Select Committee on Northern Ireland Affairs Minutes of Evidence


APPENDIX 12

Memorandum from the Association for all Speech Impaired Children (AFASIC) Northern Ireland

  I hope that your committee will be willing to accept a submission from us on behalf of children in Northern Ireland who suffer from Speech and Language Impairment. I realise that we are a few days late in getting our submission to you: this has been caused by our need to collect some information to help justify our point of view and by our inexperience in producing such a document. As we are a new organisation we did not have the information we needed to hand.

  I trust that the format and content of our document is along the lines which your Committee expects and is used to receiving. As parents, this is the first time we have attempted anything of this nature and are consequently working in the dark. I should be interested to hear any pointers or criticisms you may have. Needless to say if any clarification or further information is required we would be keen to try to provide it.

CONTENTS

1. Background information on AFASIC NI

2. Collection of Evidence

3. Definition of Speech and Language Impairment

4. Incidence of Speech and Language Impairment in Northern Ireland

5. Responsibility for providing help in Northern Ireland

6. Educational Provision for Speech and Language Impaired children in Northern Ireland

7. Conclusions

8. Recommendations

9. Bibliography and references

Annex 1. Information obtained from Education and Library Boards

Annex 2. Information obtained from Health and Social Services Boards

Annex 3. Information obtained from Speech and Language Schools/Units

BACKGROUND INFORMATION ON AFASIC NI

  AFASIC (Association For All Speech Impaired Children) was founded in England in 1968 as a parent led organisation to help children and young people with speech and language impairments, and their families. AFASIC provides information for parents and professionals and produces a range of helpful publications. AFASIC organises conferences and workshops throughout the year. Members meet in local groups in many areas of the UK. Today AFASIC is one of the UK's top 500 voluntary organisations, recognised as an authority in its field and working in partnership with other established and respected organisations.

  The Northern Ireland group was formed in November 1997 following a public meeting called by Brian Hamilton, a parent concerned at the lack of help available for his son at secondary school level. The meeting was addressed by Tony Curtis, the National Development Officer of AFASIC, and was attended by over 100 concerned parents and professionals.

  The Northern Ireland branch of AFASIC is in the early stages of its life, organising activities for the year, raising funds so that we can get off the ground and publishing the first edition of our newsletter as a means of passing information and advice to the parents of affected children in Northern Ireland. We also arranged for Madeleine Starr, the Chair of AFASIC, to make a presentation to the Northern Ireland Forum for Political Dialogue, Education Committee, in December 1997.

  We have identified the need for research to be carried out into speech and language impairment in Northern Ireland, as between the four Health and Social Services Boards and the five Education and Library Boards in Northern Ireland, there does not seem to exist a set of statistics relating to this field for the whole of Northern Ireland. We are currently approaching the National Lottery Board to obtain finance to investigate the gap between the level of incidence and the range of educational facilities provided. Your request for information regarding the level of expenditure has therefore caught us at the point of identifying, from anecdotal parental evidence, that a problem exists with the amount of educational support available, and actually carrying out research to prove this gap empirically.

  This report therefore relies on national averages, backed up by a limited range of information which we have gathered from sources in Northern Ireland very quickly. We trust that it is sufficient to make you aware that not enough provision is made for these children and that money needs to be spent to give these children a meaningful standard of education.

COLLECTION OF EVIDENCE

  AFASIC NI only became aware of the Committee's investigation into Special Needs Education on the 12 March 1998. As you had requested a reply by Friday 3 April 1998 we had very little time to gather any in-depth evidence. The steps which we took were:

    (A)  We contacted all five Education and Library Boards with the request for a range of figures. One board, the North-Eastern Education and Library Board, replied answering only seven of the sixteen questions which we asked. They have not provided information as to numbers affected by speech and language impairment, the numbers in special schools and the numbers on waiting lists. The South-Eastern Education and Library Board and the Southern Education and Library Board replied answering all questions asked. The Western and Belfast Boards had not replied at time of writing. A sample of the letter sent to the boards, along with the replies from the North-Eastern Board, the South-Eastern Board and the Southern Board can be found in Annex 1.[5]


    (B)  We contacted all four Health and Social Services Boards with a request for statistics. All four Boards replied. A sample of the letter sent to the Health Boards, along with their replies can be found in Annex 2.1 Unfortunately, each Board defines and collects its data in a different manner and we were unable to use most of the information provided.

    (C)  We wrote to the Principals of the ten schools in Northern Ireland which provide education to children with speech and language impairment. We asked a range of questions and gave them the opportunity to express views which might not otherwise be heard. Three of the schools replied in writing, a fourth replied by phone (notes taken at the time of the conversation are enclosed), one was unable to reply due to illness, one was unwilling to reply stating that all information could be obtained from the Education and Library Board (who, in fact, did not reply) and nothing was heard from the remainder. Annex 31 contains a sample of the letter of request, along with replies received.

    (D)  We used some of the evidence provided in Madeleine Starrs' presentation to the Education Committee of the Northern Ireland Forum for Political Dialogue.

DEFINITION OF SPEECH AND LANGUAGE IMPAIRMENT

  There are some children for whom speech and language does not develop as expected. They may experience difficulties with any or all aspects of speech and language—from moving the muscles which control speech, to the ability to understand or use language at all. Different categories of impairment can include phonological or articulatory difficulties (including oral dyspraxia); expressive difficulties (including sequencing and word findings); receptive difficulties (comprehension); semantic/pragmatic difficulties (understanding and using language appropriately, social interaction). Sometimes these difficulties are unrelated to any other difficulty. Sometimes they are related to physical difficulties or general learning difficulties. Some children may have both a specific language difficulty and other disabilities.

  Communication difficulty can be broken down into two groups—that which is an outcome of a physical or intellectual difficulty, such as cerebral palsy or Down's Syndrome, and that which stands alone and may be said to be a primary or specific impairment.

  Within the range of primary or specific impairment, it is possible to identify a continuum or spectrum of need, from dyslexia at one end of the scale to autism at the other. Within this spectrum is a group who can be said to have a specific language impairment (SLI), some of whom will share characteristics with those with dyslexia and others with those with autism. It is this group "in the middle" which is AFASIC's primary concern.

  The criteria for admission to the schools which replied to our request for information demonstrate this. In general, the children will have intelligence within the range found in a mainstream classroom, no other emotional or behavioural problems and a significant difference between their performance and verbal IQs.

  Parents are usually the first to recognise that their child may have a difficulty. A study by AFASIC in 1993 reported that in 83 per cent of cases parents were the first to notice their child's communication difficulties, often before the advent of intelligible speech (reference 5). All professionals should be taught to respect the initial concerns of parents, whose anxieties are very often justified.

INCIDENCE OF SPEECH AND LANGUAGE IMPAIRMENT IN NORTHERN IRELAND

  There is currently no one body of knowledge to enable us to identify the group of children suffering from SLI clearly, and no clear differentiation between disorder and delay. However, it is generally accepted, using the most recent statistical surveys, that there are in the region of 250,000 pre-school children with SLI, and a further 250,000 school-age children with SLI in the UK. There is no reason to suppose that these statistics do not apply equally well to Northern Ireland. This would give us figures of 6,000 pre-school children and 6,000 school-age children with speech and language impairment in the Province. In a recent research project in inner city Belfast, 60 per cent of a sample group of nursery children (age three to four years) presented with mild to severe language delay. (reference 3)

  In terms of severe, specific, long-term SLI, which will persist into adulthood and require long-term provision, the figure we currently work to, and which is generally accepted by professionals in the field, is 0.2 per cent (Professor David Hall, reference 2). Based on 1996 figures, there will therefore be 706 school-age children in Northern Ireland with severe, specific, long-term SLI.

  Can these figures, which have been arrived at by applying national rates of incidence, be justified? Look at the returns which have been given by the Health and Social Services Boards (Annex 2).[6] Note, that of the Boards which returned figures in the time allowed, there is a variation in the terms and categories used, with little specific detail of children with SLI as their primary disability. The one exception is Foyle Health and Social Services Trust (one of three trusts in the Western Board). In their covering letter they state "The number of children detailed on the attached information in Community Clinic, Severe Language Impairment and Hearing Impairment would have speech and language impairment as their sole or primary impairment.". These figures are:

SpecialityCurrentWaiting List for Assessment Waiting List for TreatmentTotals
Community Clinics287 45640972
Severe Language Impairment161 12153326
Hearing Impairment51 01465
Totals49957 8071,363


  We realise that this is a very crude form of evidence, but it is all we have—in fact, in the absence of detailed research, it is all anyone has. The fact that one trust, in one board, has identified 1,363 children as having speech and language as their only or primary disability seems to support the statistical figure of 12,000 for the whole of Northern Ireland. What is striking is the figure of 326 children having been identified as having severe language impairment. From this we could say that perhaps the statistical figure we arrived at earlier of 706 for the whole of Northern Ireland is conservative! Even more striking is the comparison of numbers receiving treatment—499—to the numbers waiting for treatment—807.

RESPONSIBILITY FOR PROVIDING HELP IN NORTHERN IRELAND

  Despite the importance of speech and language therapy for children and young people with speech and language impairments, the legal responsibility for providing this therapy remains unclear. A Code of Practice for the Identification and Assessment of Children with Special Educational Needs will be introduced into Northern Ireland in September 1998. A draft copy of the Code of Practice has been in circulation for some time and many of the provisions have already been put in place by the Education and Library Boards.

  The Code of Practice states that while the prime responsibility for provision of speech and language therapy to children with special educational needs rests with the Health and Social Services Boards, the ultimate responsibility rests with the Education and Library Boards.

    "where speech and language therapy for a child whose statement specifies such therapy as educational provision is not provided by a health authority, ultimate responsibility for ensuring that the provision is made rests with the Board (Education and Library) unless the child's parents have made appropriate alternative arrangements" Draft Code of Practice on the Identification and Assessment of Special Educational Needs. Department of Education, Northern Ireland, 1996. (S4:29)

  Health and Social Services Boards have an absolute right in law to refuse to provide speech and language therapy for a child who needs it, if they claim the financial inability to do so. Education and Library Boards have no such right, but, as recently as 1996, the education authority in the London Borough of Harrow unsuccessfully took court action against the local health authority over its failure to provide speech and language therapy for a child who needed it.

  Authorities seeking to avoid responsibility for providing speech and language therapy sometimes still argue that it is a non-educational provision, and therefore the responsibility of the health authorities. However, the fact that therapy is more often than not provided by health does not make it a non-educational provision.

    "We do not see how to teach a child to communicate by speech can be any different from teaching him to communicate by writing, both are clearly educational." The Lancashire Judgment. (R v Lancashire County Council ex parte CM 1989)

    "occasions when LEA's could determine that speech therapy constitutes non educational provision are now likely to be rare" Department for Education, 1993

    "Speech therapy for statemented children who are unable to progress with their education and who have a communication difficulty is a special education provision. Although LEA's are still entitled to look, in the first instance, to DHA's (District Health Authorities) for the provision of speech therapy, if the DHA is unable to make this provision, it must still be secured by the LEA" Under Secretary of State for Health, December 1993

    "LEA's are obliged to accept the responsibility of providing speech therapy if specified in a statement (Section 3) where the health authority will not or cannot do so" Local Government Ombudsman 1995

  Therefore, the situation that exists is that the Education and Library Boards have the responsibility of providing speech and language therapy for children with special educational needs, but the Health and Social Services Boards are actually providing the service—and this includes the funding. We feel that, as an acknowledgement of their responsibility to provide speech and language therapy, the Education and Library Boards should be provided with the financial resources to purchase such therapy from the Health and Social Services Boards. This is the situation in Scotland, where new monies were given to local education authorities.

EDUCATIONAL PROVISION FOR SPEECH AND LANGUAGE IMPAIRED CHILDREN IN NORTHERN IRELAND

  Most children learn how to communicate by using language which they learn as a natural process at their mother's knee. Armed with this skill, they go to nursery school, then primary school, where the state begins to educate them in reading, writing and maths, amongst other subjects. Children who do not have language will not be capable of this natural progression, as they will not understand what is happening in the classroom and will not be able to communicate back to the teacher. For the teacher, the task could be compared to trying to teach, in English, a child who can only communicate in French. The child must first be taught language before anything else. The teacher in a mainstream class of 20 to 30 children has neither the skill nor time to do this. The specialists who teach language to these children are the speech therapist, and the SEN teacher who has been trained to deliver an integrated language package in conjunction with the speech therapist. Their services are not available in mainstream schools. Therefore, to have a meaningful education, the child must attend a speech and language school or unit. Specialist help, which is not normally available in a mainstream school, constitutes special educational needs. Any child requiring special educational needs must have their needs assessed, and they must have the protection of a statement of special educational needs. From our contacts with parents throughout the Province it is clear to us that many children with speech and language impairment have neither specialist help nor a statement.

  What are the range of educational facilities available to children with speech and language impairment in Northern Ireland?

  There is one school—Thornfield House—which caters solely for children with SLI. It covers Key Stage 1 to 4. In fact, it is the only provision for Key Stages 3 and 4 in the Province. It has places for 76 children, of which only 10 to 15 will be Key Stages 3 and 4.

  There are nine speech and language units attached to mainstream schools:

  Carrick Primary School, which has places for 10 children in Key Stage 1 only, Enniskillen Model Primary School, which has places for 18 children in Key Stage 1 and 2.

  Gibson Primary School, which has places for 10 children in Key Stage 1 only. Ballygolan Primary School, which has places for 20 children over Key Stages 1 and 2. Greenwood House Primary School, which has places for 20 children over Key Stages 1 and 2.

  Killard House Primary School, which has places for 27 children in Key Stage 1 only. Knockmore Primary School, which has places for 24 children in Key Stage 1 only. Belmont House Primary School, which has places for 18 children in Key Stage 1 only. St. Francis De Sales School for the Hearing Impaired, which has places for 20 children over Key Stages 1 and 2.

  All of these schools/language units are very good—we do not dispute the expertise or dedication of the staff involved in these units, but if you add up the above provision you arrive at a total of 243 places, mostly in Key Stage 1 and with only 10 to 15 places in Key Stages 3 and 4. Compare that to the demand which we have earlier identified as being 6,000 school age children with speech and language impairment, of whom 706 will have problems that persist into secondary level and beyond.

  Let me emphasise this:

    243 places for 6,000 children

    10 to 15 places for 706 children

  We realise this is a very crude comparison but it does highlight the scale of the problem. There needs to be a dramatic increase in the number of special school places for children with speech and language impairment.

  We are sure that you are as shocked by this comparison as we are and that you would want to know if there are any indicators to back up this analysis. The following have been extracted from the replies I received to my requests for information for this report.

    —  Southern Education and Library Board—74 children with SLI as their primary disability, only 10 places in their language unit, though they claim only five on the waiting list for the unit. No outreach programme to support children with SLI in mainstream schools.

    —  South-Eastern Education and Library Board did not supply this information and the Western and Belfast Boards had not replied at time of writing.

  There does seem to be a large number of children identified as having SLI as their primary disability in each of the two board areas who supplied figures, compared to the number of special school places available. We would query why, with such a large discrepancy apparent in each Board, the waiting lists for admission to the units are so low? Speech and language therapy is not available in mainstream schools. As language precedes literacy, it is unlikely that any child with SLI will be able to access the curriculum and everyday educational facilities at a mainstream school. Therefore these children require specialist provision in a language unit or school where they can receive intensive speech and language therapy, and where the teaching is language-intensive. That being so, why are there not 327 children on the waiting lists for the two language units in the South-Eastern Education and Library Board and 64 on the waiting list in the Southern Education and Library Board? We would also ask what is happening to these children, considering that one Board operates no outreach support and the other a limited programme supported by only two teachers?

CONCLUSIONS

  In the limited time available to us we have been unable to provide extensive, statistical proof of our contention that the quantity of special needs education available for children with speech and language impairments is woefully inadequate in Northern Ireland. We contend that from the pointers we have provided the following conclusions can be agreed:

    (1)  That upwards of 6,000 children in Northern Ireland will have considerable educational problems because of speech and language impairment, and will require help in a special school or language unit for part of their school life.

    (2)  That approximately 706 children will require specialist provision for their entire school life.

    (3)  That children with speech and language impairment require help from speech and language therapists outside the scope of mainstream education. By definition this constitutes special needs education and these children should be covered by the protection of a statement of special educational needs.

    (4)  That the number of special school places available for these children is totally inadequate.

RECOMMENDATIONS

  AFASIC NI would make the following recommendations to the Committee:

  A. It should be made clear to the Education and Library Boards that the provision of speech and language therapy for children with SLI is an educational issue, and their legal responsibility. This does not appear to be the case at the moment, as is demonstrated by two quotes from letters sent to AFASIC NI in response to enquiries for this report.

    "You have asked for the number of speech and language therapists working solely in an educational setting. I would suggest that you direct this enquiry to the local health trusts who are the employers of this professional group." North-Eastern Education and Library Board

    "Speech therapists are employed by the health boards and the numbers are not known to the education board." Southern Education and Library Board

  B. In recognition of this fact, the Education and Library Boards should be supplied with separate monies in order to purchase speech and language therapy for special schools. This is the situation in Scotland. It is worth noting that this action would not only reflect the accountability of provision, it would also free up the budget currently spent by the Health Boards in special schools so that they could improve their speech therapy services in other areas.

  C. There needs to be an increase in the provision of speech and language schools and units throughout the Province. The ratio of places available to children needing help is shockingly low. Every child who needs a place in a special school or unit in order to obtain a meaningful education, should have one for as long as the need exists. More funds need to be committed to this objective.

  D. An awareness campaign should be undertaken amongst professionals in both the health and education sectors. Early recognition of speech and language impairment is vital in getting help to these children. The earlier they get help, the less they will fall behind in their education. It was apparent from the replies received that SENCO's in mainstream schools are given very little or no training in the problems of children with communication disorders.

  E. We recommend that a study is carried out into the exact level of incidence of SLI in Northern Ireland, and an analysis made of the type and range of facilities which are required to meet this need. We would suggest that this is undertaken by the Department of Education for Northern Ireland, in conjunction with representatives of the Education and Library Boards, the Health and Social Services Boards and organisations representing those in special education in need of speech and language therapy. A study of this type was carried out by The Scottish Office, Education and Industry Department which resulted in an excellent report The Education of Pupils with Language and Communication Disorders. It is important to realise that facilities for these children are delivered by five separate Education and Library Boards and four separate Health and Social Services Boards. There is a real need for a unified response to this problem which will cover all of Northern Ireland.

BIBLIOGRAPHY

  1. Crystal, D (1984) Language Handicap in Children, National Council for Special Education

  2. Hall, DBM (1996) Health for All Children, Report of the Third Joint Working Party on Child Health Surveillance, third edition, Oxford University Press

  3. Therapy Weekly, 5 June 1997

  4. Response from AFASIC to Excellence for All Children, the DfEE Green Paper on Special Educational Needs

  5. Alone and Anxious, AFASIC, 1993, page 5

  6. The Lancashire Judgement (R v Lancashire County Council ex parte CM 1989)

  7. Draft Code of Practise on the Identification and Assessment of Special Educational Needs, Department of Education Northern Ireland, 1996 (S4:29)

  8. AFASIC Presentation to the Northern Ireland Forum for Political Dialogue, Education Committee by Madeleine Starr (Chair of AFASIC) 11 December 1997

6 April 1998


5   Not printed. See p. xxix. Back

6   Not printed. See p. xxix. Back


 
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