Levels of Knowledge of Sencos in Newcastle Primary Schools

Exploring the levels of knowledge of SENCo’s in Newcastle Primary Schools Feedback from the Paediatric Community Speech and Language Therapy Team in Newcastle has suggested that Special Educational Needs Co-ordinators (SENCo’s) have variable levels of knowledge regarding Speech, Language and Communication Needs, and understanding of the role of the Speech and Language Therapist. Additionally, there is a lack of consistency in the communication and liaison between the SLT department and Primary Schools. This report is aimed at Speech and Language Therapists (SLTs) in the Paediatric Community Team to gain awareness of the levels of understanding that SENCo’s have specifically related to Speech, Language and Communication Needs (SLCN) in order to develop better communication and joint understanding.

The aim is to analyze information received from SENCo’s and identify the potential challenges and adaptations that could be made to improve the service delivery in future. Aim: To explore SENCo’s current level of knowledge and understanding in relation to Speech, Language, and Communication Needs. The Bercow Report (2008) highlighted five key themes to improve the collaboration between the health and education sectors in order to create a more effective service provision and therefore improved services for children with SLCN. Within this, the theme ‘Joint working is crucial’ expands on the importance of SLT’s and schools working more closely with one another to provide a holistic approach. In addition the policy ‘Every Child Matters’ (ref) However, the term ‘SLCN’ has been used differently in a variety of reports and policies, so this needs to be taken into account.

For example, in The Bercow Report, SLCN is used in a broad sense, encompassing anyone who falls under this bracket- SLT’s commonly use this definition. However, the Department of Education uses SLCN to describe those whose primary difficulty is Speech, Language, and Communication, disregarding those who have SLCN due to other causes. This is used throughout the SEN Code of Practice, suggesting that SENCo’s would be exposed to this definition. Therefore, these differences need to be acknowledged to reduce any miscommunications. However, the most recent SEND Code of Practice in 2015, has tried to clarify the meaning and categorized SLCN under ‘Communication and Interaction’ Needs (Department for Education, 2015). Collaborative models of service delivery are being increasingly employed to help support children with Speech, Language and Communication Needs (SLCN).

The RCSLT has also identified that trans-disciplinary working between schools, parents and Speech and Language Therapists (SLTs) is integral in the service delivery of SLT provision. This provision should encourage the consideration of the functional impact of a child’s SLCN on their ability to participate and involve themselves in everyday activities (ICAN, 2008). This holistic view can increase the child’s self-esteem, their access to the curriculum and an overall improvement in the child’s communication skills, if joint working in successful (Baxter, Brookes, Bianchi, Rashid & Hay, 2009).

Further benefits of joint working for the professionals involved include (Glover, McCormack & Smith-Tamaray, 2015):

• A consistency of service delivery
• Transferring skills and knowledge between professionals
• An approach that involves the curriculum and therapy

Although it has been suggested that we move towards a more collaborative model, it is becoming more vital in recent years due to the increasing budget cuts for SEN provision and with the introduction of extended schools (The Bercow Report, 2008). It is the combination of the skills and knowledge of teachers, clinically and theoretical knowledge of SLTs, and the insight and support from parents that should lead to the most effective intervention for children with SLCN. However, the lack of knowledge and understanding of Speech, Language and Communication Needs of SENCo’s may impact negatively on the effectiveness of referrals and liaison with the SLT service. A report by the Communication Trust in 2017 identified that 67% of SENCo’s in a survey reported that they had received a lack of training around identifying and supporting children with SLCN, with only 24% saying that they felt confident about their ability. With SENCo’s having the main responsibility to refer children at risk or those who are developing SLCN to specialist services, this may be a causal reason behind the under-identification of this client group. Additionally, it has been reported that teachers and SENCo’s identify expressive speech and language difficulties more easily than any other difficulties, consequently making this the main client group that is referred for Speech and Language Therapy (McConnellogue, 2011).

However, it is particularly important for members of staff to be aware of other children that Speech and Language Therapists work with to be able to refer for the appropriate reasons. Additionally, this would mean they would need to have a greater awareness of ways of identifying other difficulties such as comprehension and pragmatics, which may present as inappropriate behavior, to ensure that they receive adequate support. Methodology: This pre-audit study was carried out for the Newcastle upon Tyne Hospitals Paediatric Community SLT service. A questionnaire was created in order to fulfill the aim. The questionnaire was developed using previous literature and clinical experience.

In the first draft, sections in the questionnaire were as follows:

1. Knowledge and understanding of SLCN
2. Training
3. Expectations
4. Current Satisfaction with Liaison
5. Improving Communications

However, after discussions with the wider team, there were concerns over some of the sections. These worries stemmed from the thought that the survey would raise expectations, and SENCo’s would expect changes which are not realistic possibilities e.g. training sessions. Unfortunately, miscommunication within the team leads to multiple versions of the questionnaire being produced as there was a lack of clarity over the particular aims and outcomes expected of this survey.

Additional adaptations were then made including removing sections about training opportunities and practical issues, and rewording of questions to ensure that it was clear that the information gleaned from the survey is to encourage more effective joint working. A pilot sample was carried out using purposeful sampling to choose the SENCo’s with a good relationship with the service to enable quick response times, and increased reliability and response rates (Palinkas, Horwitz, Green, Wisdom, Duan & Hoagwood, 2015). Three schools were chosen and asked to respond with any adaptations to the survey regarding the length, and the clarity and relevance of questions. It was suggested that some of the wording was changed to make it clearer what the questions were asking. The questionnaire was then adapted following these suggestions. SurveyMonkey online was used as a quick and easy method of data collection, reaching a large sample size and decreasing the costs and time required (Fife-Schaw, 2012).

Additionally, the turn-around for online questionnaires is vastly quicker than that of traditional posting and/or handing out and anonymity can be preserved (Streiner, Norman & Cairney, 2015). To increase response rates, the researcher contacted the SENCo’s in advance of the research being conducted to gain consent and make them aware that the questionnaire should be anticipated. The questionnaire consisted of a combination of open and closed questions using a mixture of Likert scales and multiple choice questioning.

Open questions allow the responder to elaborate on answers, giving more narrative responses and add any additional comments. Closed questions have been used specifically to reduce the number of ambiguous answers and provide quick answering for the responder (Fife-Schaw, 2012). Results: Sixty SENCo’s were initially contacted to complete the questionnaire. 10 SENCo’s agreed to participate, however, only 7 completed the questionnaire, giving a total response rate of 11.6%. Due to late data collection, the data was not available to analyze prior to the completion of the placement.

Therefore, only one section of the questionnaire surrounding SENCo’s knowledge of SLCN has been analyzed, as there was not the opportunity to consider all sections in detail. The first question was based on their confidence in understanding the term SLCN (figure 1). All the respondents gave a confidence rating of above 6 on a scale of 1-10, suggesting an overall confidence in their ability. However, it may have been helpful to also have asked how long the respondent had been a SENCo for, to identify whether there is a correlation between years in the job and confidence. This would be beneficial to highlight the necessary training that may be suitable. SENCo’s were also asked to specify for which reasons they would refer a child for therapy. This can identify whether SENCo’s are referring for the appropriate reasons. Qualitative data were analyzed using inductive content analysis, where the overall themes of the data were identified (Denscombe, 2010). Figure 2 below shows the percentage of themes identified in ascending order.

Figure 2: Thematic Analysis of reasons for referral. Themes Percentage of SENCo’s mentioning this aspect (n=7) Examples Social Communication 14 “Social Communication Impairment”Stammering 29 “non-fluency and stammering” Concerns 29 “teacher and parent concern”Receptive Language 57 “difficulties understanding or processing language”“difficulties in receptive language”Expressive Language 57 “progress with expressive language skills impacting on learning”“children who do not speak ”Unclear Speech 57 “unclear speech”“speech difficult to interpret”2/7 (29%) of the respondents noted that concern from teachers and parents would prompt a referral. However, this does not provide enough information to form reliable results from these respondents. Further questioning through interviews or emailing would be beneficial to probe further into the reasons why concerns have arisen. 5/7 (57%) of respondents had identified receptive and expressive language difficulties and unclear speech as the main reasons for referral. This is an expected outcome as these 3 themes are the most common SLCN found in primary schools.

However, due to this fact, the majority of respondents should have identified this reason. With reference, to figure 3, 100% of SENCo’s had identified that SLT’s work with children with spoken language difficulties, therefore, it would have been expected that all SENCo’s would have highlighted this as a need for referral.

Figure 3 illustrates the responses for question 6 “An SLT can work with the following…”. All respondents selected ‘children with Spoken Language Difficulties” and “children with pronunciation difficulties” for client groups that SLT’s can work with. However, only 29% had identified that SLTs may work with children with hearing difficulties.

The response “Children with literacy difficulties” was used as a ‘dummy’ answer to preventing the respondents from randomly choosing all of the responses without thinking about the answer. However, 1 respondent had identified this as a client group that SLT’s work with. As most of the respondents had not identified all of the correct answers for this question, this highlights the need for SENCo’s to have a further understanding of the role of SLT’s.

Figure 4 below, represents the number of respondents who have received training in particular areas. 6/7 SENCo’s completed this question. 4/6 (67%) have received training in the Typical development of Speech, Language, and Communication, Identifying those with SLCN, and Methods to support children with SLCN. However, only 2/6 have received training in recognizing the importance of good SLCN and the impact that this can have on the whole curriculum. More detailed analysis has identified disparities between answers within the questionnaires. For some respondents, a confidence rating of 10 was given, however, the answers to questions regarding the referral lacked detail and questions regarding the role of the SLT showed a lack of understanding and knowledge in this area.

However, if the respondent believes that they are confident in this, then this should be of more concern. In addition, some respondents state a confidence rating of 10, and provide appropriate reasons for referral, but are then unable to name the client groups that SLT’s make work with, including those that SENCo’s would come across frequently. This highlights the further need for a more collaborative model of service delivery and the importance of Continued Professional Development (CPD) training, as suggested by Ofsted and…. It is suggested that the remaining data is analyzed using qualitative techniques such as thematic analysis, and discussed in team meetings to identify specific ways of improving communication. Conclusions and Implications for Clinical Practice The findings suggest that the SENCo’s have variable levels of knowledge regarding SLCN in terms of the training they have received, as hypothesized. The data has shown that some SENCo’s are potentially unaware of alternative methods for referral and roles of the SLT, however, not enough detail is provided in the results to make this assumption. In addition, there is variability in the levels of training that they have received… With 7.6% of children in Primary School having a developmental language disorder, this diagnosis is the most common childhood condition, above Autism and Dyslexia (Communication Trust).

Therefore, it would be expected that SENCo’s would identify language difficulties as a major concern and reason for referral. However, from the results above, this is not the case. It is, therefore, concerning that not all SENCo’s are referring to the reasons expected. In addition, results from the questionnaire about the role of the SLT received variable outcomes, suggesting that the overall consensus shows that SENCo’s are unsure of the role of SLTs. A lack of knowledge and awareness could lead to the under-identification of children with SLCN, meaning that they are not receiving the support they would benefit from. ‘Norm-shifting’ may be another major reason behind this under-identification, where due to large numbers of children with SLCN in the school, the SENCo becomes desensitized to the national age expectations, therefore referring fewer children to SLT, when they would benefit from intervention (Holland & Hosforth, 2017).

Under-identification of children with SLCN can be detrimental for the child’s future. A reduction in the opportunities to intervene early can lead to children having more significant difficulties later on in school life, consequently making it more difficult to intervene. Socially, children will become isolated as their difficulties become more prominent and self-awareness increases (McCormack et al, 2011). In addition, mental health and behavioral difficulties may arise in later schooling, impacting directly on academic achievement (Botting & Conti-Ramsden, 2000). This highlights the importance of educating the wider workforce, so this can be reduced by intervening early, starting with appropriate referrals from SENCo’s and teachers. However, this may lead to an increase in referrals to the service. With an already resource-limited service with long waiting lists, an increased caseload should be acknowledged by the commissioning services and wider team, as resource and time pressures will increase. This also indicates the necessary training that SENCo’s and teachers should undergo in terms of supporting and implementing strategies into the classroom at a universal level (three-tier model) to reduce the number of children with SLCN, and the impact upon the SLT service. In a more practical sense, identifying the SENCo’s level of knowledge and understanding of roles will enable individual SLTs within the service to adapt their approach when liaising with SENCo’s. The aim would be to decrease the social barrier of ‘mutual trust and respect’ which has been noted to be essential for effective joint working (Hartas, 2004). Understanding of each other professionals has also been Acknowledging the fact that the majority of SENCo’s have not received training on the importance of good Speech and Language and the impact of this on the whole curriculum, SLTs need to ensure that any liaison includes the rationale behind the therapy targets and intervention. This should aim to motivate SENCo’s and TA’s to implement the school programmes as instructed as they would understand the reasoning behind the therapy.

Clear communications between professionals also enable the school staff to build confidence in their abilities (McKean, Law, Cockerill, Allon-Smith, McCartney & Forbes, 2017). In addition, this increased knowledge provides the school with an ownership and responsibility to implement the programmes. Limitations A survey method of data collection was used to increase the sample size and response rates, in order to have more reliable findings as suggested by Glover, McCormack & Smith-Tamaray (2015). However, a minimal response rate has led to skewed findings and therefore data cannot be generalized. In addition, respondents were self-selected which can lead to biases in responses. Those who respond are likely to have a particular interest in this topic or believe to have a high level of understanding. Glover, McCormack & Smith-Tamaray (2015) have also suggested that those who participate have years of experience in the role and therefore have a willingness to discuss the difficulties that they face with collaboration. Open questions were chosen to provide more detailed information and views, however, these can be time-consuming and challenge the respondent to come up with ideas. As the development of the questionnaire took longer than expected, there was little time to collect and analyze data. Therefore, future research should be planned more efficiently, in order to conduct the survey in the most effective manner.

Additionally, the questionnaire should be more structured in terms of sections and themes throughout. This would make data analysis and conclusions clearer to the audience. SENCo’s were the target audience for the questionnaires. However, this research would also be beneficial to carry out with teachers and TA’s to gain more awareness of the levels of knowledge of those working directly with the client. Further research should be conducted through face-to-face interviews to gain more in-depth information about how liaison and communications could improve.