In a previous article BSA education officer Cherry Hughes discussed arrangements for setting this up in a mainstream primary school. She now comments on the issues that arise as she has experienced them from a teacher's viewpoint.
- Feedback to the teacher
- The role of the Learning Support Plan (IEP)
- Inclusion policies and the role of the therapist and the teacher
Visiting a classroom
Once it is arranged for the therapist to visit the classroom there is considerable advice available on how the therapist should manage the visit. The protocols of the RCSLT may be deferred to and every service will have developed their own. My concern here is how the teacher experiences the visit and how the two professionals are able to work together to support the child.
Usually the therapist will sit with a group of children who have been pre-selected by the teacher as likely to benefit from support. The child who stammers in that group will hopefully not feel singled out, although s/he will know that the therapist is visiting his class to learn more about his needs. The teacher should have informed the therapist of the curricular targets to be met by the exercise and any concerns that s/he has about the speech needs of the child who stammers, with some basic information provided about the other children in the group. During the session the therapist will be able to assess how the child who stammers copes with oral situations, and observe the language accessibility of the classroom environment for the pupils.
I have often found that a therapist will notice that the adults in the classroom, including the teacher, do not always appreciate the needs to differentiate their language, particularly in the oral context, when working with the pupils. I am sure that I am not the only education professional to have sat at the back of a classroom, monitoring the teacher's presentation, to note that the language level was not accessible to every pupil. As teachers learn more about communication skills, particularly in the primary school, this is improving, but for some therapists their first task might be how to convey to a teacher that their practice is actually adding to the child's difficulties in the speaking and listening environment.
It can be incredibly difficult now for the therapist to convey these concerns to the teacher and have a constructive discussion about adjustments to classroom practice. If it can be accomplished productively in a quiet chat where basic advice about chunking material, giving time, slowing down speech and ensuring that there is a good code of conduct for children in turn-taking and so forth is offered, then the issue is easily resolved. Hopefully, practice is changed and improved without detriment to the relationship between the two professionals.
However, this whole area of the therapist having legitimate concerns about a teacher's practice in communication skills is a minefield to negotiate when it does not seem possible to talk with the teacher directly. When relationships between the service and the school are long standing, and based upon high levels of trust, it might be possible for the therapist to have a quiet word with the Senco, or even the Head about these concerns if it does not seem possible to raise them with the teacher. However, that is a high-risk strategy, as it does appear that an outside professional is assessing the competence of one of the staff, and in some schools that assertion could cause great offence.
It is in the rare case where such cordial negotiation does not seem possible at any level that it might be worth the therapist considering an offer of some training to all the staff, in the hope that the staff member causing immediate concern may be influenced to change practice. In my experience of offering whole school training on site, that can be a way of engaging teachers' concerns and questions about their own practice that they feel more able to share, as other colleagues are present. The interaction can be a very useful way of moving teachers on, without at the same time appearing to be denigrating them in any way.
It might be useful to share an experience of mine where a teacher was convinced that this sort of training was intended to turn them into speech and language therapists. It was useful to hear that honest perception and alleviate those concerns because I believe teachers often feel that they are expected to have expertise in every area and manage without support.
When a therapist is known to be accessible to the school if concerns arise, where trust has been built up, progress can be constructive and open-ended. I think that social bonding to facilitate good relationships can be very useful; perhaps through an invitation to a small social occasion, both within the school and/or the therapy department. On these occasions, and I have attended a few, you can see barriers melting as cordial conversation is shared. If resources allow, the practice of one SLT service seems to work very successfully. During the last week or so of the summer term when the timetable has wound down, a group of children who stammer are invited for a week's intensive therapy. On one day, a teacher selected by each child also attends, as do those parents who can. The dynamics of this can be very powerful but in my view it takes a very experienced and professional team of therapists to manage them, as was the case in the course that I went to.
Most children who stammer will not present with other special educational needs and are unlikely to be statemented, although according to the practice of the school, they may be placed on school action which gives formal expression to the need for resources for that child. I believe that any child receiving support from an outside agency should be on school action and should have a learning support plan, or IEP as it is still known. The therapist should contribute to this, in partnership with the teacher, the parents and, where appropriate, the child. It is a powerful tool for monitoring progress and the need to regularly review it and set new targets ensures that the key partners are regularly talking to each other. I know of some schools, which have worked with the therapist to set up oral targets for the whole class, as well as the child who stammers. In view of the great curricular emphasis on oral skills, that is a commendable way of addressing their development for all children.
The challenge of inclusion in the mainstream primary school
Children are now being included, who previously may have been in separate provision, and reactions differ as to how well this works. While inclusion is helpful for many children currently in separate educational provision, I am sceptical as far as children with severe learning difficulties are concerned. I have seen that for some of them inclusion has simply meant being present in the same room. However, that is a different debate. I would merely make the point that many therapists may now find themselves working with a mainstream teacher who has had little training in the needs of the children included in the class. For children who stammer, and have other complex needs who may be in that class, the therapist is really the key professional offering detailed advice about their management. For example, it is common for Downs's syndrome children to stammer. Therapy options and advice to the teacher may be complicated by the child's cognitive difficulties. I do not know how inclusion will work out, but I note that many parents are beginning to worry about the inclusion of children with complex needs and many mainstream teachers feel out of their depth. It would be interesting to know whether therapists working in the mainstream feel that the inclusion policy has serious implications for their practice.
From the Winter 2005 edition of Speaking Out