June 2007 Issue 662

Broadening horizons: SLTs working abroad

June 2007 Issue 662

June 2007 Issue 662

COVER STORY:

Broadening horizons: SLTs working abroad

(see pages 12-14)

CONTENTS
4 Editorial and letters News: HPC registration renewal starts soon;
Good stroke practice in Gloucestershire; Connecting for Health: the latest developments; Carly wins Duke of Edinburgh gold, and more

Royal College of Speech and Language Therapists

2 White Hart Yard, London SE1 1NX Telephone: email: website:
President Senior Life Vice President Vice Presidents

020 7378 1200 bulletin@rcslt.org www.rcslt.org

Sir George Cox Sir Sigmund Sternberg Simon Hughes MP Baroness Jay Baroness Michie Rosalind Gray Rogers Mary Turnbull Ann Whitehorn Kamini Gadhok Steven Harulow Annie Faulkner Fiona McKinson Ten Alps Publishing plc Courts Design Ltd

11 What's new: information on the latest products

and courses

15 16 18 20

Mary Smith: Milton Keynes waiting list modernisation Himali de Silva: development of a service for children with autism in Sri Lanka Liz Franklin: how speech and language therapy services carry out assessments and make diagnoses of school age ASD Debbie Sell: continuing the debate on the use of topical anaesthetic for flexible nasendoscopy

Chair Deputy Chair Hon Treasurer Professional Director Editor Communication Officers Publisher Design

21 Obituary 22 Book reviews 23 Any questions: Ask your colleagues and share your knowledge 24 Quick look dates: Essential dates for your CPD diaries 23 Your speech and language therapy jobs

Disclaimer: The bulletin is the monthly magazine of the Royal College of Speech and Language Therapists. The views expressed in the bulletin are not necessarily the views of the College. Publication does not imply endorsement. Publication of advertisements in the bulletin is not an endorsement of the advertiser or of the products and services advertised.

31 Specific Interest Groups: The latest meetings

and events around the UK

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Rich pickings in this months issue

With the summer holidays fast approaching, we thought we would add a little foreign flavour into this months Bulletin to put you in the mood. Our main feature focuses on the experiences of a few of the intrepid SLTs who leave these shores, whether temporarily or as part of a permanent move, to practise their speech and language therapy art overseas. As you will read on pages 12-14, SLTs certainly travel far and wide and some have had extremely interesting and rewarding adventures. Elsewhere in this months Bulletin we cover a huge range of speech and language therapy topics. Autism comes under the spotlight in two of our feature articles. Liz Franklin looks at how UK speech and language therapy services carry out assessments and make diagnoses of school age autistic spectrum disorder. It is interesting to compare this to Himali de Silvas account of the development of a service for children with autism in Sri Lanka. We also have articles on endoscopy procedures, waiting list management and good stroke practice, together with the latest news from the world of speech and language therapy. All in all, this months Bulletin is well worth dipping into. I hope you enjoy it.

LETTERS
Bulletin thrives on your letters and emails Write to the editor, RCSLT, 2 White Hart Yard, London SE1 1NX email: bulletin@rcslt.org
Please include your postal address and telephone number Letters may be edited for publication (250 words maximum)
Its not about men or women
I very much enjoyed the article Why do men become SLTs? (Bulletin, April 2007, p12-14); however I think the context deserves closer review. First of all, it is not about men or women. In my opinion, our profession would benefit from taking a leaf from successful business recruitment practice, where the intention is to attract great employees who will be enthusiastic about their work and fiercely loyal to the business mission. I may be wrong, but I think many applicants to the profession today have a personal connection with speech and language therapy in some way I have, as do others referenced in the article. We already know what is so good about our work and why we want to do it. But what makes a profession great is the ability to attract and retain the right people and we may not be tapping into extraordinary talent that has no personal connection. Richard Cave Student SLT City University

Steven Harulow Bulletin Editor bulletin@rcslt.org

STOP PRESS
Only three weeks to go to the RCSLT managers conference (see page 7 for details)

Book your place now Visit: www.rcslt.org

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LETTERS CONTINUED
The first man in the profession
The excellent article, Why do men become SLTs? (Bulletin, April 2007, p12-14), makes no mention of the man who could claim to be the founder of the profession. Luckily, a recent International Journal of Language and Communication Disorders (Vol 41; number 6) has a short report How conceptual frameworks influence clinical practice: evidence from the writings of John Thelwell, a nineteenth century speech therapist. He even went to prison for his political views and seems to have been a fascinating character. Deborah Tor Retired member Can someone please point out where the incentive to return is as I have obviously been so out of practice that I cannot see it? Name and address supplied experiences give an SLT more knowledge and understanding than they might have had previously, and will contribute to their therapy work. Maturity is valued in speech and language therapy, so please do not be put off coming back to the profession.

RCSLT Head of Professional Development Sharon Woolf replies:

The HPC has protection of title, which means no one can call themselves a Speech and Language Therapist, or a Speech Therapist, unless they are on the HPC register. The HPC consulted widely on the standards for return to practise and these are now legal requirements. When the HPC sets standards it has to ensure these are appropriate for all registrants from all the AHPs. Self-directed reading, undertaking courses and supervised practice are objective activities that all registrants can engage in and which, if necessary, can be measured in terms of their outcomes. Previous knowledge and experience is taken into account for returners, but the HPC standards requires them to update their knowledge and skills to demonstrate continuing professional development. There is no assumption that knowledge has been erased, but there is the recognition that practitioners at all stages of the career have something to learn. To assume there have been no changes to the working environment or the clinical guidelines and research in a particular area is not realistic. The HPC standards, as with many quality assurance systems, may seem to be cumbersome and punitative to the individual, but in terms of risk management and to ensure the protection of the public these systems have to seek to prevent the worst-case scenario from occurring. The RCSLT considers that returners to the profession bring additional knowledge and life-skills with them, and become very good therapists again. We value returners very much. We regard it as a normal part of an SLTs career to take a career break for a number of years, either for domestic reasons, or to work in a different field. We feel both of these

Who makes the hard decisions?

In response to Time for hard decisions (Bulletin, April 2007, p 4), I am concerned by what my chosen career is becoming. I decided on training to become an SLT (and I graduate this year), as I wanted to do a job that made a difference in some small way and thought this would be a career that did just that. Sadly, I now wonder whether the job in its present consultative form will enable me to make any difference at all. Ideally, provisions should be in place to ensure teaching staff receive support and highly skilled interventions from therapists. However, on recent clinical placements I realised this is not always the case. For example, I observed a child with learning difficulties who had been included in a mainstream school but was understanding and learning very little as a result. The SLT was using her many years of knowledge and expertise to train the teacher and the assistant, in approximately 15 minutes, the rudiments of language pathology a subject that has taken me four years to learn. Following the visit I enquired why no further steps were being taken to provide some form of AAC such as Makaton. The response was that having just introduced a visual timetable, it would be overloading the teaching staff and could have detrimental effects. This might have proved to be the case, but I wonder how often this situation occurs across the education system in this country. I question the extent to which SLTs represent powerful agents and would argue these hard decisions have effectively already been made for us by people, ie politicians, who do not know any better. Name and address supplied

Returners: wheres the incentive?

As an SLT taking a break to look after my two young children, I am dismayed to discover the Health Professions Council (HPC) and RCSLT will both class me as a returner when I have been out of practice for two years. Then, there are a whole set of guidelines to assist me back to work. The HPC specifies 30 days of combined supervised practice, formal and private study (the later being no more that 15 days). In association with this, the RCSLT specifies a distance-learning course of nine units (10 hours study time each) at a cost of 450. At this time, I can look forward to being employed as an SLT assistant, TI, or newlyqualified therapist until my knowledge is refreshed. For me this raises many concerns and questions. As a part-time returner, this process will take a long time to complete. Why are my previous eight years experience not taken into account? Why is my experience with my own childrens speech and language development not considered valuable or useful? Why is this returning time limit in place? To protect the public? If so, is the public at significant risk from me using theories or methods that may be two years out of date?

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NEWS IN BRIEF
ASD assessment
Consultant psychiatrist Anna Mc Govern is researching assessment tools used to assess young people with suspected autistic spectrum disorder prior to establishing a dedicated assessment clinic.We do not currently have any speech and language therapy input, although we can refer to community teams if necessary. Do other teams running assessment clinics have SLTs as part of the team? Email: focus@cru.rcpsych.ac.uk

Your International Journal

You should have received copies of the International Journal of Language and Communication Disorders (Volume 42; Number 2, March-April 2007) and Volume 42, Supplement 1 with your April and May Bulletin. Unfortunately, due to a distribution problem some people received two copies of the same issue. If this has happened to you, please talk to your collegues and see if you can do a simple swap. If this doesnt solve the problem send your extra copy back to the RCSLT by 1 September 2007 and we will try and send you the missing issue. You can also access the International Journal online. Visit: www.rcslt.org/resources/publications/journallcd

Fellowships available
The Health Foundation is again seeking applicants for its Quality Improvement Fellowships. They provide an opportunity to spend a year in America examining the health system, while working with leading health policy experts to conduct original research. The Health Foundation seeks senior NHS leaders who are clinically qualified and have a strong track record of achievement in the field of quality improvement. Applications close 4 September 2007. Visit: www.health.org.uk/current_work/open _for_applications/harkness_fellowship. html

Connecting for Health: the latest developments

Louise Creighton explains how the new NHS Care Records Service (NHS CRS) will affect SLTs
There has been concern among clinicians and members of the public regarding the introduction of the electronic patient record, particularly around access to records and patient confidentiality. NHS Connecting for Health has produced a guidance document to address some of these concerns and explain how the system will operate. These are available at: www.rcslt.org/news/connecting_f or_health Allied health professional organisations and the Royal Pharmaceutical Society support the guidance, which will help you prepare for the changes that the introduction of the electronic patient record (NHS CRS) will bring to your working practices. The first 11 GP practices in England are working towards the introduction of the Summary Care Record. Feedback from patients has been predominantly positive. Other PCTs are involved in the Early Adopter phase of the roll out and we will use lessons learnt from their experiences to inform the national roll out from 2008 onwards. Initially, the Summary Care Record will contain basic information from the patient's GP record, such as details of allergies, current prescriptions and adverse reactions to medicines. In time, patients will be able to choose to include other clinical information as they wish. If you have further questions about the NHS Care Records Service or the Early Adopter programme after reading the guidance, please email: nhscarerecords@nhs.net or visit: www.nhscarerecords.nhs.uk Louise Creighton Communications Manager, Office of the Chief Clinical Officer, NHS Connecting for Health

Parkinsons DVD
The Parkinsons Disease Society (PDS) is calling on therapists to give out a new free DVD to patients who have recently found out they have Parkinsons. A recent PDS consultation exercise found 60% said they received limited or no information at diagnosis. Being There features interviews with people with Parkinsons, their families, and some of the UKs top Parkinsons experts. Email: pr@parkinsons.org.uk

Autism name test

Routinely checking to see if babies can respond to their name at the age of one could help detect autism earlier than other tests, according to University of California Davis researchers. Their name test, described in the Archives of Pediatrics and Adolescent Medicine Autism spectrum disorders theme issue, appears to aid earlier diagnosis. Visit: http://archpedi.amaassn.org/content/vol161/issue4/index.dtl

Karen Bryan joins HPC Council

Professor Karen Bryan has joined the Health Professions Council (HPC) Council as the registrant speech and language therapy member filling the vacancy created when Dr Anna van der Gaag became HPC President in July 2006. The Council is responsible for developing the HPCs strategy and policies and has a membership of 13 practitioner members and 13 lay members. Professor Bryan Professor of Clinical Practice at the European Institute of Health and Medical Sciences at the University of Surrey is Director of the multidisciplinary Healthcare Workforce Research Centre at the University of Surrey.

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The best way to predict the future is to shape it

The profession needs leadership from individuals who can influence decision makers and promote speech and language therapy. If you have a leadership role in health or higher education or have ambitions to develop your career in speech and language therapy or healthcare management, you need to attend New ways of working, the 2007 RCSLT Managers Conference in York on 25-26 June
The pace of healthcare and education reform across the UK will affect the future of all professional managers and those with leadership responsibilities. New ways of working will support managers and leaders to understand future leadership roles, and help you develop the new skills you will require to work with the reforms occurring across the public sector. The conference will support you in developing specific business skills and help you with the how to aspect of change. For those in the HEI sector, it is essential you attend so you understand the new environment and the new business skills your students will require in the future. For the first time at any professional body conference, the chief health professions officers from England, Scotland, Wales and Northern Ireland will share the same platform. This highlights the importance they place on this conference. Speakers* will include independent consultant Dr Patricia Oakley, who will discuss the future of public sector services in health, education and social care, and the implications/opportunities for the speech and language therapy provision. Professor Pam Enderby will explain how managers can communicate the value of their service and support delegates to improve their understanding of techniques for promoting the work of their service to the right people. Professor Laurie McMahon Director, Loop 2 and NHS Policy Adviser to Nuffield Hospitals will develop a big picture of where health care is going over the next five to 10 years. He will explore the implications for speech and language therapy services both in terms of procurement, commissioning and provision.

A packed programme of parallel sessions will include:

Skills workshops on information and data gathering, evaluating, planning and

communicating the value of your service (one set of workshops for managers new to this; another for those who have done service development work, but who need to step up a gear)
The future of leadership an audience with the CHPOs Case studies from care groups in England, Wales, Scotland and Northern Ireland The electronic health record new ways of communicating clinical language Managing CPD in your service and links to career management Implementing the RCSLT childrens position paper A stroke workshop developing effective stroke care pathways The RCSLT workforce planning project Patient and public involvement (PPI)

Jonathan Tritter CEO of the National Centre for Involvement will talk about the shift and importance of public patient involvement in the development and delivery of services and the expectations from commissioners. If you are in a leadership role, this conference will provide you with a unique opportunity to discuss the most up-to-date insights into the future of the speech and language therapy profession in the UK.

If you are unable to attend but have a team a member who has ambitions for career progression into management, we hope you will support their attendance. Your engagement now will help safeguard essential services for the future.
* Speakers may be subject to change

Place are still available, but going fast Visit: www.rcslt.org and book your place today

Carly wins Duke of Edinburgh gold

Manchester University speech and language therapy student, Carly Hartshorn (pictured), is the proud recipient of a gold Duke of Edinburgh award. Carly, 19, met Prince Phillip at St James's Palace and received her award from Alan Hinkes the first British climber to summit all of the worlds 8,000 metre mountains. Carly says, The award has given me the chance to explore different areas of life and determine what Im good at. Its been a lot of hard work and taken a long time to do but Im glad that I have done it.

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HPC registration renewal starts soon

to pay your registration fees and sign and return the declaration form stating that you continue to meet HPC standards. Consider sending your renewal form by registered post, so you will have a receipt. Please ensure the HPC has your most upto-date contact address so you receive your form as soon as possible. You can do this by letter or by telephoning the UK registration department (tel: 0845 3004 472 between 8.30am and 5.30pm). The current processing time for renewal applications is approximately five to seven working days. However, the HPC says that if someone returns their documents in the last two weeks of September there is the likelihood their registration will not be processed before the deadline because of the volume of registrations received. For more information visit: www.rcslt.org/news/hpc_renewal

Getty Images

Last month we told you about the Health Professions Council (HPC) renewal process for SLTs, which will take place between July and 30 September 2007 (HPC registration renewal: start planning now, Bulletin, May 2007, p7). You will soon receive your registration renewal form in late June or early July. If not it is your responsibility to contact the HPC to request one. In 2005, over 900 SLTs were deregistered;

many because of problems with the registration process some had not given the HPC their new address and some did not sign the form. If you are deregistered it can take up to a fortnight before you can get back on the HPC register. You will not be able to work as an SLT during this time. Consequently, you risk being suspended from work or having to work as assistants, on an assistants pay, until you are back on the register. In order to renew your registration you need

Tony runs for ARCOS after marathon wait

After six-years on the waiting list, Tony Mott ran in this years Flora London Marathon to raise funds to support the work of the Association for The ARCOS on Wheels vehicle Rehabilitation of Communication and Oral Skills (ARCOS). Tony (pictured) was ARCOS first London Marathon runner and the 2,000+ he raised will enable more people to benefit from speech and language therapy supported by email and webcam. ARCOS is currently developing its ARCOS on Wheels initiative with the Motion Analysis Research and Rehabilitation Centre, part of Worcester University, to provide a much-needed service to those who find it difficult to attend conventional clinics. Visit: www.arcos.org.uk

Speech and language therapy in the media

In March, the Stephen Sondheim Society described the rehabilitation broadcaster Ned Sherrin has been undertaking under the direction of Dr Ruth Epstein, head of speech and language therapy services at the Royal Nose Throat and Ear Hospital. According to the Societys website. World Voice Day on 16 April provided an opportunity for Mei Lee, voice specialist at Queen Elizabeth Hospital in Woolwich, to talk to the Financial Times. In the FT article, Right way to tune a precious instrument, she outlines ways to keep voices healthy. Similarly, Lousie Vincent an SLT from Durham appeared on Durham Radio on 16 April to talk about British Voice Association guidelines. Jane Mallinson, service manager for paediatric speech and language therapy for Edinburgh, East Lothian and Midlothian, featured in The Scotsman on 21 April. She advised a mother on how to check for signs of tongue tie. Emma Cahill featured in an article on preschool language development in Aprils Prima Baby and Pregnancy magazine. The University of Central Lancashires Dr Hazel Roddams fame spread far and wide in late April when she was quoted in The Lancashire Daily News, The Sun, Daily Mirror, Daily India.com, onlypunjab.com, South Africas Independent Online, and the Malaysia Star in connection with Dylan Thomas, a young boy with autism from Blackburn. Dylan has apparently learned to say a few words by mimicking his pet macaw, Barney. If you appear, or see speech and language therapy in the media, email: bulletin@rcslt.org

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An inspector calls...
There are many advantages to being a speech and language therapy team working for an educational organisation, but one possible disadvantage is being subjected to the scrutiny of a college inspection. City Lit, an adult education college in central London, is home to the UKs national centre for adult stammering therapy and also provides courses for adults with aphasia. The Adult Learning Inspectorate (ALI) the adult equivalent of Ofsted inspected the college in January 2007. It had a particular interest in inspecting speech and language therapy, as it is unique in adult education, but did not feel their inspectors had the expertise to do this. They found a specialist SLT to co-inspect with an ALI inspector and employed Carolyn Desforges, a fluency specialist and manager at Broxtowe and Hucknall PCT. The process was somewhat gruelling, with all therapists observed twice, and the inevitable need to have all necessary paperwork completed and up to date. Few stones were left unturned and we required evidence to back up any statements made in the departments self-assessment report. The outcome was very positive

NEWS IN BRIEF
Malta goes online
The Malta Association of Speech Language Pathologists has launched its new website, containing information on communication difficulties, the Association and its activities and details on the profession and how SLPs work in Malta. Visit: www.aslpmalta.org

Down's syndrome and deafness

The National Deaf Children's Society, Down's Syndrome Medical Interest Group (UK) and Down's Syndrome Association have published a new free information booklet. Down's Syndrome and Childhood Deafness contains information about conditions that can affect children with Down's syndrome, and advises on what parents can do if they are worried about their child's hearing. Visit: www.ndcs.org.uk/family_support/our_ publications/downs_syndrome_and.html

From left to right: Rachel Everard, Carolyn Cheasman, Peter Davies (principal), Jan Logan and Anne Watson with the speech and language therapy team receiving a Grade 1 (outstanding) rating with no weaknesses identified. The final report summarised the findings as: very good achievements; very good/outstanding teaching and learning; extensive range of courses; outstanding retention rates; and outstanding leadership and management. The report comments on the increased self-confidence of students with particular reference to positive employment related outcomes. As a result of the outstanding grade, the team have been nominated for a prestigious Queens Anniversary Prize. Carolyn Cheasman City Lit Email: carolyn.cheasman@citylit.ac.uk
Carolyn Desforges says her remit was to advise the ALI inspector a beauty specialist by trade allocated to the SLT team. I coached her in the nature of stammering, theory and therapy and how this could be viewed as part of the inspection framework. It was a rigorous process with session observations and interviews of staff and learners to gain evidence of standards and outcomes; effectiveness of teaching and learning; support and guidance given to learners; achievement of learners aspirations; meeting employers needs as well as leadership and management. The final vote, rather like a jury, was nerve racking. It was with great pleasure that, once our evidence was presented, each of the inspectors supported our outstanding grade.

Masked ball
Tommys Charity Masked Ball will take place in Knutsford on 23 June 2007 in aid of Tommy's charity for stillborn and miscarried children, Macclesfield Hospital and the Association for Rehabilitation of Communication and Oral Skills (ARCOS). Visit: www.arcos.org.uk for details.

Communication aid survey

Scope is surveying the experiences of people with communication impairments to improve communication aid provision and support. Its survey is for people who use, or would like to use, a communication aid. The closing date for responses is 1 July 2007. Visit: www.scope.org.uk/downloads/issues/ scope_comm_aids_survey07.pdf

Double discrimination
Children with autism from ethnic minorities face a double discrimination in education, according to a National Autistic Society report. The reality for families suggests 62% of parents had no choice over the school their children would attend and 40% did not get enough support from their local authorities. Parents were much less satisfied with their child's academic and social progress than White British parents.

June Bulletin Book draw

RCSLT Bulletin readers can win a copy of Assessment in emergent literacy by Khara Pence. To win your free copy, send your name, address and membership number to June Book Draw, Bulletin, 2 White Hart Yard, London SE1 1NX. Entries close 13 June 2007. Only one entry per person. The winner of the April book draw is Helen Anderson from Reading. A copy of Special Stories for Disability Awareness by Mal Leicester is on its way.

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Good stroke practice in Gloucestershire

In response to Stroke survivors need better information (Bulletin, December 2006, p11), Jennie Marshall describes the good practice in place and developing in Gloucestershire
The Stroke Association (SA) commissioned Ipsos MORI to conduct qualitative research in the light of the findings of a survey of stroke patients carried out by the Picker Institute (2005). The resulting report emphasises that people think the degree of information they receive post-stroke depends on where they live; written information given at the right time and in the right format is paramount; and the opportunity to ask questions to somebody face-to-face is missing. The Prestbury Centre in Cheltenham a partnership between the Community Adult Care Directorate and PCT provides interdisciplinary rehabilitation for stroke survivors in the Cheltenham and Tewkesbury area of Gloucestershire. In doing so, the centre addresses integrated health and social care needs, allowing people to make informed decisions about their rehabilitation and future, as put forward in The National Service Framework For Older People (DH, 2005). A physiotherapist, OT and SLT work at the Prestbury Centre Rehabilitation Wing. They work with the stroke survivor and their carer towards their goals, which are reviewed regularly as a team. Rehabilitation assistants support this ably by carrying out the work set by the therapists.

Attendees at the Life After Stroke Programme together with members of staff The Cheltenham and Tewkesbury-locality stroke coordinator contacts stroke survivors upon leaving hospital. He provides information, can answer questions face-to-face and can refer to the therapists at the centre. Stroke survivors can also attend the Centres seven-week Life After Stroke Programme (LASP). At this weekly programme they and their carers come together to receive structured information about stroke. The programme includes causes and risk factors for stroke; stroke prevention; talks and information from a dietitian, pharmacist, clinical psychologist, SLT, physiotherapist and occupational therapist; information from carers groups; opportunities to set individual goals; information about pacing; and a chance to meet others and share experiences. Attendees have a four-month break at the end of the programme, after which they return to feedback on their progress. To date, 193 people have attended the LASP over a three-year period, representing an 81% uptake. Feedback collated at the end of therapy and the LASP programme has been positive. The Stroke Coordinator comments that hospital requests for information fell dramatically shortly after the LASP programme began and have remained low. The challenge now, of course, is to prove this link and find a form of meaningful outcome measure. Although, the SA report offers an insight into the views of a small number of people who have had strokes, it is important not to lose sight of the fact that there are good news stories around the country too. Jennie Marshall SLT Email: Jennie.Marshall@gloucestershire.gov.uk References: Outspoken: making a drama Department of Health. outOlder People, 2005. The National Service Framework For of stammering Ipsos MORI. Perceptions of Information Provision, Research Study Conducted for the Stroke Association, 2006. Available online: www.stroke.org.uk/campaigns/current_campaigns/n obody_told_me/index.html Picker Institute. Is the NHS getting better or worse? An in-depth look at the views of nearly a million patients between 1998 and 2004. Oxford: Picker Institute Europe. Available online: www.pickereurope.org/Filestore/Downloads/million_ patients_for_web.pdf

Kings to hold careers course

Kings College Hospital Speech and Language Therapy Department will host a two-day careers course on 9-10 October. Speech and language therapy as a career will include an introduction to the work of the speech and language therapy; videos and discussion on all the main areas of the profession; a morning of direct observation with an SLT working in acute adult, stroke rehabilitation, paediatrics, learning difficulties, neurosciences, voice or mental health; and information on applications and interviews to BSc and MSc courses. The course costs 40. Would-be SLTs will observe therapists at work For further information contact Fleur Karageorghis, tel: 020 3299 4466 or email: fleur.karageorghis@kch.nhs.uk

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Therapy and rehabilitation in South India

Jon Baines Tours is offering SLTs the chance to undertake a therapy and rehabilitation tour to South India from 9-24 February 2008. Led by Chartered Institute of Physiotherapy International Development Adviser Liz Carrington, the tour will allow you to take a, fresh look at Indian culture and society while enjoying the cultural treasures and stunning natural beauty of south India. You will travel from ancient Mamallapuram on the Indian Ocean to the Garden City of Bangalore and Mysore, home of sandalwood, silk and spices, before exploring the lush lands of beautiful Kerala. The tour will allow you to,observe the integrated Indian approach to life and discover how limited resources have given rise to creative grass roots solutions in the area of therapy and rehabilitation. Therapy and rehabilitation highlights will include Vidya Sagar (formerly the Spastics Society), CMC Vellore, Mobility India, the National Speech and Language Centre, an Ayurvedic hospital and pharmacy and rural community projects. Other tours include Uzbekistan and Turkmenistan The Road to Samarkand, 13-22 September 2007; Healthcare and Society in Japan, 3-16 November 2007; and Syria and Jordan - historical and contemporary, 15-30 November 2007.

FREE Learning to Talk, Talking to Learn DVD

ICAN officially launched its new Learning to Talk, Talking to Learn DVD resource at its Language and the Early Years Curriculum Conference in London, on May 10. Presented by psychologist Dr Tanya Byron, Learning to Talk supports all workers in the early years, including child minders, playgroup coordinators, pre-school teachers and nursery nurses, to create communication-rich environments. The resource, which is free to childcare practitioners, includes tips and examples of how Early Years professionals can turn every activity in their setting into a communication development opportunity. What sets this resource apart is a series of observation sequences to give practitioners the opportunity to view and note how Early Years workers have seized opportunities for speech and language development in their setting, I CAN say. Video sequences filmed in a childminder setting, a setting for oneto three-year-olds and a nursery for three- to five-year-olds show staff interacting naturally with children during their everyday activities. Learning to Talk encourages the viewer to analyse what the Early Years worker is doing to encourage speech, language and communication development in a mixture of child-led activities and group time. Subsequent playback of the sequences with narration by an Early

Minister for Children and Families Beverley Hughes at the I CAN conference in May Years expert highlights the interactions in that area supporting speech, language and communication development. The expert also points out the various stages of childrens speech, language and communication development. Learning to Talk includes a career development segment and a kids karaoke segment presented by childrens entertainer Kevin Duala. Visit: www.ican.org.uk to order your free copy

The new RCSLT online bookshop

The RCSLT online bookshop is now up and running. Administered by Ten Alps Publishing Ltd, the bookshop offers RCSLT members 10% off their online orders. Visit: www.jonbainestours.co.uk for more details Visit: www.rcslt.org or call Angela on 0207 878 2364

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Broadening horizons:
Each year a number of SLTs decide to broaden their horizons by upping sticks and working overseas. Fiona McKinson asked five recent explorers about their experiences
By the end of March 2007, RCSLT records showed that 218 UK-trained members were practising overseas. Looking back, this number has been fairly constant over the past few years, despite anecdotal reports that new SLT graduates, unable to find work, are considering an overseas move. The reasons for travelling are as varied as there are countries to visit. Although some SLTs plan permanent moves to start new lives in countries like Australia, New Zealand and America, many more opt for shorter periods abroad working for voluntary organisations in the developing areas of the world. Here we talk to five therapists who decided to undertake a variety of overseas experiences.

The VSO option

Michael Terry took the Voluntary Service Overseas (VSO) route to working overseas. He has been in the Mukuru villages of Nairobi for three months, working for the Association for the Physically Disabled of Kenya a community based, multidisciplinary non-governmental organisation funded by private donors. Mukuru has practically no sanitation in place and is described as an area of absolute poverty, Michael says. Primarily, I am seen as someone who will help children with a physical disability to talk, which is a misconception I am trying to redress. Michael adds, I didn't have a particular preference for which country I worked in when I applied through VSO, but this job was appropriate to my skills and I had visited Kenya previously, so I knew just how beautiful a country it is. Michael suggests that a very obvious difference between Kenya and the UK to get used to is the level of crime. A lot of guns have flooded down into Kenya from Somalia and Sudan in recent times and there is a high level of gun crime. So you have to take sensible precautions like always travelling by taxi after dark. Another issue that sets Kenya apart is the level of illness and death as a consequence of HIV and Aids. Michael also identifies costs as a key difference between the health system in Kenya and the NHS. The difference in standards between private and public health is vast. Despite a number of occupational therapists and physiotherapists, there are next to no SLTs in Kenya. I have met practically all of them, he says. I don't know of any Kenyan SLT working here and there

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SLTs abroad
is no recognised training for SLTs. For Michael, the most important note to make if planning to work abroad is concerned with cultural specifics. I would advise any SLT working here to get a good knowledge of the local culture and customs, particularly what is involved in a client's everyday routine. Just knowing how food is prepared and what sort of food is eaten goes a long way to making therapy functional and relevant. Rebecca OMahoney chose to work voluntarily through the VSO in Indonesia for two years in 2002. Her follow up visit in 2004 showed the assistants she trained and the new VSO SLT had sustained her work. Rebecca says, When I arrived there was no evidence that there had ever been a speech therapy department. There was an Indonesian-trained SLT, but he had left just before I started, to get better wages elsewhere. There were no systems set up for the department in terms of notes, waiting lists, outcomes and joint working etc. In the absence of a trained SLT to work with I was assigned two assistants, with the idea they would eventually be trained up to take over the department. Together we translated materials for

assessment and therapy. By the time I left the two were confidently managing the caseload to the best of their abilities. Rebeccas advice for SLTs seeking to work in Indonesia is, Keep an open mind and remember the basics. I was a volunteer, but paid local wages. Local-trained SLTs are not able to afford cars and houses on their wages and they rent rooms rather than buy houses. But, I developed my confidence in my skills, and I had opportunities that would never have been available to me at home at my level in the profession.

A place in France
After 20 years in England, Nathalie Hardy is planning to return to her native France. She says, It took over a year for the process to take place, ie from my first contact with the French authority to getting the paper saying I was allowed to work. Nathalie went to France to do clinical placements, which are conditional for obtaining a licence to practice. I chose to do placements as opposed to

exams, because I felt it would give me more insight of the system and it did, Nathalie says. She comments that one of the most daunting aspects of the process was filling in the form to describe the content of the study and clinical placements. You need this so that a commission of French SLTs can compare the training and make suggestions for the recognition. It is crucial the form is completed accurately so the commission can make the right recommendations in term of the exams or placements UK-trained SLTs need to do to get their licence. The other daunting aspect was dealing with the French bureaucracy about insurance. Nathalie explains that most SLTs in France work in independent practice, either alone or in association with others. They work under a government agreement, linked to the health service, which reimburses the cost. Medical consultants or GPs refer patients for an initial assessment and grant treatment if this is deemed necessary. The government

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specifies what types of disorders SLTs are allowed to treat. I got in touch with an SLT union representative in Normandy to discuss job prospects. He suggested I buy a share in his practice, as he has retired. There are different pay conditions, according to where you work. In independent practice, the more patients you see the more you earn. But you have a lot of different charges and taxes to pay. Nathalies advice is to, look at the CPLOL and SLT trade union websites and speak to French SLTs before you start the process. There is a lot of work in France, but the health system and models of care are very different and this what is the most difficult to get a grip on when trying to find a job.

Voluntary Service Overseas

According to VSO Health Recruitment Officer Ruth Gearson, "SLTs have an important role to play in the work VSO supports across Africa and Asia - where people with disabilities, including those with communication difficulties, often lack access to therapy of any kind. "VSO SLTs are not only involved in hands-on training and shaping of therapy services, to support people with communication difficulties, they are also involved in shaping the direction of therapy care provision and the profession of speech and language therapy in developing countries. We work with volunteers up until the age of 75. The average age of a VSO volunteer is 40. While we look for SLTs to have at least two years' post qualification experience and the confidence in their skills to train others, the more professional and life experience you have, the better as far as we are concerned. Visit www.vso.org.uk/volunteering/stepone/speech_therapist.asp Communication Therapists International newsletter. This was voluntary work, although I received some funding from an Irish charity called John Grooms, Amy says. There are currently no qualified local SLTs in Bangladesh [The first Bangladesheducated SLTs should graduate in 2008 from the four-year BSc (Hons) degree in Speech and Language Therapy, affiliated to Jahangirnagar University]. The hospital I worked in The Centre for the Rehabilitation of the Paralysed was a charitable institution, and so there is a difference in size and scope compared to the NHS in the UK. Clients paid for services, depending on their income. We used our own experience of NHS practices when planning service provision, such as maintaining case notes and goal setting, to treat communication and swallowing difficulties. Amy has a lot of advice to give to SLTs keen to follow in her footsteps. Research into the background and history of the place and Islamic practices and culture. Learn a bit of the language if possible and talk to others who have worked there.

South of the Equator

When Lesley Cherriman went to live with her new husband in Chile, her search for work took her to the Falkland Islands, where she worked for 22 months on a part-time basis as a contract SLT. Lesley worked in infant, junior and secondary schools, liaising with parents, teachers and special needs coordinators, while working with the children there. One of the perks of Lesleys job was the opportunity to fly out to camp to assess a client (her contract required an ability to fly in a light aircraft). At times she had to travel by Landrover for a whole day just to assess one client. She says, The health system was similar to the NHS. Treatment was free and based in schools and clinic/home visits. I was quite impressed by the landscape and the friendliness of the people in the hospital. My advice is to be prepared to live in a very isolated place. Having said that there are regular flights to Chile. It is far from the UK though and you may have a limited nightlife if you are a city person. If you like the countryside and wildlife you should have a good time. Pay and conditions are good. Most people arrive with their flights paid and receive a tax-free bonus on completion of their contract.

If you used the Mutual Recognition Agreement (MRA) to obtain SLT work in Australia, America or Canada, or if you now work in the UK and came from one of these countries under the MRA, we would like to hear from you. Email: bulletin@rcslt.org Be open-minded and expect things not to work out as you would expect or like. For example, we discovered we could not find a suitable, affordable thickener for fluids locally, and we had to bear this in mind when assessing and treating dysphagia. Be really careful with training and offering certificates of attendance for your training. Some people use these to prove they are experienced, or experts, when it is not the case. I heard of individuals taking dysphagia referrals following a short introductory course in the management of dysphagia. Do not expect to be able to right all the wrongs you see, or change everything. Go with a small, manageable, specific aim in mind, following discussion with the institution, and stick to it.

Useful Websites
The Standing Liaison Committee of EU Speech and Language Therapists and Logopedists (CPLOL). Visit: www.cplol.org/eng/index.htm John Grooms Overseas. Visit: www.johngrooms.org.uk/page.asp?id=525 RCSLT: international working. Visit: www.rcslt.org/cpd/internationalworking/

Heading east
Amy Jenson worked in Bangladesh for eight months after spotting an advert in the

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Staff cuts? Modernise and forget waiting lists

Faced with the constant struggle to maintain, let alone reduce, waiting lists, the childrens speech and language therapy service in Milton Keynes decided to see what modernisation offered. Mary Smith explains
In an increasingly technological world, we reasoned, surely there must be some efficiency to be gained from the use of information technology. We undertook three simultaneous streams of work: Investigating the opportunities afforded by information technology Asking clinical staff what they disliked about their working lives Analysing sources of parent complaints and asking parents how therapy services could be improved Using these sources of information we looked at how we could deliver services differently to improve services for everyone. and speed up production of all correspondence. We keep electronic journals of the correspondence generated for a client, so two mouse clicks can reveal when the last paper communication was sent, by whom and what its subject matter was, without the file being present. The major benefit is that we can now access information from any of the sites where speech and language therapy is provided. via the Wizard, are then emailed to therapists. Once approved, the administrative team pps, sends out and files reports or letters. As most therapists can log on at all sites, they are able to collect messages, and correct and return reports, even if they are working away from their base.

Amazing results
The service redesign has resulted in a reduction in waiting times, from an average of six months for initial appointments, to nil; as we use dropin clinics for all appointments. Administrative staff organise therapy timetables every six weeks or so for the forthcoming six weeks. The longest treatment wait is six weeks, although this is unusual. We contact patients and ask them to phone the central office to make appointments at their convenience and rearrange staff timetables to meet the patient demand for treatment. As a result, non-attended appointments, previously approximately 5.5% of all paediatric appointments, have been around 1.9% for the last three years. Therapy staff have great administrative support and the administrative team have varied and interesting posts, with a great deal of autonomy and patient contact. These changes, initially rolled out in the preschool, clinic-based service are now being implemented in a redesigned adult community service. Centrally-based administrative support, using a single phone number and shared diaries can improve efficiency for therapists working in a variety of locations, with varied client groups reducing staff stress, improving others perspective of service efficiency and increasing the capacity of clinical staff to meet the need. I recommend these changes. All you have to lose is your waiting lists.

Redesigning systems
Once the technology was in place, we redesigned systems using the information gleaned from staff/service users, to improve the efficiency of the service. We examined all tasks relating to the clinical organisation of the service to ensure we were using staff skills appropriately. For example, administrative staff are better at organising diaries, filing and organising case notes than therapists. They are also quicker at processing paperwork and routine phone calls than therapists, who often work in homes/schools. Freed from administrative tasks, therapists now maximise their time for assessment, intervention planning, delivery and liaison. Telephone contact to the service whether for appointments or queries is via a central phone number to the administrative resource. Therapists receive phone messages by email. The handling and storage of case notes, with the exception of the point of clinical contact, is the responsibility of the administrative team. Case notes, accompanied by an instruction sheet, pass immediately to administrative staff following clinical contact. Password-protected reports or correspondence, rapidly generated

The Wizard is born

The Wizard software unites the functions of Microsoft Outlook, Word and Access and allows accessed and management of therapists diaries from a central point. The service database already ran from an Access database. When linked with Outlook this meant we could access appointment contact details without the presence of their case notes. The Wizard, designed to support new ways of working, allows patient therapy information to be stored in lists. Each list also records when and by whom someone was added to the list. We can now access information, such as the numbers awaiting review or treatment wait times etc by scrutinising the lists. The Wizard accesses standardised Microsoft Word correspondence templates and the patient database to utilise mail merge facilities

Mary Smith Clinical Director Speech and Language Therapy Services, Milton Keynes Email: Mary.Smith@mkpct.nhs.uk

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AUSTISM THERAPY IN SRI LANKA

An inclusive curriculum for children with autism in Sri Lanka

Himali de Silva and colleagues report on the development of a service for children with autism in Sri Lanka
In Sri Lanka, children with disabilities mainly receive education in integrated units in mainstream schools with children of all ages and disabilities grouped together in a physically inclusive environment. These units are often overcrowded and under resourced, and teachers are ill equipped to manage the diverse and changing needs of the children. In such an environment, the child with autism is often the first to drop out of school. Anecdotal evidence shows multiple reasons for this, including teachers attitudes towards autism, pressure from parents of other children, and practical difficulties such as using public transport. A lack of understanding of autism in Sri Lanka has led to an identification of the coping strategies of children with autism as behaviour problems most often cited as the reasons for not accepting them into a classroom. In response to this situation, a group of doctors who were parents of children with autism and a child psychiatrist persuaded the Special Education Unit (SEU) of the Ministry of Education to train special education needs (SEN) teachers on autism, and to open an autism child development centre (ACDC) within one of the teacher training college campuses. The aim of this endeavor was to raise awareness on the educational needs of children with autism. The centre was to act as a resource for the teacher training college and as a model classroom for children with autism. On obtaining the agreement of the Ministry of Education, the doctors requested the support of SLTs to develop and implement a suitable curriculum for the training of special needs teacher. The teacher training programme and the

SLT volunteers Yasasvi (left) and Mekala (right)

Teacher Anusha working on 'following a contact point' enable the children at the centre to be best prepared for integration.

ACDC began in June 2005. A group of four SLTs participated in developing the curriculum and training. They soon realised the teachers of the ACDC needed ongoing support to implement the instruction obtained from the training programme. Two SLTs, Yasasvi Perera and Mekala Ratnayake, joined as volunteers, and began work with Himali de Silva from the original group at ACDC. We now visit the ACDC twice a week on rotation and work closely with the two SEN teachers.

The curriculum
We developed a new curriculum that addressed the core challenges faced by children with autism in mainstream society, and prepared them to cope in their communities. Dr Patrick Rydell, co-author of Social Communication Emotional Regulation Transactional Supports (SCERTS) (Prizant et al, 2006) visited Sri Lanka as a Fulbright Scholar in January 2006 and helped us in this respect. The new curriculum aimed to develop five core skills: joint attention, symbol use, selfregulation, key concepts and independence skills. The first three skill areas were based on the SCERTS developmental stages. We assess each of the students comprehensively under the five core skills. The SLTs, teachers and parents provide input in deciding the childs current level of functioning, and collaboratively fill out a checklist for each skill area. Accordingly, the next stage of development is selected as the aim for the next term. As such, each student has at least five aims for each term. Students study a mixture of subjects

The centre
The ACDC caters for 10 children with a diagnosis of autism, aged 6-12, who are on loan from integrated units in mainstream schools. According to the agreement with the SEU, these children will be returned to their mainstream unit after a year at the ACDC. The SEU expects the children will be mainstreamed after a years treatment at the centre and make room for a new set of children to gain access to the ACDC. We agreed to this course of action to ensure the continuity of the programme, despite the improbability of these expected outcomes and embarked on a plan that would

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Table one: an example of an Individual Education Plan

Core skill
Joint attention Symbol use

Current level
Looks towards people Uses simple motor actions Engages in extended reciprocal interactions

Target
Shifts gaze between people and objects Uses conventional gestures, eg give

Subject
Outdoor play Snack time

Sample activity
Passing a big ball back and forth To request for bits of food Using food, sensory material etc child likes and dislikes Two feely-bags, take one item from each and decide if they go together Hide and find things that go together Use a story/song with actions about cleaning parts of body

Progress

Self regulation

Responds to sensory and social World around us experiences with different emotions

Key concepts

Identifies two similar objects

Match two things that go together, eg ball and bat

Maths Outdoor play

Independent skills

Recognises body has many parts

Knows how to clean three parts of the body

Language

selected mainly from the mainstream curriculum (mathematics, language, world around us, religious studies etc.) and based on the general themes set out by the Grade One syllabus of each subject. We aim to meet one or more of the core skills identified for each child under each subject and theme. We record these skills in each childs Individual Education Plan (IEP) (see table one). Although still far from being physically integrated into mainstream schools, these children are able to access the knowledge and information obtained by their peers in mainstream schools by following an adapted curriculum and routine that caters to the learning needs of children with autism. We use a combination of the well-known, evidence-based autism intervention strategies to meet the individual targets of the child. For example, the teachers may decide to set up a pretend grocery shop under the theme food during the World Around Us period on Monday. In this group activity, a child may use Picture Exchange Communication System (PECS) (Frost et al, 2002) to develop at least five words or echolalic phrases as symbols. Another may develop joint attention skills during the same activity by using More than Words principles (Sussman, 2004). During the same period on Wednesday, the teacher may use the same theme to schedule individual work, in which one child practises

sorting skills at a TEACCH work station, while another reads a social story about the importance of eating different foods to develop use of language strategies to regulate arousal level in new and changing situations.

Progress
Among the most noticeable changes in the children at the centre is an increasing ability to self regulate and come out of extreme deregulation within a shorter period of time. The children spend less time coping and more time attending to the various activities of the day. They are also increasingly able to interact and are now beginning to help each other. Some of the children use echolalia situationally. The staff and SLTs have also made considerable progress in understanding the learning methods and developmental trends of children with autism, and are constantly monitoring and adapting the curriculum. Parents play a lead role in the education of the children. Despite these advances, however, these children are not yet ready to enter mainstream schools, and some of them may never be able to do so. We are still negotiating to retain the children at the centre for another year. Meanwhile, the fifth group of teachers is now receiving training. Our efforts are part of a pilot project in

which we test new ways of working with children with autism in Sri Lanka. We are careful not to stray too far from the current special education mandate while meeting the specific educational needs of each of the children at the centre. Our curriculum, which is the first of its kind to be tailor-made for children with autism, merges these two imperatives. The teachers who are trained at the centre are beginning to introduce some of the principles of working with children with autism to their integrated units. We look forward to support from SLTs interested in working with us collaboratively on this project. Himali de Silva Senior Lecturer/SLT, Disability Studies Unit, Faculty of Medicine, University of Kelaniya, Sri Lanka Email: desilva.himali@gmail.com Yasasvi Perera SLT Mekala Ratnayake SLT Autism Centre, Teacher Training College, Maharagama Email: mekala_ra@hotmail.com References: Frost L, Bondy A. The Picture Exchange Communication System. USA: Pyramid Educational Productions Inc, 2002. Prizant BM, Wetherby AM, Rubin E, Laurent AC, Rydell PJ. The SCERTS Model, Vol 1 & 11. Baltimore: Paul Brookes Publishing Co, 2006. Sussman F. More than Words. Canada: The Hanen Centre, 2004.

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AUTISM ASSESSMENT AND DIAGNOSIS

School age autistic spectrum disorder: assessment and diagnosis

In November 2004, I took up a newly created post as part of a multidisciplinary team for the assessment and diagnosis of school age children thought to be on the autistic spectrum in Leeds. The Child and Adolescent Mental Health Services (CAMHS) initially funded the post, which came about as a result of guidelines from the National Initiative for Autism Screening and Assessment (NIASA) a multidisciplinary group commissioned by the Royal Colleges of Paediatrics and Psychiatry, and under the umbrella of the National Autistic Society. Leeds developed a citywide protocol for assessment and diagnosis of all children, via their own autistic spectrum steering group, a multi-agency organisation that includes parent representation. From the outset, working in two different locality-based CAMHS teams has been a great learning experience, and both teams have developed new skills and systems in a relatively short space of time. As part of the agreed citywide protocol, we use the World Health Organisations International Classification of Disorders (ICD10) as our basic diagnostic criteria. After months of using and interpreting this, we wanted to find out how other services across the country carried out assessments and made diagnoses, in order to inform our practice. In October 2005, I sent out 50 questionnaires to speech and language therapy services, aimed mainly at other citybased teams. The questions related to: Whether assessment is done as part of a team, and the make-up of these teams Procedures to gather information about the children Specific assessments and diagnostic criteria used
Level of satisfaction with these

Liz Franklin looks at how speech and language therapy services carry out assessments and make diagnoses of school age autistic spectrum disorder
30% to 95% of children seen received a positive diagnosis, with the majority (18) between 50-80%. Eleven teams used the diagnosis of atypical autism, although two of these no longer do so. An additional team uses the term hypothesis of or probable autistic spectrum disorder. The reasons given for using this term were: Most but not all of criteria fulfilled, and clinical presentation fits, and would benefit child (5) Normal early infant development with loss of skills later (2) Passive and amenable child, but with other ASD characteristics (1) Psychological illness that impacts on social communication (1) Psychiatrist uses if appropriate (1) Thirteen respondents take account of literal interpretation of language in making diagnoses. Of these, three place it in the reciprocal social interaction part of ICD10, not Table one: the make up of specialist teams SLT Medical doctor Clinical psychologist Occupational therapist Educational psychologist CAMHS professional Psychotherapist Autism support teachers Social workers Specialist nurse Physiotherapist Other therapists 26 25 17 7 12 10 2 3 2 2 1 3

assessments/criteria and reasons

Whether atypical autism is used as a

diagnosis If ICD10 used which sections of literal interpretation of language and rigidity are applied Types of post-diagnosis follow-up and support available

Study outcomes
A 76% response rate suggests this is an area of strong interest. Twenty-six respondents said they work as part of a specialist assessment team, with a further six contributing to assessments routinely. Table one shows the numbers of each profession in these teams. The SLT, medical doctor and clinical psychologist are the most common combinations, appearing 17 times. Of those who do not work within teams, all but one said they are reviewing their procedures. All respondents said they use a combination of informal, observational and structured means of assessment. Table two shows the structured means most frequently used by teams. Clinician satisfaction with the structured assessments was rated on a sliding scale (1-7) with a ratings spread of 3-6 for ICD10, ADOS, Gillberg, and 4-6 for the DISCO, ADI and 3Di R. Comments included the compatibility of the ADOS and ADI; the 3Di being relatively new but helpful so far; and views on ICD10 ranging from helpful range of criteria, confirms clinical view to too qualitative, hard to be objective. The 23 respondents reported a wide range in the number of referrals received per year, from 4 to 190. Twenty-two respondents reported that

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Table two: the structured means most frequently used by teams

Type of assessment used

ICD10 /DSM1V lists of diagnostic criteria issued by the World Health Organisation and the American Psychiatric Association, respectively. The client must fulfil a specific number and combination of these criteria in order for a diagnosis to be made (WHO, 1993). Autism Diagnostic Observation Schedule (ADOS) a standardised assessment using a number of specific activities and presses designed to elicit information, which is scored. The scores are then transposed using an algorithm, and there are cut-off scores for autism and autistic spectrum disorder (Lord et al, 1999). Autism Diagnostic Interview (ADI) is related to the ADOS, and is a very lengthy and detailed structured parental interview (Rutter et al, 2003). Diagnostic Interview for Social Communication Disorders (DISCO) a clinical and research tool. A detailed semi-structured parental or carer interview, which collects information systematically (Leekam et al, 2002). Gillberg criteria a list of features, specifically for Aspergers syndrome. Relate, but are not identical to, the DSM ratings. Developmental, Dimensional and Diagnostic Interview (3DiR) a computer-based parental or carer interview, which records and computes data to make a differential diagnosis of ASD and other disorders (Skuse et al, 2004). Childrens Communication Checklist, second edition (CCC2) a multiple choice questionnaire for parents or carers, and rates aspects of communication, such as pragmatics, that are harder to assess in the clinic setting (Bishop, 2003). Gilliam Autism Rating Scales (GARS) a behavioural checklist arranged into four subtests, which are completed by the parent or other adult who knows the child well (Gilliam, 1995). Australian Scales for assessment of Aspergers syndrome, is a screening questionnaire designed to identify behaviours and abilities of primary school children, aimed teachers, parents and carers (Garnett and Attwood, 1998).

Number of teams
21

Summary
While many of the respondents work within multidisciplinary teams, the make-up of these teams varies, and not all work in a truly multidisciplinary manner. Several are in the process of reviewing their services. It is clear respondents use a wide range of procedures and assessments, and there are varying levels of satisfaction with these. Most continue to use ICD10, but there is room for discussion around the placement of certain characteristics within the criteria and how firmly they are applied. Although this is clearly a very small survey, I will feed back the outcomes to our autism steering group and suggest we discuss, as a city, the use of other assessments, such as the 3DiR, and whether we continue to use the term atypical autism. We also need to consider the nature of our follow-up services. Liz Franklin SLT, Leeds PCT Email: liz.franklin@nhs.net

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2 References: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington: American Psychiatric Association 1994. Bishop DVM. The Childrens Communication Checklist Second Edition. London: Harcourt Assessment/the Psychological Corporation 2003. Garnett MS, Attwood AJ. Australian Scale for Asperger's syndrome. In Attwood T, ed. Asperger's syndrome: a guide for parents and professionals. London: Jessica Kingsley 1998. Gilliam J. Gilliam Autism Rating Scale (GARS). Austin: Pro Ed 1995. Leekam SR, et al. The Diagnostic Interview for Social and Communication Disorders: algorithms for ICD10 childhood autism and Wing and Gould autistic spectrum disorder. Journal of Child Psychology and Psychiatry 2002; 43, 327-342. Lord C, et al. Autism diagnostic observation schedule. Los Angeles: Western Psychological Association 1999. Rutter M, LeCouteur A, Lord C. Autism diagnostic interview, revised (ADI-R). Los Angeles: Western Psychological Services 2003. Skuse D, et al. The developmental, dimensional and diagnostic interview (3di): a novel computerized assessment for autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry 2004; 43, 548-558. World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic criteria for research, vol. II. Geneva: WHO 1993. Acknowledgements: Thanks to my CAMHS colleagues and all those who responded to this questionnaire.

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Table three: post-diagnosis follow-up and support

Table four: post diagnosis support (non-professional)

Type of support
Local community service only Autism outreach team Assessment teams Early Bird Plus Parent group Sibling group Social skills group CAMHS follow up 7 5 3 4 2 1 2 3

Type of support
Parent run National Autistic Society run Contact-A-Family Afasic Generic special needs Teenagers 14 8 1 1 1 1

specifying which sub-area; two place it in conversational skills; two place it in language impairment/delay and one places it in stereotyped use of language A further five were either unsure where it should be placed, or did not match criteria so rigorously. Eleven respondents take account of rigidity

of play and thought. Of these, six place it in restricted interests; one places it in lack of imaginative play and one in stereotyped use of language. A further three were unsure where it should be placed, or did not match criteria rigorously. Tables three and four show the postdiagnosis follow up and support from professional and non-professional groups.

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Ouch my nose
I read with great interest the article by Eryl Evans (No topical anaesthesia required? Bulletin, March 2007, p15) indicating a body of literature suggesting that topical anaesthetic is not required for flexible nasendoscopy. Although discussed in the context of voice and swallowing disorders this investigation is used routinely in the evaluation of nasal speech and velopharyngeal function under the remit of regional cleft lip and palate teams. I reviewed the papers Ms Evans sourced and was interested that her conclusion was based exclusively on adult studies. I am therefore cautious at a time when the position paper on invasive procedures is being updated that this is appreciated. Furthermore, Johnson et al (2003), who found local anaesthesia significantly decreased the patients discomfort, critiqued the methodology in some of the studies cited (Leder et al, 1997; Frosh et al, 1998) as patients were tested with one agent only, with no control group. In their own study, Johnson et al (2003) used a cross-over design in which each patient was examined on three occasions with a different agent on each examination, thereby the patient acting as his/her own control. I have been undertaking nasendoscopies regularly since 1990, in all age groups, and with clients as young as 3.6 years. The prospect of no local anaesthesia being advocated in paediatrics needs to be carefully considered. In regional cleft services, it is not uncommon for us to endoscope the same patient on more than one occasion, so we need to ensure the examination is not so painful and traumatic that patients reject future endoscopies. We also need happy patients in order to gain a comprehensive speech sample. Crying children invalidate our examination. In patients with unilateral and bilateral cleft lip and palate often the septum is deviated and turbinates are enlarged. Passing the scope can be particularly challenging in such anatomy. Ms Evans refers to cocaine, but there are now well-established alternatives, including cophenylcaine, which is a mixture of Lidocaine, a local anaesthetic with phenylephrine, a vasoconstrictor. In two randomised controlled trials, it has been shown that co-phenylcaine is a suitable and preferred alternative to cocaine (Sessler et al, 1986; Latorre et al, 1996), but it is currently unlicensed in paediatrics. Nevertheless, the pharmacy department is able to source it, and this is practice in other hospitals too. Systemic side effects are rare although dizziness, nausea, vomiting, disorientation have been reported. Phenylephrine may interact with b-blocker (eg, atenolol, propranolol), cause hypertensive crisis with irreversible monoamine oxidase inhibitors (eg, phenelzine, isocarboxazid, tranylcypromine) and anti-arrhythmics (eg, tocainide, mexiletine) (Summary of product characteristics, 1999). These types of events are very rare. In my experience of using co-phenylcaine in many hundreds of endoscopies I have had only two fainting episodes to deal with: one of a patient and the other an observer, fortunately not simultaneously. Ideally there needs to be a randomised control trial in paediatrics but until then can we be a little cautious of deleting local anaesthesia completely?

or maybe not?
Debbie Sell continues the debate on the use of topical anaesthetic for flexible nasendoscopy

Dr Debbie Sell Lead SLT, North Thames Regional Cleft Lip and Palate Service Head of Speech and Language Therapy Department Honorary Senior Lecturer, Institute of Child Health References: Cain AJ, et al. The use of topical nasal anaesthesia before flexible nasendoscopy: a double blind randomized trial comparing cophenylcaine with placebo. Clinical Otolaryngology and Allied Sciences 2002; 27:6, 485-8. Carding PN, et al. Speech and language therapy endoscopy for voice disordered patients. In RCSLT Policy Statement. London; RCSLT, 2004. Frosh AC, et al. Is local anaesthesia actually beneficial in flexible fibreoptic nasendocopy? Clinical Otolaryngology and Allied Sciences 1998; 23:3, 259-62. Johnson PE, et al. Topical nasal anaesthesia clinical and laryngopharyngeal sensory testing: a prospective, double blind crossover study. Annals of Otology, Rhinology and Laryngology 2003; 112:1, 14-6. Latorre F, et al. Cocaine or phenylephrine/lignocaine for nasal fibreoptic intubation? European Journal of Anaesthesiology 1996; 13, 577-581. Leder SB, et al. A prospective, double blind randomized study on the use of a topical anaesthetic, vasoconstrictor, and placebo during transnasal flexible fibreoptic endoscopy. Journal of Speech and Hearing Research 1997; 40:6, 1352-7. Summary of Product Characteristics, Lidocaine 5% and Phenylephrine 0.5% topical solution, Cardinal Health Martindale Products, November 1999. Sadek SA, et al. The efficacy of topical anaesthesia in flexible nasendoscopy: a double blind randomised controlled trial. Clinical Otolaryngology and Allied Sciences 2001; 26:1, 25-8. Sessler CN, et al. Comparison of 4% lidocaine/0.5% phenylephrine with 5% cocaine: which dilates the nasal passage better? Anaesthesiology 1986; 64, 274-277.

The prospect of no local anaesthesia being advocated in paediatrics needs to be carefully considered
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Obituary

Bev Wright (ne Ward) 14 December 1972 2 November 2006

t is with great sadness that I write of Bev Wrights death at the early age of 33. Although Bev never complained to her colleagues about her health challenges she had suffered with cancer from the age of three. She had a wonderful gift of putting her own difficulties to one side so others were not aware of them. I first met Bev when she was at school and came to the hospital department to assist a patient who had experienced a brain haemorrhage. She went on to study speech and language therapy at the University of Central England, returning to Grimsby Hospital for her block student placement. Her first post as an SLT was at Dudley Priority Health NHS Trust from 1995-1998, where she had a mixed paediatric/adult post. Colleagues from this period commented that Bev was, a conscientious and innovative SLT who was eager to learn new skills and develop existing ones. She was extremely hard working, committed to the profession and possessed a good sense of humour. She was full of life and enthusiasm. It was also noted that she

never complained about her health difficulties and she showed great personal courage. Bev returned to Grimsby to work in 1998, progressing from a mixed post to one of specialising in rehabilitation with adults with stroke and acquired brain injury and latterly as Principal SLT in the Rehabilitation Medicine Service. Comments from colleagues include: I remember her gentleness, sweet nature and warmth, alongside her courage and resilience. She had such a great sense of humour. We often shared a joke and a laugh. Bev was the most amazing student. She was really positive, well organised and a pleasure to be with. The patients loved her, of course. She lived life to the full. I remember her tremendous empathy with clients, her courage, sunny disposition and obvious aptitude for the job. Bev leaves behind her partner Jason and her parents Carol and Martin, to whom we extend our sympathy and condolences. Bryony Simpson and staff of North and North East Lincolnshire Speech and Language Therapy Departments

NEW WAYS OF WORKING: the RCSLT managers' conference 25-26 June 2007, Royal York Hotel
Do you have a leadership role in the profession? Are you undergoing re-structuring and do not know where your career is heading? Do you need to influence commissioners and other decision makers? Do you have ambitions to develop a leadership role in the profession or more widely?
If the answer is yes to any of these, then you need to attend the RCSLT managers' conference

For the first time at any professional body conference, the chief health professions officers from England, Scotland, Wales and Northern Ireland will share the same platform. This highlights the importance they place on this conference and its value for the profession.
New ways of working will support you to understand future leadership roles and help you develop the new skills you will require to work within the reforms occurring across the public sector. This includes specific business skills and help with the how to aspects of change.
The conference will also provide you with a unique opportunity to discuss the most up-to-date insights into the future of the speech and language therapy profession in the UK. If you are unable to attend but have a team a member who has ambitions for taking on a leadership role, we hope you will support their attendance. Your engagement now will help safeguard essential services for the future.

To see the packed programme visit: www.rcslt.org/news/managersconference_2007

Places still available, but going fast. Book your place today

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b o o k rev i ew s

Book of the month

Practical Sensory Programmes for Students with Autism Spectrum Disorder and Other Special Needs
SUE LARKEY JESSICA KINGSLEY, 2006 17.99 ISBN: 1-84310-479-2 This easy to read and practical guide, written by a specialist autism teacher, is aimed at parents, occupational therapists and educational professionals. SLTs working with children with ASD and other special needs will find it useful. It emphasises the importance of helping children with ASD to generalise their skills into different environments and stresses the importance of seeking the advice of an OT. The book is written in lay terms that any concerned person could follow. It consists of a sixstep approach to developing a programme to help children cope with sensory input they find overwhelming, and to identify activities they may find relaxing or rewarding. It includes photocopiable assessment sheets. The sensory activities can also be used as part of positive behaviour support. The book includes practical activities with a strong emphasis on encouraging communication/language development helpfully including vocabulary and concepts to introduce as part of the activities but unfortunately and frustratingly, no mention of working with an SLT, except for advice on working on blowing activities. Nevertheless, this would be a useful addition to any department as so many of the children we work with have sensory difficulties.
CO N T E N T S : R E A D A B I L I T Y: VA LU E :

*****

*****

*****

JULIE MULLIS Clinical Lead Specialist SLT (ASD) Cardiff & Vale NHS Trust, RCSLT Adviser in Autism

Nice Warm Socks

WREN SINGERS AND FRIENDS WREN MUSIC 2006, 10 WRENCD008

www.nicewarmsocks.org.uk

adaptations for different types of AAC users. Some of the more advanced songs contain less familiar vocabulary, and vocals that may be hard for some children to identify. This is a collection of positive and calming songs that has instant appeal. This CD is a useful and flexible resource for a therapist, teacher or assistant planning a music session. There is enough variety for the CD to be used either in one-to-one, small group or class assembly. It would be particularly useful for a specialist unit or specialist school where AAC is common.
CO N T E N T S : U S E A B I L I T Y: VA LU E :

****
This is a CD of folk-inspired childrens songs. Designed to encourage children of all abilities to participate in musical experiences, it is particularly aimed at those using alternative and augmentative communication (AAC). The CD is by a specialist musician, teacher and SLT. The songs are catchy and memorable and range from very simple repetitive songs children will find easy to retain, to faster melodies that have less-familiar lyrics. There are clear and simple instructions for downloading free symbols, full music sheets and lyrics, and it also refers to the songs relevant National Curriculum P Levels. The website also has a how to use section for each song, which are tried and tested suggestions for delivery, especially focusing on

*****

*****

CHLOE WALLER Specialist SLT (Language Unit) Wiltshire PCT

Communication Development Profile

CHARLOTTE CHILD SPEECHMARK, 2006, 45.99 ISBN: 0 86388 552 5 The central idea behind this book and CD ROM package is the importance of involving a childs family and other supporters in planning and developing their communication programme. It uses nine questionnaires to fill in a profile grid, with the aim of providing a

visual representation of a childs communication development that can be shared with parents and teaching teams. It is not a diagnostic tool, but a descriptive framework. As the author points out, more detailed and formal assessment is required to establish specific targets. The key areas of communication considered are attention control, comprehension, expression, sound system (not covered in any detail) and use of communication. The communication stages outlined on the grid are matched to corresponding teacherfriendly P-levels. The profile can be completed electronically (and stored) on the CD ROM or by photocopying a grid from the book. There is an occasional surprising lack of detail (eg, nothing on phonological processes) and the language of the explanations and descriptions appears aimed more at teachers than perhaps classroom assistants or parents. Its emphasis on the earlier stages of communication makes it of limited use in a mainstream schools service, but perhaps of more relevance to Early Years services or special schools.
CO N T E N T S : R E A D A B I L I T Y: VA LU E :

***

****

**

CAROLINE DENBY SLT, Mainstream Schools Team Sheffield PCT

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a s k yo u r co l l e g u e s

Any Questions?
Want some information? Why not ask your colleagues?
Email your brief query to anyquestions@rcslt.org. The RCSLT also holds a database of clinical advisers who may be able to help. Contact the information department, tel: 0207 378 3012. You can also use the RCSLTs website forum to post your questions or reply to other queries, visit: www.rcslt.org/forum

Do you work in Public Health?

Public health is concerned with threats to the overall health of a community based on population health analysis. The focus of a public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviours. Do you work in public health? If so, contact RCSLT Policy Officer Claire Moser TEL: 020 7378 3023 EMAIL: claire.moser@rcslt.org

The Listening Program

Has anybody used The Listening Program on adults with auditory processing difficulties following CVA? Terry Brownrigg EMAIL: Terry.Brownrigg@cecpct.nhs.uk

NI NQP SIG
Are you interested in getting involved or joining a NQP SIG in Northern Ireland? Judith Lyle and Lorraine McCloskey EMAIL: Judith.lyle@northerntrust.hscni.net

Aphasia counselling
Do you provide a counselling service to clients with aphasia? Sara Alderdice EMAIL: sara.alderdice@norwich-pct.nhs.uk

Symbol communication books

Do you have any versions of symbol communication books we could see, so that we can get ideas to improve our own? Laura Ainsworth EMAIL: laura@andyains.fsnet.co.uk

Speech amplifiers
Can you recommend a speech amplifier you have found to be successful? The ones I have tried are either too cumbersome, have ill-fitting headsets or have poor sound reproduction. Chris Croxall EMAIL: chris.croxall@derbyshirecountypct.nhs.uk

Post-stroke dysphasia
I am drawing up care pathways, KSF level 3 guidelines and training for community support workers to provide speech and language therapy functional support for people with dysphasia after a stroke. We have been given a total of 15 hours per week. Could any other therapists, who have done something similar, provide direction? Kay Martin EMAIL: kay.martin@peterboroughpct.nhs.uk

Rehabilitation assistants
Our interdisciplinary neurorehabilitation unit team is exploring the possibility of developing a generic rehabilitation assistant role. Have you had experience with rehabilitation assistants? Sarah Johnston TEL: 01243 831477 EMAIL: sarah.johnston@rws-tr.nhs.uk

Children's centres communication strategy

I am developing a communication strategy for all the children's centres in the Warwickshire locality. Have you already undertaken this type of work? Would you be willing to share your thoughts or experiences? Alex Williams EMAIL: alexandra.williams@nch.org.uk

Work in Ethiopia
Do you know of any therapists currently working in Ethiopia, or of organisations there that would take a newly-qualified SLT to volunteer for nine months? Catherine Heatlie EMAIL: pickwickt@yahoo.co.uk

Signing use in learning disability

We want to develop a way of assessing the quality and breadth of signing use in staff working in learning disability. Have you developed any training and/or competencies in this area? Cat Ward and Jane Hancock EMAIL: cward6@nhs.net EMAIL: jane.hancock@exeter-pct.nhs.uk

Patient group directions

Any SLTs using 'patient group directions' to supply and administer medicines? Ruth Williams EMAIL: ruth.williams2@nhs.net

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Q u i c k Lo o k D ate s
Book your date email: rcsltads@tenalpspublishing.com
Assessing and teaching social skills 4-5 September, London; 9-10 October, Belfast; 25-26 October, Edinburgh; 8-9 November, Cardiff; 22-23 November, Manchester; 3-4 December, Southampton. A two-day course by TALKABOUT series author Alex Kelly. Cost 200. For more information email: alex@alexkelly.biz visit: www.alexkelly.biz or tel: 01722 333083 18-20 June Introductory Bobath course for SLTs A three-day course designed specifically for SLTs on the Bobath approach to assessment and treatment of children (and babies) with cerebral palsy. Will be of greater benefit to SLTs working with a paediatric cerebral palsy client group. The Bobath Centre, 250 East End Road, London N2 8AU. 310. Contact Abby Stopler, tel: 020 8442 2262 or 020 8444 3355, email: abby@bobathlondon.co.uk 18-21 June RCSLT-accredited paediatric ALD dysphagia course Course can be offered as single days training or as a complete course. Quest Training. Birmingham. Further information email: jfrost@ukgateway.net visit: www.quest-training.com or tel: 0121 628 2813 25-26 June New ways of working: the 2007 RCSLT managers conference Royal York Hotel York. Limited places available: book now. Visit www.rcslt.org for details 26 June, 9.45am - 4pm Thames Valley Aphasia SIG Supporting clients in coming to terms with their communication difficulties. Speakers Sue Cable, disability counsellor; Stuart Wood, music therapist. Wycombe Hospital, Bucks. 20, including 10 membership for 2007, coffee and lunch. Contact Debbie Thomas, email: deborah.thomas@surreypcy.nhs.uk 27 June Psycholinguistic assessment and intervention with deaf children (day 2) A psycholinguistic approach to speech and language therapy intervention with deaf children's speech. Tutor Rachel Rees. All applicants must have attended day one. 150. Bridge Chapel Centre, Liverpool. Email: Angela.Taylor@cdtr.wales.nhs.uk SIG Palliative and Supportive Care meeting 28 June, 1pm- 5pm Solutions in palliative and supportive care - introduction to Solution Focused Therapy with Kidge Burns. Understanding of solution-focussed therapy can help SLTs work with clients on their best hopes for their future, even if their future is limited in nature. St Bartholomews Hospital, London. Members: first 20 places free, 8 after this; non-members 10. To book tel: 0208 725 1163 or email: Samantha.eckman@stgeorges.nhs.uk 28-29 June LSVT training and certification workshop Learn the speech treatment for people with Parkinson disease, with application to other neural conditions. City University, London. Registration: 315 professional fee. Visit: www.learningloud.com, email info@gleeco.net, or tel: 1-888-438-5788. 28-29 June Live English course Preparing deaf pupils to interact with English speakers. For SLTs and TOD working with deaf/hearing impaired primary and secondary aged pupils. RCSLT, London. 200. For more details and booking form contact Laura Threadgill, email: laura.threadgill@hotmail.co.uk, tel: 07999 843 238 29 June Semantics, vocabulary and word finding Within a psycholinguistic framework the underlying causes will be explored and therapy presented. Practical ideas for hands on therapy and classrooms strategies. Discussion, case studies and resources. Sadie Lewis. Worcester. Contact Sadie Lewis tel: 01905 340014, email: sadie@speelang.co.uk 6 July Mealtime assistants course For mealtime assistants working with children with cerebral palsy who have eating and drinking difficulties. The course has a practical focus. Basic safety issues will be addressed in relation to positioning and handling. Feeding techniques will be practiced. The Bobath Centre, 250 East End Road, London N2 8AU. Fee 160. Contact Abby Stopler, tel: 020 8442 2262 or 020 8444 3355, email: abby@bobathlondon.co.uk 19-20 July Hanen advanced workshop For Hanen-certified SLTs on Target Word, the Hanen program for parents of children who are late talkers. Hosted by The Ear Foundation, Nottingham. For information, contact Anne McDade. Tel/fax: 0141 946 5433, email: uk_ireland@hanen.org or visit: www.hanen.org 23-27 July Cued Speech Association UK residential summer school Cued Speech gives complete access to spoken language for deaf babies, children and adults. Foundation, improvers, advanced, and French children's courses. (crche available). RSD, Exeter, Devon. Visit: www.cuedspeech.co.uk, email: info@cuedspeech.co.uk, tel: 01803 832784 SULP is Coming to Scotlandand Ireland 5-6 September 2007, North Lanarkshire; 21-22 May 2008, Dublin New edition Social Use of Language Programme - infants to juniors. For SLTs, EPs, OTs, teachers and assistants new and experienced users. Includes the latest updates. Eligible for 10 CPD credits for IASLT members. Also in Dublin on 20 May 2008, Seminar Pragmatics practice: inference, organisation and relevance. Eligible for 2.5 CPD credits for IASLT members. Contact Wendy Rinaldi, tel 01483 268825, email wendy.rinaldi@ntlworld.com Visit www.wendyrinaldi.com 26-28 September Hanen advanced workshop For Hanen SLTs on Learning language and loving it, the Hanen program for early childhood educators and teachers. Hosted by The Ear Foundation, Nottingham. For information, contact Anne McDade. Tel/fax: 0141 946 5433, email: uk_ireland@hanen.org or visit: www.hanen.org 12-14 November Three-day Hanen certification workshop For SLTs on It takes two to talk, the Hanen Program for parents hosted by the ear foundation. Nottingham. For information, contact Anne McDade. Tel/fax: 0141 946 5433, email: uk_ireland@hanen.org or visit: www.hanen.org

Co u r s e s

Connect training for 2007

Discounts available for teams and first timers to Connect.
5th July 2007 Meeting the challenges of severe aphasia Gain encouragement and inspiration to work creatively and positively with this client group. Obtain an insight into the everyday life and experience of people with aphasia. Explore a practical framework for goal setting 12th 13th September 2007 Working with people with stroke and aphasia (2 day course) Gain practical communication techniques and make conversation and group work fun. Explore disability issues and emotions. For everyone, especially support workers, assistants, volunteers. Ideal for newly qualified staff Toolkit Training New for 2007-8 Connects innovative tools and training courses Learn new skills, practise and discuss with others and leave knowing how to train your whole team. Choose from Running a Conversation Partner Scheme (Oct 2007) and Making Communication Access a Reality (Feb 2008)

Visit www.ukconnect.org to see the complete 2007-8 Connect training calendar which includes new toolkit training a new style of training at Connect.

Venue: 16-18 Marshalsea Road, London SE1 1HL. Easy access from all mainline train stations
For more information contact: Maria McDonnell, Connect, 16-18 Marshalsea Road, London Tel. 020 7367 0866 email: mariamcdonnell@ukconnect.org

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Appointments

Co u r s e s

November 8th & 9th 2007

Assistive Technology: Basic Principles & Practical Solutions

A 2-day course in assistive technology, AAC and environmental control for professionals working with adults with complex Neurodisability. Venue: Royal Hospital for Neurodisability, London 150 plus VAT Conference Organiser 020.8780.4500 ext.5237 E-mail jbache@rhn.org.uk

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Appointments

Speech and Language Therapist

Hay Lane School Grove Park, Kingsbury, London, NW9 0JY
Band 6 (point depending on experience plus paid school holidays) Full time (part time considered) 1 year temporary contract (to cover secondment) Start date 4th September 2007 Hay Lane School is a special school for students aged between 4 18yrs with SLD and PMLD (including ASD). This post benefits from: Good networking and support from peers and specialist colleagues Designated administration time to assist time management Opportunities to work and further develop specialist skills in AAC, Dysphagia, and Autism. Established feeding clinic working alongside a multi-disciplinary team of professionals. SLT is an essential and respected member of the school team To discuss the above opportunity or to arrange an informal visit please contact either Jenny Drake, Head Teacher on, or Femida Vanat, SLT on 0208 206 3775. Closing date: 15th June 2007 Interviews: 22nd June 2007

An exciting opportunity has arisen for a therapist with relevant experience to work within this specialist setting. Two years post qualification and dysphagia training or equivalent is desirable.
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www.rcslt.org

Over 8,000 members now signed up!

FILLER

Complete your continuing professional development online

Appointments

June 2007 bulletin

Visit: www.rcslt.org/cpd

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Appointments

Health Professions Council registration renewal begins in July 2007

Are your name and address details up to date with the HPC? Tel: 0845 3004 472 8.30am 5.30pm

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Appointments

Co u r s e s

'Working outside the box: challenging clients in a challenging world.'

February 29th 2008 Royal Hospital for Neuro-disability, London This study day is aimed at SLTs and other therapists working with the challenges of clients with high-level cognitivecommunication difficulties and/or neuro-behavioural difficulties following brain injury. It offers a theoretical overview, practical approaches and solutions to the dilemmas faced by therapists working in in-patient and community settings. 75 plus VAT For further details/application pack, contact Emma Gale on Egale@rhn.org.uk. Tel: 020 8780 4500 ext 5230

To place ads call Katy Eggleton on: 020 7878 2344

June 2007 bulletin 29

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www.rcslt.org

RCSLT Bookshop
(All orders are subject to a p&p charge)

10% off a full range of in print publications for RCSLT members

Clinical Aphasiology: Future Directions: A Festschrift for Chris Code
List Price: ISBN: ISBN-10: Publisher: Publication Date: Pages: 39.95 9781841696706 1841696706 Psychology Press 08/05/2007 376 (Hardback)

This book presents a collection of cutting edge work from leading researchers and clinicians around the world on a range of topics within Clinical Aphasiology. However, more than this, the volume is also a tribute to Chris Code, one of the foremost scholars in the field. Professor Code has made a galvanizing impact on the field: as a savant, a motivator and an impresario of trends which have resulted in several significant developments in the field. In the first chapter of this book the editors outline the considerable contributions Chris Code has made to the area.

RCSLT members receive 10% off all titles by ordering online or call our order hotline on

020 7878 2364 and ask for the RCSLT Bookshop

(All orders are subject to a postage charge as detailed below)

Alternatively, send your order to: RCSLT Bookshop, Ten Alps Publishing, 9 Savoy Street, London WC2E 7HR
Please make cheques payable to RCSLT Bookshop including 3.50 p&p for orders under 25, 6 on any orders over.

S p e c i f i c I n te re s t G ro u p n ot i ce s
West Midlands AAC Care Pathway SIG C27 11 June, 9am - 3.30pm Transition from school to adult services for people with AAC needs, plus AGM and voting for new committee. With Gill Williams, SBPCT; Kay Brownsword, Sandwell; Julia Hampson, Coventry. Moseley Hall Hospital, Birmingham. Members free; non-members 5. Contact Carole-Ann Burnett, tel: 0121 627 8235 or email: Carole-Anne.Burnett@SBPCT.nhs.uk Scottish SLT SIG - Dysphagia (S11) 19 June, 9.30am - 3.45pm Includes: AGM, Evidence based practice in tracheostomy management (Sue McGowan, National Hospital for Neurology and Neurosurgery), NHS Quality Improvement Scotland - tracheostomy working group (Penny Gravill, Aberdeen Royal Infirmary), Kapitex (Sian Storey). The Almond Room, St Johns Hospital, Livingston, Scotland. Members 10; nonmembers 15; students free. Contact Julie Ellis, tel: 01224 553 566, email: scotland.dysphagiasig@nhs.net Oxford Voice and Laryngectomy SIG (E31) 20 June, 9.30 registration Annie Elias: psychogenic voice disorders. Kaye Radford: quality of life after laryngectomy. Fiona Duncan: quality of life relating to three methods of voice restoration after laryngectomy. Teaching Suite, West Wing, John Radcliffe Hospital, Oxford. No available parking. Members free; non-members 15; students 7.50. Lunch not included. Contact Elaine or Penny on 01604 545737, or email: elaine.coker@northants.nhs.uk Paediatric Dysphagia SIG (N Ireland) (I14) 21 June, 9.30am - 4.30pm Examination of the tongue anatomy, primitive reflexes, normal development of tongue control, abnormalities of the tongue, cranial nerve evaluation, tongue tie- assessment and report on RBHSC audit. Function Room, Royal Belfast Hospital for Sick Children. Members 5; non-members 10. Contact Christine McCormick/Julie Dick, tel: 028 90632451 or email: christine.mccormick@belfasttrust.hscni.net SIG Working with Offenders (UKRI11) 22 June Raising the profile of speech and language therapy in secure settings. Rampton Hospital. Contact Helen Clarke, email: helenkateclarke@yahoo.com Early Years SIG Western Region (WE14) 25 June, 9.30am - 4.30pm Some for all or all for some? (The relative benefits of targeted SLT input and language enrichment for all): Penny Roy, Shula Chiat and Marie Gascoigne. Six workshops on models of service delivery and practical SLT approaches in early years settings (including Janet Cooper, Marion Farmer, Sarah Hulme). Bristol. 45. Bookings: Anna Kot, Trowbridge FHC, The Halve, Trowbridge BA14 8SA. Queries Evi Typadi/Karen Hayon, tel: 0207 266 8807 or email: evi.typadi@westminster-pct.nhs.uk Trent Dysphagia SIG (C17) 26 June, 9am - 12.30pm AGM. Service evaluation of dysphagic stroke clients, Sue Parnall SLT and RCSLT adviser for dysphagia; Oral hygiene audit, Carol Davsion SLT clinical lead for stroke. Boardroom 1 and 2, Woodgate, Loughborough, Leicestershire LE11 2TZ. Membership 5. Contact Michele Adams, tel: 0116 2563597 or Bronti Cole, tel: 0116 2585363, email: michele.adams@lcrpct.nhs.uk or brontilla.cole@lcrpct.nhs.uk South West Disorders of Fluency SIG (SIG WE12) June 26, 9.30am - 4pm What groups can and cannot do (including discussion of groups for children and adults). Various contributors. Trust Headquarters, Frenchay Hospital, Bristol. Members free. 10 to join SIG. Contact Debbie Mason tel: 0117 919 0219 or email deborah.mason@nbt.nhs.uk SALTIBAD SIG UKRI05 26 June, 9.30am - 4.30pm Inclusion in deaf education. Speakers tbc. RCSLT, London. Members free; non-members 5. Contact Nicky Edmondson, email: davidedmondson5@blueyonder.co.uk SIG Speech and language difficulties in Secondary Education (C19) 27 June, 2pm - 5pm AGM. SLTs working at Key Stage 3 and 4: how do we work and why? Education staff welcome. Loughborough Hospital, Committee Room, 1st floor, Hospital Way, Epinal Way, Loughborough, Leicestershire, LE11 5JY. Contact Carol Reffin, tel: 0116 295 4670 or email: carol.reffin@leicestercitypct.nhs.uk London Speech Disorders Sig L27 29 June, 2pm - 5pm The evidence base in childhood speech disorder: Dr Jan Broomfield. Graham Fraser Room, Royal National Throat Nose Ear Hospital, 330 Grays Inn Road. WC1X 8DA. (via main entrance on Grays Inn Road). Members free; non-members 10. Contact Shula Burrows, email: shula.burrows@royalfree.nhs.uk North West and North Wales SIG Adults with Learning Disabilities 4 July, 9.30am - 3pm AM: Ros Blackburn Logically illogical information and insight into autism PM: AGM. . Ashton House, 26 Village Road, Oxton, CH43 5SR. Members free; non-members 10. Please confirm attendance before 15 June or place cannot be guaranteed. Contact Lorraine Hutchinson, email: lorraine.phillips@ccpct.nhs.uk or Emma Molloy, tel: 0151 653 9660. SIGAAD 4 July, 1.30pm - 4pm Oesophageal dysphagia: Neresha Maistry oesophageal disorders; other speakers tbc. National Hospital of Neurology and Neurosurgery Institute of Neurology Queens Square WC1. Members and students 8; nonmembers 15; 20 pay on day. Lunch not included. Application form available from Sig_aad@yahoo.co.uk. Send form and cheque to: Katie Aynge, SLT, Royal Free Hospital, Pond Street, London NW3 2QG. Places only reserved on receipt of cheque. SLTs Working in Mainstream Schools SIG (South East region) (L15) 6 July Service delivery in mainstream schools. The impact of new commissioning strategies on mainstream services: Marie Gascoigne. Presentations and discussions of different models of service delivery. RCSLT, London. Price tbc. Email: mainstreamsig@yahoo.co.uk West Midlands Dysfluency SIG (C4) 10 July, 1.30pm - 4pm Voice amplification. Lyng Health Centre, West Bromwich, Frank Fisher Way off Moor Street, B70 7AW. Contact Beatrice Mills-Klee, tel: 01384 256844 or email: Beatrice.Mills-Klee@dudley.nhs.uk Northern Research SIG (N30) 10 July, 9.30am - 4pm Evidence based practice for SLTs 3: creating the evidence. Single case studies in clinical practice, Professor Stephanie Stokes. How to devise a single case study. Applying the model to one of your own clients. Establishing support networks. Newcastle upon Tyne. Members 20; nonmembers 35. Contact Helen Stringer, email: h.b.stringer@ncl.ac.uk South Wales Learning Disabilities SIG (WA2) 11 July, 9.30am - 3.30pm AGM. Its all changed Katrina McLaughlin SLT dementia in people with LD and their carers perspectives. Appearing in Court: understanding the legal process and evidence giving Richard Griffith. Swansea Vale Resource Centre. Annual membership 5 to SLT staff; students free; SIG free to members (after renewal on the day). Free to non-working NQPs who want to update CPD for HPC. Contact Sian Jones, tel: 01792 614 100 or email: Sian.jones2@swansea.gov.uk National Gender Dysphoria SIG (UKRI12) 17 July, 9.30am - 4pm Confident female communication - three transwomen share their knowledge and skills + bring case discussions - come prepared. Ormskirk District General Hospital, L39 2JW. Members free; non-members 10. Contact Lizzy Lemon, tel: 01695 598 302 or email: lizzy.lemon@centrallancashire.nhs.uk London Special Interest Group in ASD L18 17 July, 9.30am - 4pm Growing up with autism: the impact of ASD on the family, forensic issues in ASD and mental health in ASD. Room D 104 (NB subject to change), Social Science Building, St John St, City University. Members free; non-members 10. Space limited. To book your place contact Penny Williams, tel: 020 7414 1431 or email: penny.williams@lambethpct.nhs.uk

Send your SIG notice by email to: sig@rcslt.org by 4 June for the July issue
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