SpeechLink Multimedia Limited

History & Partnership Working

QUICK LINKS

Plan

Research

The Multimedia Package

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Setting the context for Speech Link

Speech Link began in Kent in 2000. It was set up as a partnership project between Kent Education Authority (who sponsored it) and a Kent NHS Speech and Language Therapy Service.

The professionals working in the Speech Link team were an experienced IT specialist, specialist Speech and Language Therapists (SLTs) and an SLT manager who had experience as the DOH advisor and involvement in the national working party reviewing the provision of SLT services to school aged children, also numerous specialist teachers, SLTs and parents across Kent. This is true partnership working.

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Plan

The remit from Kent Education Authority was to build better support for children in schools where accessing the speech and language therapy services had been problematic. The children with severe speech difficulties waited alongside children who had mild difficulties. These children with mild difficulties would not be prioritised for SLT, but they took up an assessment space which would have been better utilised for a child with more complex communication needs. The aim was to build the expertise within schools to manage the children with mild/moderately delayed speech, empowering schools to support these children in their early sound work as a precursor to reading. Within the Speech Link programme the children with more complex/severe speech difficulties are identified and prioritized to be referred to SLT. This results in the children who would not have been prioritised for SLT having appropriate support via a speech programme delivered by a Teaching Assistant in school. The children who really needed the expertise of SLT then receive a more timely intensive service.

An iterative development process which relied on design, feedback from users and redesign was used. Three research processes ran in parallel; checking user interface usability, reviewing the computer program algorithm used to mimic the Speech and Language Therapist’s (SLT’s) decision making; and monitoring the ability of teaching assistants to listen accurately to children’s speech. This research process used the feedback from users to modify and improve Speech Link, we are now using the ninth version. Greater detail and results from this research is written up in The Australian Journal of Speech Pathology. (September 2006 proceedings). There is a link to this in our research section

The post hoc analysis reviewing the first 2½ to 3 years use of Speech Link in Kent schools has been achieved by Kent County Council Education Department commissioning an external review lead by Nick Peacey, SENJIT, London University. See download link in the research section. The research modus was a structured interview of a cross section of Kent schools. The Speech Therapy Managers in Kent completed a questionnaire regarding their views on Speech Link. This was positive with 100% stating they would recommend Speech link to other areas. See their evaluation below.

The Speech Link multi-media package is delivered on line, it comprises a speech screening assessment, a website, parent information, printable picture resources and training video. The screen is designed to be carried out by a trained teaching assistant. The web site features a full range of speech sound programs. These cover listening and perception work, before reaching the stage of production and extension of use of the sound. This 7 stage programme offers a comprehensive approach to developing a new sound, and offers guidance on regularity of sessions, timing, age appropriateness etc. It draws on extensive work with experienced SLTs to find practical simple programmes that are effective when used by TAs. Supportive information on sound development based on Barbara Dodd et al (2003) is found on the web site. A discussion group is available, and on line support from the local Speech and Language Therapy Service. During their training TAs are encouraged to use the secure on line facility to get support carrying out the programmes from their local SLT. The video features SLTs modeling therapeutic activities linked to the 7 stages of sound remediation identified in the sound programmes.

A range of information leaflets are available for parents. Schools are actively encouraged to work in partnership with parents sharing the speech programmes so that the home environment reinforces the school speech programme. Partnership working with parents is a vital part of what the Speech Link Multimedia packages offer.

Speech Link is only available to partnerships of schools and SLT services working together. We have refused schools copies of the speech link programme where they do not show evidence of partnership working with SLTs. These partnership arrangements are organised strategically between senior educationalists/schools who generally fund Speech Link and SLT services who agree to service Speech Link.

Speech Link Multimedia Ltd provide training for schools and Speech and Language Therapists in the use of the packages. Where possible we work with local therapy departments to integrate the training with initiatives and programmes already available to their schools. The Speech Link Multimedia Trainers (all experienced SLTs) visit an area to deliver the training and mentor local SLTs. The local SLTs are supplied with a training manual and full website access. To ensure quality and consistency of approach we provide standardised training to all areas. The training video, available on the website, offers offers ongoing opportunity for school staff to refresh their knowledge and skills. Speech Link is placed in the context of a child’s whole communication ability, emphasizing that speech is only one aspect, reemphasizing the need to review all of the child’s communication problems. In all it raises awareness of communication difficulties in the classroom. The local SLT service agree to provide a Speech Link ‘link therapist’ who responds on line to school queries.

Our aim is to ensure that knowledge of all of communication skills increases, and that speech difficulties are not overemphasized in the context of the child’s overall communication difficulties. Issues such as cognitive skills, hearing, receptive/expressive language and specific difficulties with sound production are explored in the training and reminders are available at the beginning of each programme. It is clearly stated that the SLT leads on the child’s use of programmes and that an established SLT programme always takes precedence over a programme recommended by Speech Link. This clarity is vital and we ensure it is included in the training.

The local SLT service take on responsibility for offering support and advice to users of Speech Link in their area via their secure on line facility. The training is targeted at Teaching Assistants and SENCOS. Our research shows that with training they are competent to carry out the Speech Link assessment. Schools are encouraged to designate a Speech Link TA who leads on sound work. They develop considerable expertise in working with children with mild to moderate sound difficulties. Every school is encouraged to train two members of staff.

The SLT service has an online notice board facility to ‘communicate’ SLT information and extend knowledge to their schools and the schools liaise with each other in their cluster and their designated SLT. Issues of school misuse or poor practice in schools are monitored by the local SLT service who are encouraged to offer annual Speech Link training updates to ensure knowledge remains current in each school.

This approach is supported strategically by the Working Party Report Nov 2000. ‘Provision of Speech and Language Therapy Services to Children with Special Needs’ - DOH/DFES. They reported the need for enhanced partnership working between Health and Education, the re-emphasis on schools prioritising communication skills work within their remit and the use of a consultative model where training and skills development in schools is to be encouraged.

As recently as 2006 the position paper from the Royal College of Speech and Language Therapists (RCSLT); ‘Supporting children with speech, language and communication needs within integrated children’s services' (Gasgoigne) reported that the matching of trained skills with appropriate speech tasks was integral to the development of speech and language delivery in schools. Pam Enderby at the 2006 RCSLT Conference keynote address stated that as a profession we must know what only SLTs do well and use a consultancy and training model to support others.

The Bercow Review July 2008 makes a number of recommendations, his themes of early intervention, light touch screening, improving equity across services and re-emphasis on Speech Language and Communication in the classroom, are all areas in which we offer support.

The three methods of evaluation include; the piloting stage prior to the development of the Speech Link package; the post hoc external review though structured interview of schools across Kent conducted by Professor Nick Peacey and the SENJIT team from London University. The third is the questionnaire results from SLT managers across Kent. Evaluation is also ongoing and we maintain a quality improvement approach to monitor the use of Speech Link.

1. Piloting.
Please see the recently published article in the September 2006 issue of The Australian Journal of Speech Pathology. This gives the full research background to the development of Speech Link. In summary the piloting looked at the assessment’s ability to mirror a Speech and Language Therapist’s decision about a child, the ability of the Teaching Assistant to accurately code the child’s response and the Teaching Assistant’s reported confidence in carrying out the speech programmes.

2. Quoting from the SENJIT team evaluation of the Kent Speech Link Project.
It has been found to be a useful tool, building the confidence and competencies of schools to manage individual children and build their knowledge and experience across the whole school SEN practice.

‘ Evaluations have suggested strong levels of satisfaction with Speech link…it was universally agreed that Speech Link is valuable for initial assessment…’lead to ‘improved referrals…..Schools valued that fact that they now ‘don’t need to wait to begin intervention’.

This is encouraging as it is clear evidence of earlier intervention for children. This has been one of the aims of the Speech Link approach. We wanted to ensure that the wait for therapy is reduced by the empowered skilled school making an appropriate start.

‘Most pupils made substantial progress when following Speech Link programmes…’.
’ Speech Link is doing the job for which it was created’.

The SENJIT report included many comments about the feedback from teaching assistants including the following:

‘it has made a great difference to their practice…’
’ emerging with defined expertise and status…’
’the design of the development programme by the Speech Link team incorporates substantial formal and informal professional development opportunities…’
’ respondents implicitly indicated the success of all this provision by their appreciation of the great confidence that users in schools normally bring to the use of the intervention’
‘ the video made to support training is well used and considered highly effective…’
’ Speech Link has opened up relationships between schools and SLT services…’
.’Respondents generally found materials very straightforward to use’.

3. Summary of SLT managers’ Questionnaire.
A questionnaire format was used with SLT managers across Kent where Speech Link had been in use for approximately 2 years. There was 100% return rate, the 5 NHS service areas across Kent were represented, covering services to approximately 400 schools.

All reported using the discussion group/secure on line SLT facility to support their schools.
75% reported more appropriate referrals, better partnership working, while 50% reported better use of expertise and skills.
There was evidence of confidence in Speech Link where SLT managers reported... ’when a school has Speech Link, children with mild/moderate speech delay are discharged from SLT on school entry and the school is advised to support the child via Speech Link’.
80% of SLT managers thought that schools in their area used Speech Link appropriately
100% reported that they would recommend Speech Link

When asked to rate the Speech Link programme using the 1 to 10 scale they scored it as;

Speech link screen	8.7
Speech Link programmes	8.0
Resources to use with the programmes	9.3
Video	8.3
Website	8.4
Discussion group	6.3

Under the section; What feedback have you had from schools regarding following the speech programmes?
‘ The majority of schools have found them easy to follow and helpful’?
‘ schools don’t always have time for programmes (not just Speech Link)’
‘ schools have found the programmes useful and like the resources’

Under the section what comments do you have re the effectiveness of Speech Link?
‘ greater awareness in schools of different sound substitutions’
‘ very effective when schools are compliant and using it properly’
‘ it enables schools to provide appropriate support’

What are your overall thoughts about Speech Link?
‘ it is an exciting useful tool….a good resource for schools and staff…’
‘ Extremely innovative and valuable, when used properly it saves valuable therapy time which can then be focused onto the children with severe problems’.

New Devlopments

2009 sees the introduction of our new on line animated therapy speech programme games. These will be recommended by the assessment. These fun activities are designed to be used by parent and child or teaching assistant and child, interacting together at the computer.

Language Link.

In 2005 we started developing Language Link, a multimedia package sharing many features with Speech Link. It is a ‘light touch screen’ of early years receptive language. For ages 4 to 5.11. It offers universal screening of all children on arrival at school.

See language link presentation for research development, design and piloting.

Design.

The language link screen is designed to be used by reception class teachers in a one to one fun interactive session with each child in the class.

The on line screen offers immediate recommendations about the child’s language; it may recommend a targeted language nurture group, general classroom work or referral to SLT for full assessment.

The individual pupils data is automatically sent on line to our Speech Link office. When complete the class file is collated and the class report is compiled by our team of Speech and Language Therapists. This report offers the teacher/head teacher suggestions for whole class focused language activities. This baseline report offers comparisons with later assessment, to produce via a second report a term later, evidence of ‘in school’ improvement. This is excellent evidence for Ofstead inspection and encourages greater focus on language in the classroom.

Data.

An annual area report is produced for the Education Authority. We encourage the authority to share this useful information with Speech and Language Therapy colleagues and other interested professionals.

The report aggregates all the data for their area enabling the following:

Identification of schools with highest and lowest levels of need for that academic year in terms of the reception children’s understanding of spoken language at school entry.
Comparison with end of year results to show levels and rate of improvement.
Comparison with national data trends.
Comparison of differences resulting from gender and age.