bluuebunny/crossref_metadata_2025 huggingface dataset:
PROVIDING INTENSIVE THERAPY IN SCHOOLS FOR CHILDREN WITH NO IDENTIFIED PROVISION
Authors: Baxter Sue , Merrils Dariel
Published: October 2009

The provision of a speech and language therapy service to a school‐age child with little home support and no identified provision for extra help in school has always proved challenging to service providers and causes many services to make hard choices in terms of best use of limited resources. These children commonly at stage three of the Code of Practice (Department for Education 1994) fall between two stools: a school which cannot provide extra help in order to carry out a speech and language therapy programme; and a speech and language therapy service which cannot effect change without back up in the home or school. In this paper a project which provides therapy programmes to this group of children via a student clinical placements initiative is reported. The project is discussed in terms of client outcomes data and offers suggestions as to how findings may be interpreted.
EQUITY OF SERVICE: A PROTOCOL FOR MANAGEMENT OF CHILDREN WITH SPEECH PROBLEMS
Authors: Owen Rosalind , Lewin Jennifer , Lawer Elma , de la Croix Heather , Davies Stella
Published: October 2009

In an attempt to achieve equity of service, the level of consistency of speech and language therapists in making decisions about the management of children with phonological delay was examined. Six cases were created and the therapists were interviewed about their management and criteria for therapy for each case. Decisions were made about standardising practice within the team. A phonological care pathway was devised to consider the criteria outlined in the results. This pathway is now being piloted with the expectation that it will facilitate an equitable service for all children with sound system problems.
ARE WE READY TO PREDICT SPEECH DEVELOPMENT FROM BABBLE IN CLEFT LIP AND PALATE CHILDREN?
Authors: Hattee Caroline , Farrow Katherine , Harland Kim , Sommerlad Brian , Walsh Melanie
Published: October 2009

The speech development of nine children with cleft lip/palate was followed longitudinally from nine months to three years of age. The results indicate speech sound development closer to the non‐cleft population than previous studies. Nasal fricatives previously not extensively described in the literature may be an experimental stage of developmental babble, which spontaneously reduce. The study has added to the evidence‐base for practice in one cleft unit. It may be useful to channel resources at our centre to children who at nine months may be more at risk, i.e. children with bilateral clefts and known developmental delay.
MEASURING LANGUAGE DEVELOPMENT IN DEAF CHILDREN WITH COCHLEAR IMPLANTS
Authors: Brinton Julie
Published: October 2009

For the past ten years profoundly deaf children in the UK have been able to receive cochlear implants as an alternative to conventional hearing aids. The South of England Cochlear Implant Centre (SOECIC) has implanted 78 profoundly deaf children. As cochlear implantation is still a relatively new procedure it is important to record progress comprehensively. One of the main aims of implantation is to give the recipient access to sound so that, in the case of a child, they can acquire speech and language. There is a need for a test that assesses a wide range of language abilities and which is also sensitive to change. The Preschool Language Scales‐3 (UK) (PLS‐3)(Zimmerman et al. 1997) has been standardised on a British population and was chosen to be part of a test battery at SOECIC. The test assesses skills from birth to seven years of age and has been administered at regular intervals to the clinic population. The outcome results show that average scores improve with use following implantation.
SELECTIVE MUTISM: HOW A SUCCESSFUL SPEECH AND LANGUAGE ASSESSMENT REALLY IS POSSIBLE
Authors: Cleator Hilary , Hand Linda
Published: October 2009

A speech and language assessment of children with selective mutism is often difficult because these children are silent in most situations. In Australia, a study was designed to assess the children in their homes, the place where they usually speak. Five children who met the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association 1994) criteria for selective mutism participated in the study. Assessment included audio‐taping extracts of the children's conversations with members of their family and the administration of a number of standardised speech and language tests. The study found that four of the five children had a communication disorder. This paper outlines these communication disorders and describes how a successful speech and language assessment of children with selective mutism is possible.
MENTAL ILLNESS AND COMMUNICATION
Authors: Kramer Sarah , Bryan Karen , Frith CD
Published: October 2009

Historical and more recent descriptions of mental illness emphasise the prominent nature of communicative difficulties in persons with these diagnoses (Sims 1995) and a large part of psychiatric intervention is verbally‐mediated. Within this study, a theoretically‐driven therapy programme addressed the communication needs of two persons with schizophrenia. Significant improvements were demonstrated using valid and reliable outcome measures.
CLINICAL TEACHING AND MENTORING: VITAL IN THE DEVELOPMENT OF COMPETENT THERAPISTS
Authors: Anderson Hazel
Published: October 2009

The needs of under‐graduate students and newly qualified speech and language therapists (SLTs) are discussed. The results of a small‐scale survey of final year SLT students and one of newly qualified therapists are presented. Similarities between clinical teaching of under‐graduates and mentoring of newly qualified therapists are identified. The paper calls for a combined training course for experienced SLTs to acquire the core knowledge and skills required to carry out either or both roles effectively.
ALL PLACEMENTS GREAT AND SMALL: AN ANALYSIS OF CLINICAL PLACEMENT OFFERS MADE BY SLT SERVICES
Authors: Gascoigne Marie , Parker Ann
Published: October 2009

This paper will present the results of a survey of clinical placement offers for one academic year in one particular region. The data presented confirm that there are issues of shortfall and inconsistency across speech and language therapy (SLT) service providers within this region. This information has been analysed in a variety of ways and presented to SLT managers within the region and the lead NHS Consortium responsible for purchasing SLT education in the context of a ‘work force cycle’. Suggestions will be made as to possible ways forward using these data.
A STRATEGIC APPROACH TO CLINICAL PLACEMENT LEARNING
Authors: Kersner Myra , Parker Ann
Published: October 2009

There are different ways of approaching the nationally reported shortages of clinical placements for speech and language therapy students in the UK. Viewing the problem as a simple issue of high demand and shortfall may result in seeking short‐term solutions. However, in order to achieve effective longer term change, there is a need for an examination of the underlying aspects of the problem. In this paper the development and implementation of one department's clinical and professional strategy are described and some of the outcomes presented. It is suggested that strategic, long‐term approaches also need to be considered more widely and that a national professional strategy should be developed.
STUDENT SUPERVISION: RISKY BUSINESS?
Authors: Morris Clare
Published: October 2009

Radical and rapid reform of the national health service (NHS) has impacted significantly on skill‐mix and the work organisation of speech and language therapists (SLTs) in recent years. These changes impact on student training at macro and micro levels. In the context of a society‐in‐transition, student supervision is argued to be a risky business. Six clinicians were selected for in‐depth interviewing, using theoretical sampling procedures. A small‐scale qualitative enquiry was undertaken to explore the clinicians' perceptions of and attitudes towards the risks involved in delegating clinical work to students. Thematic analysis of transcribed and coded data was carried out. Risks to clients, students and the service are explored from psychological, behavioural, medical and structural perspectives. Risk tolerance and risk management approaches are described.
ACTIVE LEARNING IN SERVICE DELIVERY: AN APPROACH TO INITIAL CLINICAL PLACEMENTS
Authors: Parker Ann , Emanuel Rosemary
Published: October 2009

In their first clinical placement and using an active learning approach, students provided an extension to existing service provision. Therapist‐led teams of six students carried out assessment, therapy and advice. Carefully structured preparation, supervision and feedback enabled them to discover and develop effective approaches for themselves. The learning experience and service provision were evaluated and modifications introduced over a three year period. Feedback from students and service users confirmed that the project had provided both effective learning and a valuable contribution to the local service.
SPEECH AND LANGUAGE FUNCTIONING IN PAEDIATRIC HIV DISEASE
Authors: Hodson Ann , Mok Jacqueline , Dean Elizabeth
Published: October 2009

The Human Immunodeficiency Virus (HIV) can potentially cause impairment to linguistic functioning. This study was the first to compare selected aspects of speech motor control, expressive language and receptive language functioning in individual HIV infected children. Results suggested clinically stable HIV infected children can develop linguistic impairment. Such impairment is in danger of going unnoticed without assessment. Thorough and regular assessment of the linguistic functioning of long‐term survivors of paediatric HIV disease is essential if optimal speech and language therapy management strategies are to be devised.
AN ALTERNATIVE MANAGEMENT OF OLDER CHILDREN WITH PERSISTING COMMUNICATION PROBLEMS
Authors: Nash Poppy , Stengelhofen Jackie , Toombs Louise , Brown Jane , Kellow Beryl
Published: October 2009

Speech and language deficits frequently implicate accompanying psychosocial problems (such as low self‐esteem). An alternative management approach is described which adopts a holistic paradigm and provides a unique opportunity for intensive work on communication within a supportive environment. The residential programme for 8–14 year olds with persistent communication difficulties incorporated cognitive, emotional and psychosocial dimensions of communication, co‐ordinated with work on speech features. Although the programmes were developed for children with cleft palate1, they have potential for benefiting a wide range of communication impairments of different aetiologies. A forthcoming manual with resource material developed by the research team will be used in studies across these groups.
LIFE STORY BOOKS FOR THE ELDERLY MENTALLY ILL
Authors: Baker Julie
Published: October 2009

The use of life story books with people with moderate to severe dementia in continuing care and day hospital settings is examined. The approach involved activity‐based carer and relative training and support. A collaborative approach has developed and shifts in staff attitudes are discussed. Consideration is given to generalisation to other aspects of patient care.
A SCREENING INSTRUMENT FOR LANGUAGE IN OLDER PEOPLE (BARNES LANGUAGE ASSESSMENT)
Authors: Bryan Karen , Binder Julia , Funnell Elaine , Ramsey Victoria , Stevens Sue , Dann Caroline
Published: October 2009

This paper describes the development of a clinically viable tool for the assessment of language and associated cognitive skills in the older population which was instigated by the SIG Psychiatry of Old Age (South of England). A***. series of sub‐tests is described. Data from normal older people is used to establish preliminary means and lower normal limits as a guide to distinguishing performance associated with normal age‐related change from performance associated with pathology. The importance of allowing for the effects of normal age‐related changes on language processing is illustrated. Data from older people with pathology attending clinics and hospital departments is also presented. Quantitative and qualitative language profiling is outlined. Data analysis suggests that the Barnes Language Assessment is able to profile language skills and difficulties. Indications for further research are discussed.
SHARING KNOWLEDGE WITH NURSING HOME STAFF: AN OBJECTIVE INVESTIGATION
Authors: Shaw Dorothy , May Hannah
Published: October 2009

Nursing home staff are at the forefront of coping with swallowing and communication disorders. Our study, which is ongoing, collates information on the existing knowledge of such staff and demonstrates how their understanding can be increased by speech and language therapists' input. Twenty nursing homes agreed to participate in training (91% uptake). To date 16 nursing homes (113 staff) have completed training in swallowing and eight nursing homes (47 staff) in communication problems. Questionnaires were completed before and after training. There was a highly significant improvement after training.
THE COMMUNICATION, SPEECH AND GESTURE OF A GROUP OF HEARING‐IMPAIRED CHILDREN
Authors: Hoskin Joanna , Herman Ros
Published: October 2009

The communication skills, speech and gesture of 20 hearing‐impaired children were assessed. The children were all being educated in a school using an oral/aural approach. Assessment result comparison indicated the importance of assessing gesture and speech separately for these children and comparing the use of both skills. More informal and formal assessment of gesture and the tools to complete this task effectively are needed to ensure that these children's communication skills are described accurately.
LISTENING TO DEAF SPEECH: DOES EXPERIENCE COUNT?
Authors: Klimacka Lindsay , Patterson Aileen , Patterson Rosemary
Published: October 2009

Listening for intelligibility in disordered speech involves a complex interaction of factors, including listener experience. This study examines intelligibility as perceived by two groups (experienced and inexperienced listeners) in interpreting deaf speech. Speech samples were gathered from a hearing‐impaired child over thirteen months, immediately post cochlear implantation. Results indicate that experienced listeners interpret more of disordered speech than inexperienced, but while experience appears to be a factor in intelligibility judgements, it does not alone guarantee higher intelligibility rating.
DEVELOPING AN INFORMATION PACK FOR THE ASIAN CARERS OF PEOPLE WITH AUTISM SPECTRUM DISORDERS
Authors: Dobson Susan , Upadhyaya Shripati , McNeil Jeanie , Venkateswaran Shoba , Gilderdale Debra
Published: October 2009

An investigation is described which forms the basis for the development of an information package for the Asian carers of people with autism spectrum disorders (ASD) and learning disabilities. The results of semi‐structured interviews and planning for questionnaires with three different linguistic Asian groups (Urdu, Gujarati and Bengali) are presented. The views, attitudes and awareness of autism, knowledge of support services and perceived priority of needs are analysed for the three different communities. The investigation concludes with recommendations as to whether separate information is needed by each culture or whether a single information pack can be used and presented in each language format. The possible presentation format in which the information can be produced is also discussed.
EVALUATING A PROGRAMME TO ENHANCE VOCABULARY DEVELOPMENT IN PRE‐SCHOOLERS
Authors: Piramal Reshma , Law James
Published: October 2009

This study was set up to investigate vocabulary development in a population of urban Indian socio‐economically impoverished pre‐schoolers. Since research has shown that a correlation exists with vocabulary and reading skills, hence better vocabulary would be indicative of fewer reading related problems. The introduction of an oracy programme in a nursery was evaluated and the results compared with those from a similar nursery not exposed to the programme. There was a significant difference in the growth of receptive vocabulary for the experimental group relative to the comparison group but no improvement in the expressive lexicon of either group. Results shed light on vocabulary development and its implications on later literacy progress, as well as changes to nursery practice in India.
THE JOINT DELIVERY OF PERSONAL AND SOCIAL EDUCATION (PSE) IN A SPECIAL SCHOOL
Authors: Joffe Victoria , Poulton Helen
Published: October 2009

There is a growing need for teachers and speech and language therapists (SLTs) to work together in the joint planning and implementation of lessons in the educational context to ensure successful differentiation of the national curriculum (NC) to students with special educational needs (SEN). This paper describes and evaluates the development and delivery of a language and social communication programme as part of the PSE subject from the NC to final year students at a special needs school for children with significant speech, language and communication impairment. The topics covered across a variety of common social settings are outlined as well as the controlled and progressive manner in which they were introduced.
LANGUAGE AND CONVERSATIONAL ABILITIES IN WILLIAMS SYNDROME: HOW GOOD IS GOOD?
Authors: Stojanovik Vesna , Perkins Mick , Howard Sara
Published: October 2009

Grammatical performance of individuals with Williams syndrome (WS) has been reported as being unimpaired, despite their comparatively low IQ and poor general cognitive ability. Specific language impairment (SLI) is often seen as the converse of WS, showing poor linguistic ability relative to level of cognitive functioning. Detailed profiles of language functioning in four children with WS and four with SLI are presented which show a much less clear‐cut picture than is often portrayed and suggest that children with WS may be less linguistically able than is commonly reported. A comparison of results on standardised tests with performance in real conversations shows that not only the children with SLI but also those with WS have significant linguistic difficulties. This has clear implications for their management by speech and language therapists.
FOUNTAINDALE COMMUNICATION PROJECT
Authors: Worth Nicki
Published: October 2009

Voice output communication aids are expensive in terms of initial outlay and ongoing staff support. Further efficacy research and innovative methodologies are necessary to explore the role of this technology in facilitating communication and to develop more informed, effective therapeutic approaches to service delivery in this area. A research project is reported that evaluates the progress of four children using voice output communication aids. The children's progress has been video‐recorded at six monthly intervals and analysed using conversation analysis and feedback questionnaires. Initial observations and implications for service delivery are discussed.
COMPARING LANGUAGE PROFILES AND LEARNING IMPAIRMENT IN PUPILS IN SPECIAL SCHOOLS
Authors: Winter Paula
Published: October 2009

Children were selected from schools for pupils with learning difficulties. Nonverbal ability measures classified them with what was previously termed moderate learning difficulties (MLD). A Surrey Speech, Language and Communication Profile (Surrey Profile) (Cave and McGregor 1996) was completed for each childe and the children's cognition scores were compared. Specific language impairment (SLI) was determined by the discrepancy between general language functioning and non‐verbal ability, with a focus on three Surrey Profile items. Three groups were derived using a discrepancy model to view the relationship between language and cognition. Groups 1 and 2 showed commensurate and mild language difficulties in relation to cognition. For Group 3 results indicate that difficulties in learning are due to severe and specific language difficulties. Implications emerge for assessment, educational placement, provision and intervention.
SHARING LEARNING THROUGH NARRATIVE COMMUNICATION
Authors: Cortazzi Martin , Jin Lixian , Wall Debbie , Cavendish Sue
Published: October 2009

This paper examines key aspects of the learning experiences of ten speech and language therapy (SLT) students on clinical placements, as revealed by an analysis of 102 narrative accounts. We argue that when students on placements tell stories of their learning experiences the process of recounting them can help them to reflect on and consolidate what they have learned and to have this learning validated by peer, clinician or tutor audiences. Thus, sharing learning through narrative communication is itself further learning from the original experience. We show how students evaluate their learning experiences, how their growing confidence is mediated by clinicians and how such narratives are shared in normal student interaction. Tutors might use the insights from narrative learning to raise students' awareness of their own learning, and thus to improve it.
REVIEWING THE REVIEW PROCESS: EXAMINING DECISION‐MAKING IN PRACTICE
Authors: Anderson Carolyn , van der Gaag Anna
Published: October 2009

A national multi‐disciplinary audit showed variation in SLT practice on the decision to review pre‐school children or place them on waiting lists following initial assessment. Audit evidence suggests some reasons for these differences and contributing factors are illustrated by case history examples. Current health‐care policies encourage practitioners to make decisionmaking transparent to consumers but this process is problematic if there is a lack of evidence to support principled choice. An outline is presented to enable therapists to gather their own evidence for review outcomes in daily practice.
EVALUATION OF THE HANEN EARLY CHILDHOOD EDUCATORS PROGRAMME1
Authors: Coulter Lorraine , Gallagher Ceara
Published: October 2009

The current study is an evaluation of the Hanen Early Childhood Educators Programme (Weitzman 1992). It explores outcomes for both staff and children following staff participation in the training programme. Using a comparative study design and pre‐ and post‐training measures the changes in staff and children were investigated. Results revealed that the training programme did not bring about change in children's receptive and expressive language skills. Changes were observed in children's social interaction skills. This was reinforced by staff reports of changes in children's interaction. Staff changes included increased skills and confidence in identifying and supporting children with speech and language difficulties alongside positive changes in their interaction styles. The methodological difficulties inherent in evaluating training effects and the need for further research are highlighted.
DROOLING IN PARKINSON'S DISEASE: A NOVEL SPEECH AND LANGUAGE THERAPY INTERVENTION
Authors: Marks Lizzy , Turner Kirsten , O'Sullivan John , Deighton Belinda , Lees Andrew
Published: October 2009

Drooling and difficulty swallowing saliva are commonly reported in people with Parkinson's disease (PD). Drooling in PD is the result of swallowing difficulties rather than excessive saliva production. Currently, there is little research into the effectiveness of treatments to reduce drooling. The aims of the study were to develop objective measures of saliva volume and drooling for PD and to assess the efficacy of two therapeutic strategies to control drooling, i.e. specific speech and language therapy (SLT) including a portable metronome brooch to cue swallowing and injections of botulinum toxin into both parotid glands to reduce the amount of saliva produced. This paper will describe the assessments used, including the measurement of saliva, swallowing and drooling. The main focus will be the strategies used in the SLT intervention. The preliminary results are presented.
DROOLING IN PARKINSON'S DISEASE: A NOVEL TOOL FOR ASSESSMENT OF SWALLOW FREQUENCY
Authors: Marks Lizzy , Weinreich Jonathan
Published: October 2009

A non‐invasive way to obtain objective measurements of swallowing frequency and thus indirectly, drooling was required as part of the study ‘Drooling in Parkinson's disease: objective measurement and response to therapy’. A hard disk, digital recorder was developed, for use on a laptop computer, which was capable of collecting large quantities of swallowing data from an anticipated 40 patients and 10 controls. An electret microphone was taped to the subjects' larynx for recording the swallow sounds when drinking 150 ml of water and at rest for 30 minutes. The software provides an accurate visual display of the audio‐signal allowing the researcher easy access to any segment of the recording and to mark and extract the swallow events, so that swallow frequency may be efficiently and accurately ascertained. Preliminary results are presented.
THE EFFICACY OF ORO‐FACIAL AND ARTICULATION EXERCISES IN DYSARTHRIA FOLLOWING STROKE
Authors: Robertson Sandra
Published: October 2009

Although there are many accounts of appropriate oro‐facial and articulation exercises and treatment hierarchies for clients with dysarthria following stroke, there is little evidence relating to the efficacy of such therapy and little or no information indicating either the extent or the frequency with which these exercises should be practised for optimum effect. This study investigates the efficacy of such traditional therapy for eight clients. A clinic‐based therapy programme and an exercise routine for home practice was agreed by a group of speech and language therapists. The results indicate not only the value of the therapy but also a realistic and viable programme for clients to carry out at home.
TRANSFERRING SKILLS — FROM SOUTH TO NORTH
Authors: Morris Tom
Published: October 2009

The primary aim of western‐trained speech and language therapists (SLTs) working in the ‘South’ is not to train further SLTs but to transfer a range of practical skills to carers, health and education workers working directly with under‐served populations. Considering current areas of service need in the UK, a model of primary health care has been applied to the western model, resulting in further discussion of potential applications to future SLT practice in the UK.
LANGUAGE REMEDIATION IN MOTHER TONGUE: A PAEDIATRIC MULTILINGUAL PICTURE RESOURCE
Authors: Pert Sean , Stow Carol
Published: October 2009

Bilingual clients frequently feature on speech and language therapists' caseloads and yet they are rarely assessed and treated in their mother tongue. There are few assessments targeting languages other than English. Culturally and linguistically appropriate assessment and remediation materials should be devised for the differing needs of each distinct population. This paper describes the Pakistani Heritage Asian population in Rochdale and one of the first steps taken to address its needs: the development of an early expressive language assessment and remediation package for paediatric clients. Reference is made to the importance of identifying the exact languages spoken, especially when the use of one language may be perceived as denoting lower social status. Semantic and syntactic issues involved in constructing assessments are highlighted.
THE DEVELOPMENTAL ACQUISITION OF ENGLISH GRAMMAR AS AN ADDITIONAL LANGUAGE
Authors: Quinn Christina
Published: October 2009

The results are presented here of an investigation into the development of receptive and expressive English grammar when this is acquired as a second language. A cross‐sectional survey using standardised assessments was conducted. 103 children were randomly selected from three local primary schools. These children were aged between 5 and 11 years and were acquiring English sequentially. Data relating to the receptive and expressive grammar of English as a second language was collected from each child. Analysis of this data revealed preliminary developmental patterns that appear to be specific to the sequential acquisition of English grammar. This data confirms the importance of not using data pertaining to the acquisition of first language English for English that is acquired as a second language.
COLLABORATIVE DEVELOPMENT OF A NEW COURSE AND SERVICE IN SRI LANKA
Authors: Wickenden M. , Hartley S. , Kodikara S. , Mars M. , Sell D. , Sirimana T. , Wirz S.
Published: October 2009

Great Ormond Street Hospital (GOSH) has a long established service development and research programme with Sri Lankan colleagues. The Centre for International Child Health (CICH) is an academic unit with public health interests in the countries of the South. Together a group of collaborators at GOSH, CICH and in Sri Lanka worked together to plan how a cadre of health workers could be prepared to work with people with communication disabilities. This is not an uncommon aim in under‐served countries and there is a small published literature about the courses which have been developed. Choices about models for training, service delivery and ensuring sustainability in emerging services for people with communication disabilities are complex. Links can be made with development work in other disciplines. The literature relating to these issues in countries such as Sri Lanka is examined.
VIABILITY AND EFFECTIVENESS OF TELETHERAPY FOR PRE‐SCHOOL CHILDREN WITH SPECIAL NEEDS
Authors: McCullough Alison
Published: October 2009

Telemedicine is proving valuable in the delivery of health care services. With increased competition in telecommunication markets and lower costs, the possibility of providing affordable teletherapy services for the 21st century is now a goal that can be achieved. Recognition that parent training is a vital component of successful treatment programmes makes the use of teletherapy from clinic to home an ideal medium of sharing skills with carers. Commercially available products were selected on the basis of cost effectiveness, user friendliness and audio‐visual quality. Parents reported increased knowledge and confidence in developing their child's communication skills and teletherapy was demonstrated to be an effective, reliable and exciting addition to a new era of therapy provision.
AN INTEGRATED MULTI‐MEDIA PACKAGE FOR LEARNING CLINICAL PHONETICS AND LINGUISTICS
Authors: Howard Sara , Perkins Mick , Martland Paul
Published: October 2009

Competence in the phonetic and linguistic analysis of normal and disordered spoken language is a basic requirement for all students and practitioners of speech and language therapy. This paper presents a learning package specifically designed for individuals who need to acquire or update practical skills and theoretical knowledge in clinical linguistic analysis. VISUAL‐CLIP (Video Supported Active Learning in Clinical Linguistics and Phonetics) is a student‐centred, interactive, multi‐media tutorial in clinical linguistics and phonetics, based on digitised video‐ and audio‐taped speech data from a child with a complex communication disorder. Data can be analysed from different perspectives and at different levels of difficulty using separate but inter‐linked modules on phonetics, phonology, grammar, semantics and pragmatics. Case history information, formal assessment results, theoretical background and an annotated bibliography are also integrated into the CD‐ROM based package.
STUDENTS' EXPECTATIONS OF LEARNING KEY SKILLS AND KNOWLEDGE
Authors: Jin Lixian , Hill Heather
Published: October 2009

Students' expectations of the key skills and knowledge they acquire and how their perceptions of these change during the four year period of their speech and language therapy (SLT) degree programme are explored. This is important because students are central to the teaching and learning process so their expectations of learning have to be taken into account in order to best help them to achieve the required learning outcomes. Over 100 De Montfort University (DMU) SLT under‐graduate students from the four years were surveyed by questionnaire. The research findings are discussed to examine the significance of differences between and within year cohorts. The outcomes of this research will provide a basis for recommendations for DMU and other universities' SLT programmes, and for the improvement of student learning guidance.
THE UK EDUCATION OF OVERSEAS STUDENTS IN SPEECH AND LANGUAGE THERAPY
Authors: Marshall Julie , Goldbart Juliet , Phillips Julie , Evans Ruth
Published: October 2009

Informal evidence suggests that many overseas1 speech and language therapists (SLTs) either do not return to their home country on qualification or do not work as SLTs in the public sector. Many factors may contribute to this situation. However, concern that it may result in part from a poor match between UK SLT education and the demands of the role in other countries, led the Royal College of Speech and Language Therapists (RCSLT)2 to fund a study of overseas SLT students' experiences of UK qualifying courses. The study involved questionnaires and interviews with current students and those qualifying since May 1994. The focus of this paper is the respondents' experiences of studying and working in the UK, their views of the advantages and disadvantages of working in their home countries and the UK and supportive strategies that UK universities and other agencies might adopt. Implications of the findings are discussed.
META‐SYNTACTIC THERAPY USING VISUAL CODING FOR CHILDREN WITH SEVERE PERSISTENT SLI
Authors: Ebbels Susan , van der Lely Heather
Published: October 2009

The results of a pilot study into meta‐syntactic therapy using visual coding for four children (age 11–13 years) with severe receptive and expressive specific language impairment (SLI) are presented. The coding system uses shapes, colours and a system of arrows to teach grammatical rules. A time‐series design established baseline pre‐therapy measures of comprehension and production of both passives and ‘wh’ questions. All participants made progress with passives and this was significant in three cases of the four. Comprehension and production of ‘wh’ questions also improved in all participants, although this did not always reach statistical significance. The results indicate that meta‐syntactic therapy of grammatical rules, capitalising on visual strengths, can improve both comprehension and production in secondary age children with severe persistent SLI.
‘DO YOU SPEAK PRACTICE‐ESE?’ A DISCOURSE OF PRACTICE FOR SHARING COMMUNICATION
Authors: Pillay Mershen
Published: October 2009

Speech and language therapy (SLT) is absorbed in an empirical (or ‘scientific’) discourse. A case study, involving a single practitioner, is reported. SLT's application of an empirical discourse is critically investigated. Results reveal that SLT engages reductionism, essentialism, and ‘dis‐othering’ in its practice discourse. Consequently, rich, textured lives are re‐manufactured in a less than authentic manner. A critically oriented practice discourse is recommended to assist SLT in reconsidering its present immersion in a reductionistic, technical and utilitarian discourse and toward a discourse that assists an effective sharing of communication.
AN INTER‐DISCIPLINARY APPROACH TO SWALLOWING PROBLEMS IN ACUTE STROKE
Authors: Davies Steve , Taylor Hilary , MacDonald Alison , Barer David
Published: October 2009

Many speech and language therapy (SLT) departments are in danger of being swamped with dysphagia referrals, often to the detriment of other work. At the same time surveys have shown that large numbers of patients with acute stroke have swallowing problems which are poorly managed during the critical early phase, not referred or missed altogether. The Collaborative Dysphagia Audit (CODA) study, carried out in six British hospitals, showed that nurses could quickly be trained to carry out basic screening assessments for dysphagia and that implementation of a co‐ordinated inter‐disciplinary dysphagia management policy (DMP) could substantially improve the proportion of dysphagic patients in whom appropriate feeding precautions were taken. These early DMPs were limited by the need for ward staff to keep all patients with suspected swallowing impairment nil by mouth until assessed by SLT, so in some acute stroke units nurses have been trained to a higher level which allows them to manage most routine transient swallowing problems, leaving only complex or persistent cases for referral to SLT. This approach has been used successfully in our unit in Gateshead, where a dysphagia nurse specialist post has been set up to act as a link between ward staff and SLTs, to ensure that the necessary training levels are maintained and to co‐ordinate the DMP.
SAFE SWALLOWING? ‐ AN OPPORTUNITY FOR STUDENTS WORKING WITH DYSPHAGIC CLIENTS
Authors: Gascoigne Marie , Marks Lizzy
Published: October 2009

The challenges of providing student speech and language therapists (SLTs) with clinical experience in acute hospital settings are outlined. An innovative model of student clinical placement will be described which takes advantage of the recent change in policy by the Royal College of Speech and Language Therapists (RCSLT) in respect of student involvement in work with dysphagic clients.
A COLLABORATIVE APPROACH TO THE ASSESSMENT AND MANAGEMENT OF DYSPHAGIA
Authors: Heritage Mary
Published: October 2009

An inter‐disciplinary approach to the assessment and management of dysphagia is essential. A partnership between speech and language therapists (SLT) and nurses combines in‐depth experience of dysphagia with the holistic knowledge of the patient. Nurses in acute, rehabilitation and mental health settings are trained by SLTs to use a locally‐developed screening tool. This allows the nurse to carry out a basic screening assessment when dysphagia is identified, start an interim feeding regime and monitor the patient's progress. Simple or short‐term dysphagia can be managed by the dysphagia trained nurses (DTNs). Experience, qualitative and quantitative measurement has shown benefits. Audit results enable us to share our experiences and to plan for future development of the project including a formal validation of the tool.
DYSPHAGIA TRAINING FOR NURSES IN AN ACUTE HOSPITAL SETTING ‐ A PRAGMATIC APPROACH
Authors: Magnus Victoria
Published: October 2009

Dysphagia assessment and management has significant impact on speech and language therapy (SLT) resources. Recent reports have highlighted nurses' role in the nutrition of their patients. In order to focus SLT input efficiently and effectively and to improve nurse confidence in management of patients with swallowing problems, a dysphagia screening test (DST) was devised for use by nurses within an acute teaching hospital setting. This has since been used for training SLT students and junior doctors.
DYSPHAGIA TRAINING PROGRAMMES: ‘FIXES THAT FAIL’ OR EFFECTIVE INTER‐DISCIPLINARY WORKING?
Authors: Miller Ruth , Krawczyk Karen
Published: October 2009

A number of factors influencing the development of dysphagia training programmes are identified, some of which relate to cultural issues and to the way systems operate. Lessons can be learned from current theories of relevance to effecting change in professionals' working practice. These lessons can be applied beyond dysphagia to other areas in which speech and language therapists are involved.
THE APPLICATION OF STUDENT‐CENTRED LEARNING APPROACHES TO CLINICAL EDUCATION
Authors: Baxter Sue , Gray Cheryl
Published: October 2009

This paper explores current thinking on adult learning and discusses its application to the clinical education of speech and language therapy students. It is based on evidence from a two‐year project funded by the Trent Regional Consortium, which is trialling an innovative means of providing paediatric placements. The educational literature has recognised for some time the importance of student‐centred teaching and learning and has encouraged movement away from a didactic teacher‐student model to one where students are seen as active in the learning process. This paper offers a model as to how these principles may be applied to clinical placements to promote self‐directed lifelong learning and to prepare speech and language therapists to meet the challenges of continuing professional development and the ever‐changing working environment.
THE DEVELOPMENT OF A SELF‐DIRECTED AND PEER‐BASED CLINICAL TRAINING PROGRAMME
Authors: Bruce Carolyn , Parker Ann , Herbert Ruth
Published: October 2009

A reflective learning approach for clinical training with final year students is decsribed. The training programme aims to promote the development of independent and reflective practitioners. The theories and ideas that have influenced the structure of the programme are described and an outline of the programme is provided. The views of students who have participated in the process are discussed. Most students were positive about their experiences, but some problems were reported. Suggestions for improving the supervisory process are considered.
INFORMING EDUCATIONAL CHANGE TO IMPROVE CLINICAL COMPETENCE
Authors: Brumfitt Shelagh , Hoben Kirsty , Enderby Pam , Goddard Veronica
Published: October 2009

The factors that have influenced the current approaches to speech and language therapy education in Great Britain are discussed. A project is presented which will provide data on how educational approaches can more clearly reflect professional practice.
TEACHER/THERAPIST COLLABORATION: A SCOTTISH HIGHER EDUCATION INSTITUTION DEVELOPMENT
Authors: Forbes Joan , Welbon Hazel
Published: October 2009

The collaborative work is described of a principal speech and language therapist (SLT) and a lecturer in a college of education in Scotland in writing and evaluating a Post Graduate Award Scheme (PGAS) module. This was in response to Her Majesty's Inspectorate's (HMI) (1996) recommendation that teacher education institutions should ‘consider the in‐service and post‐graduate training needs of those working with pupils with language and communication disorders and autism’. Official Scottish Executive Education Department (SEED) statements were examined by analysing HMI (1996) and subsequent official documents. Higher educational (HE) institution statements were read in the PGAS handbook and in the module descriptor (Northern College 1998). Accounts of change are described in the thinking and practice of course members as a result of the module and the implications for future module development are considered.
SUPPORTING PRIMARY AND SECONDARY PUPILS WITH COMMUNICATION AND BEHAVIOUR PROBLEMS
Authors: Sage Rosemary
Published: October 2009

Numerous studies have identified communication skills as being most predictive of long‐term school success. A Communication Opportunity Group Scheme (COGS) took place in a primary and secondary school involving 36 students aged 7–15 years. There were 24 subjects in two types of teaching group and 12 controls. One group was taught for an hour a week over ten weeks (weekly) and the other for two hours daily over five days (intensive) by teachers trained in the COGS method. Experimental groups showed significant gains compared with controls. Integrating systematic teaching of communication into the curriculum may significantly increase pupil performance. The project has fostered a learning community of schools, support services, national charities and the university.
DAY IN, DAY OUT: THE EVERYDAY THERAPY OF COMMUNITY CLINICS
Authors: Roulstone Sue , Glogowska Margaret , Peters Tim , Enderby Pam
Published: October 2009

This paper describes the timing and nature of therapy provided within a recent randomised controlled trial (RCT) of preschool speech and language therapy services. There is literature that describes and evaluates speech and language therapy but there is little indication of how this is translated into everyday practice. The study collected data from 21 speech and language therapists (SLTs) in 16 community clinics. The areas targeted, goals, approaches used, the frequency and timing of contact for the 68 children who received treatment were documented. The data show that several aspects of therapy were frequently targeted simultaneously, that approaches were combined and that the frequency of therapy did not vary with severity. The discussion will consider the gap between published programmes and everyday practice and the implications for effectiveness.
MAINSTREAM PAEDIATRIC SPEECH AND LANGUAGE THERAPY SERVICE POPULATION: EPIDEMIOLOGY
Authors: Broomfield Jan , Dodd Barbara
Published: October 2009

The epidemiology of 1090 referrals to a mainstream paediatric speech and language therapy department over fifteen months is discussed, in relation to referral information and initial detailed assessment. Clients are classified by their main presenting difficulty and by their degree of severity. This information will inform clinicians of the nature of the caseload of a typical inner city service which will, in turn, aid service planning.
SEEING THE PERSON? DISABILITY THEORIES AND SPEECH AND LANGUAGE THERAPY
Authors: Jordan Lesley , Bryan Karen
Published: October 2009

The potential value of a framework enabling practitioners to conceptualise speech and language therapy from a range of perspectives engendered by different theories about disability is explored. Four disability research paradigms are used to categorise professional activities, whilst the ‘individual’ and ‘social’ models of disability are considered as alternative value systems. Challenges facing speech and language therapists in developing roles and services to embrace different perspectives are outlined.
USERS IN THE DRIVING SEAT OR SITTING ALONGSIDE MAP‐READING?
Authors: Ritchie Julia , Levens Val
Published: October 2009

The government agenda is clear. At the highest level users are involved in policy making. We as service providers need to show evidence that users views are elicited and used to improve the quality of care. The tool bag of techniques used to elicit users views will be explored ‐ questionnaires, structured interviews, focus groups and innovative cognitive techniques such as perception score cards. We explore the continuum of user‐led qualitative techniques to provider‐led quantitative approaches. Building a framework of techniques which cover the diverse needs of people using a speech and language therapy (SLT) service is a challenge. A greater challenge is using the views of users to bring about meaningful change.
MULTI‐PROFESSIONAL STAFF DEVELOPMENT PROGRAMME FOR PAMs
Authors: Wray Nikki
Published: October 2009

A unique, accredited, multi‐professional education programme for junior staff in professions allied to medicine (PAMs) developed by Durham and Teesside Education and Training Consortium in collaboration with local trusts and social services is described. Designed to ensure competence to practice in line with clinical governance, it aims to strengthen multi‐professional working practice through a greater understanding of roles and of the way the national health service (NHS) works. It enables staff to analyse their own learning needs and to employ self‐directed learning skills for lifelong learning. Using problem‐based learning, it uses real clinical cases as triggers to promote critical evaluation and reasoning and the development of multi‐professional care pathways.
CHILD'STALK — FOR CHILDREN WITH AUTISM AND PERVASIVE DEVELOPMENTAL DISORDER
Authors: Aldred Catherine , Pollard Clare , Adams Catherine
Published: October 2009

A research assessment protocol and early intervention approach designed for use by multi‐disciplinary professionals with children who have the severe social communication deficits of early autism and pervasive developmental disorder (PDD) are described. The assessment analyses the specific pattern of social communication impairment in each child and defines the characteristics of the dyadic communication between parent and child. The intervention aims to identify facilitative strategies, using video feedback, which lead to close interpersonal interaction between the child and their parents. Parents can reflect on their own interaction and identify which strategies successfully engage their child. Child's Talk aims to facilitate adaptations to the child's level of communication by sensitively and finely tuning the interaction and mutual sharing of intentions as a fundamental agent for the emergence of communication.