A Policy Impact Analysis of Speech and Language Therapy (SLT) services within Sure Start Local Programmes (SSLPs) in Northern Ireland (NI): Service User Evaluation

Elaine Duddy Dr D. HazlettDr J. Lambe

Overview:

Project background Overall aim of investigation Methods employed and associated

ethical issues Work to date References

Wellbeing & Every Child Matters 2003

Being healthy

Staying safe

Enjoying and achieving

Making a positive contribution

Economic wellbeing

Wellbeing

‘Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.’ (WHO website )

‘Wellbeing is broadly conceived to mean the ‘level’ of life quality – i.e. The extent to which pleasure and satisfaction characterise human existence and the extent to which people can avoid the various miseries which are potentially the lot of each of us’ (Andrews, 1974 , p280)

Speech, Language and Communication (SLC)

Effective speech, language and communication development is ‘a strong indicator of successful adjustment in a variety of contexts including mental health and wellbeing, emotional development and educational attainment’ (Adamson-Macedo et al 2009 p192)

‘In many ways our ability to communicate defines us, it is one of the ways we are judged and measured by others and the means by which we forge our relationships’ (ICAN Report 2008

p3)

Impact of Speech, Language and Communication Needs on Wellbeing Speech, language and communication needs

(SCLN) in the pre-school period constitute a risk factor for poor school performance, educational attainment and social difficulties in later life (Law et al 1998)

Education is crucial to economic outcomes for disadvantaged children in later life (Walker 2006) (cited in Fuller 2010)

‘51% of preschool providers recently surveyed cite Speech and Language difficulties as the most common difficulty that is evident in children attending preschool provision’ (ETI Review 2007) (cited by NI SLT Task Force Report 2008 p30)

Speech and Language Therapy (SLT) SLTs ideally placed to assess, advise and

remediate SLCN (Fuller 2010)

Inclusion within SSLP service provision framework

Role extended beyond traditional clinical one

Ecological approach – ‘facilitating children’s language development in the wider population’ (Fuller 2010 p184)

Collaborative model of service delivery

Sure Start Background

Flagship Labour government policy 1998-2010

Sure Start Local Programmes (SSLP) - to improve the life-chances of children under the age of five living in areas of socio-economic disadvantage by means of multi-agency, multi-disciplinary programme

Northern Ireland Sure Start SSLPs began in 2000

Currently 34 Sure Start programmes

Approximately one-third are rurally based For 2008-09 £16 million invested in N I

SSLPs

Accessed by 29,210 children under four years and their families (Sure Start 2011)

Emerging Issues:

No original pilot study carried out National Evaluation of Sure Start’s results to

date indicate modest impact SSLP debate dominated by ‘adult concerns’

(Lloyd 2008) Lack of rigorous evaluation at regional level Evaluation and outcome measures used are

highly variable Wide variation across the region in services

provided Current review of SLT service by DHSSPS Current review of SSLP SLT service by DE

Research Aim:

To investigate the impact of Speech and Language Therapy within the SSLP context on the communication wellbeing of service users (parents and children) from their perspective.

Research Questions:

What evidence is there that Speech and Language Therapy offered within the SSLP context has impacted on the communication skills of service users?

What is the impact of Speech and Language Therapy within SSLPs on the communication skills of service users?

Objectives:

To identify the impact of current policy on SLT service provision within SSLPs NI

To identify the causal relationship between SLT provision and communication skills of Service Users

To identify intervening variables impacting on this causal relationship

To compare and contrast the ‘communication progress’ of Service Users

To relate ‘communication progress’ to parental perception of

well-being

To make recommendations

Research Design:

A policy impact study from the service users perspective using a…

2 stages:Policy content analysisThematic content analysis

Flowchart of Research Phases

Policy content analysis

Quantitative questionnaire with

Sure Start managers

Service report analysis

Selection of variables for service

user interviews & development of

interview outline

Stratified sampling process

Data collection: complete interviews with service users

Thematic content analysis of interview

data

Map themes to ECM definition of wellbeing

Make Recommendations

Ethical issues

Researcher objectivityReliability & validityAwareness of constraints & biasesRobust sampling frameworkConfidentiality processConsent processComplaints procedureUniversity of Ulster ethical

guidelines

Work schedule for next 2 yearsTask F/

M 12

A/M 12

J/J 12

A/S 12

O/N 12

D/J 13

F/M 13

A/M 13

J/J 13

A/S 13

O/N 13

D/J 14

Lit RV

Doc Analysis

Service report analysis

SS Manager Questionnaire

Defining variables

Consentprocedure

Complaintsprocedure

Ethical approval

InterviewDesign

Interviews

Data Analysis

Write up

Research training activity

Completed (44 credits):Introduction to Project ManagementGetting Published in the Social SciencesBuilding Your Career; Adding Value to your PhDWriting to Learn: Improving your Writing SkillsAcademic Integrity: Avoiding PlagiarismThe Literature Review – OnlineAn Introduction to Research Skills – OnlineResearchers in Residence ProgrammePlanning your CareerIntroduction to the Career Development Centre for first year PhD Research StudentsHow to be an Effective ResearcherDeveloping Information Skills for Effective ResearchIntroduction to RefworksAppraising Research Quality v2Policy Evaluation Methods

Required:- nVivo- Statistics

Progress to date

Literature Review:- Historical policy context- Current policy context- International & national legislation Establishing links with services- Scoping service- Meeting with Childcare Partnership Co-ordinators- Meeting with AHP Commissioner Working in Partnership with DE project- Access to secondary data- Demographic informationDevelopment of Methodology- Rationale- Design- Framework

References

Adamson-Macedo, E.N., Patel, R. & Sallah, D.K. (2009) An independent psychometric evaluation od a speech and language tool for two-year-old children from a Sure Start trailblazer site in the West Midlands. Child Language Teaching and Therapy 25, 191-214.

Andrews, F.M. (1974) Social indicators of perceived life quality. Social Indicators Research 2(27) 279-299

Every Child Matters (ECM) (2010) Department for children, school and

families (DfCFS) www.webarchive.nationalarchives.gov.uk

Fuller, A. (2010) Speech and language therapy in Sure Start Local Programmes: a survey-based analysis of practice and innovation. International Journal of Language and Communication Disorders, 45(2), 182-203

ICAN (2008) Speech, Language and Communication Needs and Primary School-aged Children. I CAN Talk Series – Issue 6

Law, J., Boyle, J., Harris, F., Harkness, A., and Nye, C. (1998) Screening for speech and language delay: a systematic review of the literature. Health Technology Assessment, 2 (9) NHS R&D HTA Programme

References

Lloyd, E. (2008) The Interface between Childcare, Family Support and Child Poverty Strategies Under New Labour: Tensions and Contradictions. Social Policy & Society, 7 (4), 479-494

Northern Ireland Speech and Language Therapy Task Force Report on Speech and Language Therapy Services for Children and Young People (2008) Improving outcomes for children and young people with speech language and communication needs Belfast: DfHSS

Sure Start (2011) Profile of Sure Start Projects within Northern Ireland July 2011

Sylva, K., Melhuish, E., Sammons, P., Siraj-Blatchford, I. & Taggart, B. (2004) The Effective Provision of Pre-School Education (EPPE) Project: findings from Pre-school to end of Key Stage 1. www.dfes.gov.uk

World Health Organisation (accessed 10/1/12) Definition of health www.who.int

Questions

Thanks for listening