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Birmingham Children's Community Speech and Language Therapy

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Birmingham Children's Community Speech and Language Therapy Birmingham Children’s Community Speech and Language Therapy Department Clinical Guidelines Working with Children with Hearing-Impairment - information for SLT staff and referrers to the service- Definition Clients with a permanent significant hearing loss. (congenital or acquired) Referrals 1. Open referral system – parents can refer directly 2. Appropriate referrals from medical colleagues, health visitors, teachers of the deaf, mainstream teachers, speech and language therapists 3. Referral forms will be available to all potential referring agents Caseload There is flexibility within caseload management for non-specialist Speech and Language therapists (SLTs) to have some hearing-impaired children on their caseloads. Assessment 1. for pre-school children. This usually takes place at home, playgroup or nursery. Sometimes children are seen in clinic. The specialist SLT often will assess the child with a teacher of the deaf who is usually the keyworker for the child. 2. for school age children This usually takes place at school. The SLT often assesses the child with input from a teacher of the deaf or mainstream teacher and the child’s keyworker or integration assistant. Nursery nurses and teaching assistants are also often involved. Information gathering This includes; a. Audiological information e.g..type of hearing loss, pure tone audiogram, listening test information for speech sounds. Hearing Impairment Clinical Guidelines – final SLT/other professional version Nov 2007 1 b. Audiological equipment e.g. type of aids (digital or analogue),cochlear implant, mono/binaural fitting, use of radio aid. c. Medical information d. Other professionals involved e. Preferred mode of communication e.g. oral/aural, British Sign Language, Manually coded English systems (Makaton, sign supported English, Signed English etc) Assessment 1. Assessment may involve observation, description and objective evaluation of hearing, spoken and sign language development. 2. There is a need to consider the age, hearing status and case history of the child. This may include audiological information assessment of receptive skills assessment of expressive skills 3. In assessing skills the SLT will consider: air stream mechanisms voice(quality, pitch level and range, loudness) resonance phonetic and phonological information vocabulary level syntactic analysis semantic and pragmatic aspects of communication social skills 4. video or audio recording may be used. 5. Expectations of therapy should be discussed. 6. The child should be involved and informed of assessment results where possible. 7. When requested a written report will be compiled and shared with the carer and client and other relevant professionals. Hearing Impairment Clinical Guidelines – final SLT/other professional version Nov 2007 2 Intervention General 1) The therapist plans a programme of intervention as appropriate, which will be discussed with client, carer and other professionals as appropriate. 2) The SLT’s role may be advisory or consultative to give advice to carers, educational staff and others on relevant communication issues. 3) The SLT may have a direct role in the form of regular intervention, involving direct therapy and liaison with other team members. Children 1) The SLT may be asked to advise parents about encouraging early communication development including early interaction skills, intentional communication, parent/child interaction, early language and developing listening and voice skills. This is particularly important since the arrival of the Universal Hearing Screening Programme in April 2004 where children are tested soon after birth for possible hearing loss. 2) The SLT and teacher of the deaf (TOD) will normally work closely together, reinforcing each others work and setting joint targets. 3) The SLT contributes to planning a child’s communication programme with the TOD or other professionals. The SLT will carry out agreed work as appropriate. The input may be undertaken with the teacher and could be on an individual or a group basis. 4) Programmes should be updated as necessary in consultation with other professionals. 5) The SLT will contribute to assessments and reviews of statements of Special Educational Needs. 6) In mainstream schools, the SLT may offer support to mainstream teachers and integration assistants regarding communication assessment, advice on specific aspects of communication and help with planning of individual work on communication skills. The mainstream teacher or assistant usually carries out the individual work although the therapist may demonstrate the techniques/strategies first. Hearing Impairment Clinical Guidelines – final SLT/other professional version Nov 2007 3 7) The SLT may offer workshops and/or training to other professionals involved. 8) On request the SLT will contribute to the formation and development of school policies regarding communication and language issues. 9) Where possible and on request the SLT may attend and/or contribute to meetings and case conferences. Interface with other professionals To ensure an integrated, holistic and successful programme of therapy, it is essential that SLT establishes her role within the multi-disciplinary team. The SLT needs to identify key individuals involved e.g. carers, Teachers of the Deaf, assistants and ensure that intervention programmes are discussed with those involved. Joint intervention goals are good practice. Skill Mix A SLT with specific responsibilities for this client group will have: 2 years generalist experience qualification in Post-graduate Courses 1 and 2 Speech Therapy with Deaf People British Sign Language Stage 1 /Stage 2 (preferred) from the Council for the Advancement of Communication with Deaf People Knowledge of the deaf community, deaf culture and education. It is desirable that a SLT in a department will have completed the advanced clinical course in Speech Therapy with Deaf People SLTs without additional qualifications are recognised as able to manage deaf clients provided that they can refer to colleagues who have specific responsibilities for deaf/hearing-impaired children Specialist SLTs should have access to other colleagues through RCSLT Special interest groups and training days SLT Assistants Speech and Language therapy assistants may assist the SLT in carrying out individual work or group therapy. They may be involved in the observation of deaf children, accompanying the SLT on visits and have responsibilities to find resources for this client group. They are to be a valued and respected member of the Team. Hearing Impairment Clinical Guidelines – final SLT/other professional version Nov 2007 4 Further information The National Deaf Childrens Society 15 Dufferin St, London EC1Y 8UR Freshen 0808 800 8880 Website www.ndcs.org.uk Royal College of Speech and Language Therapists Information Dept. 2 White Hart Yard, London SE1 1NX Tel 0207 3781200 Fax 0207 4037254 Website www.rcslt.org References Communicating Quality 2 Royal College of Speech and Language Therapists 1996 Communicating Quality 3 Royal College of Speech and Language Therapists 2006 These guidelines will be reviewed in October 2008 Hearing Impairment Clinical Guidelines – final SLT/other professional version Nov 2007 5.
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