Joint working with ABUHB Speech and Language Therapy Department and Communication Intervention Team (ComIT) Training Colleagues in Local Authority Schools to Support Children with Speech, Language and Communication Needs

Historical Position 2 year waiting list for Speech and Language Therapy for all children Special Educational Needs tribunals high (48% SLT) Poor relationship between LAs and Health Board Separate services Parents lobbied ABUHB AGM with banners

Solution LAs agreed to part fund 5 ‘waiting list SLTs’ to clear backlog Whole system not tackled Failed! Invoices not paid Waiting lists rose again So ‘COPRODUCTION’ attempted with both agencies, stakeholders

Communication Intervention Team Partners agreed to develop integrated service model Shared service set up between 6 partners; ABUHB and 5 LAs ComIT is committed to: Raise awareness that communication skills are key to all learning Develop integrated pathways with Health based Speech and Language Therapy department Build capacity in schools to assist identification and support for pupils with speech, language and communication needs (SLCN) Work with parents

Service Levels ComIT supports children at the Universal and Targeted levels.

Communication Pyramid Using Spoken Language Understanding of Spoken Language Attention and Listening Play/Interaction Speech Social skills

School Intervention Graduated response Use of checklists for individual children based on all the areas of the Communication Pyramid using Checklist of Emerging Communication Skills (ChECS) rating Group work, school staff co-participate to carry out intervention package Evaluation of work with post checklist completion More detailed checklist if little or no progress made Further action agreed When clearly necessary refer to Specialist SLT Targeted service continues during specialist SLT treatment and when completed

Cumulative Difference in Post Intervention Scores

Improvement in Post Scores 2011/12

Improvement in Post Scores 2012/13

Measuring Impact on School Staff of Co-production School staff self rating questionnaire rates perception of their abilities and knowledge of SLCN using 3 questions as follows: 1. How confident are you about implementing a language/communication programme/package? 2. How would you rate your understanding of speech, language and communication needs in children? 3. To what extent do you think a child’s language and communication needs impact on their ability to access the curriculum?

1. How Confident are you about Implementing a Language/Communication Programme/Package?

2. How Would You Rate Your Understanding of Speech, Language and Communication Needs in Children?

3. To what Extent do you Think a Child’s Language and Communication Needs Impact on their Ability to Access the Curriculum?

Accredited Elklan Training for School Staff Two ten week accredited Elklan courses per term. Each learner (school staff) completes a portfolio to be submitted for accreditation for the appropriate accreditation award Elklan is named after the two authors Liz Elks and Henrietta McLachlan Two-day overviews of the ten week course. The aim of the course is to provide the learners with a high level of expertise with identifying and supporting speech, language and communication in the classroom

Measuring Impact of Accredited Training Robust evaluations of all training includes: Each learners perception of their knowledge Impact on their confidence to identify and support children with SLCN How the information impacts on their practice Implementation of the strategies with the school environment

Schools (%) Attended Elklan Training by LA (data as of December 2013)

Evidence of effectiveness was analysed using the following 3 key questions (also used nationally by Elklan trainers allowing for greater comparison): 1.Your ability to promote the communication skills of children with specific speech and language difficulties 2.Effectiveness of your Communication and Engagement with Children and their Families/Carers 3. Your ability to share information and collaborate with different agencies (particularly SLTs) Evidence of Effectiveness

1. Your Ability to Promote the Communication Skills of Children with Specific Speech and Language Difficulties

2. Effectiveness of your Communication and Engagement with Children and their Families/Carers

3. Your Ability to Share Information and Collaborate with Different Agencies Regarding a Child’s Communication Skills

Results of the questionnaires strongly suggest that staff on Elklan learn new practical strategies gain in confidence working with children with speech, language and communication difficulties. But it is difficult to analyse the impact this change is having on individual children. Results

Next Steps… Measuring efficacy of the ComIT Toolkit Joint research projects with Class Teachers, Elklan trained school staff, non Elklan trained staff and Speech and Language Therapists analysing the impact children of changed for children with identified SLCN Strategic partnership to monitor and meet needs of SLCN population together as agencies Joint database of all trained school staff is shared with ABHB SLT specialist service to facilitate care planning Monitor ComIT trained staff and ensure they are continuing to identify and support SLCN children in school Monitoring programme for the Elklan trained staff to ensure they receive continuing professional development

Value of Co-production Relationships between agencies much improved Invoices paid! Development of joint integrated service going very well Waiting times down significantly from 2 years NHS Award & Staff Recognition Nomination