the challenges faced by a small aac team in a huge
TRANSCRIPT
“Keeping it local” – the challenges faced by a small
AAC team in a huge, densely populated county
Vicky Healy Specialist Speech and Language Therapist for AAC Surrey CAT [email protected]
SURREY
• 1.17 million people in Surrey (2017) • 642 square miles • 11 districts • Borders / crossover of funding /
neighbours!
SURREY – the wealthy county? • In the UK, a disproportionate number of children and
young people are in or at risk of poverty or social exclusion compared to adults
• This pattern is replicated in Surrey
• We know that this can be detrimental to educational, health and social outcomes in later life.
• There are an estimated 28,000 children and young people (0-19 years) living in poverty in Surrey.
• Surrey is also the 4th largest Gypsy, Traveller and Roma community in the UK
SURREY – A diverse population? • People describing themselves as “white British”
accounted for 83% of the population of Surrey in the 2011 census (slightly higher than the UK average)
• However, Surrey has become more ethnically diverse with rising numbers of people identifying with minority ethnic groups since 2013
• Looked after children
• Military families
• A parent set like no other….
Surrey’s challenges “We face significant challenges in achieving our ambitions for our children and young people. Not only are we facing a protracted period of fiscal restraint, we are also anticipating a significant growth in the number of children living in Surrey”
Helyn Clack, Cabinet Member for Health and Wellbeing, Surrey County Council
SURREY CAT • Naming issues…… Historical ties…. • Janet Larcher and Ruth McMorran are a
hard act to follow!! (and a lot of their cohorts are still there……)
• Surrey SEN / VI / ICT • SCAT (oops!) • SCAATT • Surrey CAT
THE TEAM and where we are • Based in Leatherhead – as part of the
Physical and Sensory Support Service Specialist teachers – HI / VI / PD / Post 16
• Technical and financial officer • Admin support for reports / school liaison • Advisory teacher for Assistive Technology • Courier (Sight for Surrey) • Day to day running from base – equipment
– loan bank and spares
SPEECH AND LANGUAGE THERAPY SERVICE - links
• April 2017 – SLT school service came to SCC from Virgin Care (NHS)
• Promises made to about improvement of mainstream provision
• Smooth transition!? • A positive step for Surrey CAT in terms of better relations / training • Lots still to do for joined up working
Referrals
• Anyone can refer to our service • SLTs, teachers and specialist teachers
(PSS),SENCOs, parents, nursery staff • Detailed form but not overwhelming! • Ask for videos and reports to support
Caseload • 239 active students on caseload • (15 in 2006 when Ruth started and around
200 when she left in 2014) • 40 new referrals this academic year (SLTs) • 200 attend schools / nurseries in Surrey • 16 are at home / home schooled • 23 are in special schools out of Surrey • Additional AT caseload is extra (200) • Only 5 or 6 of caseload would meet criteria
for Specialised Services
SURREY CAT – OUR REMIT • To assess, monitor and review the AAC needs of students in
Surrey education 0-19 years (19-25 is extra!)
• Referrer should be present
• Provision of information, support and advice to teachers, teaching assistants and other professionals in educational settings. Signposting…..
• Monitoring the progress of those pupils provided with AAC equipment including trials and longer term (TOMS)
• Supporting the management of pupils who have been provided with equipment including liaison with families
• Planning and coordinating training courses and workshops.
SCHOOLS AND EDUCATION • Overall, Surrey has high standards of educational
achievement
• 88% of schools were rated as good or above by OFSTED (2015).
• Surrey’s results in Key Stage 2 and GCSE’s in 2013 / 2014 surpassed England and the South East.
• 74% of young people are supported through provision maintained by SCC
• 3.4% of Surrey’s CYP have SEND
• Approx. 800 children in Surrey are home schooled
• In 2014, 5,383 children and young people aged 0-19 in Surrey had Statements of SEN (now EHCP) though not all have transferred.
• Since 2009, the number of children needing an education, health and care plan has increased by 7.5%
• Our team has significant involvement with EHCP statements and review process BUT lack of clarity and consistency
• 45% supported in a mainstream setting • 45% special school • 8% in a specialist unit in a mainstream school • 2% spread between parental provision, nurseries, further
education and other provision
MAINSTREAM PROVISION • Classes of 30(+) students • Physical access around school • Access to high and low tech resources (who
funds / who produces?) • Trying to adopt a whole class approach • Joint planning and target setting at the
beginning of the academic year • INSET training • Keeping parents informed and onside
SPECIALIST PROVISION • The proportion of CYP with SLD in Surrey is
double what it is nationally – 13% compared to 6% (8 SLD schools & 7 LD schools + units attached to schools)
• Training for staff is more focused on SEND • Easier to work with the SLT / therapy teams
who are often on site more often • Higher turnover of support staff • Focused day / half day dedicated to AAC
and communication built into school targets
SURREY’S commitment to SEND
• SEND 2020 is a programme in Surrey to transform the way that services for children with special educational needs and disabilities are delivered, including early identification and intervention within the antenatal period.
• “In line with SEND 2020, we should continue to develop a partnership approach to supporting children with SEND, including early identification of need and intervention”
1: Transform the customer experience
2: Re-build the system around the customer
3: Reshape the SEND local offer
4: Develop inclusive practice
OUT OF COUNTY PLACEMENTS • PD provision is lacking for secondary
education in Surrey (1 school) • Historically been an over-reliance on out-of-
county independent provision. • Despite best efforts, children in mainstream
with PD / AAC needs often end up in out of county placements (secondary)
• Comes at a price and a parental battle TRIBUNALS!!!!!
• A rethink of provision is needed…..
JOINED UP WORKING • Advice – phone / email / in settings • Variety of settings and staff groups • Communication across teams –
teachers, SLTs, Social services, health • Second pair of eyes • A back up to good practise already in
place • “I always feel so much better after
you’ve been…”
BESPOKE TRAINING • A necessary shift in how we deliver training • General AAC training – for school teams, SLT
teams • Around a child and their device • Parent training on software • INSET training • Hardware / software day training – often with
AAC company
PARENTAL CHALLENGES • Therapy input – delivery / time / how often
• EHCP process is frustrating and time consuming
• Social media / bad press / other families
• Previous bad experience with services
• Involvement of independent professionals
• Preparation for the future – expectations
A POSITIVE SHIFT IN AAC OPINION
• Better training / awareness and understanding of AAC
• Increased knowledge from social media / mainstream tv etc
• AAC less thought of as the last resort or as something to be feared
• SALT targets • More joined up working
WHAT HAPPENS AT 19 YEARS?
• Current provision….. • Depends on placement or age of equipment • Funding complicated…. • Adult SLT team • Specialised services • Colleges – continue support and can
usually hold onto equipment but chargeable visits
KNOWLEDGE BASE OF AN AAC “EXPERT”
• Someone from one of the big AT suppliers said to me the other day “I could never do your job….”
• Keep up to date with technology, latest thinking in AAC / AT……
• CPD for HPC including mandatory training • Passionate about job……..Bigger picture
can be frustrating…
THE FUTURE? • The overall population of young people aged
5-24 in Surrey is forecast to increase by 13% in the next 20 years
• This projects an increase of 10% (or just over 1,000) in the number of young people aged 4-25 with SEND between 2013 and 2033
• How will services cope?
• Funding – education / social services / CCGs?
• Additional staff – OT / Technical instructor / SLTA
• Already services are stretched to capacity – particularly OT / SLT
• More joined up working with other professionals – less battles!
LOCAL SERVICES – the challenges
• Still a lack of consistency across country • Funding – how sustainable? • How to make a good business case? • Are we seen as a “second rate service”? • Are parents scared of statutory services if
they have previous frustrations with other services eg wheelchair provision?
• Better network of local services (this is happening – bear with us!)
Case study • TB • RTA – spinal, cervical and brain injury • Children’s Trust, Tadworth • Home • Special school • Home • Huge MDT, many independent professionals,
ongoing difficulties with equipment, overlap of roles but works really well,
• Complete trust and support from parents