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Collaborative practice - an education perspective

Cherry Hughes | 01.06.2005

More speech and language therapists are working in mainstream schools to support children who stammer. BSA Education officer, Cherry Hughes in the first of two articles provides some ideas on developing this link between the therapy service and education.

  • A mainstream service for primary schools
  • School culture
  • What each professional may wish to know
  • Joint training

Planning a visit

In a classroomMany speech and language therapy departments have already established mainstream services, usually for primary schools, and have developed good working relationships with the schools. Consequently, these comments will have little relevance in that context, but for those departments seeking to set up a mainstream service there might be some value in considering some of the issues raised here.

Prior to considering a visit to support a pupil in a primary school, the therapist will have talked through the process with the parents and made sure that the child is also quite comfortable with the idea. Younger children are often excited at the thought of another adult in the class, while older pupils may need more reassurance, initially from parents and the therapist but also from the class teacher.

Next, it is always helpful if the therapist is aware of the expectations of that school's culture: for instance, dress standards for pupils and staff, and the formality of relationships between staff, and between staff, pupils and parents. To an outsider these codes of dress and behaviour may seem to be unnecessarily formal and have nothing to do with the process of collaborative practice. However, an awareness of them and a readiness by the therapist to conform to those standards will immediately flag to the staff that the therapist is working with them and can be considered part of the team. When visiting a school for the first time, if the therapist has no prior information, it is sensible to dress in an unobtrusively formal manner.

If the school has never (so far as is known) been visited by a therapist from that department, it is courteous to write to the head teacher, giving details of the pupil and the member of staff involved. The letter should make it clear that the therapist would be pleased to meet with the head or a nominated representative, perhaps the SENCO, to talk through the plans for the visit and answer any questions that may be asked. The therapist should explain that s/he will be contacting the school by telephone in the next few days to check whether such a meeting is required before the visit. It may turn out that the head teacher (or the secretary) will simply respond that the head is very happy to have the visit go ahead and would just like to be kept informed by the class teacher. At least the offer has been made. When a therapist is invited to meet with the head it can be immensely valuable to both the school and the therapist. An awareness by the head of the importance of therapy should ensure that time is made available to the class teacher for any planning meetings and that there is a general sense of support.

Once the class teacher has been approached and times and dates fixed, it is important that the two professionals can meet in a quiet environment. Ideally, at least an hour should be allocated, and it is so much easier to arrange the best of conditions for good practice if the head is supportive.

Meeting with the class teacher

What the teacher may wish to know

A complication in this discussion may be the lack of a common professional language so a readiness to share perspectives is essential.

Many teachers may not have worked with a therapist before in their own classroom and may need reassuring about the nature of the visit. There may be concern that the visitor may be 'assessing' their practice in some way. Teachers can get neurotic about this, as they are frequently the butt of ill informed comment. Another worry for the teacher is often that to meet the needs of this pupil, s/he may feel expected to 'neglect' the national curricula demands and the needs of the other children. A chat to explain that the visit is to identify the speech needs of the child who stammers should be very reassuring to the teacher, and s/he should be ready to discuss how this can be done.

A complication in this discussion may be the lack of a common professional language so a readiness to share perspectives is essential.

Another issue to clarify is that of classroom management. Questions to be sensitively addressed are: If the therapist observes poor behaviour how should it be handled, by the therapist or by referral to the teacher? How are children managed? Is there a co-operative ethic in place or is discipline top down from the teacher? I would always feel that any visiting professional in a classroom should have the confidence and competence to act as the other eyes and ears of the teacher and deal with common incidences themselves. Pupils can soon come to lose the respect for the visitor if they realise that every minor breach of behaviour is being referred to the teacher. It is best if these and related concerns are discussed in advance and a way forward agreed.

What the therapist may wish to know

The therapist needs information about the child's academic performance in relation to assessed potential and should start to explore the teacher's judgement on how the stammer affects that. Records of test results and involvement of other staff within the school, such as the SENCO, should be provided and the issue of 'School Action' explained. The code of practice on special educational needs (SEN) gives schools considerable flexibility over this and not all children who stammer will have their needs recorded through this with a learning support plan (IEP). Whatever the position it is important that the two colleagues eventually put some kind of structure in place for monitoring and management of the child's speech. Targets and some evaluation procedures, however informal, are really useful and may be passed on in the pupil record from year to year to encourage consistency of approach.

There is a need to clarify the issues connected with working in a group with other pupils so that the child who stammers is not singled out. The therapist does need to understand their language needs and that implies that there should be some access to information about a particular child. Most schools will have implied consent from parents to permit a visiting professional to have information about a child's learning and social needs, but it is a tricky issue. It is appropriate for the therapist to ask for clarification of this.

I would suggest that the two professionals agree to sum up their conclusions in notes that they share and keep an individual copy. Arrangements for the management of the visit and feedback strategies should be mutually agreed. The involvement of the parents, and also the child should be discussed and a way forward decided upon. Nowadays there is very justified emphasis on partnership with parents and also with ensuring that the pupil has some ownership of the process, and this must be agreed. Some parents may have taken advantage of access to the education authority's parent partnership officer and be very aware of their entitlement for support.

After this meeting(s), it is helpful, if time permits, for the therapist to visit the classroom as an observer before working with the child. By now, the therapist will have formed a provisional view on how to conduct the visit. At this stage in my view it is best not to provide information about stammering as this may affect the teacher's attitude and behaviour to the child who stammers during the visit. The therapist needs to observe a typical lesson with the teacher responding to the child who stammers, as s/he would normally do. After an authentic observation the therapist will be able to provide much more valuable feedback.

During this session, both the child and the standards of practice required by the teacher can be observed, so that the therapist slots easily into the classroom environment. It is always worth remembering that the teacher is ultimately responsible for the management of that classroom. In cases where that practice appears odd or idiosyncratic, it is important that any visiting professional supports that, even if their own preference is different.

Often the teacher will involve a classroom assistant in the discussion with the therapist, and this can be helpful. However, some schools may have taken advantage of recent developments, so that an assistant could have extended responsibilities for the teaching of a group. The therapist needs to be aware of the exact role of the assistant in the classroom, and to be clear to whom s/he is giving feedback.

Joint training

Collaborative practice is working well in many services already but in my view, the ideal basis for its development is to be found in joint professional training for teachers and therapists. This was recommended by a DFES/DOH working party that I attended that fed evidence to their report on the provision of speech and language therapy in 2001. Since then there has been funding available for joint training in continuous professional development meetings but it would still be helpful at initial training level.

When it works well collaborative practice supports most effectively the speech and language development of the pupil who stammers. It also brings into the classroom expertise that can benefit the communication needs and development of all the pupils.

I hope that these few ideas are useful. It would be very interesting to hear from therapists what strategies they have found helpful in their practice so they could be shared through this magazine. In the next article I will consider the actual visit and its feedback, and suggest a few ideas for working with secondary schools.

From the Summer 2005 edition of Speaking Out

Link to the second article: Collaborative practice - an education perspective (2nd article).