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SPEECH, LANGUAGE AND COMMUNICATION NEEDS
Communicating about communication Candice Lazarus and Helen Kirk look at the role of speech and language therapists in child mental health
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hen children and young people with learning disabilities access learning disability child and adolescent mental health services (LD CAMHS), they are supported by a variety of professionals, including psychiatrists, clinical psychologists, nurses, and support workers, who work with families to manage mental health difficulties and/or challenging behaviour. Communication difficulties are common in those with learning disabilities and are associated with an increased prevalence of challenging behaviour, as this is often a form of communication (Royal College of Speech and Language Therapists, 2009). Techniques to support and develop communication are recommended by the positive behaviour support (PBS) model to increase wellbeing and quality of life (PBS Coalition UK, 2015). With expertise in the area of communication, speech and language
A crucial aspect of the role is to deliver training to team members therapists (SLTs) are well placed to deliver such support. However, SLT positions within LD CAMHS teams are historically unevenly distributed across the UK, despite developments in service provision within SLT over the years (British Institute of Learning Disabilities, 2002). This article reflects on the unique contributions that SLTs bring to LD CAMHS and also the challenges that present to the role. SLTs provide in-depth assessment to inform others of communication abilities and tailor support to maximise communication for the individual. For example, an assessment of verbal comprehension will consider the level of language to use with a young person.
This may also highlight processing difficulties, specific concepts or grammatical structures that should be avoided, or whether visual resources would be beneficial. Specialist assessments and interventions like these can impact greatly on the wellbeing of the young person and those who support them. The work of an SLT takes place in a variety of settings, allowing them to work with children, families, teachers and professionals, both directly and indirectly. A crucial aspect of the role is to deliver training to team members, other professionals and parents in areas such as language development, the use of visual resources to support communication and alternative and augmentative communication systems, for example the Picture Exchange Communication System (PECS) and Makaton. SLTs may, on occasion, also provide consultations to mainstream CAMHS, particularly regarding the area of autism. This can involve contributing to assessment and advising on communication strategies.
A different way of working
Helen Kirk (left) and Candice Lazarus plan communication interventions.
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Working in a team like LD CAMHS which is close functioning and dynamic, with regular team meetings, case discussions and supervision, can prove to be a challenge for SLTs, who typically work autonomously. The emphasis on information sharing and working closely with one or more team members can be difficult, as this requires consideration of the roles of others in the workplace as well just their own. However, a smaller caseload than carried by many WWW.SENMAGAZINE.CO.UK