Presentation on theme: "Lorraine Coulter Speech and Language Therapist"— Presentation transcript:
1 Partnership Working Speech and Language Therapy School Outreach Service Lorraine CoulterSpeech and Language TherapistClinical Co-ordinator for Education
2 SETTING THE SCENE Bercow Government Report (2008) ‘Early identification and intervention are essential to avoid poor social and economic outcomes in later life. The evidence that early intervention brings benefits, and its absence incurs costs, is there for all to see. The task is to act on that evidence systematically, in delivering policy and allocating resources. ‘ (Bercow Report, 2008)10 Year Strategy for Children and Young People, in N.I. ( )‘Partnership working will be key…to improve the life chances of all our children and young people.’
3 SETTING THE SCENEN.I. Speech and Language Therapy Task Force Report (2008).“Speech, Language and Communication difficulties affect more children and young people in N.I. than any other single condition.”Speech, Language and Communication Therapy Action Plan (2011)Key Themes:-Early identification and intervention-Collaborative working-Capacity building .
4 SCHOOL OUTREACHService Redesign Collaborative Working Hard to Reach Optimum Timing Opinions Life ChancesOutcomes Unique Transferable Risks Evaluation Access Cost Effectiveness Health & Education
5 SERVICE REDESIGNDrivers:Local needsPoor accessLong waiting lists
6 SERVICE REDESIGN2007 – Funding secured from Department of Education to develop a school based serviceMove away from traditional medical model of service deliveryBased on Nursery Outreach and Speech and Language Development Project modelService level agreementsSLT integrated into the school curriculumSkill Mix: SLT Assistants involved in delivering therapy
7 CHILD AT THE CENTRE OF SERVICE DELIVERY SERVICE REDESIGNParentTeacherSpeech and Language TherapistCHILD AT THE CENTRE OF SERVICE DELIVERY
8 Signposting to appropriate services SERVICE REDESIGNSignposting to appropriate services(High need)Targeted services(medium need)Universal services(low need)(Marie Gascoigne 2006)
9 COLLABORATIVE WORKING Funding: DE ( ) , DSD ( )Partnership between Speech and Language Therapy and local schoolsWhen teachers and therapy staff work together – improved outcomes for childrenTraining staff in identification and support for children with speech and language difficultiesSpeech and Language Therapy integrated with child’s learning environmentTherapy targets linked to the curriculum‘Every single education skill presupposes the use of language’ (Dockrell etal, 1998)
11 HARD TO REACHUptake of services in areas of deprivation is low-challenge for service providers (Harasty and Reed, 1994)50% fail to attend rates at the local clinicPrevalence: up to 50% pre school children language delay (Law 1997),42% of Preschool Children in S.E.T. area (Coulter, 1997), 41% School Age Children (Coulter,Halligan and Jordan,2009)Hard to reach – families or services??
12 OPTIMUM TIMING“Children who do not receive timely intervention before 5 years of age are likely to have significant impairments in all aspects of their spoken and written language” (RCSLT, 2007)
13 OPINIONSCommunity needs assessment – ‘easier access to Speech & Language Therapy’Continuity from preschool to Primary schoolService users opinions:Teacher Questionnaires – pre & post trainingParent questionnaires (end of year)Parent focus groups
14 LIFE CHANCESThe language skills of children under three years are most highly correlated with IQ and are the single best predictor of school success (Rossetti, 1996)Many large scale studies of children with speech and language delay at the pre-school stage point to persisting problems in educational, social and behavioural development often into adolescence (Silva et al, 1987, Aramental, 1984, King et al, 1982).Communication is the currency of life
15 OUTCOMES Improved outcomes for; Children 52% discharged at end of P1 SLT embedded in classroom practicePre/ post assessment – improvementii) CommunityImproved access to services (2 week waiting time)Capacity building- resources and trainingHealth of community – early intervention & prevention
16 UNIQUE Not more of the same in a different place. We have broken the cycle of “traditional” delivery, to make a difference.Skill mix :SLT and SLT AssistantsService level agreements: management and supervisory structuresCapacity Building: systematic approach to training e.g. HANEN, ELKLAN
17 TRANSFERABLE- Replication of model by other Services e.g. Community Paediatrician- Template developed- Any locality- Bilingual children e.g. Irish Medium
18 RISKS Cost to the individual and the Nation: - Education attainment/literacy- Social/emotional development- Mental Health: One third of children withspeech and language difficulties have mentalhealth problems often resulting in criminality- Young offenders (Locked in and LockedOut, RCSLT, 2009)- NEET Population (Not in Education,Employment and Training).
19 EVALUATION - External evaluation - Pre /post assessment of children - Parent questionnaires/focus groups- Education staff questionnaires
20 ACCESSCommunity call for ‘easier access to Speech and Language Therapy’ (1997)Up to 50% fail to attend rates in local clinicsNow 100% access to serviceLess disruptive for childContinuity from Nursery school
21 COST EFFECTIVENESS - Resources have been optimised: Human: staffing, use of SLT Assistant, best use of SLT time- Quantity increased; group and individual interventionEnvironmental: familiar school environment, local, accessible, use of school equipment- Financial: 100% attendance, 52% discharged, early intervention results in reduced ongoing difficulties and need for services.
22 HEALTH & EDUCATION - Culturally different organisations - Real partnership working- Transfer of skills: Health – Education- Collaborative practice across health and education services = improved outcomes for children- Cost effective (Law et al 2002, Lindsay & Dockrell 2002, Wright & Kersner 2004, Cirrin et al 2010).
23 FINALLY..“Communication is the currency of life, you need it to develop relationships, participate in education and hold down a job.One in ten children and young people struggle with this invisible disability. Without the right help, at the right time, they will be left out and left behind.”(ICAN 2007)