Speach and Language Therapy (SALT) - Meetings, agendas, and ...

2.1.3 New demands
In addition to the general upward trend in demand there was a specific new
initiative that would put further strain on the speech and language service.
The Department of Health recommended the introduction of neonatal hearing
screening programme that was designed to detect hearing loss at a much
earlier date. Historically, therapists working in hearing impaired bases would
see preschool children on initial referral, usually around three years. These
children would then be placed on a monitoring and advisory caseload, where
Teachers of the Deaf (TOD) would bring any concerns to the therapist’s
attention, and occasional appointments were arranged where possible within
the therapist’s timetable. These children would be transferred onto the
therapists’ ongoing therapy caseload if they received a placement in the local
resource base for hearing impaired children (Five Elms School). Funding for
four extra sessions to work with deaf children was provided by Education until
March 2004. This enabled the therapy service to allocate one session per
fortnight to work with pre-school deaf children. However, since the funding
ceased there has been no provision in place for this caseload.
Implications of the neonatal hearing screening programme
The government initiative for screening all newborn infants’ hearing started in
Barking & Dagenham in January 2004. Children with a hearing loss are now
identified within the first two weeks of birth and referred to the Hearing
Impaired Services at this time. This service has referred children to Speech
and Language Therapy as young as five months old, where traditionally
children were referred at around 3 years. Research has shown that support
and intervention for families of deaf children from professionals in the field, is
crucial in the early stages of diagnosis. It has also highlighted that direct work
with families is important for developing early communication skills, rather
than just an advisory and monitoring role. This has significant implications for
the Speech and Language Therapy service.
In 1999 the NDCS asked parents about the effects of late diagnosis, and in
2000 a questionnaire was distributed to parents to gather their views on
newborn hearing screening. The outcome of this research showed that
parents identified the following issues as being of primary importance for the
provision of quality services for deaf children and their families. These
included: time with professionals to understand the implications of deafness;
early follow-up appointments; well-trained and qualified staff who are deaf
aware and who have empathy with, and an understanding of the child and
their family; long-term, local quality services and support.
With no current funding available for preschool deaf children, the Speech and
Language Therapy service is unable to provide this support.
In order to provide an adequate service for this caseload of children specific
funding is required for preschool deaf children. The demands of this caseload
would merit 0.5wte Speech and Language Therapist. Their time would be
divided between home visits for families; intervention for the children within
their preschool setting (e.g. toddler group, playgroup, nursery); joint working
with other professionals (teachers of the deaf, audiology, social workers,
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