Select Committee on Education and Skills Written Evidence

Memorandum submitted by Nuffield Hearing and Speech Centre, Free Royal Free Hospital NHS Trust


  Observations from Mrs Pam Williams, Principal Speech and Language Therapist and Dr Breege Mac Ardle, Consultant in Audiological Medicine at the Nuffield Hearing and Speech Centre, RNTNE Hospital, Royal Free Hospital NHS Trust. This is a National Centre of Excellence for second opinions on the assessment, diagnosis and management of children with severe speech and language disorders. Our Trust also provides a unique Speech and Language Unit for children aged four to seven years with very severe speech and language disorders. All children who attend the Unit have a statement of SEN and are paid for by their local LEAs or a combination of LEA & PCT. The speech and language therapy department has produced and published an internationally recognised treatment resource for children with severe speech disorders, entitled "The Nuffield Centre Dyspraxia Programme" (1985; 1992; 2004). Our department receives up to 40 requests per week by telephone, e-mail and letter from parents and professionals for advice about how to meet children's speech and language therapy needs.


  Despite clear evidence based research that provision of direct ongoing speech and language therapy is effective for children with severe speech disorders, most local speech and language therapy services do not provide this direct therapy, which can be required over many years. If children's needs are not met they can have difficulties throughout their school years and this may have long-term consequences for their future employability and ability to participate in society.


  Most children with primary speech and language disorders are placed in mainstream school.

  Without a statement of SEN, children are placed on School Action or School Action Plus and only receive a speech and language therapy programme, set by a qualified speech and language therapist, but delivered by an untrained teaching assistant/LSA.

  Many schools have difficulty in delivering IEPs effectively, due to frequent changes of speech and language therapists or vacant posts. Only a very small number of LEAs/individual schools employ speech and language therapists directly and so are dependent on local PCTs to provide a service.

  Families struggle currently to obtain a statement of SEN, because the children are identified as only having one area of need. However, not only can these children not communicate, they struggle to access the curriculum, cope emotionally, academically and socially. Research has shown that as a group they are very much at risk of having literacy acquisition difficulties.

  Even when children acquire a Statement of SEN (often after a long struggle by parents), direct speech and language therapy is frequently not identified in Section 3. This is despite case law, which has confirmed that speech and language disorders should be regarded as an educational need.


  We see many parents in a high state of distress as they cannot get their child's needs recognised or met. Many parents are not aware of the current legislation or their child's rights. Local services frequently do not inform them of supportive national or local voluntary organisations. Most have no idea that they may be entitled to claim Disability Living Allowance.

  We often see parents who are paying for expensive private speech and language therapy for their child to compensate for lack of appropriate local provision. In many cases this is causing great financial hardship or is only possible through the support of extended family.

  When parents become aware of the current legislation, they often have to fight very hard and pay considerable sums of money (eg up to £10,000) to bring the LEA to Tribunal in order to have their child's needs recognised and obtain appropriate speech and language provision and placement.


  For the children with the severest difficulties, mainstream school is not appropriate. They need to be placed in specialist Units/Schools across the educational age range.

Many primary level Speech and Language Therapy Units have limited speech and language therapy cover (despite their name) and there are all too few secondary level Units. We are very concerned that a number of special schools, which cater for children with severe speech and language problems have already shut or are under threat of closure, including our own Unit, because of the current inclusion policy.


    —  Increased recognition by LEAs of the nature and the emotional, social and academic consequences of speech and language disorders.

    —  Increased acknowledgement that children with severe speech and language disorders require regular, direct and long-term speech and language therapy.

    —  Speech and language therapy services need to be reviewed and must be considered as an educational provision for school aged children.

    —  More commitment by education, health and social services to inform parents about choices, the current legislation and local and national support organisations.

October 2005

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