Paediatric and Educational Issues 353

Developing an effective school-based service for children attending mainstream schools

MARIA LUSCOMBE and LIZ SHAW Northwick Park and St Marks NHS Trust, London

ABSTRACT In May 1 9 9 3 a new school-based speech and language therapy service for children with a Statement of Special Educational Needs was introduced t o schools in Harrow. Input was provided according t o each child’s needs as indicated by their speech and language therapy assessment and was offered o n alternate half-terms d u e t o limitations defined by funding from the local Purchasing Author- ity. T h e introduction and subsequent success of the new service depended not only o n adequate speech and language therapy resources but also o n collaborative working with both school staff and parents. A s the service was in its infancy and developing rapidly, regular review was essential. During the year 1993-1 994 the Speech and Language Therapy Department carried out audits of the service focusing on: (I) T h e frequency of input each child received; (2) T h e impact of the new service o n schools’ staff understanding of communication impairment and their ability t o modify activities t o meet the needs of individual children; (3) Parents’ perceptions of the new service and its perceived impact o n the communication skills of their children. T h e study involved a comparison of departmental records (for example, the number of contracts offered, with recommended frequency of input), a ques- tionnaire and interviews with school staff, a questionnaire to parents. T h e service was found t o be meeting the recommended levels of input. (This was within re- source constraints, i.e. every other half-term.) Both parents and teachers fe l t that the new service had improved their understanding of and ability t o deal with the children’s communication difficulties (school staff 70%; parents 84%). Seventy- eight per cent of parents felt that their child’s communication skills had improved. However, the results raised questions about other aspects of the service: 62% of parents were unhappy with the frequency of input, despite the recommended levels being met every other half-term; increased liaison t ime was required; parents re- quested more ideas for home use; and schools staff stressed the need for further training o n communication difficulties. A s a result, several changes have been in- troduced by the Speech and Language Therapy Department: (I) Amendments t o the format of written reports, leading t o greater ease of access and application within educational review meetings; (2) Improved departmental standards concern- ing provision of written information t o parents and schools; (3) T h e development of departmental standards relating t o contact with parents; (4) Further develop-

354 Caring to Communicate

m e n t of training packages provided by the Speech and Language Therapy Depart- m e n t service. T h e results and implications of the audit have been discussed with the Local Education Authority (LEA), the Purchasing Authorities, and in-borough parent support groups. Areas identified for further attention include: (1) Agreeing priority grouping f o r speech and language therapy intervention; (2) T h e implica- tions of Harrow LEA’S integration policy and the 1994 Code of Practice for speech and language therapy provision; (3) Training of schools staff and its effect o n the provision of speech and language therapy. T h e Purchasers and the L E A have formed a working party in order to address these issues in consultation with the Speech and Language Therapy Department. T h e audit has proved invaluable in providing necessary information t o those involved.