Elaine Duddy Dr D. Hazlett Dr J. Lambe

1. Elaine Duddy Dr D. Hazlett Dr J. Lambe A Policy Impact Analysis of Speech and Language Therapy (SLT) services within Sure Start Local Programmes (SSLPs) in Northern Ireland (NI): Service User Evaluation

2. Overview: • Project background • Overall aim of investigation • Methods employed and associated ethical issues • Work to date • References

3. Wellbeing & Every Child Matters 2003 • Being healthy • Staying safe • Enjoying and achieving • Making a positive contribution • Economic wellbeing

4. Wellbeing • ‘Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.’ (WHO website ) • ‘Wellbeing is broadly conceived to mean the ‘level’ of life quality – i.e. The extent to which pleasure and satisfaction characterise human existence and the extent to which people can avoid the various miseries which are potentially the lot of each of us’ (Andrews, 1974 , p280)

5. Speech, Language and Communication (SLC) • Effective speech, language and communication development is ‘a strong indicator of successful adjustment in a variety of contexts including mental health and wellbeing, emotional development and educational attainment’ (Adamson-Macedo et al 2009 p192) • ‘In many ways our ability to communicate defines us, it is one of the ways we are judged and measured by others and the means by which we forge our relationships’ (ICAN Report 2008 p3)

6. Impact of Speech, Language and Communication Needs on Wellbeing • Speech, language and communication needs (SCLN) in the pre-school period constitute a risk factor for poor school performance, educational attainment and social difficulties in later life(Law et al 1998) • Education is crucial to economic outcomes for disadvantaged children in later life (Walker 2006) (cited in Fuller 2010) • ‘51% of preschool providers recently surveyed cite Speech and Language difficulties as the most common difficulty that is evident in children attending preschool provision’ (ETI Review 2007) (cited by NI SLT Task Force Report 2008 p30)

7. Speech and Language Therapy (SLT) • SLTs ideally placed to assess, advise and remediate SLCN (Fuller 2010) • Inclusion within SSLP service provision framework • Role extended beyond traditional clinical one • Ecological approach – ‘facilitating children’s language development in the wider population’ (Fuller 2010 p184) • Collaborative model of service delivery

8. Sure Start Background • Flagship Labour government policy 1998-2010 • Sure Start Local Programmes (SSLP) - to improve the life-chances of children under the age of five living in areas of socio-economic disadvantage by means of multi-agency, multi-disciplinary programme

9. Northern Ireland Sure Start • SSLPs began in 2000 • Currently 34 Sure Start programmes • Approximately one-third are rurally based • For 2008-09 £16 million invested in N I SSLPs • Accessed by 29,210 children under four years and their families (Sure Start 2011)

10. Emerging Issues: • No original pilot study carried out • National Evaluation of Sure Start’s results to date indicate modest impact • SSLP debate dominated by ‘adult concerns’ (Lloyd 2008) • Lack of rigorous evaluation at regional level • Evaluation and outcome measures used are highly variable • Wide variation across the region in services provided • Current review of SLT service by DHSSPS • Current review of SSLP SLT service by DE

11. Research Aim: • To investigate the impact of Speech and Language Therapy within the SSLP context on the communication wellbeing of service users (parents and children) from their perspective.

12. Research Questions: • What evidence is there that Speech and Language Therapy offered within the SSLP context has impacted on the communication skills of service users? • What is the impact of Speech and Language Therapy within SSLPs on the communication skills of service users?

13. Objectives: • To identify the impact of current policy on SLT service provision within SSLPs NI • To identify the causal relationship between SLT provision and communication skills of Service Users • To identify interveningvariables impacting on this causal relationship • To compare and contrast the ‘communication progress’ of Service Users • To relate ‘communication progress’ to parental perception of well-being • To make recommendations

14. Research Design: • A policy impact study from the service users perspective using a… • 2 stages: • Policy content analysis • Thematic content analysis

15. Flowchart of Research Phases

16. Ethical issues • Researcher objectivity • Reliability & validity • Awareness of constraints & biases • Robust sampling framework • Confidentiality process • Consent process • Complaints procedure • University of Ulster ethical guidelines

17. Work schedule for next 2 years

18. Research training activity • Completed (44 credits): Introduction to Project Management Getting Published in the Social Sciences Building Your Career; Adding Value to your PhD Writing to Learn: Improving your Writing Skills Academic Integrity: Avoiding Plagiarism The Literature Review – Online An Introduction to Research Skills – Online Researchers in Residence Programme Planning your Career Introduction to the Career Development Centre for first year PhD Research Students How to be an Effective Researcher Developing Information Skills for Effective Research Introduction to Refworks Appraising Research Quality v2 Policy Evaluation Methods • Required: - nVivo - Statistics

19. Progress to date • Literature Review: - Historical policy context - Current policy context - International & national legislation • Establishing links with services • Scoping service • Meeting with Childcare Partnership Co-ordinators • Meeting with AHP Commissioner • Working in Partnership with DE project • Access to secondary data • Demographic information • Development of Methodology • Rationale • Design • Framework

20. References • Adamson-Macedo, E.N., Patel, R. & Sallah, D.K. (2009) An independent psychometric evaluation od a speech and language tool for two-year-old children from a Sure Start trailblazer site in the West Midlands. Child Language Teaching and Therapy 25, 191-214. • Andrews, F.M. (1974) Social indicators of perceived life quality. Social Indicators Research 2(27) 279-299 • Every Child Matters (ECM) (2010) Department for children, school and families (DfCFS) www.webarchive.nationalarchives.gov.uk • Fuller, A. (2010) Speech and language therapy in Sure Start Local Programmes: a survey-based analysis of practice and innovation. International Journal of Language and Communication Disorders, 45(2), 182-203 • ICAN (2008) Speech, Language and Communication Needs and Primary School-aged Children. I CAN Talk Series – Issue 6 • Law, J., Boyle, J., Harris, F., Harkness, A., and Nye, C. (1998) Screening for speech and language delay: a systematic review of the literature. Health Technology Assessment, 2 (9) NHS R&D HTA Programme

21. References • Lloyd, E. (2008) The Interface between Childcare, Family Support and Child Poverty Strategies Under New Labour: Tensions and Contradictions. Social Policy & Society, 7 (4), 479-494 • Northern Ireland Speech and Language Therapy Task Force Report on Speech and Language Therapy Services for Children and Young People (2008) Improving outcomes for children and young people with speech language and communication needs Belfast: DfHSS • Sure Start (2011) Profile of Sure Start Projects within Northern Ireland July 2011 • Sylva, K., Melhuish, E., Sammons, P., Siraj-Blatchford, I. & Taggart, B. (2004) The Effective Provision of Pre-School Education (EPPE) Project: findings from Pre-school to end of Key Stage 1. www.dfes.gov.uk • World Health Organisation (accessed 10/1/12) Definition of health www.who.int

22. Questions • Thanks for listening