Issued by: Irish Association of Speech and Language Therapists

FOR IMMEDIATE RELEASE

SUPERVISION OF NEW GRADUATE SPEECH AND LANGUAGE THERAPISTS

A response to comments from An Taoiseach Brian Cowan in relation to supervision for new graduate Speech and Language Therapists.

Speech and Language Therapists are the healthcare professionals responsible for the assessment, diagnosis, identification, prevention, and rehabilitation of individuals presenting with communication and swallowing disorders. The Irish Association of Speech and Language Therapists (IASLT) is the recognised professional body of Speech and Language Therapists in Ireland.

As a professional quality assurance and risk management measure, the Irish Association of Speech and Language Therapists (IASLT) require all newly qualified Speech and Language Therapists complete one year of supervised practice following graduation. During this year, the therapist will carry out assessment, treatment and management of individuals with communication and swallowing difficulties but at the same time must have access to direct supervision of intervention in the form of mentoring and professional support; joint clinical sessions; attendance at clinical meetings, staff meetings etc.

The requirement for a period of supervised practice is not unique to the Speech and Language Therapy profession but is common across many healthcare professions, including medicine, physiotherapy and occupational therapy. It is also a long established requirement for membership of Speech and Language Therapy Professional Bodies internationally. The Royal College of Speech and Language Therapists (RCSLT) require new graduates to undergo a one year period of clinical practice under the supervision of a senior therapist. The American Speech-Hearing Association (ASHA) requires the completion of a Clinical Fellowship year or documented evidence of a minimum of 1,260 post-graduate hours of clinical experience under supervision (the equivalent of 36 weeks of professional employment at 35 hours per week).

As a profession we aim to deliver our services in creative, innovative, multidisciplinary ways in an environment marked by an escalating demand for services and the constraint of finite resources.

We are acutely aware of the existence of lengthy waiting lists for individuals presenting with communication and swallowing disorders. We do not accept that this has resulted from inflexible work practices or the requirement for new graduate therapists to complete a year of supervised practice but rather a failure to provide a minimum level of staffing to meet the demand for a highly specialised service.

While there has been an almost 300% increase in the number of training places for Speech and Language Therapists in recent years, this has not been matched with the development of posts to meet the identified demand. The implementation of a recruitment embargo across the health service in September 2007 and introduction of an Employment Control Framework in January 2008 is of considerable concern to those highly trained graduates who will be seeking employment from June 2008.

Significant constraints in recruiting into vacant posts and identified service development posts has had and will continue to have a devastating effect on our ability to meet the needs of our service users.

IASLT has been proactive in raising these issues with Prof Brendan Drumm on behalf of Speech and Language Therapists and those that need our services. IASLT will continue to liaise with the Dept of Health and Children and the HSE highlight their concerns regarding SLT service provision on behalf of all those who wish to avail of SLT services.

Maeve Murphy
Chairperson, IASLT
01-4142780
END OF STATEMENT

Taoiseach calls for flexibility at work by speech therapists

MARIE O’HALLORAN

SPEECH AND language therapists need to be more flexible in their work practices to address the lengthy waiting lists for children seeking assessment, the D?°il has been told.

Taoiseach Brian Cowen acknowledged that “the provision of such services has been a problem for some time”.

“One of the issues was a shortage of graduates of speech and language courses, but we have doubled the number of graduates.”

He said there was a need for flexibility in work practices because new graduates “must be supervised by a senior staff member for the first years immediately after qualifying. We must determine why that should be the case.”

The Taoiseach said “the way work practice issues are operated within the system is the reason we are not getting the outputs we would expect for the resources we are allocating”.

Fine Gael leader Enda Kenny had complained that “in Dublin alone 4,000 children are now waiting for speech and language assessment”.

“There is further discrimination within that because it matters where a child lives.

“In Dublin north, the waiting period can be as low as three months, whereas in Dublin south it can be 31 months and in Dublin west 33 months.”

Mr Kenny said “there is no cohesion, streamlining or delivery of the service”.

He added that he could not “overstate the importance of early intervention and delivery of service for children who are so afflicted”.

“It is absolutely critical. If early intervention does not take place, the consequences are a lifetime of self-consciousness, speech impediment and under-performance.”

Mr Cowen said they had to determine why “newly qualified graduates cannot be released to do their job more expeditiously than is currently the case”.

That issue “must be addressed in the context of a more flexible response”.

However, Mr Kenny said that “there is no point telling the parents of children with speech and language difficulties that we have doubled numbers of qualified graduates”.

Those graduates could not get jobs because they did not have any experience.

“We are currently preparing the most costly form of human export. The graduates will not hang around. They will go to countries where they can get jobs.”
© 2008 The Irish Times

The Diving Bell and the Butterfly

One of my classmates, Eibhlin, had told me about this beautiful book called “The
Diving-Bell and the Butterfly” by Jean- Dominique Bauby (Fourth Estate, 1997).
He was the Editor-in-Chief of French Elle when he suffered a massive stroke
aged 46, which left him with “locked in syndrome”. The only way he could communicate was by raising his eyebrow and by blinking. He couldn’t move any other part of his body. He writes about his speech therapist in a chapter entitled “Guardian Angel” -

“The identity badge pinned to Sandrine’s white tunic says “Speech Therapist” but
it should say “Guardian Angel”. She is the one who set up the communication code
without which I would be cut off from the world. But alas! while most of my
friends have adopted the system, here at the hospital only Sandrine and the
female psychologist use it. So I usually have the skimpiest arsenal of facial
expressions, winks and nods to ask people to shut the door, turn on the tap,
lower the volume on the tv or fluff up my pillow. I do not succeed every time.

As the weeks go by this enforced solitude has allowed me to acquire a certain
stoicism and to realise that the hospital staff are of two kinds: the majority,
who would not dream of leaving the room without first attempting to decipher my
SOS messages and the less conscientious minority who make their getaway
pretending not to notice my distress signals. Like that heartless oaf who
switched off the Bordeaux-Munich football match at half-time, saying
“Goodnight!” with a finality which left no hope of appeal. Quite apart from the
practical drawbacks, this inability to communicate is somewhat wearing. Which
explains the gratification I feel twice daily when Sandrine pokes her small,
chipmunk face through the door and at once sends all gloomy thoughts packing.
The invisible and eternally imprisoning cocoon seems less oppressive.

Speech Therapy is an art that deserves to be more widely known. You cannot
imagine the acrobatics your tongue mechanically performs in order to produce
all the sounds of a language. Just now, I am struggling with the letter “l”, a
painful admission for an editor-in-chief who cannot pronounce the name of his
own magazine.

On good days, between coughing fits, I muster enough energy and wind to be able
to puff out one or two phonemes. On my birthday, Sandrine managed to get me to
pronounce the whole alphabet more or less intelligibly. I could not have had a
better present. It was as if those 26 letters had been wrenched from the void:
my own hoarse voice seemed to emanate from a far off country. The exhausting
exercise left me feeling like a caveman discovering language for the first
time. Sometimes the phone interrupts our work and I take advantage of
Sandrine’s presence to be in touch with loved ones, to intercept and catch
passing fragments of life, the way you catch a butterfly. My daughter Celeste
tells me of her adventures with her pony. In five months she will be nine.

My father tells me how hard it is to stay on his feet. He is fighting undaunted
through his ninety-third year. These two are the outer links of a chain of love
which surrounds and protects me. I often wonder about the effects of these
one-way conversations on those at the other end of the line. I am overwhelmed
by them. I know that some of them find it unbearable. Sweet Florence refuses to
speak to me unless I first breathe noisily into the the receiver which Sandrine
holds glued to my ear. “Are you there, Jean-Do?”, she asks anxiously over the
air.

And I have to admit that at times I do not know any more”.