THE OFFICIAL MAGAZINE OF THE ROYAL COLLEGE OF SPEECH & LANGUAGE THERAPISTS

September 2014 | www.rcslt.org

RCSLT cuts survey 2014: You tell us about the eff ects on your service users and families

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BBUL.09.14.002.inddUL.09.14.002.indd SSec1:28ec1:28 18/08/2014 10:07 Contents ISSUE 749

4 Letters 5 News →It’s RCSLT conference time in Leeds →Queen’s award for Therapy Box →Get involved in 8 dementia research 11 Opinion: Lipreading: an evolving role opportunity for SLTs?

12 Steven Harulow: Cuts 2014: 5 10 the eff ects on your services 16 Antonia Kilcommons: A pioneering rehabilitation service for children with 22 brain tumours 20 The Research and Development Forum

22 Gaye Powell, Dominique Lowenthal: the RCSLT Outcome Measures Project

27 Obituaries 28 In the Journals 20 32 Clinical Excellence Networks 33 Your speech and language therapy job adverts

38 My Working Life: Dr Amanda Smith

CONTACTS

ROYAL COLLEGE OF SPEECH AND EDITORIAL BOARD EDITORIAL Tel: 020 7324 2735 LANGUAGE THERAPISTS President: Sir George Cox Senior life vice Editor: Steven Harulow Email: beth.fi fi [email protected] 2 White Hart Yard, London SE1 1NX president: Sir Sigmund Sternberg Vice Deputy editor: Raquel Baetz PUBLISHER Tel: 020 7378 1200 presidents: Simon Hughes MP, Baroness Contributing editors: Digna Bankovska, Jason Grant Email: [email protected] Jay, John Bercow MP Chair: Bryony Sarah Matthews PRODUCTION Website: www.rcslt.org Simpson Deputy chair: Maria Luscombe Art editor: Carrie Bremner Kieran Tobin ISSN: 1466-173X Honorary treasurer: Lorna Bailey Art director: Mark Parry PRINTING Professional director: Kamini Gadhok MBE Senior picture editor: Claire Echavarry Woodford Litho

ADVERTISING DISCLAIMER Sales manager: Ben Nelmes ©2014 Bulletin is the monthly magazine of the Royal Tel: 020 7880 6244 College of Speech and Language Therapists. The Email: [email protected] views expressed in the bulletin are not necessarily PUBLISHERS Recruitment Sales: Giorgio Romano the views of the College. Publication does not imply Redactive Publishing Ltd Tel: 0207 880 7556 endorsement. Publication of advertisements in the COVER ILLUSTRATION 17 Britton Street, London EC1M 5TP Email: [email protected] bulletin is not an endorsement of the advertiser or Studio Muti - Folio Art 020 7880 6200www.redactive.co.uk Display Sales: Beth Fifi eld of the products and services.

September 2014 | www.rcslt.org Bulletin 3

0003_contents.indd03_contents.indd 3 18/08/2014 14:34 Bulletin thrives on your letters and emails. Write to the editor, MY RCSLT, 2 White Hart Yard, London Steven WORKING SE1 1NX email: [email protected] Please include your postal address and LETTERSLIFE telephone number. Letters may be edited Harulow for publication (250 words maximum) EDITORIAL

Manchester Language Study thanks Doing more Twenty years ago, I applied to the Nuffi eld Foundation to study children with specifi c language impairment attending language units across England. Th is longitudinal project, known as the with less Manchester Language Study, was successfully funded and offi cially began in 1995. For 20 years we have been able to count on the help, support and dedication of SLTs, language unit teachers, school inancial and workforce challenges are now an teachers, assistants and many professionals across the country, established way of life to many working across and especially the families and the children (now young adults) the public sector. In the areas of healthcare and themselves. We want to thank you all and invite you to celebrate Feducation, particularly, there is also an expectation with us at a special reception in November 2014. If you have been that services will deliver more with fewer resources, as the involved in any way with the study or know someone who has, or demand for those services increases. are a friend of the study, please get in touch so we can send you the Th is month’s cover feature (pages 12-15) looks at the results celebration details. Contact my assistant, Jackie O’Brien, at: jackie. of our latest cuts survey. Although the number of responses is [email protected] down on previous years, the results still show clearly the eff ects Professor Gina Conti-Ramsden, University of Manchester of cuts on service users and their families. Th e article also guides service leaders through some of the steps they can take when facing proposed changes. On the right ‘Trach’ report debate Demonstrating the eff ectiveness of what you do as SLTs is Th e June publication of NCEPOD report into Tracheostomy care an essential part of your roles as modern practitioners. On ‘On the right Trach’ is the culmination of a two-year study to pages 22-24, Dominique Lowenthal and Gaye Powell report on identify diffi culties in the care pathway for adult patients with a the progress of the RCSLT’s Outcomes Measures Project. Th is tracheostomy. Th e study collected data on 2,546 tracheostomy important venture aims to establish a framework and core set of cases in 219 hospitals across the UK (excluding Scotland) using outcomes and outcome measures for conditions and/or settings. prospective questionnaire surveys, and randomly sampled 426 I am also pleased to announce the inclusion of the RCSLT patients for detailed review. Impact Report for 2013-2014 in this issue. Th is review of the One SLT, representing the RCSLT, sat on the multidisciplinary past fi nancial year gives a real fl avour of the activities and expert group tasked with designing the study and reviewing the achievements of your professional body – defi nitely worth a fi ndings. Five SLTs were part of the adviser group undertaking read. individual case reviews.Th e report makes 25 recommendations based on fi ndings on the organisation of care, tracheostomy Steven Harulow insertion, tube care, multidisciplinary care, complications and Bulletin editor outcomes. Th ose of particular signifi cance for SLTs include: [email protected] ■ SLTs are key multidisciplinary team members and should always participate in the routine care pathway for all tracheostomy patients. Hospitals need to provide adequate staff to ensure this happens routinely and in a timely manner. My RCSLT ■ Involvement of SLTs in critical care needs to be facilitated, particularly for more complex patients, and to assist with high- Judith Payne quality communication strategies, and day-to-day ward care. ■ Dysphagia is common in tracheostomy patients and warrants I am in my second year of work as further study in terms of risk factors, identifi cation and natural a paediatric SLT for Virgin Care history. Th ere needs to be improved recognition of the incidence in South West Surrey. I work in a of dysphagia in tracheostomy patients at all points in the care pre-school language centre and in mainstream schools with children pathway – with early referral to SLTs with specifi c competences. who have a statement of special Adviser opinion found 40% of cases reviewed in critical care units educational needs. The RCSLT and 39% of ward cases received a good quality of care generally. helps me to maintain links with Download the full report from: www.ncepod.org.uk other SLTs throughout the UK and Th e next Tracheostomy CEN meeting (8 October) will focus on the constantly keeps me up-to-date report and debate ways for SLTs to facilitate implementation of the with the most recent developments recommendations. For further information email: sarah.wallace@ within our ever-changing fi eld. The uhsm.nhs.uk or contact the CEN. RCSLT was a great source of support throughout my transition Sarah Wallace, By email from student to fully-competent therapist – providing talks at university, student study days and guidance for completing the newly-qualifi ed practitioner competencies. FOLLOW THE RCSLT ON AND

VISIT: WWW.RCSLT.ORG AND FOLLOW THE LINKS

4 Bulletin September 2014 | www.rcslt.org

004_Editorial.indd 4 18/08/2014 14:35 QUICK LOOK DATES » 17;09 23;09 06;10 RCSLT Closing date for 2015 Webinar: ‘Mind the conference begins Winston Churchill gap and build a bridge News in Leeds Fellowship application across it’

It’s RCSLT conference Your July-August time in Leeds IJLCD Many of you will be wondering what has happened to your July-August special issue Places are going fast for the speech and language of the International Journal of language and therapy event of the year Communication Disorders (IJLCD), entitled ‘Th e SLI debate: Diagnostic criteria and terminology’ (see August’s Bulletin, ‘Join the Th ere is still time to book your place at the IJLCD debate on SLI’, page 6) RCSLT 2014 Conference in Leeds on 17-18 Th is exciting issue includes lead articles from September. Professor Dorothy Bishop (‘Ten questions about ‘Mind the Gap: Putting research into terminology for children with unexplained practice’ focuses on the challenges and language problems’) and Professor Sheena opportunities facing the profession and Reilly and colleagues (‘Specifi c language provides a platform for the dissemination impairment: a convenient label for whom?’). of the latest innovations in evidence-based It also features commentaries from a range of practice. experts, including academics, SLTs, educational Th e conference programme is packed with psychologists and special educational needs oral and poster presentations, workshops, lawyers. Th ere is also a response article parallel and plenary sessions, and keynote ‘Terminological debate over language speakers. It will give you the opportunity impairment in children: Forward movement to come together to focus on how the and sticking points’. profession can survive and thrive. Th e special issue content is groundbreaking Th e economic reality has set the context and, to make the most of the many for this year’s conference. It is vital that contributions, is presented in a diff erent the profession shows evidence of what host a stand in Leeds where you can meet structure than you are used to. To make sure works. Following on from the RCSLT Hub Enquiries Coordinator Tom Griffi n and the journal does it justice the production Summit 2013, Mind the Gap will look at fi nd out more about Giving Voice and the team needed a little longer than usual to get the current drivers – translating research International Communication Project everything just right into practice to inform service delivery 2014. You can also meet the editors of the We expect to deliver this issue with your and design, outcomes for service users, International Journal of Language and Bulletin later in the year. However, the online outcome measures and Communication Disorders and the Bulletin version is available via the RCSLT website: the need to strengthen editorial team. www.rcslt.org/members/publications/ the business case publications_list. Please join the debate. After NEWS for commissioning ◉ Visit: http://tinyurl.com/k3ub7cp for you have read the articles and commentaries, IN BRIEF services. more details and information on how you visit the discussion forum: http://tinyurl.com/ Th e RCSLT will can book your pace lee3za2 to have your say.

The Health and Care Correction: The obituary Childhood dysarthria is Do you have any information Professions Council (HCPC) is for Hilary Jarvie in July’s issue the topic of a special issue of the or views about child sexual seeking to appoint three lay and of Bulletin (page 26) was co- International Journal of Speech- exploitation in Northern Ireland one registrant member to its written by Lynette Smith and Language Pathology, ‘Translating and how it is addressed? In Council. Council members play Eunice Gibson, not Gibbs as we knowledge to practice in November 2013, ministers set a key role in setting strategy stated at the end of the article. childhood dysarthria’. The issue up an independent inquiry to and policy, and ensuring the Our apologies go to Eunice. includes articles on assessment, look at the matter and make HCPC fulfi ls its statutory duties Read this months’ obituary, for treatment, outcomes and impact recommendations. The inquiry is and responsibilities. They also Professor Jeri Logemann, on by a range of international particularly interested in hearing act as HCPC ambassadors, page 27. authors. RCSLT members can the views and experiences of representing the Council’s public access this journal for free via frontline workers and former protection role. Applications the RCSLT Journals Collection. workers. close on 12 September 2014. ◉ Visit: http://tinyurl.com/ ◉ Visit: www.cseinquiry.org.uk ◉ Visit: http://tinyurl.com/ pdvqtxg

IMAGE: GEOFF WILSON GEOFF IMAGE: p9gd263

September 2014 | www.rcslt.org Bulletin 5

005_news.indd 5 18/08/2014 14:36 TWEET Avril Nicoll@avrilnicoll Gillian Rudd@GillianRudd TALK » As usual, a nightmare choosing Nearly 10 years since I qualifi ed, between sessions:) MT @RCSLT: I still get excited about visiting @ See our updated conference RCSLT HQ! #NotCoolButDontCare programme at http://bit.ly/WRfk SH #slpeeps #London pic.twitter. News #rcslt2014 com/4Q5U0LxKsj

New opportunities for head and neck cancer dysphagia research

Th e future is looking bright for manage and enjoy. Workshops that are essential to swallowing. research funding into dysphagia will start in September 2014. Finally, the Scottish Chief interventions for head and neck Meanwhile, Cancer Research Scientist Offi ce Research Grant cancer patients with National UK has also made two large body has provisionally allocated Institute for Health Research investments into investigating funding for the development (NIHR) funding for three projects. whether diff erent cancer and feasibility of a swallowing Comparing pre-treatment treatments can improve intervention package. Th is gastrostomy tube versus swallowing outcomes. multi-centre study will look at nasogastric feeding in patients Postoperative adjuvant the delivery of a pre-treatment undergoing chemoradiotherapy treatment for HPV-positive swallowing intervention aiming (TUBE) aims to evaluate tumours (PATHOS) aims to to improve long-term outcomes. which options lead to a better tailor post-surgery radiotherapy Th is programme of research swallowing ability or quality treatment for patients with is crucial in furthering the of life. oropharyngeal cancer to evidence base for speech and Th e cognitive behavioural reduce side eff ects, particularly language therapy interventions. enhanced swallowing therapy Can molecular gastronomy swallowing problems. More It has involved a collaboration feasibility study (CB-EST) aims techniques help patients re- than 20 centres are participating of national academic and to develop an intervention engage with eating and drinking? across England and Wales. multidisciplinary clinical combining the principles of Recruitment starts in December. partnerships and patient cognitive behavioural therapy is a pilot study looking at Comparing dysphagia engagement. Th is is great news with usual swallowing therapy, whether molecular gastronomy optimised radiotherapy versus for our patients, team working, to help patients adjust to techniques (Heston Blumenthal- standard radiotherapy in head new networks and rehabilitation changes following cancer style cooking) can assist patients and neck cancer (DARS) is a research. treatment. re-engage with eating and multi-centre study that aims to Resources for Living (Research drinking, fi nding diff erent ways refi ne radiotherapy techniques ◉ For further information, email: for Patient Benefi t funding) of preparing foods they can both to safely reduce the dose to areas [email protected]

RCSLT Web Poll ‘Help Stop Choking’ wins national award Have your say... Are you in A unique project involving a sserviceervice mmortalityortality and adverse harm eff ects from user with learning disability hhasas chchoking.okin John hopes that by sharing favour of the bagged one of the top awardss his sstory it will help to improve Assisted Dying at the inaugural Patient seservice user experience and help Bill? Safety and Care Awards oother people reduce their risk of 2014, organised jointly by cchoking. the Health Service Journal Presenting the award, the and Nursing Times. jjudges commended Angela and Belfast Trust SLT JJohn on the uniqueness of the Angela Crocker worked pproject, which was the only one with a service user, John, to include a service user. Th ey and the Learning Disability aalsolso referenced the huge impact 62% Team to produce an accessiblele tthehe DVDVD could make by preventing say DVD called ‘Help Stop Choking.’ng.’ aavoidablevoidable deaths by choking and said YES Together they won the prestigiousgious all lelearningarning ddisabilityis services across the UK award in the ‘Preventing Avoidable Harm’ category. should use it as core training and awareness raising Help Stop Choking is based on a service user’s for both staff and service users. experience to help increase awareness of choking, VISIT: WWW.RCSLT.ORG promote safe eating strategies and reduce avoidable ◉ Visit: http://youtu.be/AEwDb3ZNkAc REX FEATURES

6 Bulletin September 2014 | www.rcslt.org

006-007_news.indd 6 18/08/2014 14:37 Claire Goodwin@bake_therapist Speech Dudes@SpeechDudes @RCSLT one of your girls is on My @RCSLT membership has #GBBO great british bake off this now been reinstated! Big thanks year! It’s ME!! pic.twitter.com/ to Tashika who fi xed my blunder NBNv4t01ES ;) Gotta love those #RCSLT folks!!

BRYONY SIMPSON & KAMINI GADHOK

GIVING VOICE UPDATE GET INVOLVED Celebrating a year THIS SEPTEMBER of Giving Voice As you open your Bulletin this month we will be coming up to the RCSLT Conference 2014, ‘Mind the Gap: Putting research into practice’, on 17-18 September in Leeds. We hope to see as many of you as possible at this exciting event, which will focus on the challenges and opportunities facing the profession and provide a platform for dissemination of innovations for evidence- based practice. Places are going fast, so book yours today. Visit: www.rcslt.org/news/events/2014/rcslt_ conference_2014. On the eve of the conference, on 16 September, we will hold the RCSLT annual general meeting. Th is is free to attend and all members are welcome. At this Have Giving Voice bag, will travel year’s meeting, we will announce proposals for a new governance structure for the RCSLT. Th ere will be an Eight members of the University you couldn’t live without written on opportunity for members to fi nd out more about this. College London society spent a the back, and then nominating other For more details and gruelling week in July undergoing friends to do the same. Th e message information about “At this year’s various SLT-related challenges. Th is copied into every post spreads key how to submit a proxy included three students on a pureed statistics about speech and language vote, visit: www. meeting, we food diet, two replacing all fl uids with and links them to the Giving Voice rcslt.org/about/ thickened liquids, one student only website. Hundreds of people have howwearerun/council will announce using a tablet for communication, already taken part. Th e person behind We hope to use the proposals one voluntarily stammering and one the concept, Holly Strickland, even this opportunity to wearing a heat-moisture exchange took it to Glastonbury with her and develop new ways for a new system, as used by those who have made it into the BBC TV coverage. to refresh the way had a laryngectomy. You can read Th e students also came up with we engage with governance about their experiences via their an ingenious way to spread the members, particularly structure for the blog (http://uclugivingvoiceblog. message further afi eld. During the at a time of ongoing wordpress.com). By the end of the long summer break, all are taking pressures in the RCSLT” week they had raised an incredible their Giving Voice bags with them on health and social care £1,064 for the Stroke Association. holiday to spread the news about the systems; the need to Th e students launched a viral campaign (see photo of the progress infl uence at national, campaign #GiveMe5. Th is involves so far). regional and local levels; and potential changes as a posting a ‘selfi e’ on Facebook, result of the referendum in Scotland on 18 September showing your hand with fi ve words Lucy Crook and General Election in 2015. We would also encourage you to sign up to the post- conference webinar that will take place on 16 October. Queen’s award for Therapy Box If you attended the conference, RCSLT Councillor for Research and Development Professor Vicky Joff e and Communication technology a reception at Buckingham Palace Research Manager Dr Emma Pagnamenta will provide business, Th erapy Box, has received in July to celebrate the achievement ideas of the ‘what next’ you might want to take forward a Queen’s Award for Enterprise for and meet the Queen. Following in your practice. Innovation. Th e company, which this, an intimate event took place If you could not attend, they will provide you with a specialises in developing apps for at Th erapy Box’s offi ces, where fl avour of the event, encourage you to view the post- individuals with a variety of speech the Lord Lieutenant of Greater conference slides and help you think about how the and physical disabilities to enable London, Sir David Brewer, themes relate to your practice. Visit: www.rcslt.org/ them to communicate, is one of the representing Th e Queen, presented news/webinars/rcslt_webinars ■ smallest businesses to have received the pair with a chalice and scroll in the prestigious accolade. commemoration. Bryony Simpson, RCSLT Chair; Kamini Gadhok, MBE, Co-founders former SLT Rebecca RCSLT Chief Executive. Email: [email protected] Bright and Swapnil Gadgil attended ◉ Visit: http://therapy-box.co.uk

September 2014 | www.rcslt.org Bulletin 7

006-007_news.indd 7 18/08/2014 14:37 FAST FACTS » £260 £0 fee for a RCSLT member cost for RCSLT members to attending the two-day access the British Journal of News RCSLT Conference in Leeds Learning Disabilities

Manchester students impress during Action on Stroke Month

University of Manchester (UOM) of stroke and this provided SLT students worked closely participants with inspiring fi rst- with Th e Stroke Association hand accounts of how speech and throughout Action on Stroke language therapy is fundamental Month in May 2014 to promote to the rehabilitation of stroke the RCSLT’s Giving Voice survivors. Campaign. Th is was through Being part of the Giving Voice ‘Science Stroke Art 2014’ – a UOM SLT students promote Campaign has been a truly series of innovative public the important role of SLTs rewarding experience and we during stroke rehabilitation engagement and awareness have received incredibly positive events in Manchester, which feedback from Th e Stroke included talks, storytelling, diffi culties by fi nding Aphasia researchers from the Association’s regional head theatre productions, and science augmentative ways of delivering university attended to support of operations. On a personal and art demonstrations. their story. us by providing details about level, I have enhanced skills Th e students had an important We held three Giving developments in aphasia in networking, leadership and role throughout these activities, Voice stalls at several other research. creativity. I believe the UOM SLT particularly during a ‘human events to provide the public We organised an end of year students have shown dedication library’ event. Th is involved with information about the academic ball for students and to and enthusiasm for the Giving working with stroke survivors communication and swallowing university staff . Giving Voice was Voice Campaign and we are very to help develop stories based diffi culties people may experience at the heart of this event, while proud of our achievements so far. on their experiences of stroke. after stroke. We also strongly also raising an impressive £877 for Students were able to support promoted the important role of Th e Stroke Association. Two guest Alana Botwright (Newly- those with communication SLTs during stroke rehabilitation. speakers shared their experiences qualifi ed SLT)

Th e RCSLT prize draw Win a book... Afternoon tea highlights speech and language therapy role

Th e Adult Acquired Disordersders HeadwayHeadway andan Age UK. Community Speech and GuestsGuest were able to fi nd out more Language Th erapy team iinformationnfor about communication PRIZE from Anglian Communityy aaids,id therapy for people with DRAW Enterprise held a dydysphagia and communication successful afternoon tea ttherapies. Th e team also networking event in promoted the International July, at Great Horkesley Communication Project 2014 Bulletin readers can win Village Hall near Pledge and the RCSLT’s ‘Giving a copy of ‘Voice therapy: Colchester. VVoice for people with dementia’ clinical case studies’. Email As a newly- ccampaign, highlighting the need your name, address and established team, staff fofor SLT input. membership number to wanted to raise awarenesss HHannah Astley and Jennifer [email protected] and of the role of SLTs, to buildd WWhitaker,hita both SLTs, gave a short talk put ‘September draw’ in the new links with local servicesces ababoutout tthehe department’s role and services subject line. Entries close and to share ideas and informationti offffdith ered, with other guest talks from Ryan Jones 15 September. July’s winner about the services off ered by each other. Th e event from Essex Carers Support and Alison Heavey was Vanessa Lloyd from was well-received by guests from a wide variety from Huntington’s Disease Society. Wrexham. of organisations, including Alzheimer’s Society, Essex Carers Support, Th e Stroke Association, Hannah Astley, SLT

8 Bulletin September 2014 | www.rcslt.org

008-009_news.indd 8 18/08/2014 14:38 £1,064 £30,000 Derek raised by UCL students available to support research for the Stroke through a Peel and Rothwell Jackson Association Postgraduate Travelling Fellowship Munn COLUMN

email: [email protected] for more information. To apply, send your contact details, CV and a brief SUMMER statement on why you would like to be part of the interview panel to REFLECTIONS Emma by 19 September 2014. It’s summer at the RCSLT and we’ve been making the best Travelling fellowships of the warm weather by taking stock. For example, as I available write, we have recently compared notes across the UK on Apply now for a Peel and Rothwell developments around children and young people – and Jackson Postgraduate Travelling what we’ve found is that despite the diff erences in political Fellowship. Up to £30,000 is available context, the issues and challenges are often the same. to support your research, advanced Northern Ireland’s Public Health Agency is reviewing study or the acquisition of a new Morag is new deputy chair allied health profession provision for children with clinical skill unlikely to be available in The RCSLT Council has approved – in the UK. Candidates will be planning statements. Th ere’s also a review of Sure Start, a the absence of multiple candidates, in a UK career that will be enhanced by ‘Delivering Social Change’ programme led from the top accordance with the RCSLT’s Articles spending up to a year at a centre of of government and a strategic partnership looking at – for Scotland Councillor Morag international excellence. Closing date, outcome-based commissioning for children and young Dorward to be the next deputy chair 6 November 2014. people. Th e RCSLT is involved in all these developments. of council. Morag will take up her Visit: www.peeltrust.com/ In Wales, consultation has just closed on additional position at the 2014 annual general ◉ meeting in Leeds on 16 September. fellowship.php learning needs (special educational needs have diff erent All members are welcome to attend names in the diff erent parts of the UK). Alongside the AGM. The agenda, minutes of Dysphagia information this, is a review of special schools provision. We are the 2013 meeting, background notes, online particularly pleased booking form and proxy voting form In line with the RCSLT’s plans to though that following are now available from: www.rcslt.org provide online support for key clinical RCSLT lobbying, “Th e Welsh and topic areas, we have created a the Welsh Assembly Assembly Dementia impact survey new webpage to raise awareness of Government is taking and encourage member involvement To mark the fourth year of the speech language and in our dysphagia-related work (www. Government is National Dementia Declaration, the communication needs Dementia Action Alliance is surveying rcslt.org/members/clinical_areas/ taking speech dysphagia). The RCSLT Dysphagia seriously, with money people aff ected by dementia and committed to its Flying the professionals supporting them Working Group is currently drafting language and Start programme for to fi nd out whether current activity content for the dysphagia section, priorities that include is leading to real changes on the including clinical information, links to communication ground. The online survey has a key RCSLT and external resources, language development, needs seriously” fi lter with diff erent questions for and important contacts. A link to this awareness training people aff ected by dementia and page will also be available on the new for civil servants and professionals. current projects page. forthcoming guidance Visit: www.rcslt.org/about/ ◉ Visit: www.dementiaaction.org. ◉ on early language. uk/impactsurvey current_rcslt_projects In Scotland, the focus is on the implementation of the Children and Young People’s Act passed earlier this year. IJLCD editor interview NICE updates for AHPs We are infl uencing the guidance, linking speech and opportunities The National Institute for Health and language to the eight outcomes that the law seeks for each The RCSLT would like to off er two Clinical Excellence (NICE) produces child. certifi ed members the opportunity guidance on the most clinically and Bulletin readers will know about the changes that have to be part of the interview panel cost-eff ective, evidence-based care. now come in for special educational needs and disability Recently published guidelines, quality for the new editor in chief of the (SEND) in England (read ‘RCSLT produces online SEND International Journal of Language standards and implementation tools reforms guidance’ August 2104 Bulletin, page 5). We’ll also and Communication Disorders. for allied health professionals include: be addressing this as part of our approach to the General We are looking for an SLT working Antisocial behaviour and conduct clinically and an RCSLT member disorders in children and young Election – more next month. working at a higher education people (QS59), Domestic violence We are also taking stock of the RCSLT’s campaigning institution. You will be required and abuse (PH50), Autism (QS51), work. Just a reminder that for the time being, if you to attend up to two days of Mental wellbeing of older people want to talk to us about Giving Voice or the International presentations/interviews with in care homes (QS50) and Stroke Communication Project 2014, email: [email protected] the prospective candidates at the Rehabilitation (CG162). Visit: www. or phone Tom Griffi n on 0207 378 3012. ■ RCSLT offi ces in London during nice.org.uk/guidance to read the guidelines. Register for the NICE November 2014. The RCSLT will Derek Munn, RCSLT Director of Policy and Public Aff airs. pay reasonable travel costs. If you e-newsletter and updates, visit: Email: [email protected] are interested in taking part, please www.nice.org.uk/newsletter

September 2014 | www.rcslt.org Bulletin 9

008-009_news.indd 9 18/08/2014 14:38 NEWS News IN BRIEF

Post-conference webinar Get involved in The RCSLT will host a webinar, ‘Mind the gap and build a bridge across it: a post-conference round up’ between 2pm – 2.45pm on 6 October 2014. Panellists RCSLT Deputy Chair Maria Luscombe, dementia research Research and Development Councillor Professor Victoria Joff e, and Research Manager Dr Emma Pagnamenta will discuss key themes from the Th ere is currently hugege dedicateddedic care, services conference. The webinar will also help you with investment in anand public health your refl ections and provide ideas of the ‘what dementia research reresearch funding next’ that you might want to take forward in and while a sstream and would your practice. If you are not able to attend the signifi cant focus is like SLTs to get conference, the webinar will provide a fl avour of the on drug involved. Th e event, encourage you to view the post-conference treatments, ssociety provides materials and consider how the themes relate to funders recognise fufunding for project your practice. that research is grgrants,a a range of ◉ Visit: http://tinyurl.com/RCSLT2014 equally necessary intoto ffellowshipellow grants (for living well with dementia.entia. cclinicianslinician and researchers) Professional indemnity arrangements Alzheimer’s Society is leading the and PhD studentships (visit: All Health and Care Professions Council (HCPC) way in the UK and has promised to http://tinyurl.com/ptbbcd5). It has SLT registrants must now have appropriate invest at least £100m in dementia also launched its new Dementia professional indemnity arrangements in place as research over the next decade. Research Leaders programme, a condition of registration. Director of Policy and Standards Michael Guthrie says, “The majority of In 2013, Alzheimer’s Society led a which brings together new and our registrants will already meet these requirements Dementia Priority Setting existing ways to support promising because they will be indemnifi ed either through Partnership with the James Lind early career researchers to forge their employer, a professional body, union or Alliance. Th e partnership consulted careers in the dementia fi eld. defence organisation, directly with an insurer, or with people with dementia, their Funding and development a combination of these. However, it is important carers and health and social care opportunities are available for people registrants ensure they have cover in place that practitioners. Th e top 10 priorities from biomedical, clinical and social is appropriate for their practice.” In future, the include the eff ectiveness of care and science backgrounds (visit: http:// HCPC will ask registrants to confi rm they meet interventions for people with tinyurl.com/nlak9wp). the requirement by completing a professional dementia and their carers, ways to If you know of any further declaration when renewing or registering. encourage people with dementia to opportunities for SLTs to get involved ◉ Visit: www.hcpc-uk.org/registrants/indemnity maintain nutritional intake, early in dementia research, email: diagnosis, and acute and end of life [email protected] CPLOL call for abstracts care (visit: http://tinyurl.com/ The Scientifi c Committee is inviting abstracts for mdu3yhk). Katherine Gray, Research Grants the scientifi c programme of the 9th European Alzheimer’s Society has a Manager, Alzheimer’s Society CPLOL Congress, which will take place in Florence on 8-9 May 2015. The congress will cover all the fi elds of the speech and language therapy practice, particularly child language and non-language disorders; acquired speech, language and swallowing Make an IJLCD date this winter disorders in adults and older people; and speech and language education and profession. Submissions Th e International Journal of and restorative justice. Karen will also close on 1 November 2014. Language and Communication present evidence for the over- ◉ Visit: www.cplolcongress2015.eu Disorders (IJLCD) team is delighted representation of people with to announce that Professor Karen cognitive and communication Implementing the SEND reforms Bryan will give the 2014 IJLCD diffi culties in the criminal justice The Communication Council has published a free Winter lecture on 4 December 2014 system, and evidence for the report ‘Implementing the SEND reforms’, which (5.30pm –8pm). potential value of speech and aims to provide practical information regarding Hosted by the Division of language therapy to youth justice commissioning for speech, language and communication needs services within the context Language and Communication services, and the impact of registered of implementing the special educational needs and intermediaries on justice processes. Science at City University London, disabilities (SEND) reforms. The report provides Karen will discuss ‘Language A drinks reception will follow a synthesis of the key messages from a seminar diffi culties and criminal justice Karen’s talk. Tickets are free, but held in February 2014, together with additional processes’. Th e lecture will consider places are limited. background material around the 2014 SEND reforms. the demands on language required ◉ Visit: http://bit.ly/1t3fl jw to book ◉ Visit: http://tinyurl.com/nzz38kg by processes, such as police your ticket. Registration opens 15 interviews, giving evidence in court September 2014.

10 Bulletin September 2014 | www.rcslt.org

0010_news.indd10_news.indd 1100 18/08/2014 14:41 COLUMN LindaL Armstrong Opinion

Linda Armstrong wonders whether lipreading Group on a project to improve Ireland. Th ey are wholly or could be an evolving role opportunity for SLTs access to lipreading classes for mainly concerned with hearing adults with hearing loss. loss in children. Specialist Th e Scottish Government speech and language therapy funded the group’s work, services to people with hearing recognising that lipreading loss exist, but again mainly classes are an integral part of focus on children. adult hearing rehabilitation but How many SLTs out there currently available to only about work in specialist posts with 500 people in Scotland at a time adults with hearing loss? Are you (1% of those receiving their fi rst also a lipreading tutor/teacher? NHS hearing aids annually). Do you refer clients to lipreading Th e Scottish Government classes? Is there an evolving role is particularly interested in opportunity here (RCSLT, 2008)? improving and joining up Is the training of some SLTs/ services to people with hearing SLT students to be lipreading loss at present as part of its new tutors a possible way forward to joint sensory strategy, ‘See Hear’ deal with the lack of lipreading On everyone’s lips? (Scottish Government, 2014). classes in remote and rural Th e Quirk Report (DES, 1972) areas, and a way of attracting recommended that SLTs have a younger people to classes? I’d role in adult acquired deafness be delighted to hear from you on management. Th e RCSLT these or any related questions by considers deafness/hearing loss the end of November when the a core SLT clinical area – for project ends. example, in the competencies National Lipreading framework, Communicating Awareness Week is 8-12 Quality 3, Clinical Guidelines September 2014. For and ‘Resource Manual for more information about Commissioning and Planning lipreading classes visit: www. Services for SLCN’. Hearing loss lipreading.org.uk and www. can have a signifi cant impact scotlipreading.org.uk ■ on speech and language therapy delivery and eff ectiveness, for Linda Armstrong, Research example for clients with aphasia. Offi cer, Action on Hearing Loss Conversational problems for the Scottish Lipreading and misunderstandings are Strategy Group. Email: linda. inevitable. Improved digital [email protected] hearing aids make a diff erence, but are not usually the total References answer. & resources Currently, three of the 26 lipreading tutors in Scotland Royal College of Speech and are SLTs. One is a retired Language Therapists. Evolving roles in speech and language therapy. SLT manager, another does London: RCSLT, 2008. http://tinyurl. ILLUSTRATION Trina Dalziel lipreading classes as an integral com/onpg8nj part of her post as specialist Department of Education and ipreading classes SLT for clients with hearing loss Science. Speech therapy services. aren’t a million “Is the training across the life-span and the London: HMSO, 1972. See Hear miles away from third does lipreading classes in Scottish Government. of some SLTs/ Strategy. 2014. http://tinyurl.com/ Lspeech and language SLT students to addition to her NHS SLT post nt2xocg therapy groups for people with with people with acquired communication problems. be lipreading neurological conditions. Acknowledgement: Th at’s the conclusion I quickly tutors a Eight RCSLT-registered Many thanks to the three SLTs/ reached when talking to tutors clinical excellence networks lipreading tutors in Scotland – Liz Hurst, Liz Kraft and Alison and current lipreading class possible way relating to hearing loss exist Pendlowski – for signifi cantly members about the impact of forward?” around the UK: two UK-wide, informing this discussion through their classes. I am working for three in England and one each their specialist knowledge and the Scottish Lipreading Strategy in Scotland, Wales and Northern experience

September 2014 | www.rcslt.org Bulletin 11

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does and are looking at what you do simply in terms of what you cost.

Count the money It is important that you fully understand the Cuts 2014: You tell savings required by your organisation as a whole and from your service in particular. Ask how the changes proposed will meet us about the eff ects the local priorities and patient need, as well as the needs of commissioners. Understand the rationale behind the decision to reduce on your services your budget. Establish the fi gures, both in terms of how much your service costs and the income you bring in to your organisation. Do these fi gures match what you have been presented Steven Harulow looks at the results of the with in the consultation? If no fi gures have 2014 RCSLT cuts survey and ways forward for been provided, ask to see them. those facing funding reductions You know what your service does better than anyone else, so make sure your decision-makers are aware of the income you generate and the money you are already saving. Look at the Department of he RCSLT’s third RCSLT CEO Kamini Gadhok. Health’s Quality, Innovation, Productivity survey on the eff ects Services also need to act quickly to ensure and Prevention website (http://tinyurl. of fi nancial cuts, in local union representatives are aware of com/9rnzfxp) for examples of the way other May 2014, shows the situation, particularly if staff are under teams have reported their effi ciency savings. speech and language threat of redundancy or downgrading, or therapy services there are other changes to their terms and Question the clinical evidence are continuing conditions. It is very important to examine the clinical to lose posts, are basis behind any proposed budget decisions. facing a reduction Start the dialogue Have your decision-makers taken into in the banding of staff that remain, and are Th e fi rst thing to remember is not to panic. account the local population needs in havingT to restrict the services they provide We all know public sector fi nancial cuts are their decision to reduce posts and limit the in order to save money. All this at a time of inevitable, but the fact your organisation provision of services? increasing demand for speech and language has asked you to take part in consultation “We know of a recent example where therapy services. means you have opportunity to at least a decision to reduce children’s services As with our 2012 survey, your feedback partly infl uence the fi nal decision. was based purely on an analysis of local tells us that ‘service effi ciencies’ have Kamini adds, “It is vital that you keep deprivation to predict future levels of moved beyond saving money on your back lines of communication open during any speech, language and communication needs offi ce functions and are having a real impact change process, so you can discuss the [SLCN],” Kamini says. on your service users. In light of these implications of decisions made and be clear “While deprivation is one indicator of results and the RCSLT’s activities to support about the impact they will have on patient/ the prevalence of SLCN, this measure alone services under threat, this article looks at service user outcomes. How you infl uence fails to account for specifi c needs, such as some of the steps you can take when faced and the tactics you use are particularly specifi c language impairment and autism with funding and workforce challenges. important. Decision-makers are probably spectrum disorders.” not fully aware of what your service actually NHS and upper-tier local authorities Contact the RCSLT Th e RCSLT, while not able to enter specifi c negotiations on local pay and conditions, does have a wealth of resources you can use “We are unable to provide to help you in your negotiations. We are very keen to help you, so make sure you contact the full range of support the RCSLT (tel: 020 7378 1200) as soon as you fi nd out that your service is under threat. Over the past few years, we have engaged that we had previously with several services and found that face- to-face meetings can be very helpful. provided.” “However, we are very dependent on you telling us what is happening locally – either in your own or neighbouring services,” says

September 2014 | www.rcslt.org Bulletin 13

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have had a statutory duty to produce an ■ Th ere is a risk to the safety of service users. annual joint strategic needs assessment ■ Th e service provided would be detrimental (JSNA) since 2007. Th is analyses the health to or of no benefi t to service users. needs of populations to inform and guide ■ Th e service provided/not provided would commissioning of health, wellbeing and expose the therapist to risk of reference to social care services within local authority the Health and Care Professions Council. areas. Have your decision-makers taken full ■ Th e service provided/not provided would account of your region’s JSNA in predicting breach the therapist’s duty of care. future demand for your services? If not, this Visit: http://tinyurl.com/m2nrtgj 44 RESPONSES: is an area your team can investigate further England 68.2% to challenge their assumptions. Clinical leadership counts Scotland 9.1% Local decision makers are looking to make Wales 18.2% Mandate for quality instant savings in staffi ng, their biggest cost Northern Ireland 4.5% Th e failings in care standards at Mid centre. Th is has resulted in the downgrading Staff ordshire NHS Foundation Trust and of senior clinical leadership posts across all Who are you employed by? Winterbourne View Hospital are still high of the allied health professions. Remind your NHS 85.7% on the Government’s healthcare agenda and decision makers that clinical specialists are Local authority 8.6% are continuing to drive the focus on quality. an essential long-term resource for further School 5.7% In this light, the Department of Health service innovation and improvement. Th ey ‘Mandate to the NHS Commissioning Board are responsible for staff supervision and (NCB)’ is a very powerful infl uencing tool. continuing professional development, to It sets out the objectives for the NHS and ensure patients receive the best practice in highlights areas of health and care where care. Th ey minimise risks, improve outcomes government expects to see improvements. and lead developments in research and According to the Mandate, all providers service delivery. will be, “legally required to publish to According to Kamini, “Th e role of highly- account for the quality of their services”. specialised clinicians is critical within the It also makes reference to the need to NHS to enable the eff ective development of promote research and innovation through skills, knowledge and expertise to support the creation, diff usion and adaption of good more junior SLTs. Loss of these posts will Which client groups do you serve? practice. result in poorer patient outcomes, for Children only 60% Importantly, the Mandate talks about example longer stays in hospital. Without the Adults only 20% leading the continued drive for effi ciency skills and knowledge of senior clinicians the Children and adults 10% savings through the QIPP programme and profession will be stripped of a signifi cant Adults with discusses the statutory duty with regard to specialist resource.” learning diffi culties 10% the planning and delivery of education and training. Visit: http://tinyurl.com/amrjqzp Cuts toolkit Th e RCSLT’s Giving Voice campaign has Know your duty of care helped members to demonstrate how speech benchmark against which to gauge decisions Professionalism is also very high on the and language therapy makes a diff erence you are being asked to make. You can also national agenda following Mid Staff ordshire to people with SLCN, their families and the use the ‘RCSLT briefi ng for decision-makers’ and Winterbourne View. Remember this wider society. As part of the campaign we to give an insight into the short- and long- in your negotiations. Th e RCSLT requires have produced a ‘cuts toolkit’ (www.rcslt. term impact of poor budget decisions. members to challenge, risk assess and org/members/cuts_toolkit/intro). Th e toolkit also provides information on appraise funding levels, and identify and Th is contains two key documents. how to engage and infl uence local budget articulate risk with relevant partners. In Th e ‘RCSLT statement on the roles and holders, and how your services users and particular, this must happen where, due to responsibilities of registered practitioners’ their parents and carers challenge cuts. the proposed funding levels or models of is an important statement that reiterates It will also direct you to RCSLT resources, service: your professional obligations. It is a useful including: ■ Th e ‘Matrix Report: An economic evaluation of speech and language therapy’ “We have lost the most ■ Giving Voice campaign delivery toolkit – includes templates for letters to decision makers and advice on how to explain experienced therapists in the initiative to your colleagues and communications teams. the recent restructure.” ■ Manager’s Resource Pack – provides information to infl uence commissioners and others, focusing on achieving fi nancial balance. It includes information relating

14 Bulletin September 2014 | www.rcslt.org

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Do you anticipate a cut in your budget and/or income in 2014/2015? Yes 55.8%

Have you had a cut in your budget If yes, by whom? Health and/or income in 2013/2014? 82.6% Local authority Yes 52.3% 17.4% Service abolished 7.7% School 17.4% Service reduced in scope (eg loss of universal provision) 42.3% By what percentage has your budget Service rationed (eg age bar) 7.7% has been cut? Eligibility threshold raised 19.2% Average: 10% Waiting lists increased 38.5% Range: 2-30% Waiting times increased 46.2%

Has this aff ected your service users? Are these cuts one-off Yes 79.3% or recurrent? One-off 30.8% How? Recurrent 69.2% ► Reduced clinical specialist/lead time ► General follow-up carried out by Has this cut had a assistant no longer available negative impact on your ► Now only able to see clients once a service? week (maximum) and have less time to Yes 92.3% plan and provide best therapy possible ► Longer wait for initial appointment and If yes, by whom? How? Posts cut follow up Health 86.4% 61.5% Posts frozen ► Longer follow up waiting times Local authority 13.6% 19.2% Posts downgraded ► Increase in time taken to access speech School 18.2% 46.2% and language therapy ► Lack of access to rehabilitation services ► Loss of specialist expertise, knowledge and therapy ► Poorer quality SEA2 (statement) reports being written ► Prolonged periods nil-by-mouth ► Dysphagia service cut – service users advised to seek GP advice instead

to the risks of not providing speech and Essential training East Midlands and North West. We have language therapy. You are not alone in facing these plans to roll out the developing package in ■ Quality Self-Evaluation Tool (Q-SET) – challenges. Th e East Midlands Local other areas soon. You can watch the East allows teams to evaluate the quality of the Education and Training Board has funded Midlands RCSLT Hub workforce planning services they provide and compare with the development of an informative and session at: http://tinyurl.com/mxos9rs others of a similar type. practical training programme to support David and Kamini will present a session ■ Commissioning Resource Manual SLTs and their leaders in all settings, as on the training at the RCSLT Conference in – supports leaders in the planning, they face major fi nancial, service and Leeds, in September. Th ey will describe, commissioning and delivery of speech workforce challenges. Th e programme aims in clinical business terms, what are safe, and language therapy services in line with to help SLTs get a better understanding of productive and value-for-money speech government and local priorities. the principal drivers and nature of change, and language therapy services. Th ere will ■ Quality standards for schools as and enable them to have more infl uence also be case studies, including, ‘how to commissioners of speech and language and control over the design and delivery of make a clinical business case’ and ‘advanced therapy services – highlights the quality clinical services. job planning: how to make the most of, and standards that are priorities for schools to Speech and language therapy services justify, the expert clinical specialist role’. adhere to in the commissioning process. have been working together at a RCSLT Frontline SLT leaders who have worked with ■ Policy statements and position papers – Hub level to develop this resource. Our the RCSLT programme will illustrate their tools to infl uence the commissioning and workforce planning and development practical examples of how they have built a organisation of services. adviser, David Amos – who was human bridge between knowledge and practice, in ■ RCSLT list of outcome measurement tools resources director at two London teaching order to understand, infl uence and control – maps outcome measurement tools/ hospitals and the deputy HR director the challenges they face. To book your systems and highlights where they were for the English NHS at the Department conference place, visit: http://tinyurl.com/ useful. of Health – has delivered training in the k3ub7cp ■

September 2014 | www.rcslt.org Bulletin 15

012-014_Feature_Cuts.indd 15 18/08/2014 14:44 FEATURE PAEDIATRIC NEURO-ONCOLOGY

An eff ective model of neuro- oncology care

Antonia Kilcommons reports on a pioneering rehabilitation service for children with brain tumours

rainbow is a tumours are the second most common rehabilitation service group of cancers in children (exceeded only for children with by leukaemia). Th ey account for a quarter of brain tumours, based all childhood cancers (CRUK, 2014). Each at Addenbrooke’s year, around 350 brain and CNS tumours Hospital in are diagnosed in children aged 0-16 years. Cambridge. Launched About a third of these occur in children in September 2013, under three years of age. Brain tumours the service has generally have a better outcome in children been funded for three years through the than in adults, but children are often collaborationB of three local charities1. unwell for months prior to diagnosis and a Th e multidisciplinary service is part of prolonged period between symptom onset Addenbrooke’s paediatric haematology and diagnosis is associated with increased and oncology team, and works closely with morbidity (Wilne et al, 2010). inpatient teams, as well as with local teams Paediatric brain tumours diff er from across the region. adult tumours in some important respects. particularly with speed of processing (Wilne I took up my new full-time SLT post Approximately 60% are infratentorial and et al, 2013). It is important that professionals within the Brainbow Service at the arise in the posterior fossa region, including recognise these issues and implement beginning of September 2013. Th e service the cerebellum and/or brainstem (CRUK, supportive strategies when looking at includes a physiotherapist, occupational 2011). Th ey can typically present with ongoing educational needs. therapist and clinical psychologist, diffi culties in coordination, hemiparesis with overall leadership from Consultant and cranial nerve palsies, contributing to Th e role of the SLT Paediatric Oncologist Dr Amos Burke. A swallowing diffi culties and dysarthria. Neurological dysphagia and communication project coordinator supports the overall Survival rates have improved considerably diffi culties are wide ranging in children development and management of the over the past decade. Th is may be due to with brain and CNS tumours – attributable service and clinical team. As part of my factors including improvements in imaging, to diff erences in histology, size, shape and role, I continue to link professionally with a multidisciplinary approach, improved location of the tumour, and the nature of my paediatric colleagues in the larger neurosurgical techniques, more precise surgery and treatment regimes. Th e impact Addenbrooke’s speech and language radiotherapy and more intensive and on speech, language and communication therapy team for clinical supervision, combined chemotherapy options. development can depend on the age continuing professional development Rehabilitation and support for of the child at diagnosis and length of opportunities and joint clinical working. reintegration into education and society hospitalisation. are essential. Children and young people Th e role of the SLT can be a signifi cant Brain tumours treated with chemo-radiotherapy for brain one in the case of posterior fossa syndrome

Brain and central nervous system (CNS) tumours often develop cognitive diffi culties, (PFS), a collection of neurological, IMAGES GETTY

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Th e Brainbow Service (www.cuh.org.uk/brainbow) aims to:

■ Help children with brain tumours reach their full potential. ■ See every child and family prior to any surgery for suspected brain tumour. The Service coordinates assessments by team members to obtain a baseline of each child’s existing abilities. This involves gathering a case history of their pre-morbid communication function, as well as an eating and drinking history. The SLT will recommend appropriate management strategies where dysphagia symptoms or communication diffi culties exist. ■ Follow up all children post-surgery, working with the inpatient multidisciplinary teams to guide and assist with rehabilitation. ■ Ensure clear communication between diff erent professionals involved in each child’s care, coordinating transition between hospital and teams closer to home. ■ Review all children treated for a brain tumour who are in long-term follow up. Children and their families attend clinics at Addenbrooke’s to establish current level of functioning and discuss specifi c areas of diffi culty. Individual profession-specifi c assessments identify the clinical needs and draw up a detailed rehabilitation plan with agreed functional goals. Children may be off ered further input from the Brainbow Service or we will liaise closely with local teams. ■ Provide key data on clinical and service outcomes using Therapy Outcome Measures, Paediatric Evaluation of Disability Intervention and Goal attainment Scales. We ask parents and children to complete the Paediatric Quality of Life Inventory (PedsQL- Core scale) and the Peds QL multidimensional fatigue scale as a measure of health- related quality of life (Varni, 1998-2014). The project also uses patient satisfaction questionnaires to provide a qualitative measure of the service.

rarely the same as before surgery (Steinbok diagnosis. Magnetic resonance imaging et al, 2003). Th ere are often ongoing remains the most widely used means of speech and language therapy needs, with imaging. Once a tumour is confi rmed, the signifi cant long-term impairment in severe main options for treatment involve partial or cases. Children may present with residual complete surgical resection, chemotherapy diffi culties aff ecting nasality, pitch and and/or radiotherapy. prosody of speech as well as wider higher- level language diffi culties and executive Th e Brainbow Service function aff ecting processing, sequencing With many children diagnosed with and memory. childhood brain tumours achieving Children with PFS may require periods of long-term survival (65% overall fi ve- non-oral feeding secondary to neurological year survival) (Peris-Bonet et al, 2006) involvement, treatment regimes and the consequences of both the tumour and behavioural issues (Morgan et al, 2008). treatment are often considerable. Decisions Th e SLT will be closely involved in assessing around management of childhood brain behavioural and psychosocial symptoms swallow safety and supporting the gradual tumours often require a careful balance that can occur in children following introduction of oral intake throughout between optimising chances of survival surgical resection of posterior fossa tumours the child’s recovery and during ongoing versus long-term morbidity. (Pearlman et al, 2008). Th e impact of rehabilitation. Th ere is increasing recognition of the PFS can be traumatic for both the child late eff ects of treatment, often resulting in and family and can result in long-term Integrated care pathway physical, endocrine, cognitive, behavioural, rehabilitation needs in severe cases. Addenbrooke’s Hospital (Cambridge emotional and communication diffi culties One of the most distressing post-surgical University Hospitals NHS Foundation Trust) is (Anderson et al, 2001). Th ese life-long symptoms is the onset of cerebellar mutism the regional centre for paediatric oncology2. chronic conditions can have an adverse – a severe incoordination of the volitional Th e hospital treats about 30 new cases of eff ect on functional outcomes. aspects of speech (Parent et al, 2011). Th is childhood brain tumours each year and in the Currently, access to rehabilitation can occur immediately postoperatively or region there are almost 200 children who are for children with brain tumours varies present within the fi rst week. Speech and in long-term follow up over the past 10 years. across the region and approaches to language therapy support is key during All children admitted with a suspected rehabilitation are inconsistent across the this period to explore alternative means of brain tumour enter the ‘Integrated Care UK (NICE, 2014). Brainbow aims to help communication and to support the gradual Pathway for Paediatric Brain Tumours’. improve access to a more standardised and return of speech, often over days, weeks or Th is provides a standardised model of care coordinated rehabilitation approach that months. Th ere have been no cases reported that coordinates the input of medical and can be tailored for all children with brain where a child with cerebellar mutism does allied health professionals involved in each tumours across the region. Each child with not regain functional speech, although it is child’s care up to the point of a confi rmed a newly-diagnosed brain tumour will have a

September 2014 | www.rcslt.org Bulletin 17

016-018_Feature_Kilco.indd 17 18/08/2014 14:45 FEATURE PAEDIATRIC NEURO-ONCOLOGY

From left to right: Carole Hughes (Anna’s Hope), Kate Stephens (physiotherapist), Katie Johnson (occupational therapist), Antonia Kilcommons (SLT), Rob Hughes (Anna’s Hope).

can be recognised and developed in other centres around the UK. ■

Antonia Kilcommons, Specialist SLT, Brainbow Service, Addenbrooke’s Hospital. Email: antonia.kilcommons@addenbrookes. nhs.uk

References & resources

Anderson DM, et al. Medical and neuro-cognitive late eff ects among survivors of childhood central nervous system tumours. Cancer 2001; 92: 10, 2709–2719. Cancer Research UK. Childhood Cancer Incidence Statistics 2014. http://tinyurl.com/kw2zzox Cancer Research UK. Brain and other central nervous system tumours – UK incidence statistics 2011. http://tinyurl.com/l6vvhqe standardised approach to assessment and be to gather the necessary evidence to prove off ered a clear programme of rehabilitation the service can make a real diff erence to Morgan AT, et al. Pre and post-surgical dysphagia outcome associated with posterior fossa tumour in tailored to their needs. Timely intervention children diagnosed with a brain tumour, children. Journal of Neuro-Oncology 2008; 87:3, will maximise the opportunity for each child improving long-term functional outcomes 347-54. to re-integrate back into society, access and quality of life. Parent E, Scott L. Paediatric posterior fossa education and minimise the likelihood of Although the service is in its infancy, it is syndrome: Nursing strategies in the postoperative adulthood dependency. clear there is a much-needed role for speech period. Canadian Journal of Neuroscience Nursing and language therapy in this specialist fi eld. 2011; 33:2, 24-31. Future developments It is exciting to be part of such a pioneering National Institute for Health and Clinical Excellence. We hope the Brainbow Service will continue service from the outset and I hope we will be Support for commissioning for children and young as an NHS-funded service after its initial able to share the fi ndings from this project people with cancer. February 2014. three years. However, it will be essential – providing an eff ective model of care that Pearlman LS, McVittie A, Hunter K; Discharge management of an adolescent female with posterior fossa syndrome: A case report. Canadian Toby’s story Journal of Neuroscience Nursing 2008; 30:3, 14-20. Peris-Bonet R, et al. Childhood central nervous system tumours-incidence and survival in Europe Toby was diagnosed with a medulloblastoma at 12 years of age. He underwent full surgical (1978-1997): report from Automated Childhood excision of the tumour and commenced a treatment protocol involving radiotherapy and Cancer Information System project. European chemotherapy. He met all members of the Brainbow Service team pre-surgery for baseline Journal of Cancer 2006; 42:13, 2064-2080. assessments. Follow up took place during his acute admission and as an outpatient during Steinbok P, et al. Mutism after posterior fossa ongoing treatment. tumour resection in children: incomplete recovery Post-surgery, Toby developed Posterior Fossa Syndrome presenting with marked on long-term follow up. Paediatric Neurosurgery agitation, poor secretion management, very limited communication and signifi cant 2003; 39:4 (179-83), 1016-2291. ataxia. We kept him nil by mouth due to the risk of aspiration and provided nutrition via a Varni JW. The Peds QL Measurement Model for the nasogastric tube until the insertion of a percutaneous endoscopic gastrostomy. Frequent Paediatric Quality of Life Inventory 1998-2014. re-assessment and intervention took place as his swallow function began to improve – www.pedsql.org provided jointly by the Brainbow Service – to optimise the functional skills and positioning Wilne SH, et al. The diagnosis of brain tumours in needed for safe swallowing and resuming oral intake. Toby’s family required close support children: a guideline to assist healthcare. Archives in helping them understand the nature of his swallowing diffi culties. of Disease in Childhood 2010; 95:7, 534. His speech began to return relatively quickly post-surgery. As he developed stronger vocalisations, single words and short phrases began to emerge and Toby also used some Wilne SH, et al. Identifying brain tumours in children and young adults. British Medical Journal 2013; 347; basic gestures to support functional communication. We supported his parents in how 7928, 27. to maximise Toby’s communication while minimising frustration. Prior to discharge his communication returned to its pre-morbid level. Notes: Toby continued to have regular physiotherapy and occupational therapy from the 1 Anna’s Hope, Camille’s Appeal and Tom’s Trust – Brainbow Service during his radiotherapy treatment. He presented with low mood during all of whom have had personal experience of having treatment and saw the Brainbow clinical psychologist for further emotional support. children with brain tumours He also saw the Brainbow SLT for further swallow reviews as an outpatient because he 2 Covering Cambridgeshire, Peterborough Suff olk, presented with new swallowing concerns with fl uids, infl uenced by his treatment. Norfolk, Bedford, Essex and Hertfordshire The Brainbow Service will continue to review Toby up to the age of 16 with close Acknowledgements liaison with community teams and his secondary school. Neuro-cognitive and language The author is grateful to her Brainbow colleagues assessments may take place in the future to support his ongoing education, given the likely and SLT Sophie Phillips for their helpful comments impact of his treatment on his future learning potential. and guidance in producing this article

18 Bulletin September 2014 | www.rcslt.org

016-018_Feature_Kilco.indd 18 18/08/2014 14:45 ;

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To order direct or to see more details on these and our other speech and language resources go to www.speechmark.net, or email [email protected] and don’t forget to quote B15 to receive your 15% discount 28 BulletinBulletin MayMay 2014 | www.rcslt.orgwww.rcslt.org

BUL.09.14.019.indd Sec1:28 18/08/2014 10:14 FEATURE SUB HEAD XX XXXXX Victoria Emma Joff e & Pagnamenta

Vicky Joff e and Emma Pagnamenta look at we may perceive that service the issue of explaining treatment options users, family members and carers may not respond well and the evidence available to uncertainties. In the best- case scenario, we would have plenty of evidence to show an intervention is safe, eff ective and effi cient. How many of us can say this confi dently to our clients? Not only do many of us face diffi culties accessing the latest evidence and keeping up to date, but we also have the challenge of working with complex cases, often requiring intricate individualised interventions in the context of gaps in our evidence base.

Informed discussions Th ose that have done their Making sense of it all own research may ask why you are not employing an intervention that they know vidence-based evidence is as key to service someone else has received, the practice is a common users as it is to professionals. new intervention described in thread underpinning Interestingly, Alston et al a newspaper or the treatment Emost of our (2012) suggest that patients discussed on a blog or website. activities and discussions as view evidence for what Th ese situations can be diffi cult, may not know about every professionals. An essential part works as more important especially when you, as the intervention out there, but you of our role is to inform service in healthcare than their therapist, do not know about can certainly commit to fi nding users and their carers about the provider’s opinion and their the alternative interventions out more information about the treatment choices available, own preferences. they are discussing or if the treatment options suggested so that they understand and A question often asked is, intervention you have chosen by your clients. Similarly, support the intervention ‘Why has this happened?’ has a limited evidence base. there may be occasion where provided, and to ensure they To answer this we need to Th ese scenarios are likely a recommended intervention are partners in the decision- draw upon a wide-ranging to increase as the amount lacks a strong evidence base. making process. evidence base, investigating of information in the public In this case too, it is vital to be Service users and their the aetiology of diff erent domain grows. For example, a transparent about this with families have the right to conditions, risk factors and new initiative, ‘patientACCESS’ your clients and their families, services based on the best diagnostic features. Often, enables service users to request and explain why this is the best available evidence. In some there is no straightforward journal articles for a minimal current treatment available. areas, we have robust evidence answer. Many clients processing fee. Th e aim is to of good practice; in others, we experience multifaceted provide the means for informed Eff ectiveness and have less evidence on which and complex diffi culties discussions between service effi ciency to base our decisions. In either with speech, language users and those providing their It is not only service users case, service users and their and communication, and care. Similarly, Th inkWell who ask about the evidence carers may approach you as the swallowing that we cannot is a novel online research base underpinning our work. ‘expert’ after having done their account for by a simple cause- programme that aims to help Decision makers – such own research, and may want to eff ect relationship. Frequently, the public understand health as service purchasers and ask you about the approaches there is also little consensus information and encourage commissioners, schools, clinical they have come across. regarding aetiology and participation in online research managers, local authorities, importantly, the progression studies. other professionals and third Challenging questions and long-term impact of a We need to be able to give sector organisations – aim to Many of you will be able to disorder is often unknown clear answers and provide purchase the most eff ective and recall at least one example (Law et al, 2010). reassurance to anxious effi cient service, and will look to where somebody has Clients may also ask, ‘What carers and family members. you to provide answers. challenged you about the work is the evidence that this is Honesty and openness in these It is useful to think about the you are doing. Remember, going to work? As clinicians, scenarios are paramount. You level of detail these audiences

20 Bulletin September 2014 | www.rcslt.org

020-21_research_column.indd 20 18/08/2014 14:45 COLUMN Research and Development Forum

Table one: Examples of the online support available

RCSLT Commissioning ▶ http://tinyurl.com/3lc94sc Resource Manual – provides a synthesis of the evidence that includes epidemiology and the evidence for interventions

Guideline documents ▶ RCSLT publications: http://tinyurl. provide useful com/pr4wq8a summaries of evidence ▶ NICE guidance: www.nice.org.uk/ guidance ▶ National Clinical Guidelines for Stroke http://tinyurl.com/ox69l77

Tools in the public ▶ The What Works’ searchable domain can help database of interventions for frame discussions with children with SLCN: http://tinyurl. commissioners, settings com/px268kd and parents ▶ The Best Evidence Encyclopaedia UK (reviews of evidence-based educational programmes): http:// tinyurl.com/q6queqa ▶ ‘The Early Intervention Foundation Guidebook’: http://tinyurl.com/ lcbl63x

ILLUSTRATION BY Ben Mounsey The Bulletin ‘In the ▶ RCSLT journal collection: http:// journals’ section tinyurl.com/pdvqtxg are interested in and how they urge all of you to do. You will signposts readers to ▶ OpenAthens: http://tinyurl. may diff er. For example, a then have information about the latest research and com/2d88mr clinical commissioner might what is eff ective in your setting makes the most of want to know how recent the and service. Even if there is the journal access the evidence is on which you are then a gap in the published RCSLT journal collection basing your model of service research evidence, you will have off ers alongside other delivery or the outcomes for important information to share initiatives, such as OpenAthens the local population. Another with others. professional could be more Local data is a particularly An outline of ‘red ▶ Bishop D. Neuroscientifi c interested in long-term important part of your toolkit fl ags’ to frame your interventions for dyslexia: Red trajectories for a particular in the current climate of discussions with service fl ags. 2012. http://tinyurl.com/ condition or information about austerity. You need to be ready users who suggest their bspztql own treatment options the intensity of intervention for questions around the level required to ensure eff ectiveness. of service you provide and the resources available. You may and build evidence where it is You’re not alone need to seek guidance from your non-existent are complex, time References & resources We need a toolkit to be able to managers in order to provide a consuming and diffi cult. Th ey

access, appraise and keep up to clear rationale for why you are are also essential to being an Alston C, et al. Communication with date with the latest evidence. off ering a particular model of eff ective therapist. Every SLT patients on health care evidence. You will feel more confi dent if service delivery or intensity of faces these same challenges, Institute of Medicine of the National you have a good knowledge of therapy, particularly if there is so look around you, build Academies 2012 http://tinyurl.com/ the evidence base. Being part of evidence for the eff ectiveness of knowledge and let’s reduce the pnysghs a professional community, such a higher level of provision than uncertainty collectively.■ Law et al. Speech and language therapy as a clinical excellence network, you are able to provide. Don’t be interventions for children with primary speech and language delay or disorder a local group or your RCSLT Hub afraid to ask these questions; it Professor Victoria Joff e, RCSLT (Review). The Cochrane Collaboration. can help keep abreast of new is far better to be prepared when Councillor for Research and 2010 knowledge. Table one provides others ask them of you. Development. Email: vjoff e@ Thinkwell. The International Network further examples of support Our endeavours to embed city.ac.uk Twitter @vjoff e for Knowledge about wellbeing. Putting online. our clinical practice with Dr Emma Pagnamenta, RCSLT patients at the heart of research. 2014. Collecting local outcome data appropriate evidence; critically Research Manager. Email: http://tinyurl.com/po8k4wp is invaluable and something we appraise the evidence available [email protected]

September 2014 | www.rcslt.org Bulletin 21

020-21_research_column.indd 21 18/08/2014 14:46 FEATURE RCSLT OUTCOME MEASURES PROJECT

o what are outcomes and outcome measures? Th is is not a straightforward question, Outcomes nor is there a straightforward answer. Th ere have and outcome been a myriad of papers written on the Ssubject (Fratali, 1998; Donabedian, 1980; 2005). For those less familiar with the measures concept and how it relates to services, this is a brief overview. Outcomes mean diff erent things to diff erent people, which is why there is confusion. Th ey are not diagnostic, nor are they descriptions of service processes, Gaye Powell and Dominique Lowenthal or assessments of need, but they are present an update on the RCSLT absolutely key to demonstrating the Outcome Measures Project ultimate eff ectiveness of care (John, 2011). Clinically, therapists tend to think of the achievement of intervention goals as outcomes – ie, the focus being the ILLUSTRATIONS BY Davor Pavelic remediation of the presenting diffi culty, for example, improved intelligibility, increased word fi nding ability, or moving from puree similar and include increased healthy life measure (indicator), should refl ect the to solids. As such, these may be described expectancy, reduction in health inequalities impact speech and language therapy has as clinical level, or short-term outcomes. (DH, 2012), treatment eff ectiveness, had on enabling an individual’s real life Historically, and in the absence of anything wellbeing, prevention, independence, functioning. For example, increasing more tangible to provide explanation and achievement, and service user experience intelligibility may enable a child to play with evidence for expenditure (Raleigh, 2011), (DH 2013; Scottish Government, 2013). peers more easily, increase confi dence and commissioners and budget holders have Th ere are also regional and local outcomes their level of integration and participation. focused on ‘processes’ and countable that refl ect the local population needs and Voice therapy can enable return to work, ‘outputs’, such as waiting times, number of priorities more specifi cally. It is against reduce anxiety and dependency on treatments and discharges as ‘outcomes’. this multi-level collection of outcomes antidepressants, and increase wellbeing. that commissioners and budget holders are What is required is evidence of the Levels of outcomes seeking to commission speech and language improved level of functioning or other At a national level, outcomes are embedded services. indicator of change, before and after in policy and there are ‘ultimate outcomes’ How can we make explicit the causal intervention. For some outcomes it is easy to relating to health, social care and education relationship between what we do with see the causal link between therapy and the at a whole population level. While these are an individual and their family, and the outcome. For others, it may be less obvious, worded slightly diff erently in each of the eff ect this has on the ultimate policy level and diffi cult to defi ne over time (Deloitte, UK countries, the underlying concepts are outcomes? Th e outcome, and its subsequent 2011) – for example, the contribution to academic achievement, or reduction in reoff ending. “What is required is Project aims Th e RCSLT Outcome Measures Project is striving to arrive at a framework and core evidence of the improved set of outcomes and outcome measures for conditions and/or settings in two phases. level of functioning or other Phase 1 is focusing on identifying an existing outcome measurement tool that has a broad application across as many indicator of change, before care groups as possible, in order to begin gathering consistent data nationally. Th is and after an intervention” must have good reliability and validity, and meet as many of the 11 agreed criteria as possible (table one). Th is tool will be recommended for adoption by the profession

22 Bulletin September 2014 | www.rcslt.org

0022-024_Feature_Powell.indd22-024_Feature_Powell.indd 2222 118/08/20148/08/2014 14:4614:46 FEATURE RCSLT OUTCOME MEASURES PROJECT

THEORY OF CHANGE MODEL This is diff erent from a logic or business model that is descriptive in terms of listing required resources and countable outputs – which is what has been used historically, but which is not necessarily causal (Clark et al, 2004).

Activities Interim Outcomes Ultimate Outcomes What you do therapeutically Enable individuals to… Policy level

An example from work done to date is shown below:

Pre-school training packages and specialist speech and language therapy input

Activity Interim Outcomes Ultimate Outcomes Provision of tailored School staff , and wider School readiness training for school staff children’s workforce Children achieve to identify children with demonstrate clear educationally SLCN and understand understanding of duty of Children and families have typical development care of SLCN and risk a positive experience of services Indicators (evidence) Staff use strengths and needs profi le for all children Increased identifi cation and appropriate referral of children Targeted intervention is embedded in school plans

in the short term. Information from illustrate your theory of how and why of change in a similar way to clinical decision members and research to date has found what you do works, and the impact it has making, but at a higher level. very few measures which fi t the majority on service users’ real life functioning. It is It may depend on where your initial thinking of these criteria. Th ey are either focused on causal and provides an overview of how is focused and who you are devising it for. Th e one particular aspect, (EuroQol, 2014), are desired change is expected to come about by key is that having determined what activities/ not applicable across the age range or client visually linking activities (interventions) to interventions you deliver, the next step is to groups or are very lengthy to administer. outcomes. ask, “So what?” What you need is not a list of Th ere is no defi nitive starting point for the clinical level outcomes or goals referred to Th eory of change developing a theory of change model. You earlier, but the impact the achievement of these Phase 2 is running in parallel to identify could start with activities and work forwards will have on enabling the individual, family, existing or develop new valid and reliable or outcomes and go backwards. However, colleagues, and carers in day-to-day life. condition and setting-specifi c outcome justifi cations are required at each step – you measures. Th e RCSLT has recommended a have to articulate the hypothesis about Critical step theory of change model to help undertake why something will cause something else Th e next critical step is to show how this this task. Simply, it aims to help you (with evidence) and it maps the pathway translates into the ultimate outcomes of »

September 2014 | www.rcslt.org Bulletin 23

022-024_Feature_Powell.indd 23 18/08/2014 14:46 FEATURE RCSLT OUTCOME MEASURES PROJECT

LOGIC MODEL EXAMPLE

Inputs (structure) Process (what you do) Outputs (countable) OUTCOMES ■ Resources £££ ■ Therapy or intervention ■ No of treatments, ■ Staff numbers activities assessments, referrals ■ Equipment ■ Type of programme ■ Number of goals ■ Buildings ■ Training achieved ■ Skill mix ■ Service model ■ % consonants correct

concern to whoever is requiring information level of knowledge and confi dence about number of existing measurement tools about the value and contribution of speech using outcome measures and the degree of identifi ed, or currently being used by and language therapy. Th e explanation organisational and peer support available members and map these against the must be easily understandable and interim to promoting their work in practice. It is 11 criteria to help us move towards the outcomes require evidence and measurable therefore essential that we ensure there adoption of a tool in the short term. ■ indicators of the change. Th eories of change is support and understanding of outcome and logic models are not mutually exclusive measurement at individual therapist, team Dr Gaye Powell, RCSLT Outcome Measures and work very well together to provide and organisational levels. Ultimately, Project Manager. Dominique Lowenthal, robust arguments for changes in funding or the profession will need to arrive at a RCSLT Head of Professional Development. styles of service delivery. consensus on a core set of outcomes for each Email: [email protected] Many of the hubs and clinical excellence condition/setting and a number of core networks have already done some brilliant indicators for each. work on starting to develop models for Th at is not to say you cannot use any References & resources clinical specialities. An online theory local indicators you or your commissioner/ of change tool will soon be available to budget holder may require. At a national Clark H, Anderson A. Theories of change and logic enable you to develop models and access level there will be core evidence of the models: Telling them apart. Presentation at master templates for diff erent conditions impact of speech and language therapy that American Evaluation Association Atlanta, Georgia with details of what others have already is consistent, comparable and meaningful. November 2004. http://tinyurl.com/kuyf8am generated to help take this work forward. Remember, the reason behind the project is Deloitte, 2011. Hit the ground running: Five critical Finally, research has identifi ed facilitators to ensure the right services for individuals success factors in contracting for outcomes. http:// tinyurl.com/k8sa7t4 and barriers to the adoption of outcome with speech, language, communication Department of Health. The Public Health Outcomes measures by allied health professionals, of and swallowing needs are available to be Framework for England, 2013-2016. http://tinyurl. which we need to be mindful (Duncan and commissioned now and in the future. com/d45acrg Murray, 2012). Th ese include professionals’ In the next Bulletin we will present a Department of Health. Health and social care outcomes frameworks. 2013. http://tinyurl.com/ Table one: Th e 11 criteria agreed for existing outcome measures at the p427ce4 October 2013 and subsequent RCSLT Hub meetings Donabedian A. Explorations in quality assessment and monitoring. Volume 1: The defi nition of quality and approaches to its assessment. 1st ed. Ann 1. Is it reliable? Arbor MI: Health Administration Press, 1980. 2. Is it valid? Donabedian A. Evaluating the quality of medical care. Milbank Quarterly 2005: 83:4: 691-729. 3. Is it suitable across key client groups? Duncan EAS, Murray J. BMC Health Services 4. Is training available? Research 2012, 12:96 http://tinyurl.com/qa8dzvw 5. Is it easy to access? EuroQol. What is EQ-5D? 2014 www.euroqol.org 6. Is it easy and quick to use? Fratali C. Measuring outcomes in speech-language pathology. 1st ed. New York: Thieme, 1998. 7. Is it compatible with existing tools? John A. 2011. Therapy outcome measures: Where 8. Can it work with the main areas of SLT practice and current priorities? are we now? International Journal of Speech- Language Pathology 2011; 13:1, 36-42. 9. Can it capture long term/ultimate outcomes? Raleigh VS. Pick ’N’ Mix: An introduction to choosing 10. Can it take account of diff erent stakeholders’ priorities for outcomes? and using indicators. The King’s Fund. 201. http:// 11. Can it capture the range of service elements provided: interventions, training, tinyurl.com/nd6yjdv adaptations to the environment, universal level etc? Scottish Government. National Outcomes. http:// tinyurl.com/kwa6ebd

24 Bulletin September 2014 | www.rcslt.org

0022-024_Feature_Powell.indd22-024_Feature_Powell.indd 2244 18/08/2014 14:47 ROYAL COLLEGE OF SPEECH AND LANGUAGE THERAPISTS NOTICE OF 2013/2014 ANNUAL GENERAL MEETING

Notice is hereby given that the Annual General Meeting of the Royal Some important changes to the RCSLT’s constitution are going to College of Speech and Language Therapists will be held on Tuesday be proposed to members at the AGM as a result of the ongoing 16 September 2014, at 6.00 pm at University House, University of governance review. The AGM papers therefore include a background Leeds, LS2 9JT. (This is a repeat of the calling notice that appeared message from the Chair of RCSLT, following on from her message in in August Bulletin). the May 2014 Bulletin. All members are welcome to attend the AGM. Papers for those members who have requested to receive formal notices in hard copy were posted on 22 August. Please contact the The AGM agenda, minutes of the 2013 meeting, background notes, RCSLT Company Secretary if you have not received them. booking form and proxy voting form will be available to download from www.rcslt.org/about/howwearerun/council If you wish to send in a proxy form, it must be received at RCSLT no later than 6pm on Friday, 12 September. Proxies received after that time will not be counted. Please note that: • Only full members are entitled to vote at the AGM • Proxy votes are only counted if a poll is called for at the meeting; they are not counted with a show of hands

September 2014 | www.rcslt.org Bulletin 29

AGM.inddBUL.09.14.025.indd 1 Sec1:29 14/08/201418/08/2014 12:0610:24 Autism and communication Tuesday 25 November 2014, Hilton Hotel, Reading

This conference will discuss the types of communication diffi culties that people on the autism spectrum can experience, as well as the various tools and strategies to help support verbal and pre-verbal communication.

Key presentations: Seminars include: Don’t miss the early > the practicalities of delivering effective booking rate Understanding and supporting communication in > therapy for children with autism – register by people on the spectrum: making therapy irresistible 26 September Gina Davies, Specialist Speech and Language > reasonable adjustments to aid 2014! Therapist and Sleep Counsellor communication in specialist hospitals and residential settings > The next generation of Social Stories™ Carol Gray, President, The Gray Center for > understanding and using Intensive Interaction Social Learning and Understanding. > using IT as a communication aid – useful apps and programs.

www.autism.org.uk/conferences/communication2014 Email: [email protected] | Tel: 0115 911 3367 @networkautism

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26 Bulletin September 2014 | www.rcslt.org

BBUL.09.14.026.inddUL.09.14.026.indd SSec1:26ec1:26 18/08/2014 11:53 FEATURE Bulletin remembers those who have SUBdedicated HEAD XX XXXXX their careers to speech and language therapy Obituary REMEMBERINGREMEEMMBERING

Jeri Logemann 1942 – 2014

Jeri Logemann, Professor of Communication In developing the ‘cookie Sciences and Disorders at Northwestern swallow test’, later known as University and Professor of Otolaryngology the modifi ed barium swallow/ and Neurology at the Feinberg School of videofl uoroscopy study of Medicine, died on 19 June 2014. swallowing, Jeri revealed the potential Jeri grew up and lived her life in the for studies into swallow physiology and Chicago area attending Northwestern changes with age, swallowing disorders University as an undergraduate, a masters and therapy interventions, which she was She was also a hugely joyous person with and a PhD student. She spent her working later to exploit to the full. It was the fi rst a love of theme parks and rides. It is no life at the university, researching and tool available to assess oropharyngeal coincidence that during one of Jeri’s terms of teaching within speech pathology and swallowing, providing an image that offi ce as ASHA president the convention took directing the voice, speech, and language allowed an analysis of swallowing and place in Orlando, with the opening evening service and swallowing centre within the impaired swallowing. It remains the in Disneyworld. hospital. gold standard against which all other She enjoyed parties and hosted Christmas Jeri was one of the most signifi cant assessments for swallowing are compared parties in her beautiful home, which was international fi gures in speech and language and is utilised extensively as an outcome meticulously, extensively and extravagantly therapy/pathology in the past 30 years. measure for therapy intervention studies. decorated for the holidays. In addition to Her immense contribution was primarily in Th rough meticulously designed and Christmas, Jeri loved Halloween when she developing theoretically-driven assessments executed studies, Jeri contributed to could add themed decorations both inside and management for people with swallowing our understanding of how the tongue and outside her home. diffi culties. Th e publication of the fi rst manipulates and holds the bolus, how Jeri enjoyed travel enormously and was a edition of her book in 1983 was a pivotal pressures are generated within the self-confessed Anglophile, regularly visiting moment for the management of people with oropharynx, and the mechanism for the UK and spending many hours and days swallowing diffi culties – for the fi rst time closure of the larynx during swallowing. browsing antique shops and markets looking there was a resource to facilitate evidence- She produced detailed profi les of the for additions to her ‘collectibles’, including based assessment and management in types of swallowing diffi culties people a vast Toby jug collection she had acquired clinical practice. with diff erent medical diagnoses present over the years. Another of Jeri’s collections Publications produced by Jeri and her with, including post-CVA, PD, SCI, HI was of beautiful ornamental glass balls, extensive collaborators exceed 400 articles and particularly within head and neck which were used to decorate lightning rods and book chapters. Th ese publications are cancer, where her work into the eff ects of on the outside of houses in the USA during not only numerous, but cover a range of surgery, reconstruction, chemotherapy and the 19th Century. topic areas and are published in a huge array radiation on swallow function and quality of Many people have met Jeri and few of journals including Neurology, Cancer, life informed the decisions individuals with would fail to see her humour and joy in life. Gastroenterology and the Journal of Speech head and neck cancer made about their She inspired us to strive for excellence in and Hearing Research. Her contributions treatments. Jeri was a major contributor to research and clinical practice ensuring the were recognised across disciplines and the development and evaluation of many best outcomes for our clients and for that I internationally with awards from American therapy interventions, including postures, am very grateful. Academy of Otolaryngology, the American manoeuvres, bolus modifi cations and Speech-Language Hearing Association swallowing exercises. Dr Christina H Smith, Senior Lecturer, (ASHA), and an honorary fellowship from Jeri was an exacting colleague and Language and Communication Research the RCSLT in 2013. mentor, and a formidable PhD supervisor. Department, University College London

September 2014 | www.rcslt.org Bulletin 27

027_obituary.indd 27 18/08/2014 14:47 FEATURE SUB HEAD XX XXXXX OurOu monthly look at the latest in In the publishedpub research journals

SendSend articles or publications to consider for future issues. Email: [email protected]

StorytellingS and Biomusic reveals languagel learning personhood

AlthoughA reading plays an important Th e use of biomusic with people with rrole on children’s language learning, profound and multiple disabilities (PMD) ooral storytelling should not be could enhance the perceived personhood ooverlooked as an important facilitator of these individuals and enrich interactions of vocabulary development, with their family members and caregivers, Robots and according to German researchers. American researchers suggest. dementia Th eir study investigated the eff ects Biomusic addresses some of the widely on vocabulary learning of stories acknowledged challenges of interacting which were narrated spontaneously with and relating to people with PMD. An innovative study carried out in by adults, read to children or read Th e novel technology measures four Brisbane has explored maintaining independently by the children. physiological signals (pulse, respiration, links between people with dementia In both the Grade 2 and Grade 4 fi ngertip-temperature and electrodermal living in residential care settings children, signifi cant advantage was activity) and converts them into musical and their family members using shown when stories were told to elements that caregivers can hear. telepresence robots. children rather than read. Th e project Researchers recruited clusters of Th e researchers tested the involved 37 typically developing participants – three people with PMD and potential of the technology to German children, who were tested largely pre-intentional communication maintain communication links on their knowledge of 18 novel words behaviours and four of their caregivers. between family members and their after these were included in stories Th ey participated in four individual relatives with dementia living in a in the three narrative conditions. biomusic sessions. Th e researchers residential care setting. Th ey used Number of presentations of the words gathered qualitative data from semi- a mixed method approach and a was controlled, and sequence of structured interviews with carers and feasibility framework to evaluate conditions counterbalanced. Word analysed this using grounded theory the participant’s experiences of learning was also correlated with techniques. the Giraff e telepresence robot. Th e language measures. Th e majority of caregivers respondedponded results showed residents were able to Although reading comprehension positively to the use of biomusic This section engage in and enjoy the opportunity was signifi cantly related to the during sessions; some reported aims to re highlight cent rese to interact with their family via the acquisition of the new vocabulary via it provided a representation of that ar arch articles e rele profession. Inclusionvant tdoeso the not robot. Family members appreciated reading, and receptive vocabulary the person they could relate refl ect streng off er a critical thappr of e vidence or the visual contact that enabled them correlated with learning of to. Th is helped some to relax fi nd an aisal. If y y of these int ou to see the physical state of their vocabulary aurally, overarching in the presence of the person follow them up eresting y and apply relative as well as the benefi t that fi ndings were in favour of learning and increase their awareness of our own critical appraisal. the visual link aff orded in enhanced from ‘told’, rather than ‘read’ stories. minimal physical cues. communication. Possible advantages include the more Th e authors acknowledge the Th e families and care staff had interesting and social aspects of limitations of the research but felt, anticipated that the participants the storytelling, greater animation, “results support the continued study with dementia may have a fear of the prosody, eye contact and body of biomusic as a means of revealing technology, but this proved not to be language or the more natural mode of the personhood of some of the most the case. speaking by the adult. vulnerable members of our society.”

Reviewed by Deborah Slate, Team Reviewed by Natalie Hasson, Alix Lewer, Safeguarding Adults Lead, Leader, Dorset Community Adult Lecturer, City University London Guy’s and St Th omas’ NHS Foundation Speech and Language Th erapy Trust Service Reference Reference Reference Suggate SP, et al. Incidental vocabulary acquisition from stories: Second and Blain-Moraes S et al. Biomusic: A novel fourth graders learn more from listening Moyle W, et al. Connecting the person with technology for revealing the personhood of than reading. First Language 2013; 33:6, dementia and family: A feasibility study of people with profound multiple disabilities. 551– 571. DOI: 10.1177/0142723713503144. a telepresence robot. BMC Geriatrics 2014. Augmentative and Alternative Communication http://fl a.sagepub.com/content/33/6/551 http://tinyurl.com/kupqfca 2013; 29:2, 159-173.

28 Bulletin September 2014 | www.rcslt.org

028_Journal Watch_column.indd 28 18/08/2014 14:48 RK GS IN SE MIN ARS NS AI CE S G MEETIN INNETWO TRSEM R MNS O ERENCES NS NF FUNCTIONFFU N NCTIO ON SEMINASE ON UNHIRE INAN AFFORDABLETIOCONFERENCONS MEETINME VENUEION FUFUNCLOSE TO LONDON BRIDGE SESSION EETINGSThe RCSLT is the perfect solution to your room hire needs. We off er a contemporary, aff ordable meeting RS space with the fl exibility to be set-up in a range of layouts. G MMEETINMEESENTATIONSWHY HIRE ATSESSIONS THE RCSLT? Following our extensive refurbishment, the venue is ideal for seminars, FUNCTIONStraining sessions, conferencesTRAINING and meetings. Our SESSIO ground fl oor rooms have natural daylight, amazing audio-visual equipment and breakout areas for delegates to relax and PRPRESENTATIOnetworkWORKING between sessions. TA With a dedicatedING events team, we will ensure your event runs smoothly.PRESENTATIOPRESENTATION KI ETETWORKINGSpecial rates for CENs/SIGs and members with businesses. MEETINMEETING AININGFor further details visit www.rcslt.org/about/RCSLT_venue_hire/Introduction EETINGSSESSIONSNS SEMINASEMINARSNS SEN RAIN FERENCESMMEETINGSTWORKINGS WOR TR TIOTIONSNENETWORKINGNET TIOTIONS ETWORKIET Stammering: Basic Clinical SkillsONONS16-17 SeptPRESENTAPRE 2014, MidlandsNCES NEW PROMOTIONAL “VITALSTIM THERAPY DynamicONONFERENCES 2+ hour DVD demonstration of stammering therapy techniques by experts from around the world to CERTIFICATION COURSE” help you work effectively with children and adults who stammer. DVD No. 9600

DVD CHAPTERS INCLUDE: • Explore talking • Holding/ and stammering tolerating • Identification moment of • Explore stammering stammering • Pullouts • Explore change • Cancellations • Tools for change • Making change • Soft starts durable • Changing rate • Transfer TRANSCUTANEOUS NEUROMUSCULAR • Voluntary • Disclosure ELECTRICAL STIMULATION (NMES) FOR stammering OROPHARYNGEAL DYSPHAGIA - A UNIQUE APPROACH OF TREATMENT NICE has produced guidance that recommends NMES (IPG490) should only be used with special arrangements for From Michael Palin Centre for Stammering Children, London: Frances Cook, . MBE, MSc, Cert. CT (Oxford), Reg UKCP (PCT), Cert MRCSLT (Hons); clinical governance, consent, audit or research in May 2014 Willie Botterill, MSc (Psych. Couns.), Reg UKCP (PCT), Cert MRCSLT; www.nice.org.uk/guidance/IPG490/chapter/1-recommendations Ali Berquez, MSc, BA (Hons), Dip. CT (Oxford), Cert MRCSLT; Alison Nicholas, MSc, BA (Hons), Cert MRCSLT; Jane Fry, MSc (Psych. Couns); Faculty: Yorick Wijting , VitalStim Certifi cation Program Developer Barry Guitar, Ph.D., University of Vermont; Peter Ramig, Ph.D., University and Instructor (USA) will cover the theoretical background of of Colorado-Boulder; Patricia Zebrowski, Ph.D., University of Iowa; and June this modality and the research supporting its use. There will be Campbell, M.A., private practice, provided additional footage. extensive hands-on time with the equipment. Dysphagia clinicians will acquire the knowledge and skill to incorporate VitalStim Therapy in their respective settings effectively and appropriately. THE To order: STUTTERING Places are limited so don’t miss this opportunity | Private ® FOUNDATION StutteringHelp.org group training is also available on request. A Nonprofit Organization Since 1947 Click on “store” and then Email: [email protected], visit www.vitalstim.co.uk Helping Those Who Stutter click “professionals”

September 2014 | www.rcslt.org Bulletin 29

BUL.09.14.026.indd Sec1:29 18/08/2014 10:22 September 2014 | www.rcslt.org Bulletin 29

BUL.09.14.030.indd Sec1:29 18/08/2014 10:23 LAST CHANCE TO BOOK

17-18 SEPTEMBER 2014 UNIVERSITY OF LEEDS Royal College of Speech and Language Therapists Conference 2014 Book your place today

This event more than all others in the RCSLT specialisms. Mind the Gap promises to be a portfolio focuses on the challenges and busy interactive event providing delegates opportunities facing the profession and will with the opportunity to share: provide a platform for dissemination of new • Clinical research innovations for evidence-based practice. • Best practice and skills in clinical practice `Mind the Gap: Putting research into practice’ and clinical education will give delegates the opportunity to come together to focus on how the profession can • Emerging innovations and collaborations survive and thrive. • Entrepreneurial approaches to service delivery The economic reality has set the context for the conference. It is vital that the profession shows • New models of employment evidence of what works. Following on from the • Leadership RCSLT Hub Summit 2013, Mind the Gap will look at the current drivers – translating research into practice to inform service delivery and design, Fees One day (£) Two days (£) outcomes for service users, outcome measures RCSLT member £180 (£150 + VAT) £260 (£216.67 + VAT) and the need to strengthen the business case Non-member £210 (£175 + VAT) £290 (£241.67 + VAT) for commissioning services. The conference will feature two days of oral and Terms and conditions apply. poster presentations with workshops, parallel and plenary sessions and keynote speakers. Topics will cover a range of adult and children For further information visit www.rcslt.org

Headline sponsor September 2014 | www.rcslt.org Bulletin 29

2014BUL.09.14.031.indd Conference.indd Sec1:29 1 18/08/2014 11:3613:31 SEPTEMBERCEN NOTICES CLINICAL EXCELLENCE NETWORKS

Send your CEN notice by email: [email protected] by 3 October for November, by 7 November for December and by 5 December for January. Venue hire at the RCSLT – special rates for CENs (formerly SIGs). For further details or to arrange to view our refurbished rooms, email: [email protected]

Yorkshire and Humberside Dysfl uency CEN Psychiatry of Old Age (Southern) CEN Essex SLI CEN 16 September, 9.30am – 12.30pm 7 October, 9am – 4.30pm 11 November, 1pm – 4pm Includes ‘Interiorised stammering’, feedback from Includes less common dementias – assessment, Professor Courtney Frazier Norbury: ‘The impact of Oxford Dysfl uency Conference and discussion diagnosis and intervention; RCSLT update (theory language impairment at school entry - A population about ‘Is fl uency the best outcome of therapy for of change); AGM; other items tbc. RCSLT, London. study’. The Lodge, The Chase, Wickford SS11 7XX. those who stammer’. 12.30: Trudy Stewart’s For further info and to book, Members free; non-members £8. To confi rm place, celebration and farewell lunch before retirement. email: [email protected] email: [email protected] Please bring food to share. All welcome. There will be no journal club. Leeds Stammering Support Tracheostomy CEN Centre. Email: [email protected] 8 October, 9.30am – 4pm Head and Neck Oncology (North) CEN Feedback on NCEPOD tracheostomy report: 14 November Counselling and Therapeutic Skills CEN Implications and future planning for SLTs. £20 York Hospital FEES workshop and master class in 19 September includes lunch. Queen Square, London. head and neck cancer dysphagia led by Annette ‘Introduction to counselling approaches are Email: [email protected] Kelly. £20 members; £25 Head and Neck CEN relevant to and eff ective in SLT’. Sam Simpson South members; £40 non-members. (www.intandem.co.uk) will present ‘Person-centred Trent Voice CEN Email: [email protected] therapy touchstones’; Carolyn Cheasman and 9 October, 9.30am – 4.30pm Rachel Everard (City Lit) will talk about ‘Acceptance ‘New to voice’ day for recently-qualifi ed therapists Yorkshire Voice CEN and commitment therapy’. RCSLT, 2 White Hart working in voice or those returning to the area of 17-18 November Yard, London SE1. voice. This interactive study day covers aspects of Two-day laryngeal manipulation workshop with Email: [email protected] assessment and therapy, including laryngeal image Jacob Lieberman. Practical hands-on tool for voice interpretation and case discussion. Rotherham. clinicians. New Mill, Saltaire, West Yorkshire. £150 Learning Disabilities SIG (Scotland) Members £30; non-members £45. for full two days (including lunch and 23 September, 9am for 9.30am – 4pm Email: [email protected] refreshments). Booking deadline 12 September. Palliative care study day: presents opportunity to Email: [email protected] or learn how SLT is involved in palliative care in Scotland CEN for Voice [email protected] for more information learning disabilities. Includes bereavement and loss, 10 October, 9.30am – 4pm end of life care, dysphagia, communication and Dr Alistair Dobbin, ‘Positive mental training’. A Computers in Therapy CEN mealtime toolkit, and case studies of work. Also self-help modular programme based on developing 19 November, 9.30am – 4pm launch of the LD SLT online community of practice, relaxation, visualisation and self-hypnotic ‘IDEA (Inclusion in the Digital Economy for Aphasia) plus AGM. Stirling Community Hospital. Email: techniques for anxiety, stress and depression. Project: How does aphasia impact on Internet use?’ [email protected]. Tickets from Eventbrite online RCGP-accredited programme. The Perth Royal Main speaker SLT Fiona Menger. Plus Gaze viewer ticketing system: search under ‘SLT Learning Infi rmary, The Steele Lecture Theatre. Members discussion, app share, Twitter, and telehealth Disability’. £25; non-members £35; students £25. journal review. PCAS Room Claremont School, Email: [email protected] Henleaze Bristol BS9 4LR. £7.50. Free parking. Criminal Justice and Secure Settings CEN Email: [email protected] 29 September, 10am – 4pm Central Neuro-Rehab CEN Durham YOS SLCN project; therapy workshop; and 22 October, 9.30am – 3.30pm SLT in Children’s Centre SIG RCSLT outcome measures team. Newcastle Dr Steven Bloch: ‘Assessment and treatment of 8 December University. Members free; non-members £10. dysarthria beyond intelligibility’. Day will include Workshop: ‘Grab them when you can. Maximise Email: off [email protected] practical workshops and presentations. Brief your opportunities to engage with families via overview of current research into dysarthria current initiatives. An opportunity to keep your London Speech Disorders SIG management, led by committee members. practice up to date.’ Parkside Community Hall, 29 September Birmingham City University B15 3TN. Members £25; Ampthill, Bedfordshire MK45 2HX. Members £20; Caroline Bowen: one-day course. Developmental student members/SLTAs £15; non-members £40; non-members £30 to include membership until 31 verbal dyspraxia. Friends House. Members £50; students £25. Payable on the day by cash/cheque. August 2015. Pay on the day (cash or cheque). non-members £60. Agenda/timings to follow. Visit www.bcu.ac.uk. Choose ‘Online Store’ from Places limited. To book, email: Booking essential. ‘Useful Links’ drop-down menu on the top right. [email protected] Email: [email protected] Listed under ‘Events & Conferences’. South East and London Stam mering SIG Yorkshire Adult Dysphagia SIG Aphasia Therapy CEN 12 December, 9.30am – 4pm 2 October, 9.30am – 2pm 27 October, 9.30am for 10am – 4pm Study day: Stammering therapy in the group The Poppleton Centre, York, YO26 6JT. Members A day with Professor Linda Worrall. RSCLT, London. setting. Explore the benefi ts of delivering therapy free; non-members £10. Email: ellie.girdwood@york. Members £20; non-members £30 (includes lunch). to groups of children, adolescents and adults. nhs.uk or tel: 01904 725 768 Email: [email protected], London venue. Email: [email protected] tel: 01553 613 471 Head and Neck (South) CEN 2 October, 9.30am – 5pm Central Paediatric Dysphagia CEN ‘Optimising swallow outcomes following chemo- 4 November, 9am for 9.30 start – 4pm radiotherapy’. Evidence reviews regarding Membership £15. For more details visit: prophylactic exercises, tube feeding and minimising www.cpd-sig.co.uk, email: [email protected] treatment toxicity. Also includes updates on clinical trials and DAHNO/NICE. Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB. Members £10; non- members £40 (includes lunch). For further info and to book, email: [email protected]

32 Bulletin September 2014 | www.rcslt.org

0032_CEN_groups.indd32_CEN_groups.indd 3322 18/08/2014 14:49 TO ADVERTISE CALL GIORGIO ROMANO ON 020 7880 7556 OR EMAIL APPOINTMENTS [email protected] AppointmentsCALL GIORGIO ROMANO ON 020 7880 7556

I CAN Centre with Dawn House School, Nottinghamshire

Speech and Language Therapist Coordinator Dawn House School is an Outstanding, non-maintained day and residential school for young people aged 5 -19. We provide high quality Permanent, Full time Contract care, education and therapy to help children with complex SLCN and Salary range: £37,496 – £41,874 per annum Asperger’s to fulfil their potential. Working collaboratively as part of a multidisciplinary team of teachers, therapists, teaching assistants and care (according to experience) officers, we create a stimulating learning environment where all pupils are The successful candidate will be expected to show leadership skills and enabled to communicate as effectively as possible, individuals are valued support the Head of Therapy. You will have the opportunity to shape and achievement is celebrated. therapy provision with input into the development plan and departmental The successful candidate will join an established, dynamic therapy team. management including the monitoring of therapy to promote outstanding They will be responsible for managing a small, complex caseload and service provision. You will assist in supervision of therapy staff ensuring an will show excellent clinical and collaborative practice skills. The successful appropriate level of support and monitoring of practice is maintained. You candidate will have a flexible and forward thinking approach, strong will have at least four years relevant experience working with young people with SLCN, Asperger’s and associate difficulties. Relevant post graduate interpersonal skills and enthusiasm to work within a team. qualification and previous management experience would be highly desirable. In return you will enjoy the chance to work within a well-resourced department, access excellent training and development, receive effective Speech and Language Therapist supervision and a generous holiday entitlement. Full Time, Temporary Maternity Cover Contract HCPC and RCSLT registration is essential. An enhanced DBS disclosure is required. Salary range: £26,397 – £29,397 per annum For an informal discussion about either role, please contact (according to experience) Jenny McConnell, Head of Therapy on 01623 795361. For further We are looking for a forward thinking and enthusiastic, developing or information about Dawn House School or I CAN, please visit main grade SLT who wants to further their career, skills and knowledge www.dawnhouseschool.org.uk or www.ican.org.uk in an educational setting. You will have a minimum of two years relevant For an application pack and full job description details: experience. You will receive a comprehensive induction programme, Download application pack from: www.ican.org.uk/jobs effective supervision and development opportunities. Email [email protected] Telephone 020 7239 0004 I CAN is the children’s communication charity and are experts in helping Closing date: 12pm 19 September 2014 children develop the speech, language and communication skills they need Interview date: w/c 22nd September 2014 to thrive in a 21st century world. Our vision is a world where all children have the communication skills they need to fulfil their potential. I CAN is committed to equality of opportunity in employment

HIGHLY SPECIALIST SPEECH AND LANGUAGE THERAPIST (1.0 WTE) ALSO MATERNITY COVER –FIXED TERM CONTRACT NOVEMBER – JULY 2015 (0.6 WTE) AFC BAND 7, SPINE POINT 26-31 (BOTH POSTS) SCHOOL TERM TIME ONLY (ACTUAL SALARY PA :£26,504 - £31,589 WTE POST)

St John’s is a day and residential school for deaf/ hearing impaired pupils For further information, please contact: aged 3 to 19. We work with children and young people with a wide range Mark Varley, Speech and Language Therapy Manager of communication, sensory and physical needs in addition to their hearing [email protected] loss. We are an oral school, so knowledge of sign language is not required.

We are looking for a qualifi ed therapist, ideally with experience of working For an application pack, please contact: with deaf/ hearing impaired children and young people to join us providing Mandy Dowson, Offi ce Manager a highly specialist service at St John’s School. The role involves providing [email protected] assessment, individual and group therapy, advice, recommendations, training and writing detailed assessment reports. Closing date for applications: 26 September 2014

We are a small, friendly team with excellent supervision and support Interviews will be held w/c:13 October 2014 systems. Our team links regularly with local and national clinical excellence networks to support continuing professional development. St John’s is committed to safeguarding children. All staff are expected to share that commitment. This post will be subject to DBS and reference checks to establish We welcome applications from therapists who have experience working with suitability to work with children. children with complex needs and are interested in developing specialist skills working with deaf/hearing impaired children and young people. St John’s Catholic School for the Deaf St John’s is a registered charity 529319

September 2014 | www.rcslt.org Bulletin 33

SSept14Rec.inddept14Rec.indd 3333 18/08/2014 10:27 APPOINTMENTS CALL GIORGIO ROMANO ON 020 7880 7556

THE RCSLT INVITES INDIVIDUALS TO APPLY FOR THE POSITION OF: EDITOR IN CHIEF INTERNATIONAL JOURNAL OF LANGUAGE AND COMMUNICATION DISORDERS (IJLCD)

Following the end of her term of offi ce, we are seeking a replacement publications and presentations at conferences) for Dr Katerina Hilari to work alongside Dr Nicola Botting on the IJLCD • Have experience of carrying out peer review from January 2015 • Commit to carrying out the role for a term of three years • Have a vision for the IJLCD The IJLCD is an international, peer-reviewed journal, which draws together fi ndings derived from research in language and communication For a full job description and details of how to apply, visit: disorders. The Journal is published in six issues per year, with occasional www.rcslt.org/about/jobs/job_opportunities special issues. The deadline for receipt of applications is 6 October 2014 The successful candidate for this position will: For an informal discussion about the post, please contact Dr Emma • Be a certifi ed member of the RCSLT Pagnamenta. Email: [email protected] • Have a PhD in a related academic discipline • Possess a proven track record in research (peer-reviewed www.rcslt.org

Better futures for young lives with epilepsy

Speech & Language Therapists SPECIALIST SPEECH AND Part-time (full-time considered) LANGUAGE THERAPISTS Young Epilepsy is the UK charity working exclusively to improve the lives of children, teenagers and young people with epilepsy and related neurological (Equivalent Band 7) conditions. Our therapists work within a multi-disciplinary health team, which We are seeking Speech & Language Therapists skilled in includes Consultant Paediatric Neurologists, nursing, research, psychology, assessment and management of communication and swallowing play therapy, EEG and pharmacy. We provide a full therapy service for students disorders arising from Acquired/Traumatic Brain Injury and other attending our campus provisions: St Piers Specialist Residential School, St Piers neurological conditions. Residential College, “Connect 2” Adult Community Access Service and the Health Centre Assessment & Rehabilitation Unit. We also provide outreach Post 1: Birmingham, 37.5hrs per week. therapy to local community colleges. Post 2: Northampton/Bedford, 21hrs per week. We are looking to recruit two experienced Speech & Language Candidates should have experience of working with clients with Therapists, to join our dedicated therapy team. We prefer the posts to be challenging behaviour, and be familiar with inter-disciplinary goal part-time, but full-time hours will be considered. planning and key-working. Why not take the opportunity to visit us at our Open Afternoon? Here you will be able to check out our beautiful campus set in 200 acres of Surrey Due to occasional travel car owner/drivers are desirable. countryside. This will take place on: Applicants must be eligible to work in the UK in this fi eld. Salary is negotiable depending on skills and experience. Visit Friday 19 September 2014, 1pm to 6pm www.christchurchgroup.co.uk to see the amazing work we do. at St Piers Lane, Lingfield, Surrey RH7 6PW For an informal discussion please contact Michaela Emm-Evans Please bring an up-to-date copy of your CV with you. on 07971 069310 or [email protected] For further information, please visit our website To apply please email your CV, specifying which role you are www.youngepilepsy.org.uk/about-us/working-at-young- applying for and outlining your current remuneration, to: Debbie epilepsy/current-vacancies or contact Tony Peake on 01342 831271 Kirton, HR Assistant at [email protected] or email: [email protected] quoting reference: YETODSLT/09/2014. No agencies please. Christchurch Group is an equal opportunities employer. Charity No. youngepilepsy.org.uk 311877

34 Bulletin September 2014 | www.rcslt.org

Sept14Rec.indd 34 18/08/2014 10:27 APPOINTMENTS CALL GIORGIO ROMANO ON 020 7880 7556

PAEDIATRIC SPEECH & ... LANGUAGE THERAPY le SERVICE p Band 7: Highly Specialist Speech and Language Therapist – Preston Manor School and Mainstream im Primary Reference: 337 REC 2407 s Salary: £35,159 to £44,953 it This is an exciting opportunity to join our dynamic and well-established team providing services to primary and secondary students attending Brent and Harrow schools. The department offers excellent support p systems with appraisal and personal development plans. e For 3 days of your week you will lead our service to Preston Manor e School supporting secondary aged students attending the Speech K and Language Resource and ASD Resource. Both specialist provisions were described as offering outstanding support by OFSTED (May 2012) Contact us and won the 2011 Shine a Light Award for Communication Friendly Schools and achieved Secondary Talk Accreditation (ICAN 2012). for locum SLT In addition you will supervise a band 6 SLT providing services to key stages 1 and 2 as part of the all through school. Positions nationwide For further information regarding the position, please contact Jo Hickey, Principal Speech and Language Therapist - Secondary Schools on 020 8869 2473 or Melanie Abba, Principal Speech and t: 020 7292 0730 Language Therapist - Schools Team on 020 8869 2476.

Closing Date: 18th September 2014 e: [email protected] Interview Date: 6th October 2014 www.piersmeadows.co.uk

HEAD OF SPEECH AND LANGUAGE THERAPY IN NEUROLOGY Location: 28-32 London Road, Bagshot, GU19 5HN Hours: Permanent, Full time, 40 hours per week, 6 day week working pattern Salary: £45,124 - £54,151 inclusive

A new opportunity has arisen for a specialist clinical staff in addressing complex development of long-term business plans, and Speech and Language therapist in Neurology to patient issues in neurological rehabilitation. creating successful partnerships with work in our exciting private unit. Ascot Rehab is • Work in a collaborative manner with existing other organisations a 15 bed bespoke specialist rehab unit providing services and new service developments in order exemplary interdisciplinary rehabilitation. We are DESIRABLE EXPERIENCE to contribute to the ongoing development looking for an innovative, experienced SLT to lead of Ascot Rehab Service, and provide leadership • Basic knowledge of company and employment our team of Speech and Language Therapists. in service developments and initiatives in the legislation New ideas, forward thinking and dedication are area of neurological rehabilitation. • Experience of working with an organisation or a prerequisite. governing body to promote good governance • Carry a specialist caseload and work with You will be one of a team of Physiotherapists, • Experience of working independently, team members to assess, plan and implement managing a team, and juggling workloads Occupational therapists, Neuropsychologists and appropriate rehabilitation programmes. Rehabilitation assistants. • Initiate and direct research and clinical audit ***If you meet the above criteria, please send THE MAIN PURPOSE OF THIS JOB IS TO: within the service relevant to this area of your CV and supporting statement to: louise. [email protected] • Be responsible for leading and overseeing the expertise. Speech and Language Therapy team including ESSENTIAL EXPERIENCE Please email [email protected] for rotas, division of clients and therapy sessions, the full job description. supervision of the Speech and Language • Good understanding of responsibilities Therapy team members. expected from a Head of Speech and Interview will take place: 3rd or 4th week of • Provide, maintain and review comprehensive, Language Therapy within a neuro rehabilitation September 2014 client-focused, highly specialist Rehabilitation centre Speech and Language Therapist services for • Experience of the staff planning process, For further information please contact: patients aged 16 years and above. including identifi cation of both fi nancial and Louise Turpin • Provide clinical leadership in neurological non-fi nancial risks and their subsequent General Manager and Head of Rehabilitation - rehabilitation, covering a range of neurological management for services and projects Ascot Rehab disorders and act in an advisory role for all • Experience of working to and assisting with 01276 450820 / 07850 244706 www.ascotrehab.com

September 2014 | www.rcslt.org Bulletin 35

Sept14Rec.indd 35 18/08/2014 10:27 APPOINTMENTS CALL GIORGIO ROMANO ON 020 7880 7556

If you enjoy working with children, making a positive diff erence in their lives, and would like a new adventure, this could be exactly what you’re looking for in your next SLP job. We are seeking an experienced SLP to provide services to a 10 year old from a VIP family in Saudi Arabia. The candidate will work individually with him at home, as well as providing direct services, A charity providing specialist services to children, young people and and professional development in the main stream adults with autistic spectrum conditions. As part of the Speech and school setting. The candidate will be supervised by an Language Team you will be based at Doucecroft School, a converted Educational-Clinical Consultant and will work closely estate in a beautiful setting in Eight Ash Green, Colchester. with other team members (Occupational Therapist and The available posts are part of our Clinical and Therapeutic Services Educational Therapist). involving working within our Multi-Disciplinary Team, liaising with staff , parents, other professionals and contributing to staff training. These REQUIREMENTS roles off er the ability to work creatively, flexibly, in a truly personalised • Master’s Degree in Speech and Language Pathology. way with individuals with autism, giving frequent opportunities for • SAC, ASHA or RCSLT certifi cation collaborative working. Salaries negotiable – experience dependent. • Excellent communication skills, including profi ciency in written and spoken Ref D101 Speech and Language Therapist - hours negotiable – ENGLISH Working with children at the school, you will be an enthusiastic • Excellent interpersonal and organisational skills therapist and have some experience of working with individuals with • Experience with providing professional development for teachers at the autism and/or special needs. This post could be suitable for a newly elementary and middle school level qualified therapist. • Experience working with children with expressive-receptive language disorders Ref D102 Highly Specialist/Principle Speech and Language • Experience modifying and diff erentiating the school curriculum Therapist - hours negotiable – you will be an experienced therapist • At least fi ve years clinical experience able to carry out supervision/line management responsibilities • Familiarity with Visualizing and Verbalising, Fast Forward, use of graphic for other therapists and work clinically within our services; with organisers and essay planners, considerable experience of working with individuals with autism and • Experience providing therapy in the home the ability to demonstrate qualities to lead a team. BENEFITS Successful applicants will receive ongoing supervision/CPD and Medical insurance, one bedroom accommodation provided in a private require a criminal records check. compound and a competitive tax free salary. For job descriptions and application forms go to www.autism-anglia. To apply, please submit your application (including resume, org.uk/jobs/vacancies or 01206 771234. Closing date: 30.09.14. cover letter and three references), to: [email protected] Interviews: w/c 13.10.14.

Speech & Language Therapist Base: Adult Learning Disability Services, Gervas House, Lincoln or Carlton Centre, Boston • Salary: registered Speech & Language Therapist posts available (banding dependent on experience) • Ref: 274-LPFT3266 SPEECH & LANGUAGE THERAPIST An exciting opportunity has arisen for Speech and Language Therapists (p/t .4), Grade: LBR8 to join LPFT’s multi-disciplinary Learning Disability Service in Lincolnshire. We are looking for people who are passionate about working with Required for September 2014. A Speech & Language Therapist of the people with learning disabilities, person-centred and able to work Hearing Impaired in this 11-18 mixed comprehensive school. independently and flexibly to meet service demands. Experience using a range of communication tools and approaches and designing and Caterham High School houses the Hearing Impaired Provision for delivering training packages required. Post-graduate qualifications in students aged 11-18 who have a permanent hearing loss and live in the London Borough of Redbridge. The provision is highly successful dysphagia are desirable but support to achieve these competencies with a proven record of academic and personal development for its would be provided to suitable candidates. students. There is a supportive and well-established team of teachers New developments are providing opportunities for post holders to be of the deaf, special support assistants and communication support involved in the future development of speech and language services in the workers. The communication approach is student- centred but all wider trust and close working with other organisations to support speech students use speaking and listening as their primary communication and language therapy delivery across a range of client groups. If you are mode. passionate about developing your profession this could be the post for you! We are looking for a speech and language therapist to join our Lincolnshire Partnership NHS Foundation Trust is committed team in developing the communication skills of our pupils through to clinical supervision, management supervision and continued 1:1 intervention, group therapy, providing advice and guidance to professional development staff and parents and liaising with cochlear implant teams. We would If you would like to discuss these posts please contact Deb Hussey, welcome applications from people with a genuine commitment Team leader on 01522 577404 to working with young people with hearing impairments. Some knowledge of BSL, or a willingness to learn would be an advantage. Applications are welcomed for the above position. For a more detailed job description please visit www.jobs.nhs.uk and All candidates will be subject to an enhanced DBS check and search for Lincolnshire Partnership NHS Foundation satisfactory references.

Trust using the above reference number. Gainsborough Louth Please download an application form/information regarding the Closing date: 19th September 2014. Lincoln Skegness post from our website or e-mail the school for an application form/ We are committed to ensuring Equal Opportunities for all Sleaford Boston further details. Closing date: 19th September 2014. and employing a workforce which reflects the diversity of Grantham Spalding

our local community. We are also committed to flexible Stamford working patterns within the needs of the service. We also have a team to advise on childcare and carer issues. www.ecaterham.net

36 Bulletin September 2014 | www.rcslt.org

Sept14Rec.indd 36 18/08/2014 10:27 APPOINTMENTS CALL GIORGIO ROMANO ON 020 7880 7556

SPEECH AND LANGUAGE THERAPIST September 2014, Full/Part time, Band 5-6

ERS provides specialist support within a small and caring environment for our pupils, many of whom have additional needs. We are seeking a Speech and Language Therapist to join our multi-disciplinary team. The successful candidate will be required to assess pupils, provide therapy, set up programmes and work with staff in supporting pupils’ communication needs. The successful candidate will be fully qualifi ed and registered with the HCPC and NEW RCSLT and have experience in a school setting. Egerton Rothesay School is committed to safeguarding children. Successful candidates will be subject to a DBS check.

To apply please contact Mrs Susan Lucas, [email protected] Closing Date: 15 September 2014 JOB? www.eger-roth.co.uk The offi cial recruitment site for the RCSLT, the professional body for speech and language therapists in the UK, and the best place for speech and language specialists to fi nd jobs.

You can search for vacancies for SLTs, including full-time speech and language therapy vacancies and part-time roles, or view lists of vacancies matching popular searches, such as speech and language therapy jobs in London and lecturer vacancies.

Start your search today and visit RCLSTjobs www.speech-language-therapy-jobs.org bulletin

September 2014 | www.rcslt.org Bulletin 37

Sept14Rec.indd 37 18/08/2014 10:27 Dr Amanda

MY Smith WORKING LIFE OCCUPATION: EXECUTIVE DIRECTOR OF THERAPIES AND HEALTH SCIENCE, QUALITY AND SAFETY, POWYS TEACHING HEALTH BOARD

“Each year, NICE appoints 10 Fellows to join a growing cohort of professionals who act as ambassadors”

n late 2010, I read a note in the Bulletin opportunity to infl uence the guidance, that said the then National Institute of both when it is fi rst developed and when Health and Clinical Excellence (NICE) it is reviewed and updated. Th e review Iwas developing guidance for patient and update of patient experience guidance experience. With a background in paediatric CG138 was completed in 2013, taking into specifi c speech and language diffi culties, account available new evidence. and a relatively new role as head of therapies Examples of existing and recent guidance and speech and language therapy in my include autism, ADHD, neurological organisation, this felt like a rare opportunity conditions, stroke, dementia, glue ear/ to become involved in the work of NICE. I otitis media, looked after children and applied to be on the Guidance Development service user experience. New guidance Group (GDG) and was recruited onto the in the pipeline includes cerebral palsy group. (2016); challenging behaviour and learning Th e GDG was sizeable – made up of experts disabilities (2015); transition from children from a number of fi elds and professions to adult services (2016); Parkinson disease and included six fantastically committed (update 2016); motor neurone disease patient members. With skilful chairing by (2016); and multiple sclerosis (2014). our academic chair, Warwick University’s In February 2014, NICE supported me Dr Sophie Staniszewska, we soon developed to visit Northern Ireland to meet NICE a productive relationship with healthy and opportunitiestititb to observe and d participate tiiti in Implementation Facilitator Lesley Edgar lively challenge and debate, sifting through the working of NICE and to support from and to learn about the approach NI has evidence that was prepared and collated for senior members of the NICE team. Fellows taken in implementing NICE guidance. us by the research team. also have the opportunity to use their As with Wales, where I work, NI has a After several meetings, consultation and expertise to shape the Institute’s guidance service level agreement with NICE to use late revisions the group was delighted to programme and initiatives. the resources and is now two years into a fi nally see CG138 (Clinical Guidance Patient In April 201, NICE was renamed the new approach to engaging organisations Experience in Adult NHS Services) (www. National Institute for Health and Care in developing a consistent approach to nice.org.uk/guidance/cg138) together Excellence because it embraced social care implementing NICE guidance. In Wales, the with the Quality Standards (QS15) (www. guidance alongside its exiting programme of updated agreement has been in place for nice.org.uk/guidance/qs15) published in health guidance. NICE’s role has broadened a year. As a Fellow, I now chair the NICE February 2012. out and at the same time the team has been Liaison Group for Wales, where we are Having personally and professionally working to make all guidance much more committed to support a similar focus in the learned a huge amount from working accessible, with free apps and easier links to implementation of NICE guidance across with NICE, in September 2012, once again the evidence base. health and social care. ■ following a piece in the Bulletin, I applied As SLTs work across so many domains for a three-year NICE Fellowship. Each of health and social care, it is of value Dr Amanda Smith, Executive Director of year, NICE appoints 10 Fellows to join a that guidance – whether existing, under Th erapies and Health Science, Quality and growing cohort of professionals who act development or in the pipeline – has Safety, Powys Teaching Health Board, NICE as ambassadors for the Institute at local, become readily accessible. Th e NICE website Fellow. Email: Amanda.Smith2@wales. regional and national levels. I was fortunate provides easy links and search methods to nhs.uk to be appointed to join the 2013–2016 group. all guidance. Pathways have been developed Th e fi rst SLT to be a NICE Fellow, I so that all NICE-approved guidance can ◉ Visit: www.nice.org.uk/guidance and felt privileged to be able to bring my be accessed in relation to any particular www.nice.org.uk/Get-Involved/Fellows- professional background and knowledge condition. and-scholars (recruitment for the 2015 into this new role. As a Fellow I have All guidance goes through a period intake of Fellows and Scholars will open in access to development through workshops, of stakeholder consultation. Th is is an Autumn 2014)

38 Bulletin September 2014 | www.rcslt.org

038_workingweek.indd 38 18/08/2014 14:49 QUICK LOOK DATES

Picture Exchange for professionals working Contact below for funding/ papilloma in adults and Communication System with clients with listening payment options: Judith children and working with (PECS) difficulties. £300 (Early Jackson, tel: 0207 288 5546, chronic cough/ paradoxical vocal fold function. Further Level 1 Workshops York, Bird £275). Email: camilla@ email: [email protected] information at: www. Aberdeen, London, johansenias.com, tel: 0131 337 5427 24 October, London britishvoiceassociation.org.uk Birmingham, Liverpool, (Courses and Events) Southampton, Cambridge, British Dyslexia Association 13-17 October, London Conference: Speech/ Cardiff, Newcastle, Glasgow 24-27 November, Edinburgh and more. SoSAFE! Sexual/ Adult Dysphagia Training – language impairment and Social Safety Training – Theoretical Course dyslexia Johansen IAS Cardiff, Liverpool, Newry, One-week intensive course Book now. Features eminent Learn to use selected or Newcastle and London. aimed to provide participants speakers including Professor customised music CDs. All Language of Emotions with with theoretical knowledge to Maggie Snowling, Anne Fox, ages. Individual and group Andy Bondy Phd – London, assess and manage adults with Rita Fogarty and Dr Courtney programmes. Organises Bristol and Sheffield. Visit: acquired dysphagia. Cost: £200. Norbury. Prices from £110. For and enhances listening and www.pecs-unitedkingdom. Contact: Judith Jackson, tel: more information and booking: auditory processing. Supports com tel: 01276 609 555 020 7288 5546, email: email: katrinac@bdadyslexia. spoken and written language. [email protected] org.uk or tel: 01344 381 569 £500 (Early Bird £475). Email: 22 September, University of [email protected], Southampton 15 October 30-31 October, Greenwich visit:www.johansenias.com Challenging Isolation: Speech acoustics: Plain Swallowing rehabilitation 1-4 December, Manchester Working with adults who English and the use of surface EMG are alone biofeedback ADOS-2 administration and Develop your understanding of coding course @University of Southampton how speech sounds are made in Maggie-Lee Huckabee PhD. Auditory Implant Service. the mouth and how this relates Two-day course exploring ADOS-2 is the latest revision A one-day workshop for to the acoustics of speech. the evidence and practical of the Autism Diagnostic professionals supporting Practically apply this knowledge application of swallow-skill Observation Schedule and is the most widely used adults with cochlear implants to case studies. £85. The Ear training using sEMG. £210. observational assessment in who have few communication Foundation. Email: sam@ Limited places for last half- the diagnosis of autism. Visit: opportunities in their daily earfoundation.org.uk day practical workshop (£70). ados2training.co.uk or tel: lives. A joint workshop from Email: [email protected] the Auditory Implant Service 16 October 0115 7149 000 and Yorkshire Implant Service. ‘Let Me Tell You!’ Story and 4-5 November Cost: £25. Tel 023 8059 3522, narrative development International Feeding email: [email protected], visit: Focusing on pre-school years Disorders Conference www.southampton.ac.uk/ais we’ll explore the skills needed The emphasis will be on 3 October - memory, theory of mind and research and clinical practice social scripts – to use spoken developments relating to Home Supporting: Leave language to tell stories. £85. the bag of toys in the car developmental, systemic The Ear Foundation. Email: and bio-behavioural aspects Practical ideas to help parents [email protected] of feeding and eating develop techniques to disturbances. Contact: ICH support their child’s spoken 16-17 October, London Events, tel 020 7905 2699, language using daily routines: Supporting stories of email: [email protected] use the ideas the very next change: using narrative day. £85. The Ear Foundation. ideas and practices 7 November, SIG SpLD Email: sam@earfoundation. Introduction to theory and (Dyslexia) Conference org.uk practice of narrative ways ‘Dyslexia – An Impairment of working; topics include 9 October, Northwick Park of Language Learning’, Prof externalising, re-authoring, Hospital Maggie Snowling. ‘Putting listening for alternative the IT into LITeracy’, Jenny Nasendoscopy scoping for storylines and developing Thomson, Senior Lecturer SLTs skills in narrative questioning. Univ of Sheffield. ‘Apps that Theoretical and practical Suitable for all client groups. really make your life easier’. BOOK YOUR sessions to help in developing £148. Email: rachel.everard@ ‘LinkedIn – getting your nasendoscopy technique. citylit.ac.uk, tel: 020 7492 message across’. Exhibition QUICK LOOK Useful for therapists working 2579 and delicious lunch included, DATE TODAY with voice and dysphagia. Institute of Materials, Carlton 20 October onwards, Increase the potential of your course £120. For application form House Terrace, SW1Y 5AF. £90 or event by advertising in the RCSLT and information email: London including membership. Email: Bulletin Quick Look Dates section. A [email protected], Bulletin survey shows 77% of readers Dysphagia training – [email protected] have attended a course advertised in tel: 020 8869 2410 practical competencies these pages. 21 November, St Thomas’s Looking for work? A Contact Beth Fifi eld to book your 13-14 October, Edinburgh practical eight-week full-time Hospital, London advert. Tel: 020 7324 2735 or email: beth.fi fi [email protected] Working with Listening course aimed at achieving Voice Clinics Forum 2014 and Auditory Processing RCSLT specialist dysphagia Voice Clinics present Terms and conditions Diffi culties Payment must be received by Redactive Media practitioner competencies so current thinking and before we can publish your Quick Look Date Understanding, profiling and you can work independently advert. Advert text will be edited for consistency. practical experience on Enhanced coloured boxes: the editor will managing auditory processing with adults with acquired postoperative voice rest, determine the box colour. difficulties. Two-day course dysphagia. Cost: £2,000. therapy, management of

September 2014 | www.rcslt.org Bulletin 39

QLDSept.indd 39 18/08/2014 14:08 Nutilis fills the nutritional gap in patients with dysphagia

The complete* dysphagia range

Stage 1 *For thickening powders and all 3 stages of pre thickened oral nutritional supplements. Stage 2 Nutricia Ltd, White Horse Business Park, Trowbridge, Wilts BA14 0XQ. Stage 3 www.nutriciaons.co.uk. For further information call 01225 751098. 28 Bulletin May 2014 | www.rcslt.org

BUL.09.14.040.indd Sec1:28 18/08/2014 10:11