Identifying the needIdentifying the need

Care Aims model adopted by the Northern Care Aims model adopted by the Northern Health and Social Care TrustHealth and Social Care Trust

Fundamental principles of the Care Aims Fundamental principles of the Care Aims model:model:

Focus on IMPACT – client basedFocus on IMPACT – client based

Focus on functional communicationFocus on functional communication

Evaluation of current practiceEvaluation of current practice As a clinician am I addressing the true As a clinician am I addressing the true impactimpact for for

the older children on my caseload?the older children on my caseload? Do the older children I work with feel equipped Do the older children I work with feel equipped

as a result of my input and empowered with the as a result of my input and empowered with the tools to manage their communication difficulties?tools to manage their communication difficulties?

Is my focus on over-assessing and providing Is my focus on over-assessing and providing additional work loads instead of getting to the additional work loads instead of getting to the root of the issues? root of the issues?

Is my intervention clinician led, resulting in Is my intervention clinician led, resulting in limited discharge as I am not fully addressing limited discharge as I am not fully addressing the concerns of children and their parents?the concerns of children and their parents?

Listening for the Listening for the ImpactImpact

““I am really worried that my child is I am really worried that my child is withdrawing and chooses to hold back in withdrawing and chooses to hold back in the classroom”the classroom”

““I would like to know what to do to help my I would like to know what to do to help my child when he is experiencing difficulties” child when he is experiencing difficulties”

““I can see my child’s confidence I can see my child’s confidence decreasing and he gets so frustrated decreasing and he gets so frustrated because he cannot seem to tell me what because he cannot seem to tell me what he wants to in the way that he wants to”he wants to in the way that he wants to”

Listening for the Listening for the ImpactImpact

““I know in my head what I want to say but I I know in my head what I want to say but I cant get the right words”cant get the right words”

I find it really hard to remember everything I find it really hard to remember everything my teacher says as she talks so fast and I my teacher says as she talks so fast and I get left behind”get left behind”

““I hate it when my teacher asks me to I hate it when my teacher asks me to speak out in the class. I get all muddled speak out in the class. I get all muddled up”up”

Forming a ResponseForming a Response

Functional impactFunctional impact Client focusedClient focused

Equipping and EmpoweringEquipping and Empowering

Group InterventionGroup Intervention

Children to attend 7 sessions with a focus Children to attend 7 sessions with a focus on development of a range of higher level on development of a range of higher level language skillslanguage skills

Introduction and practice of a range of Introduction and practice of a range of strategies strategies

2 training sessions provided for parents 2 training sessions provided for parents and teachers and teachers

Fundamental AimsFundamental Aims

Develop higher level language skillsDevelop higher level language skills Equip children, parents and teachers with Equip children, parents and teachers with

functional strategiesfunctional strategies Increase confidenceIncrease confidence Increase participationIncrease participation Decrease frustrationDecrease frustration Decrease isolation and withdrawalDecrease isolation and withdrawal

Importance of team workImportance of team work

Speech and Language Therapy AssistantSpeech and Language Therapy Assistant Clerical OfficerClerical Officer Education staffEducation staff ParentsParents Colleagues: to ensure sustainability and Colleagues: to ensure sustainability and

transferabilitytransferability

OutcomesOutcomes

OutcomesOutcomes

Percentage of discharges as an Percentage of discharges as an outcome of group interventionoutcome of group intervention

73.68%73.68%

Percentage of children provided with a Percentage of children provided with a follow up school programme and follow up school programme and pending dischargepending discharge

15.79%15.79%

Percentage of children requiring Percentage of children requiring ongoing therapyongoing therapy

10.53%10.53%

OutcomesOutcomes

Percentage of discharges as an Percentage of discharges as an outcome of group interventionoutcome of group intervention

62.5%62.5%

Percentage of children provided with a Percentage of children provided with a follow up school programme and follow up school programme and pending dischargepending discharge

12.5%12.5%

Percentage of children requiring Percentage of children requiring ongoing therapyongoing therapy

25%25%

EvaluationEvaluation

EvaluationEvaluation

““All of the exercises were very beneficial All of the exercises were very beneficial and the strategies were really helpful”and the strategies were really helpful”

““All of the information was beneficial for All of the information was beneficial for my child my child to progress and to cope in lifeto progress and to cope in life””

““I am looking forward to using the “How I I am looking forward to using the “How I can help myself” cue cards”can help myself” cue cards”

““More of these courses please. Older More of these courses please. Older children tend to be overlooked”children tend to be overlooked”

Further evaluationFurther evaluation ““I liked hearing that other kids find it hard to remember I liked hearing that other kids find it hard to remember

things”things” ““I ask my teacher to repeat things and sometimes he I ask my teacher to repeat things and sometimes he

writes them down for me so that I can remember”writes them down for me so that I can remember” I use my cue cards a lot so that I don’t feel stuck”I use my cue cards a lot so that I don’t feel stuck” I showed all my teachers my cue cards so that they I showed all my teachers my cue cards so that they

know I might need some help”know I might need some help” I am not afraid to put my hand up and ask for help. This I am not afraid to put my hand up and ask for help. This

helps me get my work done properly”helps me get my work done properly” ““When I cant think of a word my Mum helps me to use When I cant think of a word my Mum helps me to use

my Word Web”my Word Web”

Amendments and Future PlansAmendments and Future Plans Action plan to accompany training sessionsAction plan to accompany training sessions Separate training sessions provided for parents and Separate training sessions provided for parents and

teachersteachers Evaluation of feedback from the children as well as the Evaluation of feedback from the children as well as the

parents and teachersparents and teachers Possible transfer of group intervention to the educational Possible transfer of group intervention to the educational

setting: increased working across the boundaries of setting: increased working across the boundaries of health and educationhealth and education

Possible co-facilitation of groups with education staff so Possible co-facilitation of groups with education staff so that strategies and supportive techniques can be that strategies and supportive techniques can be demonstrateddemonstrated

Continued evaluation and amendments as appropriateContinued evaluation and amendments as appropriate

Maximising ResourcesMaximising Resources

Skill mix: close working with SLTASkill mix: close working with SLTA Focus on Impact and functional communication: Focus on Impact and functional communication:

increased parental and child satisfaction resulting in increased parental and child satisfaction resulting in more timely dischargemore timely discharge

Training provided for parents and teachers: on-going Training provided for parents and teachers: on-going long term supportlong term support

Empowerment: increased management of current and Empowerment: increased management of current and future communication difficultiesfuture communication difficulties

Fundamental focus on strategies vs years of direct Fundamental focus on strategies vs years of direct clinician led therapy: shorter care pathwayclinician led therapy: shorter care pathway

Intervention model that is transferrable and sustainable: Intervention model that is transferrable and sustainable: already replicated with similar positive outcomesalready replicated with similar positive outcomes