INTERNATIONAL RELATIONS

Conversing with the world
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id you know that a lateral /s/ is part of the normal process of speech sound development in Greece? That the age of speech sound acquisition across languages can vary by more than two and a half years, even for languages sharing similar consonants? Or that, once the universal CV (consonant – vowel) has appeared, the development of syllable structure differs depending on the syllable structure of the language concerned? As Sharynne McLeod emphasises, this kind of international acquisition knowledge matters to our profession. When a child or client speaks another language, we need to “map out what they are bringing to the mix” so we don’t make too many – or too few – allowances. I met Sharynne in Bristol, where she was delivering an energetic and inspiring day’s seminar for speech and language therapists working with children with speech sound disorders. In the month since then, her blog shows she has continued on her quest to “have a conversation with the world”, listening to children across Zambia and making the most of networking and learning opportunities at the International Association of Logopedics and Phoniatrics Conference in Athens. Sharynne’s tour was made possible when she became one of the first cohort of mid-career recipients of a 4 year Future Fellowship Award from the Australian Research Council. Her aim with this grant is to: a. estimate the prevalence of communication impairment in Australian children who speak languages other than English
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READ THIS IF YOU WANT TO • PUT RESEARCH EVIDENCE INTO PRACTICE • KNOW MORE ABOUT FIRST LANGUAGE INFLUENCES • WRITE FOR PUBLICATION

Australian researcher, educator and editor Sharynne McLeod visited Bristol in July 2010, where she led a seminar to update speech and language therapists on international developments in speech sound disorder assessment and practice. Avril Nicoll caught up with her afterwards to continue the discussion about making sense of the literature, writing for publication and making a difference across the globe.

Picture courtesy of Sharynne McLeod who says, “This sign means friendship: a gesture that was offered to us frequently during our visit to Zambia.” b. critique current professional practices for identifying speech impairment in children who speak languages other than English c. develop an international speech assessment to facilitate accurate diagnoses to support children’s short and long-term social, educational and occupational outcomes. Reading these intended outcomes it is not surprising that Sharynne is an internationally renowned researcher, educator and editor, driven by a passion for making a difference in the lives of children with communication difficulties, in particular speech sound disorders. Recognising that we can’t all read all the research, Sharynne sees her role as a broker, reading and interpreting the evidence so we can follow up and apply what we need in our own situation. She wants to “bring together information from the world – helping people access the diversity and confusion.” Judging by the feedback from Bristol participants, she does this very successfully. As one said, “You made me feel that things which I often feel daunted by were accessible to me.”

The bigger picture

In spite of current financial pressures on the NHS and its impact on training budgets, this study day was oversubscribed. This is perhaps a recognition not just of Sharynne’s standing but of the profession’s acceptance that we need to get better at knowing, implementing

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and communicating therapy that is evidence based, efficient and appropriate to the individual. Speechlanguage pathology in Australia has always been smaller than in the UK, with less public provision and far greater logistical challenges to service delivery, yet the richness of the research, the wish to share knowledge and the awareness of the bigger picture is arguably more developed there. When Sharynne qualified there were no speech language pathology jobs so necessity was the mother of invention. She “created” one through joining forces with a friend in a

assessed using EPG pictures, she got us to prove it! (As a result, we will remember that lateral bracing is very important for quick speech and that ‘side contact’ and ‘horseshoe shape’ are useful terms to use with children, along with EPG pictures as a biofeedback tool.) Sharynne is also generous in sharing work online, for example the freely available ‘Single Word Test of Consonant Clusters’ (McLeod & Hand, 1991), and peppers her conversation with signposts to other important work. This includes initiatives close to home, such as the Speech Pathology

Lusaka, Zambia, courtesy of Sharynne McLeod

preschool facility and submitting a grant application. Although as an undergraduate she couldn’t wait to get out into the real world, Sharynne quickly discovered the benefits of ongoing learning and a love of teaching and spreading good practice. She is constantly listening to therapists and responding to their suggestions so that the information she brokers will stand the best chance of making an impact on practice. Rather than handing out copies of her PowerPoint slides from the seminar, for example, she presented us with a comprehensive booklet of information arranged as a clinical resource. And, rather than just telling us that speech and language therapists had only 13 per cent accuracy when their knowledge of tongue placement for sounds was
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Australia evidence based practice database SpeechBITE and Caroline Bowen’s website. It also crosses the globe, from Amy Glaspey’s dynamic assessment at Miami University to the parent inspired FOCUS (Focus on the Outcomes of Children Under Six) from Canada and the PEPS-C (Profiling Elements of Prosodic Systems) developed in Edinburgh.

The whole child

It is clear that Sharynne’s family and life experiences, while not part of her public face, have as much of an ongoing and reciprocal influence on the direction of her work as what she does professionally. She talks about how, traditionally, speech sound disorder practice focuses on the mouth, but that we need to consider

the whole child. This term is often used rather glibly, but Sharynne brings in the well-known phrase “the hundred languages of children” (Malaguzzi, 1998) to include practical examples of what we can observe (bitten fingernails, a kiss on the cheek) and to suggest questions we can ask children and parents (SPAA-C, 2004). Sharynne was involved with the World Health Organisation’s ICF-CY (Children & Youth) 0-18 years (WHO, 2007), and Australia is considering it as a way of reporting health data. As she says, in terms of functioning, the ability to be invited to birthday parties may be the outcome of intervention most valued by parents. Meanwhile, for children, the polysyllabic words we don’t necessarily assess may be key to their ability to participate in “their own little society”, whether it be as fans of dinosaurs, football or electronic games. It is also interesting to compare the views of children, their siblings and parents. In research where children drew pictures of themselves in communicative situations, Sharynne’s research team found many drew big ears on the listener because they saw the problem as one of the listener not listening properly. She is now taking the use of visual images further in new work, by getting children to take photos of happy places. She believes there is much still to do with the children with the lowest percentage of consonants correct in terms of advocacy as well as direct intervention. It’s worth noting Sharynne’s finding from work with parents that they liked a therapist if they thought the therapist liked their child and had their child’s best interests at heart. This value on relationships is clear throughout Sharynne’s work, and was recognised recently when she was awarded best postgraduate supervisor in the whole of Charles Sturt University. When Sharynne worked with colleagues to set up the speech pathology course at Charles Sturt 10 years ago, her world view was already well developed, and she identified the importance of the course producing graduates who were brave and resourceful, as they would ultimately be working in places like Cambodia, Fiji and

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remote Aboriginal communities. Now based at the Bathurst campus, the postgraduate students she supervises are as far-flung as Canada, and she meets them in convenient locations around the world - whether a cottage in her own back yard or a New Orleans steamboat. Sharynne and her award-winning research team are such prolific contributors to academic journals that I was curious to know their secret. Not surprisingly, perhaps, travel is involved, but importantly writing is valued, so she creates the conditions which allow it to happen. Often a year in advance, Sharynne plans several 3-4 day writing retreats in a wide variety of places, but by a beach if possible. There are no phone calls or emails, no academic work is accepted for these times and the team moves into an apartment. Before applying for research grants the team has already decided where they want to publish their research, so they are focused on what and how they want to write. A team of four can produce a number of journal articles between them when given this space. Sharynne’s advice for readers who want to share their practice is to recognise that the hardest thing is “just to write” but that our skills as speech and language therapists help us analyse our writing and make it clearer. Rejection can mean that it has been submitted to the wrong place for your article, but may also mean it is good but not sufficiently new. She suggests making a PowerPoint presentation to get the flow / story / logic down before shifting this around to form the basis of an article. As a firm supporter of Dollaghan’s E3BP (2007), Sharynne says that in writing we are aiming to get clinicians to ask themselves how well their current repertoire (internal evidence) compares with other approaches (external evidence). She says, think big and write about what is important, and “it will change people’s practice”. While Sharynne protests she is “very aware of how monolingual I am as I travel the world”, her success suggests she has speaking multiple languages – of the child, parent, therapist, researcher, commissioner and policy SLTP maker – down to a fine art.
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Aberdeen, Hong Kong (June 2010). Picture courtesy of Sharynne McLeod.

Sharynne McLeod PhD, CPSP, FSPA, ASHA Fellow, is Professor in Speech and Language Acquisition and Australian Research Council Future Fellow based at Charles Sturt University, Bathurst, Australia. She is also editor of the International Journal of Speech-Language Pathology. Avril Nicoll is Editor of Speech & Language Therapy in Practice magazine. ‘Speech Sound Disorders in Children – Seminar for SLTs’ on 12 July 2010 was organised by the Speech & Language Therapy Research Unit, Bristol, http://www.speech-therapy.ik.com. REFLECTIONS • DO I REALISE THAT JOURNAL ARTICLES ABOUT SPEECH AND LANGUAGE DEVELOPMENT IN OTHER LANGUAGES ARE RELEVANT TO MY WORK? • DO I REGULARLY COMPARE MY CURRENT REPERTOIRE OF THERAPY TOOLS WITH OTHER APPROACHES? • DO I CONSIDER OUTCOMES IN TERMS OF FUNCTIONING, PARTICIPATION AND WHAT MATTERS TO CLIENTS AND THEIR FAMILIES? To comment on the impact this article has had on you, see the information about Speech & Language Therapy in Practice’s Critical Friends at www. speechmag.com/About/Friends.

References Dollaghan, C.A. (2007) The Handbook for Evidence-Based Practice in Communication Disorders. Baltimore: Paul H. Brookes. Malaguzzi, L. (1998) ‘No way. The hundred is there’, in Edwards, C., Gandinin, L. & Forman, G. (Eds) The hundred languages of children: The Reggio Emilia Approach – Advanced reflections. Greenwich: Ablex Publishing, p.3. McLeod, S. (2004) ‘Speech pathologists’ application of the ICF to children with speech impairment’, Advances in Speech-Language Pathology 6(1), pp.75-81. World Health Organisation (2007) International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). WHO: Geneva. Resources Sharynne’s blog (includes updates on published articles) - http://www. speakingmylanguages.blogspot.com/ SpeechBITE - http://www.speechbite.com/ Caroline Bowen’s website - http://www. speech-language-therapy.com/ Single Word Test of Consonant Clusters (Sharynne McLeod & Linda Hand, 1991) http://athene.riv.csu.edu.au/~smcleod/ Consonantclustertest.pdf Amy Glaspey, with further information about the Glaspey Dynamic Assessment of Phonology - http://www.units.muohio.edu/ spa/faculty/glaspey.html Nancy Thomas-Stonell, with more on FOCUS - http://www.hollandbloorview.ca/research/ scientistprofiles/thomasstonell.php PEPS-C (Profiling Elements of Prosodic Systems in Children) - http://www.qmu.ac.uk/ ssrc/prosodyinasd/PEPS-C.htm SPAA-C (Speech Participation and Activity of Children) Version 2.0 (2004) - http://athene. riv.csu.edu.au/~smcleod/SPAAC2.pdf Children draw talking art exhibition http://child.etsu.edu/resources/mcleod/ McLeod_children%20draw%20talking_ sample.pdf

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