What Speech Therapists can Contribute

Abstract

The way we observe and assess a child will be strongly influenced by our own professional perspectives. It is therefore essential that we try t o raise t o a conscious level what these perspectives are and realise where their strengths and weaknesses lie. To the teacher the speech therapist should be able t o offer particular insights and skill, in both the assessment of children and the development of appropriate intervention.Most of the major handicapping conditions can also be the primary cause of speech and language problems affecting children. For example, cerebral palsy which affects a child's motor control as a whole will frequently give rise t o a speech problem related t o motor control (dysarthria) as well as problems with language learning. Langauge delay will be central in children who are subject t o hearing difficulties. In addition maladjusted children may have communication problems. Children with hearing loss, discussed elsewhere in this issue, will show difficulties related to speech and language learning. A few schools and units are provided for children with severe speech and language problems. All such children, wherever they are, although often appearing superficially 'normal' insofar as they d o not have obvious physical o r mental handicap, may be at risk in social and cognitive development. Assessment proceduresIt is not practicable in an article of this length t o give details of the range of speech and language assessments which may be used by speech therapists. A useful introductory account is give in Muller et al. (1981). Rather than focussing on specific procedures, it may help t o consider the levels o f speech and language which the speech therapist will explore through various appraisal procedures. In the past speech therapy, like many other disciplines, has been criticised for being too tied t o a medical or aetiological model. Recently there has been a move away from a focus on causes and categorisation of children t o a description of the child's functioning, leading to identification of need and the development of appropriate intervention plans. However, the identification of factors which cause o r maintain the difficulty may sometimes make clear the necessity t o provide appropriate medical or educational management. The teacher's contributionThe recent advances in the understanding of the processes through which a child acquires language have led t o the development of more sensitive and appropriate procedures for describing language and thus may provide us with greater confidence t o move away from categorisation (Crystal et a t , 1976;Bloom and Lahey, 1978).The value of what the teacher can contribute t o the assessment of language does not lie in her ability t o carry out specific and often time consuming procedures but in her opportunity to observe the child's language use in a day t o day setting. Similarly, the observations made by parents are invaluable. In a clinical setting there is a tendency, partly dictated by t h e situational context, t o use highly structured...