I learned my speech and reading at school.

I like talking to people.

Thank you.

Sarah aged 14

The central importance of language to learning is widely acknowledged. The aim of Speech and Language Therapy at St Mary's is to enable young people to develop functional communication to achieve their full potential, enabling them to communicate in any situation. This, in turn, will build their confidence and self-esteem whilst reducing frustration and anxiety.

We have a large team of speech and language therapists, each working with between ten and fifteen young people. Staff and young people are also supported by a Speech and Language Therapy Assistant.

Therapists are able to work intensively in a way that is integrated across the waking curriculum, and tailored to the needs of each individual. We aim to develop and generalise skills that can be used functionally in all areas of the young person's daily life. This includes all aspects of communication such as speech, listening skills, comprehension and expression of language, social communication, and literacy.

We have a flexible approach to therapy, and work directly with young people through individual sessions, small group work, and support in classrooms, Living Areas and in the wider local community. We also work in close collaboration with all other staff and parents to create the best possible learning environment for each young person, and ensure an holistic approach to their needs. Targets are set jointly through the Individual Learning Programmes and Annual Reviews, and regular meetings enable us to monitor and evaluate progress.

Close working with teachers and weekly planning meetings ensures that differentiation of work takes account of the young person's speech and language impairment so that the curriculum offers maximum benefit to them. Work in the residential setting enables Speech and Language Therapists to teach skills in ‘real life' settings and to ensure that these skills are used by the individual to increase their independence.

Within the team, we have developed specialist knowledge in a range of areas; for instance, autistic spectrum disorders, hearing impairment, specific language impairment, dyspraxia, augmentative alternative communication (such as signing and communication aids) dyslexia and sensory integration. The team includes therapists with specialist qualifications in dysphagia (eating, drinking and swallowing disorders). Therapists constantly update their knowledge and skills through In Service Training days and attendance at external courses.

The Speech and Language Therapy service at St Mary's offers:

• Comprehensive assessment, regularly updated and leading to an individual programme for each young person
• A range of therapeutic approaches to address a young person's difficulties in all areas of speech, language and literacy
• Assessment and management of young people with eating, drinking and swallowing disorders
• Sensory integration therapy for the development of attention and listening skills and oro-motor skills (movement of the muscles of the mouth)
• A total communication approach in a sign and symbol supported environment based on the use of Sign Supported English/Signed English and Rebus/pcs symbols
• Signing classes for pupils, staff and parents
• Assessment, training and support for young people needing communication aids, such as symbol books or voice output communication aids (VOCAS)
• Group work for communication aid users to develop their functional use of aids in social interaction
• Support to develop use of ICT, including use of multimedia computers, and software such as voice activated word processing programs and programs to develop a range of speech, language and literacy skills
• Facilities for video and audio recording to contribute to assessment and therapy
• Interventions to support the development of social interaction and play skills through individual and group work, and consistent feedback from knowledgeable adults relating to social communication targets for all interactions across the waking curriculum
• Intervention to develop young people's use of language and non-verbal skills in socially appropriate ways

St Mary's strives to provide a language-rich environment appropriate to each individual's needs with an integrated approach to therapy provision. In close liaison with other therapists and staff in the Education and Care and Nursing Departments, Speech and Language Therapists work to facilitate a young person's access to the National Curriculum and to promote their academic, social and emotional development.

Communication

Lack of reliable communication inhibits learning, independence and social skill development, and prevents the expression of feelings and physical needs.

At St Mary's, Alternative and Augmentative Communication (AAC) Systems are used to support or stand in place of speech to allow those young people who require it, to communicate to their full potential.

St Mary's supports the idea of ‘total communication'. That is, helping the young person to develop a range of skills to enable them to communicate to their full potential in all environments. The range of strategies which may be employed include:

• Facial expression, gesture, pantomime
• Voice/speech
• Drawing/writing
• Signing (Sign Supported English and Signed English)
• Low technology aids such as symbol books
• High technology aids such as voice output devices like the DynaVox range and Say It Sam communicator

St Mary's aims to provide all young people, including those who require AAC, an equal opportunity to:

• Exercise appropriate control in their environment and develop self advocacy skills.
• Formulate, clarify and convey their ideas and subsequently, through discussion, share and modify thoughts and understand feelings
• Display their knowledge and facilitate new learning through asking questions, discussion and debate
• Engage in social interaction with peers and staff and build relationships
• Develop a range of communication skills that will allow them to communicate in all environments

The signing system used at St Mary's incorporates Sign Supported English (SSE) and Signed English (SE). SSE uses the vocabulary from British Sign Language (BSL) but within the structure of normal spoken English. That is to say, signs from BSL are matched to the speaker's words as they are spoken. Some young people, especially in the classroom, benefit from the modification of this system by the use of SE which offers the addition of newly generated signs for specific vocabulary and grammatical markers, together with finger spelling, to reproduce more accurately the components of grammatical English, for example, to signal past tense or plural ‘s'.

At St Mary's, manual signs are used to help the young person's comprehension and/or expression of language. In order to promote the signing environment, which is so necessary for many of the children, staff try to develop a habit of supporting their own speech with signing as much as they can. Often it is not necessary to sign every word but there is value in reinforcing verbal concepts and keywords, where possible, with signs, so as to give visual cues to the young person.

The same approach is applied to the use of signing by the young person. They are all encouraged to develop signing skills either for their own benefit or to enable them to communicate, as fully as possible, with friends who need signs to augment their speech and language.

Young people develop signing skills through structured tuition as part of their therapy programmes, during work on curriculum vocabulary in class lessons, through Circle Groups and, within the Living Area and Pupil Enrichment programme, through use in the social context. Some young people choose not to use sign language and this preference is respected.

A small group of children is invited to interpret the words during the singing of hymns and songs in Assembly. This group of volunteers usually comprises a mix of young people, some of whom are oral communicators and some who rely on signing. New songs are always introduced with a demonstration of signed keywords.

Young people with particular signing needs or special interest are encouraged to participate in Signing Groups with Therapists, Education and Care staff, where activities and games focus on developing a core vocabulary and the use of simple functional phrases/sentences.

St Mary's Sign Language Programme is the structure used for signing tuition throughout the Trust. Practise DVDs and a book are available to support work done in the lessons. Level 1 consists of a core vocabulary of over five to six hundred words arranged in ten stages.

Each stage contains fifty to eighty words organised in topic vocabulary lists, followed by practice sentences.

On completing each stage, a short test of accreditation may be taken, for which a certificate is awarded. Level 2 comprises further stages based on the WPSE manual, ‘Signed English for Schools'.

A range of half-hour classes are on offer each week for staff, children or parents to attend. Parents' classes are held once or twice a term on a Friday afternoon so that parents collecting their children can take advantage of the opportunity to learn the signing system used by their children.

The integrated Speech and Language therapy across the waking curriculum allows young people to achieve functional communication targets that are life changing.