speechmag.com. Sam Simpson & Cathy Sparkes continue their goal negotiation series, and include discussion of the thought-provoking Model of Change by Prochaska and DiClemente (1986).

In 2009, Louise Greenstock wrote an interim report on her PhD research into the use of graphic symbols in schools, and here she shares her final findings. These include a theoretical framework which looks as if it would be very helpful in practice.

Alison Roberts is back with 'Here's one I made earlier'. Her low cost and fun therapy suggestions for groups have proved so popular that Speechmark has released a book of them! Cynthia Pelman tells us about one of her top resources, Stern Structural Arithmetic, and Jan Broomfield explores the ethical issues raised when your new referral is the son of your Trust's Chief Executive Officer... 

As well as reviews and editor's choice from the journals, we have brief contributions from Diana James about Paget Gorman Signed Speech, and a delightful snapshot of Nicola Grove's granddaughters talking about talking. As always there are great reader offers, including a Grow Words resource set, books from Plural Publishing and the recently released New Reynell Developmental Language Scales (NRDLS).

You can sign up for all 4 issues in the final year of Speech & Language Therapy in Practice. You will also receive the Winter 10 issue free, and get access to the members' area of www.speechmag.com until 29 February 2012.

Voice banking to preserve the freedom of speech

More on voice banking, a subject I posted on a year ago when Laurence Brewer was interviewed for Radio 4’s Word of Mouth. This time there was a Scottish flavour to another Radio 4 programme ‘Giving the Critic Back His Voice’, presented by Deacon Blue’s Ricky Ross.

Mike Arnott - who is originally from Belfast but now lives in Aberdeen – is 45 and has motor neurone disease. He was referred to speech and language therapist Karen Yuill at a time when he had no speech difficulties to explore possibilities for voice banking. Like Laurence, his goal was primarily to ensure his children would still be able to hear him as him in the event of him losing his speech and voice as the disease progressed. As he says, “How you sound is so much of who you are.”

Karen explains that she had to go away and do a bit of reading and, “We kind of explored the whole thing together really”. Initially this was via ModelTalker, which was straightforward but left Mike a little disappointed.

The next port of call was Edinburgh based company CereProc. They specialise in characterful speech synthesis, and created a text-to-speech voice for film critic Roger Ebert from his recorded documentaries when he was diagnosed with thyroid cancer. The process adopted for Mike involves software recording thousands of phrases and sentences based on phonetic coverage so that all speech sounds can be captured in a way that will make the synthesis sound as natural as possible.

The programme explores the difficulty for synthetic voices in conveying emotions and feelings adequately, including humour, boldness, fear, anger, excitement and joy. Joanna Courtney from CALL Scotland is interviewed about CereProc’s female Scottish voice ‘Heather’, as is Louise Smith whose 19 year old daughter Leanna has Worster-Drought Syndrome. She has been excited to get the Heather voice for her communication aid as it sounds “so normal”.

Michael Arnott says that after the months of recording there was “a hesitation pressing the play button just in case I’d be disappointed – but I certainly wasn’t.” Most importantly, his 8 year old immediately said, “'That’s you daddy!' And I was so pleased because all of that’s been part of the goal...they still hear me as me.”

You can download Scottish voices from the CereProc website. The programme is available for a limited period on BBC iPlayer.

Article on speech sound disorders course posted as Caroline Bowen receives special award

By happy coincidence, I completed a new article reflecting on two days immersed in speech sound disorders with international expert Caroline Bowen just as Caroline was awarded life membership of Speech Pathology Australia at its National Conference in Darwin. She is pictured here being congratulated by Ros Neilson, Councillor for New South Wales.

Having known Caroline 'virtually' for many years, it was a pleasure to meet her at last at her two day 'Speech Sound Disorders - the Basics and Beyond II' course hosted by the Association of Speech & Language Therapists in Independent Practice (ASLTIP) in the beautiful city of York. Reading my article will give you a sense of the contribution Caroline has made to promoting evidence based practice around the world, and of why she thoroughly deserves the highest honour of her own professional body.

Caroline is returning to the UK shortly to run three one day courses in London (18, 20, 22 July). She will then deliver two complementary one day courses (28, 29 July) in Durham, 'Spoiled for Choice - Therapy approaches for speech sound disorders in children' and 'Sound Reasoning: Therapy targets and techniques for children with speech sound disorders'. If you are interested in attending, there is more information here.

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.

 

Access to journals for speech and language therapists

Throughout April, Routledge is having an Education Free for All, which means you can get online access to the most recent issues of all the publisher's education research journals.

You can print off any article which is of interest, as long as it is for your own use in research, teaching or private study.

Having browsed through the titles, I have added the journal 'Emotional and Behavioural Difficulties' to my email alert list. This means I will be sent a table of contents with access to abstracts every time a new issue is released.

Many speech and language therapists working for the NHS can get a certain level of online access to journals. For me, the National Information Centre for Speech-language Therapy (NICeST) provides a great service. When I see an article I am interested in, I send in a photocopy request form and am invoiced for £3-£6 per article. It's a great way of getting your inspiration from a variety of sources.

To find out more about this and other services that NICeST provides to members of the Royal College of Speech & Language Therapists, contact the librarian Breege Whiten.   

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!