The management process in speech and language therapy begins as soon as children are referred and therapists need to make decisions about how to proceed. Initially these relate to the choice of assessment procedures and whether or not intervention is required. Then, choices will have to be made about the best approach to therapy. Further assessment decisions will be made, if appropriate, throughout the process resulting in options for review and discharge. The management process can be divided into four major stages:• forming working hypotheses; • assessment, including information gathering, observing and interpreting behaviour; • setting objectives for therapy; • facilitating and evaluating change.
As a strategy in education, short termism has been much criticised. In this article Jannet Wright and Myra Kersner consider the effects of short‐term projects in relation to their own area of expertise in speech and language therapy. While they find such projects encourage creativity they also identify some serious limitations.
Many paediatricians with a special interest in the use ofdrugs in children have waited a long time for a textbook that covers all that is currently known in the field of paediatric pharmacology, and most of them will not be disappointed as this book presents a comprehensive overview of the subject. Many of the contributors, each a recognised authority on his subject, have not been afraid to point to the many gaps that exist in our knowledge. I found this a refreshingly honest and useful approach and one that should stimulate the research-minded reader. Criticism that there is a lack of information and that the book has been compiled too early can, I think, be refuted by the overwhelming need for the practising clinician to have such information to hand. The contents are rightly limited to clinical pharmacology, but the practising clinician looking for guidance will be pleased by the therapeutically orientated style of the chapters-for example, anticonvulsant usage, use of antipyretics, etc. The areas covered are broad-for example, pharmacological principles, compliance, ethics, adverse effects, poisoning, and the usual major drug classes, but a chapter on antihypertensive drugs would have been useful. Most books can be criticised and this one is no exception. Much of the information is duplicated and in the first two chapters, different abbreviations are used for dose, elimination rate constant, and volume of distribution. With careful editing it should have been possible to avoid the repetition that is a feature of this and of many other multiauthor texts. It suggests a lack ofconsideration of chapter content, an unwillingness to alter an authoritative contribution, or an inability to provide adequate cross referencing. With lack of data on many subjects recourse to studies on adults is often necessary, but I think this should have been better clarified especially in areas where a difference between ages is most likely to exist. Also, some chapters-for example, the one on drugs in human milk-are of greater theoretical than practical help as the author has given data on a fairly small number of drugs compared with a large total for which information, though limited, is available. Paediatricians on this side of the Atlantic will be surprised by the mention of tetracycline and oral contraceptives until they remember the different patient populations existing elsewhere. Likewise the preponderance of information on theophylline preparations for the treatment of asthma reflects the natural history of drug (un)availability in the USA rather than the balance of experience of such drug use here. These are not major criticisms; this is a good book which may be a little large as a forerunner in the open market of a specialty subject here. Nevertheless, general acknowledgement of the principles and use here will be bound to enhance our approach and will greatly benefit our drug-receiving child population. Acknowledging its deficiencies, I warmly recommend it.
There are different ways of approaching the nationally reported shortages of clinical placements for speech and language therapy students in the UK. Viewing the problem as a simple issue of high demand and shortfall may result in seeking short-term solutions. However, in order to achieve effective longer term change, there is a need for an examination of the underlying aspects of the problem. In this paper the development and implementation of one department's clinical and professional strategy are described and some of the outcomes presented. It is suggested that strategic, long-term approaches also need to be considered more widely and that a national professional strategy should be developed.
Jannet A. Wright and Myra Kersner, senior lecturers in the Department of Human Communication Science, University College London, consider the practical implications of recent policies for teachers and speech and language therapists working together in inclusive settings. Their conclusions complement McCartney's ideas in the previous article.
Traditional models of clinical placements for students in speech and language therapy (SLT) are often based on a one-to-one model where the structure of the learning process is: theory, observation and practice. Literature relating to adult learning and professional education suggests alternative approaches to clinical training which may be relevant to SLT. Work in progress is discussed where alternative approaches to placements and student learning in a range of placement settings are being developed.
Questionnaires were sent to speech and language therapists (SLTs) and teachers in 83 special schools catering specifically for children with physical disabilities. Sixty two teachers and 47 SLTs responded. The results indicated that there were different patterns of collaborative working in these special schools than had been found in a previous study in schools for children with severe learning disabilities (SLD). The majority of SLTs and teachers were using alternative and augmentative communication systems (AAC) with the children and, in the main, the SLTs introduced the aids to the children and their families. These findings have implications for the specialist training of speech and language therapists.
A questionnaire was sent to teachers and speech and language therapists who work together with children who have communication problems and severe learning disabilities. In the study the effect of the exchange of information on the collaborative working practices of these professionals and the subsequent implications for professional development is considered. This study was set up to examine whether this exchange was affected if the teachers and speech and language therapists were perceived as being ‘specialists’ in the field of SLD. The research addresses the issues of the knowledge and skills gained, the type of information exchanged and the ways in which this may affect the nature of the collaborative process.
