Wednesday, 3 April 2013

Speech and Language Therapy: A great profession.. In danger of extinction ?

 I absolutely love my job. It is so satisfying to see the dramatic changes one can bring about even with the most disabled of our client group. It is an honour to be part of a process that can significantly change the lives of the individuals I work with and have a huge impact on those around them. My passion for my work has not dimmed since my early days as a “rooky” therapist within the sobering environment of Horton Hospital and the  old, but no longer existing  ‘asylum’ in Surrey.  I know that many of my colleagues share my huge enthusiasm about the work we do, which is why so many of us continue to fight to stay within the Profession we love, despite the challenges we, like so many of our peers within the Health Services, currently face.

Speech and Language Therapists work with a huge variety of people with speech, language and communication impairments, from birth to senescence.  We are found within Health Centres, Hospitals, GP Surgeries, Schools and Nurseries. In addition to the work we undertake within the arena of speech language and communication, our in-depth knowledge of the neuro musculature of the head and neck has equipped us to play a key role in the assessment and treatment of swallowing and eating disorders.

The sheer number and variety of the disorders that fall within our remit give many of us the opportunity to develop expertise in our own area of special interest and despite the apparent unitary nature of these impairments e.g. Dysphasia or Down Syndrome, each individual person we work with presents a different and therefore unique challenge. There is, in short, no such thing as a text book case.

It goes without saying therefore that we are a bright lot who are put through our paces during the jam packed and gruelling 4 year degree course that equips us to take on the huge task we face in our clinics. We cover in considerable depth linguistics, psychology, statistics, audiology, neurology and anatomy, as well as the voluminous array of disorders we are likely to meet within our clinics. On top of this we are developing our practical skills as therapists within placements and assessed regularly as to our clinical as well as our academic competence.

The important message for me to get across is that speech and language therapy can and does produce significant and measurable change to the speech and language of those we work with. Given that we are still such a young profession, established only after the war in 1945, we have made incredible progress in understanding our discipline as well as in articulating and mapping interventions.

 Never has there been a more exciting time to work as a therapist, as more and more is being understood about the plasticity of the mind and the ground breaking opportunities this could provide to those of us at the clinical “coal face”.  Goodness knows what frontiers will be advanced as a result in the future which may enable us to work much faster and even more effectively with our client.

Critical to this development though is our continued therapeutic contact with our clients. However the increasing reality for many of my NHS colleagues, is that the opportunities for such direct work are becoming fewer and fewer. Many therapists have, because of this, opted for independent practice where they can continue practising and developing their therapeutic skills. This whittling away at our opportunities to work directly with our clients poses a major threat to our profession and many of us are extremely concerned that we may not survive as an independent discipline if this continues.

 The financial shortfall within the NHS is given as a legitimate reason for such reduction in our service provision. Yet in one fell swoop, such a proposition doesn’t just demonstrate a serious failure to recognise the vital value of our work, but shows a complete lack of understanding as to the devastating human and financial costs that will inevitably result because of the failure to provide our service.

In 2009 the Royal College of Speech and Language Therapists produced a paper ” Locked out and Locked up: Communication is the Key”. In this they highlight the incidence of speech and language disorders amongst the prison population, focusing on those within Young Offenders Institutes, of which 60% have some recognised communication and/or language disorder. In this they state:
“There is a strong correlation between poor education s, particularly those of literacy skills and subsequent criminal behaviour. Improving literacy and social skills is essential to reduce re-offending (Snow and Powell, 2004) ....A third of children with speech and language difficulties develop mental health problems, often resulting in criminal involvement”

In 2010 a paper published by the Prince’s Trust and RBS suggested that the result of an increasing prison population amongst juveniles was costing our nation £1.2 billion per annum.

It is clear to me, that the decision to cut our service has less to do with the lack of money within the Treasury Coffers and more to do with a lack of understanding as to the nature and wider importance of our work. This maybe a failure on our part and one that is perhaps due to the lack of professional maturity and confidence, which under the normal course of events would come with time and age,  as we evolve and develop our ideas and our practice.

Time is sadly not on our side at present. However I believe we can survive, but we have to show far more ferocity in our self belief and not shy away from presenting our case, because what we have to contribute is vital and so much is at stake if we do not.

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