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therapists and teachers are

learning to work together to meet the needs of

Getting comfortable with collaboration I

Speech and language children more effectively. But are we giving our students the preparation, opportunities and confidence they need to work collaboratively from the outset? Myra Kersner and Jannet Wright investigate.
n 1995 the Department of Human Communication Science at University College London introduced a professional studies strategic plan which led to innovative developments regarding clinical placements for the 260 students who are working towards becoming speech and language therapists (Kersner & Parker, 2001). Our clinical placements are offered in a variety of settings. Students work with different client groups, and this may be either on a day release or block basis. The department offers two pre-registration courses for speech and language therapy students: a four year BSc Speech Sciences and a two year MSc Speech and Language Sciences. The strategic plan is supported by a continuing series of workshops which are run for supervising clinicians. Now, students may be placed individually, in pairs or even as part of a team. For example, the initiative with therapists in the Hounslow area of London reported at the Royal College of Speech & Language Therapists conference in Liverpool (Parker & Kersner, 1998) has continued to be developed. Here up to 20 students at a time have worked in pairs as part of a team. It is not possible for all students to experience every type of client group or setting for themselves during their time at university. The integration of students theoretical learning in practical settings is therefore supported and facilitated not only by lectures, seminars and workshops but also by small group tutorials. Here the students have the opportunity to share and discuss their various clinical settings and their work with different client groups. From the first year of the courses, students are introduced to the concept of working with others including parents/carers/relatives, as well as colleagues in education, health and social services (Kersner & Wright, 1996; Wright & Kersner, 1999). In preparation for working in educational settings, theoretical approaches to the ways in which teachers and therapists may work together are introduced. These include a consideration of different models of collaborative working in schools as well as the barriers and facilitating factors such as those described by McCartney (1999) and Wright & Kersner (1998). Despite any difficulties which may arise, there is evidence to show that speech and language therapists and teachers are working closely together for children with communication problems in an attempt to provide more effective therapy (Law et al, 2000).

Opportunities
On graduating, a large proportion of students are employed as therapists within educational settings where they are automatically expected to work effectively with teachers. It therefore seemed important to establish whether their university preparation was appropriate and whether they had opportunities to observe the models of practice being described when they were on placement in educational settings. A study was conducted which was divided into two parts. The aim of the first part was to investigate whether our students were aware of joint working practices between their supervising therapists and teachers. If so, in what ways did the therapists work with the teachers and how did the students themselves work with the teachers while on placement? The aim of the second part was to investigate the perceptions of new entrants - on their first day of their speech and language therapy course - to see what they thought about the role of students and the role of therapists when working in schools/units. In the first study, self completion questionnaires were given to students in the third and fourth year of the Bachelors degree and both years of the Masters degree. They had already experienced working on clinical placement. The aim was to find out what joint working practices they had

Myra Kersner and Jannet Wright

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if you want to be more innovative with pre$registration students help students work with other professionals change students perceptions of their role

From the first year of the courses, students are introduced to the concept of working with others including parents/carers/ relatives, as well as colleagues in education, health and social services

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Table 1 Activities undertaken by the supervising therapists with the teachers which had been observed by the students
Activity Responses

# either

(n=99) observed, or knew about through Give feedback to each re: work with children 44% discussion with their supervising therapists, Evaluate/record progress of specific children 33% while on paediatric placement. Work with teacher in classroom 30% A semi-structured interview was then Plan future work with teacher 26% conducted with 12 of the students about Contribute to Individual Education Plans 26% how they worked with teachers during Attend staff meetings 26% their placements. Observe each other working 25% Ninety nine questionnaires were analysed. Assess communication problems together 19% The students had been on a variety of Attend parents meeting 18% placements and some had been in more Plan modifications to the National Curriculum 16% than one educational setting. These included: Attend school INSET (in-service training) 15% mainstream schools (43) Run joint courses for other adults 4% special schools (32) Attend courses together 2% units in mainstream schools (27) nurseries (8) units in special schools (2) All students who responded indicated that they were aware of joint working practices occurring A second study was then carried out to investibetween their supervising therapists and the gate the perceptions of new entrants onto the teachers in the schools. Eighty seven percent of courses about therapists and students working the respondents indicated that their supervising with educational staff. Self completion questiontherapist talked to the teachers about the work naires were given to the next cohort of incoming undertaken with the children, although only 14 students on the first day of their courses. Both the per cent said that the time for such discussions MSc and BSc groups had had considerable prewas timetabled. course experience in educational settings, 90 per The students were asked to indicate the specifcent of the MSc students and 85 per cent of BSc ic activities that they had observed their supervistudents having worked or volunteered in such a sors carrying out with the teachers setting. However, these students (table 1). Some students indicated that, had not yet been on a clinical although they had not actually placement as a student speech and observed their supervisors engaged in language therapist. the activities, they knew through disAll the questionnaires were cussion that such activities occurred. returned so that 82 were available Students were asked how they themfor analysis. selves worked with the teachers while Almost all the students in both on placement. They indicated that they groups expected to share information received information from the teachers with their therapist about the chilabout curriculum topics and topic-relatdren they were working with. Almost ed vocabulary which they were then all also expected to be observed by able to use in their own work. For examtheir supervising therapist. ple one student said: The teacher is Although 87 per cent of the MSc really helpful. She gave me her targets students thought that they would for the Spring term and she was hoping share information with the teachwe could link up curricular aims. ers only 65 per cent of the BSc stuThe majority of students interviewed dents thought that they would do withdrew the children for their therathis. Less than 50 per cent of both py sessions and reported that they shared inforgroups thought that they would plan any future mation primarily with their supervising therapists work with the teachers. rather than the teachers, because they saw themThe students were also asked about what activselves as attached to the therapists. They did not ities they expected qualified therapists to carry see it as their role to provide written information out when working in a school setting The folabout the children for the teachers. lowing four were ranked highest by both student The students perceived liaison with teachers as groups: part of the therapists role, although not neces to assess communication problems with the sarily as part of their role as students. As they said, teacher The therapist did it best.; The therapist is very to give feedback to and receive feedback from competent, so it would not be appropriate for me the teacher about their work with the children in that situation. to evaluate and record progress of children However, the students did sometimes liaise with with the teacher assistants: The learning support assistant wants to plan future work with the teacher. to know what we did and wants to have teaching plans so that in the week she can go over them with that child individually... and next week shes In the first study it was encouraging to note that going to come and sit in on the session. 82 per cent of students had experienced a school-

Perceptions

Clinical supervisors and college-based tutors need to ensure that they help all students to maximise their skills from previous work experience and develop new professional skills

Encouraging

based placement during their course. The increasing number of mainstream placements now being offered for students also reflects the patterns of service provision in speech and language therapy which has changed in line with current inclusive education policy. An increasing number of children with communication problems are being educated in mainstream schools and speech and language therapists need to be able to work with educational staff from the moment of graduation. The importance of therapists working with educational staff has long been recognised (Lacey, 2001) and continues to be encouraged by government policy (DfES, 2001). While on placement in schools most students work with the same pupils on a regular basis, establishing and reinforcing their assessment and intervention skills. They do not work on a consultancy model and not all students become involved with working with other members of staff. Within the first study, those interviewed did not necessarily see liaison with the teacher as part of their role, although almost all of the questionnaire respondents indicated that they had observed their supervising therapists working together with teachers. It is possible that once they were involved in planning and carrying out therapy the students found it difficult to manage the additional task of liaising with the teachers. They possibly did not have the confidence to do this because, as some students said, they felt that, the therapist did it best. It is interesting to note that the students in the second study who had not yet been on clinical placement said that they saw liaison with educational staff as part of their student role. This was not how it was perceived by students in the first study who had been on clinical placement. Not unnaturally, 83 per cent of the students who were just beginning their course said that they expected qualified therapists to carry out the planning, therapy and liaison with others. Students in the first study reported that they discussed collaborative practices with their supervising therapist even where they had not directly observed such liaison. This indicates that they were aware of the importance of professional collaboration and that professional issues regarding models of practice are discussed on placement. As newly qualified therapists need to work collaboratively with teachers as soon as they graduate, such an awareness should go some way towards helping them develop ways of working in an inclusive education environment. When the new students were asked to indicate whether they would liaise with classroom assistants when on placement both groups said that they would, although this applied to a greater number of MSc (80 per cent) than BSc students (52 per cent). It is possible that all students might find liaison with assistants easier than working with teachers as many students nowadays have

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considerable pre-course experience as assistants. However, the variation between the MSc and BSc students may reflect the students life experience as 50 per cent of the MSc students were aged 25 years and over while only 19 per cent of the BSc students fell into this age bracket. These age differences may also account for other ways in which the students indicated that they might work. For example, more MSc students (67 per cent) than BSc students (46 per cent) indicated that they would give written information to the teachers about their work with the children when they were on placement. Such differences in age, life experience and work experience with related client groups mean that the students on these two courses may have different learning styles and will need to be approached differently to facilitate their professional development. Right from the start of the Masters course, students are expected to be ready for immediate client/colleague contact and involvement. The expectations for new entrant BScs, however, are different as these students have four years in which to develop their professional skills more gradually. Such differences and expectations are supported by the findings of this study.

modelling collaborative working practice providing opportunities for role play during workshop activities providing opportunities for contact to be made between students and teachers encouraging students to take more responsibility in relation to working with teachers, for example by gathering information about the children from the teachers, or by explaining therapy activities to them expecting students to take the initiative in liaising with teachers/assistants encouraging teacher colleagues to help foster working relationships with the students for example when they come into contact with them in the school staff room. Students need support and encouragement in order to adjust their perceptions and expectations about their role. In the same way, managers need to support and encourage newly qualified therapists so that they can have a clear and well defined professional identity... in school (Roux, 1996). Jannet A. Wright and Myra Kersner are senior lecturers at the Department of Human Communication Science, University College London.

Confidence
In discussion with supervising clinicians and students, confidence is often acknowledged to be a critical factor in determining the ways in which students work while on clinical placement. The more they are able to practise their professional skills the more likely students are to develop their confidence. Thus, the more opportunities they have to practise skills and the more encouragement and support they have to carry out different roles, the more likely they are to gain confidence. Clinical supervisors and college-based tutors need to ensure that they help all students to maximise their skills from previous work experience and develop new professional skills by:

References
DfES (2001) Revised Code of Practice for Special Educational Needs. London: The Stationery Office. Kersner, M. & Parker, A. (2001) A strategic approach to clinical placement learning. International Journal of Language and Communication Disorders 36 (Supplement) 150-155. Kersner, M. & Wright, J.A. (1996) Collaboration between teachers and speech and language therapists working with children with severe learning disabilities: implications for professional development. British Journal of Learning Disabilities 24 (1) 33-37. Lacey, P. (2001) Support Partnerships: Collaboration in Action. London: David Fulton Publishers.

Reflections
Do I work collaboratively and am I seen to work collaboratively? Do I acknowledge the critical role of confidence in student education? Do I give students the opportunity to observe and then to practise liaison?

Law, J., Lindsay, G., Peacey, N., Gascoigne, M., Soloff, N., Radford, J. & Band, S. (2000) Provision for Children with Speech and Language Difficulties in England and Wales: Facilitating communication between education and health. London: The Stationery Office. McCartney, E. (1999) Speech/Language Therapists and Teachers working Together: A systems based approach to collaboration. London: Whurr Publishers Ltd. Parker, A. & Kersner, M. (1998) New approaches to learning on clinical placement International Journal of Language and Communication Disorders 33 (Supplement) 255-260. Roux, J. (1996) Working collaboratively with teachers: supporting the newly qualified speech and language therapist in a mainstream school. Child Language Teaching and Therapy 12 (1) 48 - 59. Wright, J.A. & Kersner, M. (1998) Supporting children with communication problems : Sharing the workload. London: David Fulton Publishers. Wright, J.A. & Kersner, M. (1999) Teachers and speech and language therapists working with children with physical disabilities: implications for inclusive education. British Journal of Special Education 26 (4) 201-205.

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