Sarah White

Many speech and language therapy (SLT) services have limited capacity for providing school-based input. Some offer commissioned SLT input, to enhance the service provided by the UK National Health Service (NHS), giving schools the option to increase the amount and scope of SLT intervention. This two-tiered model of service provision is relatively new and has not been researched. This study investigated the experiences of schools who had commissioned input from the local SLT service, in terms of (1) describing how this was utilized and (2) exploring perceptions of its value. Semi-structured interviews were carried out with special educational needs co-ordinators (SENCos) from 11 schools and were thematically analysed using Framework Analysis. SENCos reported many positive aspects of the commissioned model, including better communication with Speech and Language Therapists (SLTs) and improved outcomes for children. SENCos felt that the numbers of children with speech, language and communication needs (SLCN) had reduced following commissioned input. Very few disadvantages of the model were identified. SLTs delivered a range of activities, including training staff and providing direct input for children. SENCos would recommend the service, and perceived the cost to be moderate. These data suggest that SENCos place a high value on SLT in schools, and welcome the opportunity to purchase additional input.

BACKGROUND: Adjectives are essential for communication, conceptual development and academic success. However, they are semantically and syntactically complex and can be particularly challenging for children with Developmental Language Disorder (DLD). Surprisingly, language interventions have not typically focused on this important word class. AIMS: (1) To provide a supportive and accessible primer on adjectives for practitioners; (2) to explore how the SHAPE CODINGTM system can be adapted to support adjective learning in DLD; and (3) to provide practical recommendations on how to support adjective learning in clinical practice and education. METHODS/PROCEDURE: We synthesise linguistic and psychological research on adjective semantics, clinical insights into DLD and pedagogical practice supporting this population. MAIN CONTRIBUTION: We address the lack of specific training in the nature and acquisition of adjectives for speech and language therapists (SLTs) by providing an accessible primer. We also provide an innovative guide detailing how an established metalinguistic intervention might be adapted to support adjective learning. CONCLUSIONS/IMPLICATIONS: Without targeted support for adjective learning, the communicative potential of children with DLD is compromised. Our recommendations can be used across a range of therapeutic and educational contexts to guide SLTs and teaching staff in developing practice in this area. WHAT THIS PAPER ADDS: What is already known on the subject Adjectives are an essential word class needed for effective communication. They are also vital to successfully achieve academic objectives across all curriculum areas. For example, most subjects require children to be able to describe, evaluate, compare and discriminate different events, objects or techniques. Children with Developmental Language Disorder (DLD) have deficits in various domains of language that can affect adjective learning and use. What this paper adds to existing knowledge Despite the importance of adjectives, speech and language therapists (SLTs) and other professionals supporting language development rarely receive specific training regarding their structure and meanings, and how to teach and support their use. This article provides an accessible primer on the many subtypes of adjectives and how these behave syntactically and semantically. It explores how adjective teaching could be enhanced for children with DLD by adapting an established metalinguistic technique and provides practical recommendations for implementing this approach. What are the potential or actual clinical implications of this work? By raising awareness of the complexities of adjectives and providing strategies to support their acquisition by children with DLD, this article will enable SLTs and teaching staff to improve their understanding and practice in this area and, with further research, to develop robust, effective interventions for children with DLD. This will contribute to enhancing the long-term academic, social and employment success of children with DLD.

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.