Making Change Meaningful
A review of paediatric speech and
language therapy provision in
Dublin South East
Rosemary Kavanagh
Eilís Dignan
Senior Speech and Language Therapists
Communication
a fundamental human right
and need

Speech, Language and
Communication
Needs



a life-enabling skill


Lifelong
Prevalence rate is 7-10%
2 to 3 children in every
classroom in the UK
Without help a proportion
of these children will need
therapy for mental health
difficulties in adulthood
Speech and Language Therapy
Department HSE Dublin South
East
Our Aims
Positive
Communication
Environments
Build Knowledge
and Skills
Maximise
Communication
Speech and Language Therapy
Department HSE Dublin South
East
HSE Change Model
Initiatio
n
Main
Streaming
Planning
Implementati
on
Speech and Language Therapy
Department HSE Dublin South
East
Initiation
Speech and Language Therapy
Department HSE Dublin South
East
Solution Focused Approach
Strength-based
Collaborative
Goal-driven
Practical
Acknowledging difficulties
Empowering
Speech and Language Therapy
Department HSE Dublin South
East
Listening
Planning
Speech and Language Therapy
Department HSE Dublin South
East
Implementation
How was the
session
useful?
What’s been
better since
you were last
here?
Speech and Language Therapy
Department HSE Dublin South
East
Mainstreaming

Review March 2014

Outcome measure

Agree changes


Plan for sustaining
change
Service user
experience
questionnaire

Monthly peer support
meetings
Speech and Language Therapy
Department HSE Dublin South
East
Our service is
changing….
Speech and Language Therapy
Department HSE Dublin South
East
What parents are saying……
“I feel I have been heard – our needs have been met”
“Good to see myself on video even though I wasn’t looking
forward to it. The session was really enjoyable”
“This approach to therapy, using play and building structures
and skills to enable me to work with C at home has had
remarkable results”
“A is confident now – he used to be very frustrated. At
Sport’s Day this year he said “This year I can say my
name””
Speech and Language Therapy
Department HSE Dublin South
East
What we are saying…
‘I feel that I am seeing the kids that need to be seen’
‘It has been really positive to take a step back from the
day to day business and really examine what we do
and why we do it’
‘We are really listening to what our stakeholders want and
can actually make real change to try to accommodate
that’
‘I think the involvement of team members in the change
process has been vital. I’m really glad to have been
involved and proud of what we’re doing’
Our Vision
‘to deliver a speech and language therapy service that benefits
and supports children and young people in their everyday
communication and helps them to reach their potential and
achieve their goals in life’
Speech and Language Therapy
Department HSE Dublin South
East
References




Baker, E. and McLeod, S (2011) Evidence-based practice for children with speech sound disorders: part !
narrative review. Language Speech and Hearing Services in Schools. Vol 42. pp102-139.
Baker, E. and McLeod, S (2011) Evidence-based practice for children with speech sound disorders: part 2
application to clinical practice. Language Speech and Hearing Services in Schools. Vol 42. pp140-151.
Beardshaw, V and Hosford, A. (2007). in Cross, M. Language and Social Exclusion. I Can Talk Series.
Issue 4.
Boyle, J., McCarthy, E., O Hare, A. & Law, J. (2010) Intervention for mixed receptive-expressive
language impairment; A review. Developmental Medicine and Child Neurology. 52. pp994-999.

Bowen, C and Cupples, L (2006). PACT: Parents and children together in phonological therapy. Advances
in Speech Pathology. 8 (3).

Broomfield, J. & Dodd, B. (2005) ‘Clinical effectiveness’ in Differential Diagnosis and Treatment of
Children with Speech Disorder. Barbara Dodd (ed.) Whurr. London



Broomfield, J. & Dodd, B. (2011). Is speech and language therapy effective for children with primary
speech and language impairment? Report of a RCT. International Journal of Language and
Communication Disorders. Vol 46, 6. 628-640.
Enderby, P (2012) How much therapy is enough? The impossible question! International Journal of
Speech-language Pathology. 14 (5) 432-437.
Gascoigne, M and Jordan E. (2011). Joint Commissioning Services to Children and Young People with
Speech, Language & Communication Needs Service Redesign - Proposed Model of Service Delivery. NHS
Worcestershire and Worcestershire County Council.
References







Gascoigne, M. (ed). (2012). Better Communication – Shaping Speech, Language and
Communication Services for Children and Young People. London. RCSLT.
Gibbon, F et al. (2012). Growing Up in Ireland – National Longitudinal Study of
Children – The Prevalence of Speech and Language Impairment among a Nationally
Representative Sample of Irish Children. Paper presented at the Growing Up in Ireland
Annual Conference.
Kelman, E. & Schneider, C. (1994) Parent child interaction therapy: an alternative
approach to the management of children’s language difficulties. Child Language
Teaching and Therapy. 10 (1).
Law, J., Garret, Z & Nye, C (2004) The Efficacy of treatment for children with
developmental speech and language delay/disorder: a meta analysis. Journal of
Speech, Language and Hearing Research. Vol 47. pp 924-943.
Law, J and Garret, z. (2003). Speech and language therapy interventions for children
with primary speech and language delay or disorder. Cochrane Database of Systematic
Reviews (3).
Law, J et al. (2013). Child speech, language and communication need re-examined in
a public health context: a new direction for the speech and language therapy
profession. International Journal of Language and Communication Disorders. Vol 48,
(5), 486-496.
Mercow et al. (2010). An exploratory trial of the effectiveness of an enhanced
consultative approach to delivering speech and language intervention in schools.
International Journal of Language and Communication Disorders, 45 (3).
References








McCartney, E. et al (2011). Indirect language therapy for children with persistent language impairment
in mainstream primary schools: outcomes from a cohort intervention. International Journal of Language
and Communication Disorders, 46 (1).
McIntosh, B & Dodd, B (2008) Evaluation of core vocabulary intervention for treatment of inconsistent
phonological disorder: Three treatment case studies. Child Language Teaching and Therapy. 25 (1),
pp09-30.
Morgan, AT & Vogel, AP (2009) Intervention for childhood apraxia of speech (review) The Cochrane
Collaboration.
Roberts, M. & Kaiser, A. (2011). The effectiveness of parent implemented language interventions: a
meta analysis. American Journal of Speech-Language Pathology, 20 pp180-199.
Roberts, M. & Kaiser, A. (2012). Assessing the effects of a parent implemented language intervention for
children with language impairments using empirical benchmarks: A pilot study. Journal of Speech
Language and Hearing Research, 55, pp1655-1670.
Snowling, M et al. (2006). Psychosocial outcomes at 15 years of children with a preschool history of
speech-language impairment. Journal of Child Psychology and Psychiatry. 47(8), 759-765
Williams, L (2012). Intensity in Phonological Intervention: is there a prescribed amount? International
Journal of Speech-language Pathology. 14 (5) pp 456-461.
www.ican.org.uk