conference report

I CAN make collaboration

Avril Nicoll attends the 7th I CAN national conference.

clear message from the 7th I CAN conference is that collaboration has to start somewhere - and talking to each other does help. With his usual perception, James Law suggests that people who describe themselves as working towards collaboration probably dont talk at all. Ruth Paradice believes that having a coffee together would be a start for some. One delegate welcomes the spread of email, as she finds it invaluable for making initial contact with colleagues in other professions, and making it easier to set up face-to-face meetings. Contact is, however, of limited value if you cant understand each other. Mary Auckland finds that teachers knowledge of language development is poor, so all the other skills they have cannot be used until this knowledge gap is addressed. Julie Dockrells research highlights split perspectives, with speech and language therapists striving for an appropriate diagnosis, and local education authorities looking for a needs based model. She asks, are they in conflict, or can they be complementary? To make collaboration count, Barbara Clarkson & Angela Peel say dont go to people who dont want you. Stick with people who are eager, and your work will grow and the enthusiasm spread. Mary Auckland agrees. A designated staff member is vital to the programme of empowering schools which is underway in the Bracknell area, and she recommends targeting projects on the really keen teachers within the really keen schools.

A win/win model
What do you do though when, as in Herefordshire, there is no history of multi-agency working and no service to mainstream schools? And where, due to curriculum demands, children have insufficient time to develop their vocabulary and language? An Education Action Zone has been set up to provide additionality, and this seems to have provided some of the answers. A survey before the project found 28 per cent of children at Key Stage 1 had language problems,

rising to 35 per cent at Key Stage 2. In contrast, following the introduction of the Education Action Zone, the figure dropped from 25 per cent at Reception to 6-8 per cent the following year. The Action Zone educational psychologist Val Dann and speech and language therapist Judy Winfield have brought in the Teaching Talking package and find it a win/win model. In addition to the language gains in the population targeted, teachers are now more confident dealing with simple delay, have taken on board the repetition, repetition, repetition mantra, and are using the emerging skill category in Teaching Talking to target consolidation. The clinic-based speech and language therapy department is receiving better quality referrals and there is now support for the recommendations made by their speech and language therapists, as teachers and therapists have a common language which facilitates discussion. Julie Dockrell argues that an oral language curriculum and written policies would be positive steps, and that built-in collaboration is a glaring omission from local education authority plans for children with speech, language and communication difficulties. Along with other speakers she asks that we attempt to agree on terminology for describing these children (she counted 17 different descriptors in the course of her research), and that the needs of children with autism are addressed as well as, not instead of, children with more specific speech and language difficulties. In arguing for greater collaborative practice to benefit children, Gill Edelman commented that, professionalism is a very exclusive business. At times the business was so exclusive at this conference that parents rated barely a mention, perhaps reflecting the prevalent attitude in our education system compared with clinic-based therapy. Julie Dockrell notes that local education authority plans for children with speech, language and communication difficulties do not discuss the role of parents. James Law points out that parents who are engaged early with a system are much more likely to understand the logic of different models of service delivery, and that parents are

Initially parents were kept at a safe distance. Now parents are attending training activities and joining in with discussions true partnership in action.

one of our best measures of whether health and education work well together. Denise Ford, however, has really run with this. Although working with parent groups had always been part of the Kent plan, initially parents were kept at what she describes as a safe distance. Now that everyone has moved on in their thinking, parents are attending training activities and joining in with discussions - true partnership in action. The government says its reform of secondary education in England will enable a shift from the old one-size-fits-all system to tailored-made teaching and learning for every pupil. Plans include commitments to develop partnerships beyond the classroom with parents, business, universities and others, and to reform the school workforce by allowing teachers time to teach and a far greater role for more trained adults in the classroom. It seems this cant come a moment too soon as the woeful inadequacy of speech and language therapy at secondary level was a repeated theme of the day. Mary Aucklands work is at the primary stage - and she believes a completely different approach is needed for the secondary level. Julie Dockrell wants to see strategic development for Key Stage 3-4 and post 16s, where speech and language therapy provision is particularly poor. Barbara Clarkson and Angela Peel are one of the few speech and language therapist / teacher teams working with pupils in a mainstream secondary. The school has a speech and language resource, mainly for children who have been in a primary language unit. Like Mary Auckland, they emphasise that teaching metacognitive skills supports both inclusion and collaboration. They identified the actions which commonly make up learning support - help, tell, read, write, check, ask, stop...in effect, think for - and which serve to isolate pupils from their peers and classroom teachers. By introducing four types of lesson covering skills in learning and independence, and social skills and problem solving, and adding classroom observation and modification of teaching, pupils are actively thinking and problem-solving in whatever context they find themselves. Debriefing is an important element - What have we just been doing? What would have been useful? Who could help you with this? When are you going to plan? What resources could help you?

SPEECH & LANGUAGE THERAPY IN PRACTICE SUMMER 2003

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Shared vision
The importance Barbara Clarkson and Angela Peel attach to a shared vision was also taken up by Denise Ford, who finds it overcomes the problems caused by continual organisational change. In addition, it allows for wider experimentation in delivery of speech and language therapy, and one result in Kent has been the production of Speech Link, a multimedia phonology assessment. Staff have been so impressed with I CANs Joint Professional Development Framework that there are plans to use it as the structure for professional development pathways within Kent across all the special educational needs dimensions - physical & sensory, cognition & learning, behaviour, emotional & social, as well as communication & interaction. The approach to schools across the Kent county is one of rights and responsibilities - they have the right to rapid access to services if they take responsibility for allocating training time and assistants. Taking an organised, whole service approach with leadership is also favoured by Mary Auckland, and results in the Bracknell area bear this out: carryover to classroom practice, schools now feel they have more to offer all children with special educational needs, listening and attention groups have led to improvements in behaviour and learning. As well as commitment from schools for training, designating staff and protecting time, this model also depends on cultural change amongst speech and language therapists, schools and parents, and Mary Auckland believes we sometimes underestimate the shifts in thinking that are required. James Law supports the need to develop leaders and for more strategic thinking in our profession. He cautions against creeping consultancy, a move to a model which has not been properly

5 themes for action 1. get talking

2. 3. 4. 5. share a vision develop leaders work with parents teach metacognitive skills
dont serve the same purpose as a one or two day course in a particular approach, and delegates need to appreciate that and adjust their expectations accordingly. What they do achieve is to bring together the people who are driving the change in the profession, to enthuse and inspire them to find out more and to keep going, even when the going gets tough. If you want to make your collaboration count, you can audit your continuing professional development needs on the I CAN website. The 7th I CAN conference Collaboration Counts was on Monday 3rd March 2003 at the Commonwealth Centre in London. There were six main speakers and three workshop sessions where delegates could choose to attend one workshop out of five offered. Power Point presentations of most sessions are at www.ican.org.uk.

thought out, supported or evaluated. He is unequivocal - a consultant is an expert practitioner and a newly qualified therapist does not have the skills and experience to be put in this position. As he says, a choice about a consultative model is not a binary one, but is intimately linked with other choices. Leaders need to work with birthrate and population figures and notional caseloads, and to use evidence rather than policy to drive decision making. He notes that the push towards equity of service is resulting in more people getting less, and is therefore working against evidence based practice. Denise Ford talked about Kents Communication & Interaction service as being a virtual service and I suspect this is something were going to come across a lot more. A difficult concept to grasp, it emphasises a highly flexible but well coordinated structure with a clear vision. Val Dann points out, though, that a virtual team can only work if its members know it exists! Ruth Paradice called for more strategic developments, not just grass roots support. Collaboration that works combines strategic lead with backup on the ground - hardly rocket science but, in practice, we know how difficult it can be to achieve, and we need to be aware of what works so we can do more of it. Conferences with many short presentations

Resources
Teaching Talking (1985) by Ann Locke and Maggie Beech is available from NFER-Nelson, see www.nfer-nelson.co.uk/html/health/products/tt.htm. Further information on Speech Link from Derry Patterson, Speechlink Co-ordinator, Speech and Language Therapy Department, Medway Maritime Hospital, Windmill Road, Gillingham ME7 5NY, e-mail

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SPEECH & LANGUAGE THERAPY IN PRACTICE SUMMER 2003