Jois Stansfield

Healthy lifestyles for adults with intellectual disability: Knowledge, barriers, and facilitators

Abstract Background People with intellectual disability (ID) are more likely to have health problems than people without disability. Little previous research has investigated health from the perspective of the people with ID themselves. We aimed to focus on what people with ID understand being healthy to mean and what their experiences are of healthy lifestyles. Method Semistructured interviews were conducted with 13 adults with ID to ask them about their health and healthy lifestyles. Data were analysed thematically. Results Participants demonstrated understanding of what it means to be healthy, have a healthy diet, the dangers of substance misuse, and the benefits of exercise. Participants demonstrated some knowledge about rationales for engaging in healthy behaviours. The idea of moderation was raised, along with barriers and facilitators to engaging in a healthy lifestyle. Conclusions Findings suggest that people with ID demonstrate some understanding of what constitutes being healthy and are aware of healthy lifestyles, the consequences of unhealthy behaviours, and of the need for moderation.

Speech and language therapy service delivery for bilingual children: a survey of three cities in Great Britain

BACKGROUND Speech and language therapy (SLT) managers are expected to ensure that there are appropriate services available for bilingual and multilingual clients in order to ensure an equitable service to all clients. However, there is a paucity of data available to inform service planning. AIMS To identify the level to which SLT services in three UK cities meet the recommendations of The Royal College of Speech and Language Therapists (RCSLT) Good Practice Guidelines. Socio-demographic information is provided about the number of children from ethnic minorities in the population and the proportion of (bilingual) children from ethnic minorities on the speech and language therapy caseload. Based on this information, it is estimated whether there is proportionate representation of bilingual children on SLT caseloads, and whether services are in place to meet the needs of those clients. METHODS & PROCEDURES Population statistics were gathered from Census data and data were gleaned from Local Education Authorities. The study used a combination of interview and postal questionnaires to SLTs, with particular emphasis on the issues that may affect service provision. OUTCOMES & RESULTS As in previous studies, it was difficult to find reliable data. However, two of the three cities studied appeared to be offering a proportionate service to both monolingual and bilingual children in terms of the relative numbers of children on caseloads. Only one city was confident that their SLT service was fully meeting the RCSLT Good Practice Guidelines on bilingualism, although all three cities were aware of them and appeared to be making an effort at varying levels to address the principles of those guidelines. CONCLUSIONS There is a need for a change in how data on linguistic diversity in society are collected and disseminated, both at a national level and within SLT services, so that informed decisions can influence the future of quality services to minority groups.

Beliefs and Attitudes of Primary School Teachers in Mumbai, India Towards Children Who Stutter

Beliefs and attitudes of teachers in Mumbai, India, towards children who stutter were investigated using questionnaires and semi-structured interviews. Questionnaires were completed by 58 teachers, four of whom were subsequently interviewed. Results from the questionnaires showed that teachers believed that a child’s environment influenced stuttering and that children who stuttered had the potential to overcome the condition. They did not agree that children who stuttered were quiet and shy. Two global themes emerged from the interviews. These were teachers’ philosophies about stuttering, and their perceived roles in supporting children who stutter. All teachers reported limited experience of children who stutter, but their responses indicated a desire to do their best to support such children in the classroom. Stuttering was, however, considered to be less important to teachers’ working lives than dyslexia.

Issues and innovation in clinical education: Regulation, collaboration and communication

McAllister (2005) outlines a number of current issues in clinical education in a field where principles are relatively stable, but structures and practices are subject to rapid change. These issues have resonance for all those of us working to enable students to graduate as competent health care professionals, regardless of McAllister’s suggestion that the paper is Australian centred. This response in turn has an Anglocentric bias, and is informed by current policy and practices within the United Kingdom (UK) and especially England. It discusses how innovation in clinical education might be enhanced within the heavily regulated sector of health care education in the UK and how collaboration and communication between university staff and clinical educators might be the catalyst for innovative practice.

Introducing advanced clinical reasoning to an adult learning disability service

The advanced clinical reasoning approach is widely adopted in speech and language therapy practice. This article reports on the introduction of the approach across a multidisciplinary adult learning disability service and staff reports on the impact of this initiative. Staff in the service were offered training in the approach. Staff completed pre-course questionnaires, immediate post-course evaluations of the training and questionnaires a year after initial training. Semi-structured interviews took place with three team managers a year after the training. Staff and team managers reported that the training had a positive impact on their practice. All respondents demonstrated confidence in the use of the advanced clinical reasoning terminology and a clear understanding of the nature of duty of care and clinical risk. Enhanced knowledge about caseloads and greater confidence in managing episodes of care were reported by staff and team managers to have resulted in a more efficient and effective service.

Mothers’ perspectives on the lived experience of children with intellectual disability and challenging behaviour.

Children with intellectual disability and behavioural needs (challenging behaviour) are vulnerable to exclusion from services and communities. The situation is exacerbated by difficulties in accessing appropriate support and services to effectively meet the needs of children and carers. Family perspectives on the ‘lived experience’ of children can provide insight into how behavioural needs can affect their ability to access everyday experiences. Semi-structured interviews were conducted with mothers of children with intellectual disabilities and challenging behaviours. Phenomenological thematic analysis provided four key themes: finding our way; square services, round needs; behaviour touches everything and belonging. Experience of inclusion and exclusion was a central tenet of the lived experience. Recommendations call for timely proactive and bespoke interventions to identify and support children at risk of exclusion from communities. Early intervention and effective local provision will avoid increased burdens placed on families and services, in supporting children whose needs are currently unmet within child-centred provision.

Content Analysis of the Professional Journal of the Royal College of Speech and Language Therapists, III: 1966-2015--Into the 21st Century.

BACKGROUND Following content analyses of the first 30 years of the UK speech and language therapy professional bodys journal, this study was conducted to survey the published work of the speech (and language) therapy profession over the last 50 years and trace key changes and themes. AIM To understand better the development of the UK speech and language therapy profession over the last 50 years. METHODS & PROCEDURES All volumes of the professional journal of the Royal College of Speech and Language Therapists published between 1966 and 2015 (British Journal of Communication Disorders, European Journal of Communication Disorders and International Journal of Language and Communication Disorders) were examined using content analysis. The content was compared with that of the same journal as it appeared from 1935 to 1965. OUTCOMES & RESULTS The journal has shown a trend towards more multi-authored and international papers, and a formalization of research methodologies. The volume of papers has increased considerably. Topic areas have expanded, but retain many of the areas of study found in earlier issues of the journal. CONCLUSIONS & IMPLICATIONS The journal and its articles reflect the growing complexity of conditions being researched by speech and language therapists and their professional colleagues and give an indication of the developing evidence base for intervention and the diverse routes which speech and language therapy practice has taken over the last 50 years.

Consensus-building on developing dysphagia competence: a North West of England perspective

BACKGROUND Dysphagia has been an increasing area of practice for speech and language therapists (SLTs) for over 20 years, and throughout that period there has been debate about how practical skills in dysphagia can best be developed. The implementation of the new Royal College of Speech and Language Therapists (RCSLT) framework was considered from a regional perspective seeking to establish consensus across different speech and language therapy settings. AIM To explore practical solutions to the development of dysphagia competency in new graduates whilst acknowledging the wide variation in staffing and clinical dysphagia experience across the geographical and clinical landscape in the North West of England. METHODS & PROCEDURES A four-phase study involved a literature search; interviews with experts in the field of dysphagia; a survey to identify current practice; and a two-round Delphi process. OUTCOMES & RESULTS Five themes emerged for dysphagia competency development: development of practical skills; supervision; clinical excellence networks; workforce planning; and postgraduate formal training. Challenges, and solutions to these, were identified through the phases of the study. A model for dysphagia competency development relevant to the North West context was achieved by consensus. CONCLUSIONS & IMPLICATIONS There are many practical ways of developing dysphagia competency. The themes and model generated provide constructive support to services in adopting the most appropriate methods for their own settings.