Speechmag

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. 

Communication Champion's final report shows communication is everyone's business

Despite her two year term as Communication Champion officially ending in December, Jean Gross was up with the lark this morning for a 5 minute slot on the Daybreak sofa to talk about ‘testing’ of 2 years olds. 

Having read her carefully considered and detailed final report, I knew that what Jean had actually asked for was inclusion of “a measure of children’s communication and language development at age two” (p.10) in the Department of Health’s Public Health outcomes framework. On the report's release a week ago, the press furore was around its supposed call that parents should receive texts to remind them to talk to their children. What Jean actually recommended was that the Department for Education should “provide parents with interesting, accessible information on how to enjoy and support their child’s communication and language development from birth onwards, using…the full range of technologies – phone apps with free film and text content, social media, texting, daytime television and so on – in order to ensure reach” (p.11). 

Early identification, workforce capacity building, skill mix and team work, joint commissioning, user and voluntary sector involvement and the need to measure impact are all among the report’s recommendations. There is a focus on specialist services including AAC, speech and language therapy provision in different settings, and hard to reach populations. A strong theme is the need for greater recognition of speech, language and communication difficulties in children with behaviour problems. There is plenty of food for thought for speech and language therapists when Jean highlights the continuation of ineffective models of intervention where therapists are expected “to ‘fix’ children through face-to-face work” (p.25) and urges us to question our practice in relation to people who do not attend.

In using examples from a number of places which have really embraced the idea that communication is everyone’s business, Jean shows that transformation is a realistic prospect even when budgets are under enormous pressure. This contrasts with her frustration at the loss of services in other areas and concerns about the long-term impact.

I have often reflected on the strength of character, strategic nous, inveterate networking and chameleon-like adaptability that a ‘champion’ position requires. Presenting complex arguments in soundbites to answer TV presenters' questions such as “Do you think children as young as 2 should be tested for how well they speak?” is just another prerequisite of the job. Admittedly “Do you think it is better to spot a communication problem early and help a child and their family rather than letting them struggle?”, “Do you think good quality information should be available to parents who want to know more about child language development?” and “Do you think people working with young children should know how to get them listening and talking well?” don’t invite quite the same controversy. 

On the positive side, every media opportunity raises awareness of communication and gets people talking about talking, and the Communication Champion’s role has been to make this happen at every level. Media coverage is aimed at the general public but, for those with a real interest in supporting children's communication, the report offers a more complete picture of where we are at and where we should aspire to be going. 

 

Aphasia charity needs online votes to Speakeasy

It is sad that, in spite of top level commitment to user involvement and community engagement, funding cuts mean charities including Speakeasy are having to seek income through routes such as the NatWest CommunityForce, where entrants are in competition for public online votes to win £6000.

Speakeasy was established in Bury almost 30 years ago with support from both social services and the NHS. Over the years the social services support was gradually withdrawn, but the primary care trust financed core services to which Speakeasy added a range of project work such as developing employment opportunities, computer therapy and piloting new approaches for people with aphasia.

Gill Pearl, Chief Executive of Speakeasy, wrote an article for the Winter 10 issue of Speech & Language Therapy in Practice with Gill Jackson of Dyscover, a specialist aphasia charity in Surrey. They described a pilot study of the Personal Development Programme, which promotes volunteering and increased activity among people with aphasia, bringing wide-ranging benefits to the participating individuals and their communities.

Gill explains, "Speakeasy has developed a justifiable reputation as a centre of excellence where people with aphasia from across the North West grow the skills to better navigate their lives with aphasia. In summer 2011, Speakeasy received the devastating news that the PCT had decided to withdraw 100 per cent of its financial support. This loss of funding may close Speakeasy. Although every effort is being made to seek alternative funds, the current financial climate and changes in the health and social care sectors are compounding the difficulties."

I have registered and cast a vote to support Speakeasy's attempts to win £6000 of stop-gap funding and hope other people who have an interest in aphasia will do so too before the closing date of 23 October. This doesn't have to mean that I like the recent trend among big companies to use social media to advertise their products. Such methods certainly will not provide a sustainable approach to funding of charities who provide important services that complement and enhance those offered by health and social care.

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.

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:

 

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.

 

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.

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!

 

Learn with rhyme and help children shine - I CAN's Chatterbox Challenge 2011

I love reading and singing, but there is something uniquely special about books and songs for children. While we're now on to Tolkien's The Two Towers as a bedtime story, it's not so many years since I knew several Julia Donaldson rhyming picture books off by heart! Yet the importance of sharing stories and rhymes to later communication skills is not always recognised.

Julia Donaldon's most famous creation, The Gruffalo, is also a popular stage show, and the cast at The Garrick Theatre (right) is endorsing this year's I CAN Chatterbox Challenge. Now in its 10th year, this sponsored event for children, families, nurseries and other early years settings aims for everyone to have fun while developing their communication skills and raising money to benefit children who have difficulties with speech, language and communication.

The Chatterbox Challenge 2011 is 'Learn with rhyme and help children shine'. To take part in the challenge contact I CAN for your free fundraising pack. This includes songs and activities, stickers and sponsor forms. You can even help in a Guinness World Record attempt for the largest game of Head, Shoulders, Knees and Toes, which will be in multiple venues across the UK.

Chatterbox Challenge is also a key event in Hello, the year-long campaign to help children communicate.

Supporting people with aphasia to volunteer: useful publications

Do you encourage or support people with aphasia to volunteer?

This topic was explored in the article 'Any volunteers?' in the Winter 10 issue of Speech & Language Therapy in Practice. Carole Cross of Connect has been in touch to alert readers to two further publications that might be of use: 'How to volunteer - A guide for people with aphasia' and 'Volunteering and aphasia - A guide for organisations recruiting people with aphasia as volunteers'. The titles are self-explanatory, but you can read more and order them via the Connect website. They cost £7.50 each. 

In the article Gill Pearl and Gill Jackson reported on a pilot study of the Personal Development Programme and concluded that it engaged and supported people to do more with aphasia. Identified activities included gardening at the local YMCA sports centre, teaching bowls to new members of the bowls club, helping at the local Citizens Advice Bureau, helping in a charity shop, taking on a new role in a Masonic club, volunteering at Dyscover, and making tea in a residential home. The Personal Development Programme is available to buy at cost from Speakeasy, tel. 01706 825802.

In an accompanying article, 'Actions not words', Rebecca Allwood and Jane Terry found a volunteer placement at Wheelbase for their client Colin. This has enabled him to embark on a journey back to work in spite of his communication difficulties.