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Funding gaps
JULIE COLEY REFLECTS ON THE BENEFITS OF BEING PART OF A PROPERLY RESOURCED AND MANAGED PROJECT TO IMPROVE THE SPEAKING AND LISTENING SKILLS OF CHILDREN WHO WOULD NOT NORMALLY ACCESS SPEECH AND LANGUAGE THERAPY.
n March 2004 a two and a half year Childrens Fund Speaking and Listening Project was set up in Burtonon-Trent, Staffordshire. The Childrens Fund - a central part of the governments agenda for children and families - aims to make a real difference to the lives of children and young people at risk of social exclusion. My manager Isabel Dodsley spotted a service gap and put together a successful bid for funding. She backed up her proposal with information about the links between juvenile offending, potential social exclusion and communication skill difficulties. She also tied it in with one of the key outcomes of the government green paper Every Child Matters (Be Healthy) with a health indicator of improved speaking and listening and social interaction skills leading to enhanced self-esteem. Our project is managed and delivered by a speech and language therapist (me) and two assistants, Wendy Burton and Helen Saville. It aims to improve the speaking, listening and social interaction of children and young people by developing their: listening and attention knowledge and behaviours story telling skills through narrative ability to reason and infer social skills / self-esteem. The project was set up for children in the 5-7 year and 9-11 year age range who did not meet the criteria for accessing the mainstream speech and language therapy service but who nevertheless had been identified by schools as needing to develop or improve their skills in any or all of these areas. In addition, the project aimed to enhance the knowledge of teaching staff and parents about communication skills and to develop their skills as communication facilitators. The Childrens Fund identified places in Burton where children and young people had not been able to access other national or locally driven preventative programmes or services. They specified the two wards in Burton where we could work, so this necessarily limited the number of schools with which we could be actively involved. As the project developed we were given permission to extend and by the end of the financial year to 2007 we will have delivered the project in 10 schools. We asked the schools to help us identify children who these supportive of skill development in the classroom. One of our primary aims was to work with parents to develop and encourage their skills as primary language facilitators with their children. We were targeting some parents who had never been into school for any purpose at all. Although the numbers are relatively small we have, with the childrens encouragement, been able to inform and engage some very difficult to reach parents. We worked very closely with schools to obtain parental consent. We designed our own letter or used school pro-formas with adapted wording. Schools were very good at promoting the project (an exciting opportunity, very lucky to be chosen). We produced flyers to attract the children and used existing home school liaison staff to phone or contact parents on our behalf. Where English was a barrier we ensured that there was someone at home who could translate, or used bilingual support.

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were struggling with social and communication skills development. With the assistance of a teacher, we supported this process by providing staff with a formative assessment profile based on a combination of National p-scales and National Curriculum Literacy attainment targets. We also observed the children from a social interaction perspective in the classroom setting. In addition to identifying children, this initial assessment phase would provide a baseline for ongoing evaluation and reporting to the Childrens Fund.

Incentives
We got the children to create the invites for their parents and carers to come to group sessions and actively encouraged attendance through incentives. Initially we offered small general prizes from pound type shops but with recently increased funding we have bought in games to encourage language development, communication and cooperation. We also always have refreshments. We keep parents fully informed about the aims of the work we do through leaflets (symbolised as appropriate), drop-ins and parent sessions. Home school liaison staff inform us about any special requirements of families. We send activities and ideas home with children on a regular basis and regularly ask parents for opinions and comments. The Childrens Fund also promotes and encourages the active participation of children and young people. As a team we have developed skills and knowledge about gaining opinions and feedback through involving children and young people. Satisfaction levels are monitored closely by the Childrens Fund Management team and indeed funding has depended not only on perceived improvement of skills but also on service users satisfaction (see figure 1). As well as actively inviting spoken comments, we use smiley face feedback from younger children where they select one of three faces to post in a box to indicate their satisfaction. With the older children we use red, green or amber cards for their feedback. We also use a system of reward cards linked to communication behaviours like good waiting, you didnt butt in, good ideas, and the children are encouraged to reward each other if they a identify a good behaviour in a group session. We also regularly give out certificates. Our high school children prefer to have their rewards via existing school reward systems such as merits. Childrens Fund Projects are performance managed on a quarterly basis and so staff are required to moni-

We have, with the childrens encouragement, been able to inform and engage some very difficult to reach parents. Continuity
The project is delivered in weekly one hour sessions over three terms and relies on schools making a commitment to provide accommodation. When possible we actively encourage an assistant from school to work with us, for the purpose of continuity, feedback and skill sharing. All sessions aim to develop effective listening and spoken language but focus on more specific elements of language skills as required (reasoning, inference, story telling, components, using and understanding questions, giving opinions). We evaluate all sessions at the end, and some of these observations help to inform class teachers about skill development. We have found it necessary to develop promotional resources and material to support and promote our work. The two speech and language therapy assistants have become experts in this! Training school staff has taken several forms, initially using I CANs Joint Professional Development Framework. We have actively encouraged staff to observe and participate in group sessions and to run parallel groups. As well as talking to school staff as a whole we have done talks for groups such as teaching assistants, and we share and discuss aims of group sessions to make

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SPEECH & LANGUAGE THERAPY IN PRACTICE Summer 2007

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tor and evaluate childrens progress regularly. Outcomes have been very positive with comments from school staff about improvements in childrens confidence and self-esteem, improved listening and attention, more contribution to class discussions and increased parental involvement in schools. With an extension of funding until March 2008 we have been able to offer our project to several new schools in the area and also to include young people in the 11-13 year age range. We have also been awarded a further sum of money to build on the work we have done so far with parents. This will involve running parent workshops to enhance their knowledge as language facilitators and attending parents evenings with display boards, resources and information regarding the importance of communication skills for life. We are also looking for alternative sources of funding in order to allow the project to run on beyond the scheduled finish date.

Photos: far left: Julie talks to parents and children Left: Helen working with some older children Below: Wendy gets the children involved

Rewarding
It has much such a difference having dedicated time, staffing and resources to carry out a project effectively! The opportunity to use and adapt my skills has been personally rewarding, and I have benefited from working alongside two assistants who take a less clinical approach to intervention. As I normally work in a Speech and Language Centre, I now feel more in touch with what is happening in mainstream schools in terms of social and educational expectations and demands on education staff. Going into schools frequently and regularly and being accessible before and after sessions has helped enormously to improve relations between health and education. The project has also created opportunities to reach more parents and children than we would normally be able to see. There are signs that the project will have ripples beyond the initial splash. Every school involved has welcomed the initiative and recognised that we need to do more to promote effective speaking and listening. They recognise that children respond to regular, focused work in a small group on basic communication skills, that they make progress and enjoy the sessions. Staff are now more easily able to identify children who may be at risk because of their poor communication skills. Teaching and support staff have picked up skills through observing sessions and some schools are setting up similar groups to run in parallel with ours. Julie Coley is a speech and language therapist with South Staffordshire Primary Care Trust. To see examples of resources developed by the team, go to www.speechmag.com.

Figure 1 Feedback

For some members of the group this is the first time they have been asked what they think and why and within a safe environment are being encouraged to form and articulate their ideas. (teaching assistant, 11-13 years) One of the boys is now confident enough to speak in front of a group. Strong links have been built between school and the speech and language therapy department. (teaching staff, 9-11 years) That was really good. Id like to come again because I could take these ideas to playschool. It was brilliant, I love the interactive stuff. (parents, 5-7 years) I find it easier to talk to teachers and parents about problems [now]. (Sarah, 12)

Resources
Every Child Matters, see www.everychildmatters.gov.uk/aims/outcomes Joint Professional Development Framework, SLTP see www.ican.org.uk

SPEECH & LANGUAGE THERAPY IN PRACTICE Summer 2007

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reprinted from www.speechmag.com

reprinted from www.speechmag.com

reprinted from www.speechmag.com

reprinted from www.speechmag.com

reprinted from www.speechmag.com

reprinted from www.speechmag.com

reprinted from www.speechmag.com