Dr Sarah James

Self-report measures are a valuable tool in clinical intervention for people who stutter but may be inadequate for accurately capturing situational variations in dysfluency, perceived dysfluency, attitude to the situation and the relationship between these. This exploratory study describes the development of a Speaking Task Response Questionnaire (STRQ) that enabled recording of affective and cognitive responses to speaking situations at the time at which they occurred. A quasi-experimental design was used to compare the responses of participants who do (n = 7) and do not (n = 7) stutter across two telephone speaking tasks and a face-to-face speaking task. All participants rated their responses to the tasks using the STRQ. In addition, participants who stutter self-rated their fluency and percentage syllables stuttered in each of the situations was also measured. The STRQ was able to differentiate between groups of participants who do and do not stutter and between telephoning and face-to-face tasks, indicating that it has face validity. Participants who stutter rated their responses more negatively in the telephone situations than the face-to-face situation. Qualitatively, there was lack of congruence between objective and subjective fluency ratings. Clinical implications and future development of the STRQ are discussed.

Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of provision was variable. There was a lack of consensus on what the main aims of group therapy should be. Important barriers to group therapy provision were identified, including a perceived lack of clients' interest in group therapy, and insufficient numbers of clients able to travel to group venues. This study enhances the profession's understanding of the provision of group therapy for CWS by identifying patterns of service delivery and highlighting areas of need. Educational objectives: Readers should be able to: (1) Provide a rationale for the provision of group therapy for school-aged CWS; (2) Summarize the factors affecting group therapy provision for school-aged CWS; (3) Summarize the aims of therapy identified by the respondents to this survey. © 2011 Elsevier Inc.

In 2012, Leeds Metropolitan University2 formed a partnership with the West Yorkshire Probation Trust3 in Leeds, enabling final year speech and language therapy students to undertake placements within the Trust. The opportunity enabled pairs of students to explore the need for Speech and Language Therapy within the Probation Service, working with high levels of independence, as there were no Speech and Language Therapists employed by the Trust.4 This discussion will review evidence of the level and types of communication difficulties within the offender population, consider the impact of such difficulties, how issues have been addressed and reflect on our experiences as Speech and Language Therapists at Leeds Beckett University of working with the Probation Service in Leeds. Courts can award intensive community orders as an alternative to prison sentences. As part of community sentencing, the Leeds Probation Service runs a series of programmes. Attendance at the groups is compulsory and non-attendance can result in offenders returning to court for breaching the requirements of their sentence. Students were placed in three different settings; the Thinking Skills Programme; the Integrated Domestic Abuse Programme5 and the Skills for Work team (not a compulsory intervention). The placement aims were to observe and assess the communication skills of the offenders attending the programmes; to observe and assess the communication style of the facilitators running the programmes and to review the resources used on the programmes.

Introduction Speech and language therapy education in Europe currently has differing forms, languages and levels. This paper outlines the challenges, outcomes and opportunities resulting from a European wide project reviewing SLT education and training. Methods This was a mixed methods project. Stage 1 used an ethnographic approach to identify relevant web and paper based documents from SLT sources across the world. Following review of the documents, eight subject specific and five generic areas of competency were identified, utilising the EU Tuning procedure. For stage 2, two surveys based on these competencies were created. The first survey was translated into 24 languages and circulated to employers, speech and language therapy (SLT) academics and recent graduates in every country across the EU. The purpose of this survey was to identify which competencies were considered essential for a new entrant to the profession. The second survey, sent to academic institutions, collected data on curriculum content, level and structure of educational programmes. This material was linked to a biennial survey (survey 3) carried out by CPLOL to collect data on student and staff numbers. Data were analysed using SAS software and Excel to provide descriptive statistics. For survey 1 and 2, statistical analyses also generated detailed information on results by respondent groups and characteristics. A summary profile was drawn up by a process of triangulation, merging the data from surveys 2 and 3. The resultant “snapshot” of each country’s SLT education profile was recirculated for member checking and verification. Results Survey 1 4383 responses were received to survey 1. 25 subject specific competences, focused on assessment, diagnosis and case management, were most frequently cited as “essential” by all three respondent groups. Some competences (e.g. instrumental analyses of speech, service development) were rated as unnecessary for initial entry to practice by the majority of respondents. Survey 2: A total of 93 responses were received to the departmental survey. Survey 3 conducted by CPLOL was completed by their 29 national education representatives. These surveys identified that SLT programmes in Europe are typically within universities, mainly state funded and predominantly organised with other health related programmes. Germany is an exception, with over 100 college based sub-degree level 4 programmes. Almost all established programmes (96%) at the surveyed departments are regulated by the state or the government and programmes almost always have to be approved or validated by their host institution (99%) and need to be reviewed periodically. Discussion Employers academics and graduates and showed a high degree of agreement on what is essential in order to be able to start to practise as a newly qualified SLT, despite differences in emphasis. The resulting document can be regarded as the EU-wide agreed common standards which every SLT must meet in order to practise the profession. Future projects include investigating approaches to clinical education. It would also be valuable to explore methods of enhancing student and staff mobility across Europe. NetQues, 2013 NetQues project report. Speech and language therapy education in Europe. United in diversity www.netques.eu

A study of the use of and attitudes towards the telephone by persons with stuttering impairment is presented. Data was collected by survey (postal questionnaire). Results indicate that making calls may be more problematic than answering them. Avoidance-like behaviours were more prevalent amongst younger adult stutterers than their older counterparts. Severe stutterers use the telephone least. Many stutterers surveyed see telephoning as being more problematic than 'face-to-face' communication and give a range of reasons for this. Telephoning difficulties can have wide ranging effects. Some implications of these findings are discussed.

Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of provision was variable. There was a lack of consensus on what the main aims of group therapy should be. Important barriers to group therapy provision were identified, including a perceived lack of clients’ interest in group therapy, and insufficient numbers of clients able to travel to group venues. This study enhances the profession's understanding of the provision of group therapy for CWS by identifying patterns of service delivery and highlighting areas of need.

Using the telephone can be difficult and uncomfortable for people who stutter, leading to anxiety and avoidance of the phone for many. The possibility of an aid to reduce the amount of stuttering and the feelings associated with phone use may appeal to people who stutter and who need to use a telephone for social or work-related communication. Such a device is currently being developed by the makers of VoiceAmp, a small body-worn feedback device, using altered auditory feedback through a telephone interface. This study is an initial trial of a telephone assistive device (TAD) using a multiple case-study time series procedure. Five participants were recruited in order to record themselves making phone calls in natural settings before using TAD and with TAD. Percentage syllables stuttered and self-ratings of feelings and attitudes to phone calls were collected. Results suggest a trend towards both reduced frequency of stuttering and increased positive feelings and attitudes. It would appear from this small scale study that use of a dedicated device for a specifically problematic situation such as telephone calls is positively indicated for some people who stutter and warrants further investigation.

Self-report measures are a valuable tool in clinical intervention for people who stutter but may be inadequate for accurately capturing situational variations in dysfluency, perceived dysfluency, attitude to the situation and the relationship between these. This exploratory study describes the development of a Speaking Task Response Questionnaire (STRQ) that enabled recording of affective and cognitive responses to speaking situations at the time at which they occurred. A quasi-experimental design was used to compare the responses of participants who do (n = 7) and do not (n = 7) stutter across two telephone speaking tasks and a face-to-face speaking task. All participants rated their responses to the tasks using the STRQ. In addition, participants who stutter self-rated their fluency and percentage syllables stuttered in each of the situations was also measured. The STRQ was able to differentiate between groups of participants who do and do not stutter and between telephoning and face-to-face tasks, indicating that it has face validity. Participants who stutter rated their responses more negatively in the telephone situations than the face-to-face situation. Qualitatively, there was lack of congruence between objective and subjective fluency ratings. Clinical implications and future development of the STRQ are discussed.

There is hegemonic knowledge and a growing body of literature that demonstrates that the process of seeking support for children with special educational needs and disabilities (SEND) has long been a challenge. This has remained the case, despite the Children and Families Act (2014) mandating a single Education, Health and Care Plan (EHCP), aimed at improving the process for families, supporting partnership and interagency working, and enabling better outcomes for children with SEND. The system remains largely adversarial, lacks accountability and results in ineffective provision for children with SEND. Existing research into experiences of the EHCP process since the reforms largely focusses on the views of parents and education professionals. This research shares new insights into experiences of the EHCP process using a critical realist position and involving two qualitative studies. Study 1 explored the experiences and views of 13 parents via interviews and one focus group. Their views were analysed using reflexive thematic analysis (RTA) (Braun & Clarke, 2022) which explained the challenges and impact of the process and the fundamental need for strong partnerships. The data representing the challenges of the process was further explored using a narrative analysis of the battle metaphor, which is commonly associated with accessing support for children with SEND. Study 2 involved 10 professionals from education, health and social care backgrounds who joined 3 focus groups and shared their perspectives of the EHCP process, as well as commenting on the views of the parents from study 1. This data was analysed using RTA, and the theory of practice architectures (Kemmis, 2008) was used to interpret the data and explore professional practices. This analysis illustrated the practice architectures that scaffold and constrain the enmeshed ‘sayings’, ‘doings’ and ‘relatings’ of practices involving EHCPs. The tensions within the system were exposed and understood. This analysis has shown that whilst the ideologies of transdisciplinarity, parent-professional partnerships and person-centredness set out in the reforms are sound, they are unattainable within the current sociocultural, political and financial landscape and as such, represent metaphorical ‘unicorns’ that professionals chase, but inevitably struggle to capture. The EHCP system remains challenging for both parents and professionals, in a climate of reduced resources and competing agendas. The findings from both studies have illuminated a need to invest in relationships. Recommendations are shared to improve the system, with the overall aim of enhancing outcomes for children and young people with SEND.

Background Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs’ views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth. Aims To investigate SLTs’ views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these. Methods & Procedures A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis. Outcomes & Results Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under-confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges. Conclusions & Implications SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD. What this paper adds What is already known on the subject Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription. What this paper adds to existing knowledge By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs’ views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service-wide level. What are the potential or actual clinical implications of this work? Transcription is often de-prioritized in non-specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole-service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention.

The aim of this paper is to describe the implementation and evaluation of a ‘whole course’ approach to embedding an e-Portfolio across 3 years of a pre-registration speech and language therapy course and to discuss the implications for pre-and post-registration professional development. The e-portfolio tool used is PebblePad which consists of a private personal learning space and an ‘institutional’ space that allows individuals to submit elements of their portfolio for assessment. Use of the e-portfolio builds through the course culminating in a final assessment of overall ‘readiness for practice’, which encourages the students to consider their development holistically as well as to present evidence for individual HCPC Standards of Proficiency. This mediates the potential difficulties associated with constructing and assessing competencies. Use of the eportfilio was evaluated through an online questionnaire, gathering both quantitative and qualitative data on attitudes to using PebblePad, impact on the course, training and support, and recommendations, and with open response questions to probe reasons for responses given. 94% of students who responded agreed or strongly agreed that they found PebblePad useful, 82% agreed that they had received useful feedback and 68% agreed that PebblePad had helped them to become an independent learner. Fifty-six percent agreed that the intended to continue using PebblePad beyond registration. However, only 29% agreed that they had found the experience enjoyable. Thematic analysis of responses to open questions indicated that the practical aspects of using the technology and the time involved in learning how to use it were a barrier to enjoyment for some students. Positive themes included accessibility and convenience of use and the structure and feedback the tool provides for assessment, self-reflection and learning. Future research will investigate whether and how graduates go on to use their e-portfolio to support their ongoing development as they embark on their professional careers.