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E462"9$ Article by Berkshire Healthcare Trust SLTs at Whitley Park Infant and NurseryMeeting the Mainstream NeedIn the current economic climate, many education and health services are facing toughfinancial decisions about service provision. In a time when some schools or LocalAuthorities are unable to continue to afford their current level of Speech and LanguageTherapy provision, or in some cases, appear to doubt the true value of such a service,it is refreshing to be able to report on a school that decided to increase their level ofprovision.In 2009, Whitley Park Infant and Nursery School in Reading increased the amount ofinput they received from our service by buying in additional Speech and LanguageTherapy Assistant (SLTA) sessions. With the support of Head Teacher Ann Tanner,who always recognised and promoted our work, we set about proving that this modelof working was effective.The teamJennifer (Specialist SLT) covers children in the nursery and up until the end of year 2and Michelle (SLT) covers years 3 and 4. We are supported by Anita Holland (SLTA)with each of these year groups. We feel that having this small therapy team on site isan integral part of our successful relationship with school.We work with both statemented and non-statemented children. In 2011, the Infant andJunior schools merged to form Whitley Park Primary School.Social ContextThe caseload is large and varied, featuring many of the impairments expected on amainstream caseload. The school is situated in an area of social deprivation, with asignificant proportion of the caseload presenting with some degree of languagedeprivation.Many recent studies have indicated a link between social disadvantage and languagedeprivation. Tough (2000) stated that children in nursery who were from low socioeconomicstatus backgrounds started school at a linguistic disadvantage to theirpeers, and that as such children presented in different ways, staff reducedexpectations, used less complex language, which in turn offered further academicdisadvantage. Ginsborg (2006) agrees that children from low socio-economic statusbackgrounds do not achieve the same academic standards as more advantagedpeers, due to language deficits impacting on ability to access the curriculum.How the service changedIn 2009, the school decided to fund additional SLTA sessions, alongside those alreadyfunded by the Local Authority, as shown in Table One. The school continue to receivefive sessions per week of therapist time, with school now funding two of thesesessions and the Local Authority funding three.This increase allowed us to work in different ways that appear to have made a hugedifference to the children on our caseload. The main differences are:18

• A high level of SLTA time and the direct therapy that she is able to deliver, freesup therapists to work more flexibly and respond to the needs of pupils and staff• Our increased accessibility to staff – we are now able to be more flexible withour time, and to use this to talk to school staff about communication skills,behaviour and general information about particular children. We can arrangetimes for staff to join assessment sessions, and for 1:1 support workers to jointherapy sessions. We have time to support staff with onwards referrals, and forthem to help us with this• More joint working with other professionals – this includes working with the SureStart therapy team to ensure a smooth transition into the Nursery class• Packages of care – flexibility to meet the child’s needs, including 1:1 and groupsessions. We can offer continuous input when needed, extending programmesto meet the need rather than achieving whatever is possible in a particulartimeframe• We are more visible and accessible to the parents• More involvement in school events – we attend nursery introduction days andmeet more parentsMeasuring Success: is it working?We decided that the most obvious way to measure success was to investigate thenumbers of discharges before and after the new model was introduced. If the childrenare discharged it means they have speech, language and communication skills fallingwithin the typical range before they enter Key Stage 2. Figure one shows that ourdischarges have increased each year, with children counted over the September toAugust school year.We investigated which year groups children were in at the time of discharge. Figuretwo shows this breakdown. We aimed to resolve communication difficulties as early aspossible and therefore minimise the impact of speech and language difficulties onlearning and social development. Bercow (2008) emphasises that a child’s chances ofovercoming communication difficulties are maximised through early identification andintervention. The number of children discharged during the reception year hasincreased each year. During 2009 and 2010, children were discharged during theirtime in nursery, which had previously not happened. While it is possible that thechildren in those cohorts had different levels of need to those in subsequent years, it isunlikely that this would vary to such a significant degree. The most striking aspect ofFigure two is that the majority of discharges during 2010 occurred for children in yearone, meaning more children were attaining typical scores before year two than we hadseen previously.We explored how many children continued to need support as they moved into KeyStage 2. Figure three shows the percentage of the caseload that transferred into keystage two during each academic year. Overall, the pattern shows that fewer childrenare transferring each year. The number dropped greatly during the 2009-2010academic year, corresponding with the change of model. The figure rose during 2010,partly due to several children transferring into the school during year two from schoolsthat had not been able to provide this level of input. It should be considered alongsidethe fact that the level of discharges was actually highest during the 2010 - 2011academic year.19

The children who continue to need support as they transfer into key stage two typicallyhave persistent communication difficulties or require specialist involvement relating to,for example cleft palate or dysfluency. Children needing support beyond year fivereceive input from the transition service, which supports pupil transition from primary tosecondary school. This is jointly funded by the PCT and Local Authority and isaccessible to both statemented and non-statemented pupils.Why does it work?Law et al (2000) state that collaboration between therapists and schools is mosteffective when professionals clearly understand each others’ roles, when therapiststake account of the educational context, when teachers appreciate the importance oflanguage development within the curriculum, and when schools value therapistinvolvement. We feel that our model demonstrates each of these aspects ofcollaborative working, contributing in part to our reported success. Examples include:• Clear understanding of roles - therapists provide training to school staff, andschool includes therapists on school-based training• Take account of educational context – modelling activities that are suited to theclassroom environment, and incorporating activities such as whole-bodylistening• Appreciate importance of language development – teachers make the time todiscuss individual cases, and to share information considered relevant• Valuing therapist involvement – we feel part of the school team throughinvitation to meetings, inclusion in newsletters and being allocated a purposebuiltclinical room within the new buildingIn addition to this, our SLTA works hard to promote the ‘Hello’ campaign throughoutthe school, becoming involved in events and initiatives and raising awareness.The futureWe can see the positive impact of working in this way, but are aware that furtherinvestigation is needed into how this model could be effectively transferred anddeveloped in other educational settings. We are hopeful that by collating the evidencewe have shared in this article, we will help other schools in the locality to see the valueof investing in this level of input in early years and the benefit to children’s lateracademic success.Every child discharged because they are ‘within normal limits’ is a child able to achievetheir future aspirations without hindrance of a communication difficulty. Supported bya school that value our role so highly, we can continue to provide a service that we areproud of.Jennifer Heath, Specialist Speech and Language Therapist,Jennie.heath@berkshire.nhs.ukMichelle Phillis, Speech and Language Therapist, Michelle.Phillis@berkshire.nhs.uk20

ReferencesBercow, J (2008) The Bercow Report: A Review of Services for Children and YoungPeople (0-19) with Speech, Language and Communication Needs DCSF RetrievedAugust 23 rd 2011 fromhttps://www.education.gov.uk/publications/eOrderingDownload/Bercow-Report.pdfGinsborg, J. (2006) The Effects of Socio-economic Status of Children’s LanguageAcquisition and Use In J. Clegg & J. Ginsborg (Eds.), Language and SocialDisadvantage (pp. 9-27) Sussex, England: John Wiley and SonsLaw, J., Lindsay, G., Peacey, N., Gascoigne, M., Soloff, N., Radford, J., Band, S., &Fitzgerald, l. (2000) Provision for Children with Speech and Language Needs inEngland and Wales: Facilitating Communication Between Education and HealthServices DFEETough, J. (2000) Appendix to the Minutes of Evidence Presented to the SelectCommittee on Education and Employment, The United Kingdom Parliament RetrievedDecember 1, 2010 fromhttp://www.publications.parliament.uk/pa/cm200001/cmselect/cmeduemp/33/33ap34.htm21

Table one – The number of SLTA sessions funded by Whitley Park School andthe Local Authority.Number ofsessionsfunded byschoolNumber ofsessionsfunded by LocalAuthorityBefore2009From 20090 7 83 3 2Total 3 10 10From July2010FiguresFigure one - Percentage of Children discharged from WhitleyInfants caseloadPercentage of childrendischarged4540353025201510502007 2008 2009 2010Year Discharged22

Figure Two - Discharges by Year GroupActual Number of ChildrenDischarged25201510502110 1187 6 7 7 5 53 20 1 02007 2008 2009 20107NurseryReceptionYear 1Year 2Year DischargedFigure Three - Percentage of Infant Caseload Transferred toJuniorsPercentage161412108642014.2213.099.64.043.162007 2008 2009 2010 2011Year of Transfer23