Communication - ACC success story Working in France Group therapy for voice disorders Dosage - New Zealand ...
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SUMMER 2019
ISSUE 33
communication
ACC success story
Working in France • Group therapy for voice disorders • Dosage
Contents From the editor Who to follow
Karen Watson editor@speechtherapy.org.nz @ PamelaSnow2
1 2 3 4 6 7
Kia ora koutou and namaskaram, Speech Pathology Australia estimates Pamela is a La Trobe University professor
around five percent of Australia’s who tweets prolifically about the
My office for working on much of this
population have a communication evidence base for developmental
From the President’s NZSTA Family group Dosage for Caring for issue has been a veranda in Kerala, India.
disorder. Assuming that the prevalence is language disorders, literacy and at-risk
our littlest The sun is shining, the air is warm, and
editor report governance conferences speech sound the same in India, people will be missing young people. She has introduced me
the birds are singing. Coconut trees
structure with Talking disorders patients are everywhere, interspersed with
out on their right to communicate. There to several valuable websites including
Who to follow Trouble is clearly a need to grow the speech- fivefromfive.org.au which outlines
banana, pepper, cashew and other trees
language therapy profession in India. research on literacy instruction that all
I couldn’t name. The lush landscape
parents, teachers and speech-language
is truly beautiful, and I can see why Even with our more favourable ratio
therapists should know about. She is
8 9 10 11 12 13 people here, like we sometimes do in
New Zealand, refer to their home of
of speech-language therapists in
New Zealand, I know that our jobs can be
critical of reading recovery, insightful
about our role in the justice system,
Kerala as “God’s own country”. challenging at times. It can be wearisome
Good news Teachers doing Working in IHC Library Cough I’ll drink and co-author of @txchoices – Making
knowing there is more you could do for
AAC story amazing things France resolution thickened Thus, I read the International
your clients, but you can only deliver
Sense of Interventions for Children with
en masse fluids, but not Communication Project’s infographic Developmental Disabilities. •
so much due to limited resources and
on Saturday (see page 21) marking the 70th
over-stretched teams. With this in Shannon Herring
anniversary of the Universal Declaration
mind, I hope that you have all enjoyed
of Human Rights with interest. I noted
a refreshing break this festive season,
that India has just one speech-language
14 16 17 22 therapist to 800 000 people. This
equates to about 1900 speech-language
spent time with family and friends, and
did the things you love.
Pamela Snow
@PamelaSnow2
Area updates Walking for a NZSTA Board Contact details therapists in a country of 1.5 billion Communication Matters aims to
I’ll link to these via my blog at
good cause Member people, whereas New Zealand has celebrate our profession and share the
some point, but if you’re looking
updates about 1200 speech-language therapists learnings of its members and board. For
for @tserry2504’s wonderful
for a country of around 4.9 million. this issue I received the most submissions
Dept of Ed (open) webinars,
since taking on the role of editor, so
@spelfabet has posted them
thank you to everyone who sent me their
on her website: https://www.
articles. Topics in this issue include the
spelfabet.com.au/2018/09/
Cover: Good news AAC story. Photo credit: Jessamy Bell, TalkLink Trust. Talking Trouble approach to working with
free-learning-difficulties-including-
families and young people involved with
Submission deadline for Autumn edition of Communication Matters: 12 March 2019. Send to editor@speechtherapy.org.nz dyslexia-webinars/… Not
the justice system, getting the right dose
surprisingly, these have been
ISSN 2324-2302 (Print) for our young speech clients, practising
incredibly well-received.
ISSN 2324-2310 (Online) in France and more.
7:29 PM – 28 Nov 2018
Noho ora mai,
The NZSTA reserves the right to refuse for inclusion in Communication Matters, any articles, features or advertisements which are contrary to the NZSTA Code of Ethics.
Unless formally stated to the contrary, acceptance and publication of material and advertising does not imply endorsement of views, positions, programmes or products by NZSTA.
Karen
ii • may
Articles Communication
be edited. Matters Communication Matters • 1
President’s report NZSTA governance structure
Annette Rotherham president@speechtherapy.org.nz Naku te rourou nau te rourou ka ora ai te iwi
With your basket and my basket the people will prosper
Save July 4 for our 2019 annual general Māori and our clients. We endeavour
meeting in Wellington. This will be to provide speech-language therapy
held a little bit earlier than usual due services in a culturally safe manner
to the combined conference. We aim while also meeting our client’s goals for NZSTA Board Operational Advisory groups
to hold a literacy-focused professional communication and swallowing. President Secretariat – ONZL Kaumatua
development day with the Talking
On a celebratory note, how are you Professional standards Website He Kete Whanaungatanga (HKW)
Matters team. We look forward to seeing
all enjoying your new membership
you there. Professional development Auditors Consumer group
status now that our registration process
Kia ora koutou, Giving Voice Aotearoa will continue to is live? We have a special gift for you Member networks Legal SLT leadership groups
flourish in 2019. Geneva Hakaraia-Tino, and encourage you to celebrate this
As I write this there is an electrical storm Māori and cultural development Communication Matters editor
supported by Amy Oughton, will lead milestone with some coffee and cake
outside – bring on the dry hot summer Communications
the consumer focus group. We look in your workplace and community.
as promised! However, by the time you
forward to their feedback as it will guide Speech‑language therapists are pretty
read this we will be well into summer, and
the strategic direction of our association. good at morning teas! That should be
Christmas will have passed by, hopefully
the perfect way to start the year.
leaving you all feeling relaxed and ready Renee Taylor has developed some clear
for an exciting new year. objectives for her role in the Māori Aku mihi nuiki a koe, NZSTA sub-groups
and cultural development portfolio. Annette
The new NZSTA Board met for the first
Renee shared her personal feelings and
Expert advisers
NZSTA
time in early December. We are fortunate Ethics committee
to have four very experienced board perspectives on some of the challenges members
members in our team and we also brought by her portfolio and role in Programme accreditation
NZSTA in the previous edition. Although committee (PAC)
welcome the energy and skills the two
younger members, Amy and Renee, this piece was not the usual update Right: We have created this infographic to Area representatives
bring to our team. Our team has some from a portfolio holder, it gave us all the explain the many rōpū that come together
opportunity to look at these issues more Private practice representative
key areas of focus in 2019. One area is to form the NZSTA. Many of these are
our collaboration with Speech Pathology in-depth and revitalise our strategic plan. dependent on member participation Student representatives National engagement International engagement
Australia for the combined conference, I believe it has helped Renee gain a fresh including the NZSTA Board, other expert Ministries International Association of
Conference programme
June 2 to 5 in Brisbane. The organising focus for what she can contribute and and international groups that collaborate Logopedics & Phoniatrics (IALP)
committee (CPC) Allied Health Association
committee has worked hard to finalise the bring to the association. This includes and guide our governance. The different of New Zealand (AHANZ) Mutual Recognition Agreement (MRA)
programme in December. We encourage gaining further support and guidance groups are represented on the strands of
you to start planning how you might from a kaumātua for our association. harakeke (flax) and this represents how Unions International Communication
We continue to work towards a better the collaboration and mahi contributes Project (ICP)
attend this fantastic opportunity as we join
forces with our neighbours over the ditch. understanding of biculturalism and equity to our collective kete of knowledge with
issues for our members who identify as members at the centre.
2 • Communication Matters
Good communication practice in Generally, the FGCs got a lot of legalese, complicated words
and processes and I think we lose our families and kids very early
family group conferences (FGCs) – Police on in the piece. Because the presentation (FGC) was simplified
youth aid
Alayne McKee officer terms of language … and pictures helped (the young person)
piece everything together … you could see he was able to make
Since 2017, Talking Trouble This work has involved building How are these wonderful practitioners an informed decision.”
awareness of: applying what they have learned?
Aotearoa New Zealand has
• speech, language and communication
been working alongside the Before the FGC • Whether or not they need Now we’re going to talk about…” After the FGC
needs and how to identify them
Meet to discuss: communication assistance from a and putting up a new visual or key
Oranga Tamariki workforce • the complexity of legal • Creating a short, simpler version
communication environments and • The communication demands speech-language therapist to help word to represent the new topic. of the FGC plan that provides the
across the country in of the FGCs. Identify the words, them plan their communication or • Drawing flowcharts and diagrams to information that everyone really
processes.
Waitakere, Mangere-Otahuhu, information, options, opportunities to mediate communication during show processes as they talk about needs to know.
This work has also focused on developing and consequences that need to be the FGC. them. These strategies are a great
Papakura, Palmerston North, Youth Justice, and Care and Protection • Creating visual versions of things
clearly understood. • The best way they can provide way to make sure that options, like bail conditions, timetables and
Otara, Rotorua, Tauranga, practitioners’ confidence and competence
• The speech, language and information given what they know opportunities and consequences are organisers.
in using a range of communication
Otago and Hawke’s Bay. communication needs of the young about the communication demands all made clear.
• Saving copies of the resources used
strategies to enable young people and and identified communication needs.
person, victim, whānau and other • Using comic strip conversations to to demonstrate good communication
their whānau to understand what’s
participants. explore information that comes up practice in the child or young
happening, participate and share their During the FGC
perspectives in the conversations that • How the practitioners and the young during the meeting. person’s file. •
person can plan, and prepare in • Including good communication
affect them. Family group conference practice in the ground rules. Making
(FGC) coordinators, social workers, advance, resources to help ensure that
everyone’s views are expressed. For sure that everyone knows it is OK to
youth advocates and police are say “I need break” or “Sorry, I missed
beginning to collaborate to plan and example, where they live, what they
want in their plan, what they feel and that. Say it again” or “I don’t know
support FGCs that meet the speech, what you mean”.
language and communication needs believe about what happened.
• Signpost topics by visually orienting
of everyone involved because of this
everyone to each introduced topic by
communication project.
using pictures or writing key words
on a whiteboard. When the topic Right:
is finished, saying something like Talking Trouble’s
That was the best ever FGC in my whole career, “ we’ve finished talking about… three pathways to
almost nine years as a youth justice coordinator. help young people
understand and
– FGC
coordinator
You know, we need to have this kind of FGC for express themselves
during FGCs.
every single kid that we deal with.”
4 • Communication Matters Communication Matters • 5
Dosage: A critical consideration for working Caring for our littlest patients:
with children with speech sound disorders A review of professional
Dr Jayne Newbury, lecturer in paediatric speech and language disorders in the Department of Communication development workshops
Disorders, University of Canterbury and NZSTA Expert Adviser on Child Language, jayne.newbury@canterbury.ac.nz
Natalie Myles
Kia ora koutou katoa, For example, giving a child the From the research findings, I suggest the Provide frequent and regular I recently attended five days of thought-provoking professional
opportunity to hear, then say a target following to ensure our intervention for opportunities to practice
development in Wellington: the two-day Newborn Observation System
Dosage is a medical term sound or word, and receive feedback on SSD is effective: Allen (2013) reported that a session
(NBO) training followed by the Infant Mental Health Conference.
their attempt. “Cumulative intervention once a week for 24 weeks was no more
which refers to the amount intensity” refers to the total number of Consider overall amount of effective than a control condition of story
of a medicine taken at doses given over a course of intervention. dose provided reading for mild to severe phonological A variety of professionals and particularly in a multidisciplinary
prescribed intervals, which For example, you might give a child a Glogowska et al. (2000 ) showed that disorders for children aged 3 to 5 years. attended, including psychologists, team where other professionals such
dose of 50 opportunities in a session to 8 to 10 visits to a clinic per year was not In contrast, three sessions per week psychotherapists, doctors, social as neurodevelopmental therapists and
is required to achieve a say /t/ words, twice a week for eight effective in making functional changes (in this case with a speech-language workers, neonatal intensive care nurses are using the system.
therapeutic effect. When weeks, which equals 800 (50 x 2 x 8) in phonology for pre-schoolers with therapist) was an effective model of (NICU), special care baby unit
The keynote presenters were the
opportunities to learn to produce /t/ (SCBU) and community nurses,
applying this concept to words. While many prefer to avoid using
SSD compared to children assigned service delivery.
and occupational therapists. I really
highlights of the conference. Professor
to a “watchful waiting” group. Kevin Nugent, founder of the Brazelton
speech sound intervention, medical terms to describe learning, If you rely on parents or paraprofessionals enjoyed the opportunity to meet
Institute at Boston Children’s Hospital
dosage is a useful concept to consider in Consider severity and age of to help the child practice newly people from so many different
a dose refers to the number established speech skills between and senior author of the NBO
relation to effective practice. the child professional groups.
of discrete learning Jacoby et al. (2002) reported that children
therapy visits, they too need to handbook, spoke of the importance
There has been a series of studies in meet these dosage targets for the The NBO is essentially a tool that helps of early bonding between parent
opportunities which help this area recently. The challenge for us with more severe difficulties needed a parents to get to know their baby. and child, and his research on infant
intervention to be effective.
the child accelerate their is that studies are showing that if the higher dosage of intervention than those The clinician and parent observe the behaviours. And Dr Helen Minnis spoke
critical dosage is not reached, no with milder difficulties. Older children If you’d like more information, feel free baby’s behaviour together, noticing about attachment disorders and the
development. (5 to 6 year olds) needed more support
therapeutic benefit is gained by the to email me. and interpreting what they see. It can impact of early attachment on mental
child. I raise this issue because our than younger children (3 to 4 year olds) be used with healthy full-term babies health and general development.
to change their speech sounds. Ngā mihi nui,
service delivery for SSD (speech sound as well as pre-term, medically fragile There were also several presentations
Jayne
disorder) in New Zealand is often highly or infants with developmental issues. on initiatives designed to promote
Consider intensity of dosage within
constrained by limited resources. NBO may be used alongside the optimal emotional and general
practice sessions Please contact the editor for reference list. Neonatal Behavioural Assessment development in the early years of life,
Williams (2012) recommended that Scale (NBAS) in some settings, such mainly amongst high‑risk infants. •
children aged 3 to 6 years with moderate as NICU or SCBU. Although NBO is
to severe SSD needed 50 to 70 trials not focused specifically on feeding Find out more about infant mental
(doses) per session for around 30 to 40 behaviours, I found the training very health in New Zealand
sessions to make substantial intervention relevant to our role with young infants, www.imhaanz.org.nz
gains using phonological contrast both in SCBU and the community,
interventions.
6 • Communication Matters Communication Matters • 7Good news AAC story Teachers doing amazing things
Jessamy Bell, TalkLink Trust Alysa Duda
In the Northland AAC Bob was referred to TalkLink Trust two overwhelming. He couldn’t attend to In the special school setting we are in the midst of teacher strikes.
years ago when he was five years old any of the activities: he was constantly
(alternative and augmentative Teachers are fighting for the needs of their students. There is a big
and had started school. He presents with trying to get away or pushing and
communication) special global developmental delay with some throwing things. He did not appear to focus on the kids that we see, who struggle with communication and
interest group, we always start autistic features, epilepsy, sensory needs comprehend any language and was need more support with learning. The teachers are also fighting to
and behaviour challenges. He has very not speaking. Polly Thomas, a specialist be recognised for the work they do. Therefore, it is a good time to
with a good news story. We high ORS funding (Ministry of Education’s teacher at TalkLink Trust, and I were a little
showcase some work by a teacher who regularly goes above and
have talked about this young Ongoing Resourcing Scheme) as well overwhelmed ourselves!
as High and Complex Needs Unit beyond for his students.
man (let’s call him Bob) before funding, which gives you an idea of the
His Ministry of Education (MoE)
speech‑language therapist and TalkLink
but as his AAC journey has complexity of Bob’s needs.
Trust team recommended implementing After getting a student a set of six This same classroom has another
Fast-forward a few more months and I got
progressed I thought it was He came to KiwiChat Day (a day for a visual timetable and a 77-symbol this email:
switches, this teacher had the idea to student who uses a TouchChat.
students to practice their communication core board with personalised fringe velcro all the switches onto a portable The teacher regularly takes screenshots
too good not to share with “Just wanted to share the most exciting and very sturdy piece of wood, so the of his sentences to share with the
skills using AAC) when he was on vocabulary. Bob has the most amazing
the rest of New Zealand. the waitlist and he found it totally support team, and they just decided that news, that Bob has started talking!!! student could make choices easily. parents and to measure his progress.
even though it was hard-going, and Bob Some words include walk, bird, bee, A day later, one of his teacher aides He also decided to screenshot the
would often throw, hit or bite the core fish, look, bye, library and come. thought it was meant to be used as most frequently used pages, then
board, they would keep trying! All of his favourite words. It’s soooooo a core board for our “bucket time” print, laminate and bind them to
exciting!!!” sessions and told me it was missing be used as a low-tech AAC option
At the beginning of 2018, Bob’s MoE visuals. Brilliant idea! The switch core when the student’s iPad is charging.
speech-language therapist rang to say So, what was the key? Consistent
board was born. He knew this would also help him
that he was pointing to three symbols repetition with variety using a robust
and the teacher aides to get used
on the core board to create sentences, communication system. His team just
to the symbols’ locations without
and that it was time to trial high-tech. kept modelling language on the core
having to remove the TouchChat from
I was shocked and so excited. All that board every day, all day, for all activities.
the student.
Left: modelling and consistent use of visuals Now Bob is using a high‑tech device and
Bob uses both high had worked for Bob and he was now a low-tech communication system and It’s so inspiring to have teachers
and low-tech AAC to really communicating. Bob was supplied even saying some words verbally. This and teacher aides who prioritise the
interact with peers with a high-tech communication system: did not happen overnight or even over communication needs of their students
and adults. TouchChat with WordPower60basic. a term but was the result of two years of in the classroom, particularly when
consistently implementing AAC across my time in class with each student is
Above right: so limited. •
the day.
Adding language
to play using a It was so worth it! Well done to Bob’s
core board. team – you guys are incredible! •
8 • Communication Matters Communication Matters • 9Bonjour, je suis une speech-language therapist IHC Library: A resource for all
Grace Lindley Anna Childs (née Wivell), Capital and Coast District Health Board & Talking Plus
In early 2013, I went to France Fun facts about working in France: Not so fun facts: Like all my colleagues and peers, I am constantly on the look-out
on a working holiday with the • France is behind the rest of the
• Our degree is not recognised here, for resources to enhance my practice, my knowledge and to use in IHC library
so we are not able to go by the French developed world when it comes to
intention of being there for equivalent “orthophoniste”, instead, the treatment of children with special my work as an acquired speech‑language therapist. So, it’s been a 0800 442 442
librarian@ihc.org.nz
a year while I did my “OE”. speech-language therapists work needs, particularly autism. An article pleasure to stumble upon the IHC Library in central Wellington. www.ihc.org.nz/library-page
by The Guardian in February 2018
Six years later and I’m still here under the title “formateur en langues”
estimated that France is 50 years
(language teacher) which we get
working in private practice. through being auto-entrepreneurs behind. Psychoanalysis is still one of the IHC Library covers all aspects of titles, depending on the age and
go-to methods for working with children intellectual disability and autism. diagnosis of the child). Some of the health information (including how to
(self‑employed). There are currently
with autism, and the “refrigerator The library contains resources that cover resources are older, however, there is work with people with differing health
roughly 10 of us working in Paris.
mother” concept is still shockingly a range of client groups and there is some gold in there and it is worth looking needs and clinical guidelines), behaviour,
• Most of the work available is in even a dedicated speech-language through. The staff are approachable and
prevalent. Parents with concerns are parenting and personal stories.
early intervention and with school- therapist section. There are activity cards, always offer to help you find the right
often told to wait until the child is three
aged children. a few assessments (mostly paediatric), book. They are also happy to consider The more I practice, the more my “No. 8”
years old before seeking help.
• France has a lot of school holidays: journals such as New Zealand Journal purchasing recommended resources. wire mentality comes out and I can adapt
• Children with special needs have a very resources that are aimed at other client
two‑weeks’ break every 6 weeks, of Disability Studies, Australian Journal
difficult time finding a school, sometimes The library has a definite spotlight on groups. For example, I find the Talkabout
then two months off over summer. of Dementia Care, and International
waiting years for a place. Even though it developmental difficulties, but its large series to be great for people with cognitive
This is a both a blessing and a curse Journal of Disability, Development, and
is illegal, children with special needs are range is adaptable to different client communication disorders and the picture
when you’re self‑employed! Education. There are also DVDs and,
After arriving in France, I worked as a regularly discriminated against when groups. Topics include: alternative or recipe books to be useful rehabilitation
• Travelling to my clients’ homes each of course, many, many books including
teacher aide for a family who had two applying for schools, with schools stating augmentative communication, bicultural activities for those with aphasia, as well as
day involves using the metro, public over 1500 e-books. As well as lending
boys with autism. During the nine months that they do not have the resources or resources for working in Aotearoa, some great behavioural ideas for people
bikes and my own two feet. Traffic and books, the library also provides families
I worked for them, I discovered that there accessibility to cater for the child. feeding, eating and drinking, social with sensory difficulties which adapt well
parking make using a car impossible, with a free book to keep (from seven
was a real need for English‑speaking • Special schools here are called stories, sensory difficulties, picture books, for people with dementia.
so I typically walk 7 to 10 kilometres
speech-language therapists specialising “établissements” (establishments) and
per day wearing a heavy backpack The resources are available to all
in early intervention, autism and resemble daycare more than school.
filled with all my materials (it helps to New Zealanders over the age of 18.
AAC (alternative and augmentative Staff are often resistant to input from
burn off all the croissants and pain au The library is free to join, and the only
communication). In May 2014, I set up outside therapists and will sometimes
chocolats though!). cost is returning borrowed items to
my private practice to provide home- prevent children using their iPads for
their Wellington location. Registering
based services for these kiddos who AAC while at school.
is easy and can be done online but it
were so under-serviced. I miss New Zealand, but France needs must be done as an individual not as
motivated therapists willing to fight the an organisation. Donations to IHC and
good fight, and let’s face it, the fromage the library are welcome to support this
and baguettes are not going to eat Left: wonderful resource.•
themselves. • The IHC Library team.
10 • Communication Matters Communication Matters • 11Cough resolution en masse: I’ll drink thickened fluids, but not on Saturday
Dunedin voice function group Julia Corbett & Grace Combellack, Middlemore Hospital
Anne Mannion
For the Giving Voice Aotearoa Myth or Fact? Whatever you’re making for the family,
just put that in a blender
I have been treating vocal cord cough. These were sent out to patients one for a hoarse voice and the other for Week of Action, two speech- You can thicken everything, tea,
coffee, beer … Myth: Preparation is challenging and time-
dysfunction (VCD) individually ever since with their appointment letters and self- difficulty projecting their voice. The first language therapists, a dietitian
consuming. Our friends with babies and
participating in Dr Anne E Vertigan’s addressed envelopes for their return. group was run with just one therapist and an occupational therapist Myth: You cannot thicken beer. Whilst
supporters2 provided us with yummy pre-
NZSTA presentation on the subject in We collated information in a group and a final year speech-language therapy technically you can thicken tea and
attempted a week of only purée modified meals – thanks! We learnt that
2013. Patient referrals are about evenly reference sheet so that questioning and student, and the second group with two coffee, one person had pulled out early:
stick blenders and slow cookers are your
split from the ENT (ear, nose and throat) advice could be appropriately targeted therapists plus the student. and moderately thick fluids, “I can’t survive without my coffee”. After
best friends and a little bit of liquid goes a
and respiratory departments. We provide within the group sessions. The Vertigan including water1. trialling ways of getting a caffeine hit
Participants described good success long way. Also, psyllium husk, cornflour,
training annually to the ENT department patient information sheets (adapted for (thickener, banana-coffee smoothie,
with the techniques acquired during Although the campaign’s focus this year and bananas can be good alternative
which reminds rotating fellows and the Southern District Health Board) are coffee ice-cream) the remaining
the groups: was on communication access, our roles thickeners. “Fasting is way easier than this.”
registrars that we do successfully treat provided during the sessions. participants gave up caffeine completely.
patients with VCD. The success rate for “I was sceptical at first, but the have a heavy dysphagia component
Treatment consisted of two 90-minute Free water protocol increases
compliant patients is excellent and I am very techniques really work” and we found our modified diet still Patients on modified diets are often
group sessions, two weeks apart in year compliance
happy to be able to relieve their symptoms generated a lot of discussion about other non‑compliant
one and one week apart in year two. “Knowing that the problem is common aspects of speech-language therapy. Fact: We didn’t manage to finish one
in just a few sessions, typically three. Myth and fact: Sometimes you’re trying
The first group consisted of a mix of and that others are living and coping entire thickened drink. Without the
Naively, we had thought this week would to be compliant, and you’re making your
Last year with a voice waiting list regularly patients with PVFM and chronic cough, with it was reassuring” protocol we would have bailed on day
be achievable and bearable. Our week was fruit smoothie, and suddenly you realise
exceeding 20, I decided to trial group the second was solely chronic cough. two, especially as we wanted to exercise.
“I felt supported within the group and otherwise “normal” including café outings, you’ve eaten a piece of orange. “In
therapy for VCD. I modified Vertigan‘s Follow‑up was via phone calls with the “I’m worried about going to the gym,
would definitely do it again” first dates, gym visits, and shared lunches hospital, I would have a ‘watch’ by now”.
case history form into two self-evaluation intention to add individual sessions what if I regurgitate?”
forms, one for paradoxical vocal fold as required. In each year, just one In each year, I discovered that the (we had to abstain from most of these).
Modified diets are socially isolating
movement (PVFM) and one for chronic participant has required additional help, group experience is not for everyone. Purée diet can affect your bowel motions
Together we have more than 15 years Fact: Going out to a café was awkward.
Patients with social anxiety or depressive of experience, but we were surprised Fact: Enough said.
And expensive. “$20 for my smashed
conditions often prefer to wait (up to four and challenged at times. The following avocado on toast. Puréed. No toast.” The experience was eye-opening and
months) for individual therapy. The wait “myths and facts” are based on our Shared lunches at work were impossible. has started to change our approach
Left: time is always made clear to them at time opinions and experiences. The quotes are Doing this together was so helpful: to modified diets and fluids. It has also
Therapy team for of the initial contact. And just to reassure from “hangry”, potentially-dehydrated, we vented and dominated lunchtime re‑emphasised to us that diet modification
the second Voice you, patients with severe PVFM are seen caffeine-deprived participants! conversations with our experiences. in a rehabilitation setting should be
Function Group in within two working days of their referral. •
temporary if possible. •
2018. (Left to right)
Anne Mannion, Reference: Gibson, P.G. et al. (2010) CICADA:
Jess Dickinson, and Cough in Children and Adults: Diagnosis and 1 As per the Free Water Protocol: Implementing the Free Water Protocol does not Result in Aspiration Pneumonia in Carefully Selected Patients with Dysphagia:
Charlotte McCully Assessment Australian Cough Guidelines, Medical A Systematic Review. Gillman, A., Winkler, R., et al. (2016). Dysphagia, 1–17.
(student). Journal of Australia 192 (5): 265-271 2 PureFood Company and Flavour Creations.
12 • Communication Matters Communication Matters • 13Area updates Wellington/Nelson Canterbury/Westland embarking on journeys as new graduate
speech‑language therapists.
89 members 184 members
• This year we had student placements
• We have had more reports of • Thanks to all who attended and
in Malaysia, Birmingham and
Giving Voice Aotearoa posters “zoomed” into our final meeting of
Cambridge University Hospital.
spotted around town. the year. Award for the longest
distance “zoom-in” goes to Grace, • We’re excited to announce the revival
• We also overheard the high and
based in France, in the early hours of of the University of Canterbury’s speech
complex needs teams at Oranga
her morning. therapy club: Speech Society. We will
Tamariki say that “dollar for dollar,
work with Speech Society to promote
speech therapists give some of the • We’ve had good engagement
Northland all the members for their contributions University of Auckland best value in terms of improving the in professional development
an inclusive and inspiring view of what
and support. It’s been great working we do in our diverse degree.
22 members with you all.”
22 members lives of young people”. We agree! opportunities, including the free
• We hosted a well-attended mini- IDDSI (International Dysphagia Diet A big congratulations to all of those who
I’m an adult inpatient rotating therapist from • We raised awareness of
Caroline Bartholomew Standardisation Initiative) webinar have completed their studies here and all
Whangarei Hospital at the conclusion communication access for Giving workshop by Sally Kedge of Talking
Trouble in September. hosted by the Rose Centre, the the best for the future.
of my graduate year. It’s humbling to Voice Aotearoa on campus with each
University of Canterbury clinical
have support to take on the NZSTA Massey University of us challenged to give fliers and • Judge Andrew Becroft, Children’s
education symposium, a paediatric
Helena Sincock & Livvy Pride
representative role. I would like to tautoko 18 members postcards to students and staff. Commissioner, was spotted in
Lucy Schumacher who has served this area feeding study day and the
• The second-year students presented Wellington speaking up for children
for three years. Our highlights for 2018: • In 2018, we held our largest NZSTA
their final research papers on a variety with communication challenges
Neurological Foundation seminars. Otago/Southland
student gathering, attended by over
of topics within the scope of speech- at local conferences and public • The University of Canterbury 54 members
• Whangarei Hospital purchased 22 students. It was helpful for students Department of Communication
FEES equipment with training language therapy. meetings, including the Australasian • The Southern District Health Board
to connect with the professional body Society for Intellectual Disability NZ Disorders is on the move in 2019
commencing in 2019 and to engage across the year groups • The first-year students have completed team were in the process of recruiting
conference. and are saying farewell the well-used
• Michelle Bonetti is doing amazing and encourage one another. their five-week placements around a new graduate in November.
prefabs. Staff will post pictures of the
work with the courts New Zealand, as well as the United • Our regional meeting includes • SHOUT, a private practice, will be
• We supported the Speech and new premises on the UC Speech and
Kingdom and United States. speech-language therapists working employing two more staff in the
• More Ministry of Education staff have Language Therapy (SALT) club to Hearing Alumni and Friends Facebook
• We brainstormed names for a new in health, education, and private Dunedin area in 2019, and Shannon
accessed Hanen training hold our annual Speech-language page and we hope to show you
speech-language therapy scholarship practice. We are eagerly waiting to Emmerson has joined the team in
• Gay Easterbrook has reduced the Therapy Awareness Week barbecue around at our next area meeting.
to raise awareness for our profession see how registration will impact our Southland.
caseload for Northland Kindergarten for students on campus. In addition to local membership numbers. At our last Ruth Ramsay & Kate Cook
helping students order using Makaton and encourage Māori and Pasifika • Many members are passionate
Association meeting, 29 people attended remotely
or AAC devices, we demonstrated students to apply to our programme. about raising awareness of the
and 14 at the face-to‑face meeting.
Message from Lucy: some sensory games we use with • We held a quiz night to raise money University of Canterbury speech-language therapy profession
ACTIVEating clients, and promoted and awareness for the Australasian Shannon Hennig 40 members and the needs of the clients we serve.
“I’ve stepped down from the end of my
three years as the Northland NZSTA the role of speech-language therapists Society for the Study of Brain We continue to contribute to the
across the age spectrum. Every year, Impairment (ASSBI). Congratulations to everyone for Giving Voice Aotearoa campaign
representative. Northland has the
our fellow students comment on completing another fun-filled, hectic despite busy professional lives.
smallest number of members, which Shauna Pali
how much they learn about speech- year! Some of us will be able to enjoy • We would love to have more
means small meetings at times, but
language therapy from these a spot of summer over the break, representation from Ministry of
the small numbers also give time for
conversations and activities. some will be working hard on research Education therapists at our meetings.
everyone to speak, and for a range of
scholarship projects and others will be
perspectives to be heard. Thanks to Brianna Oosterbroek Meryl Jones
14 • Communication Matters Photo credit: Graeme Murray Communication Matters • 15MND Event NZSTA Board Member update
Walking for a good cause Māori & cultural development
Brigid Fay Renee Taylor culturaldevelopment@speechtherapy.org.nz
Motor Neurone Disease (MND) This causes progressive loss of mobility The MidCentral District Health Board perspective as the norm within the involvement the better. Are there any
in the limbs, and difficulties with (DHB) speech-language therapy team organisation. Some of the goals I have interesting projects happening in your
is the name for a group of speech, swallowing and breathing. participated in the walk in Palmerston put together to help achieve this are: workplace that are helping to address
diseases that cause the death The progression varies significantly from North. We walked a circuit around • Develop guidelines for incorporating Māori inequities?
person to person. The most common the Palmerston North Square for
of the nerve cells (neurones) type of MND is amyotrophic lateral an approximate total distance of
an equity lens and te ao Māori lens for: Me mahi tahi tatau mo
that control the muscles that »» research, projects, events and te oranga te katoa
sclerosis (ALS). In North America and 2.5 kilometres.
conferences We should work together for
enable us to move, speak, other parts of the world, MND is more
It was a wonderful “balmy Palmy” spring Kia ora koutou katoa, the wellbeing of everyone
commonly referred to as ALS. »» clinical practice
swallow and breathe. With no day. Members of our wider DHB team,
I’d like to take the chance to truly There is great stuff happening in the
Walk to D’Feet MND events were held including nurses, occupational therapists »» interviewing protocols, targeted
nerves to activate them, these all over the country on November 11 and social workers, and their families
apologise to anyone I offended in my at tertiary providers with the aim pipelines. We have good traction on
last article. It was not my intention and finalising documents to appoint a
muscles gradually weaken to fundraise for research into MND. were also walking. Our ElderHealth of encouraging and supporting
kaumātua for the NZSTA. We are also
for that I am sorry. I understand that these future Māori students through the
and waste away. team (those with the blue bows) were
topics often evoke emotion, however application and interview stages. creating a mauri for our association and
the fifth highest fundraising group in the
my piece was not intended to generate its members. Our mauri will be a symbol
country. Our speech-language therapy • Develop an equity workshop for
negative emotion or personal offence. of the NZSTA’s entity and life‑force.
team’s photos were shared widely on members to access as professional
It was a personal reflection on some of I am in discussions with an artist in
social media. The event was attended development.
the feelings and barriers I have faced, and Rotorua who is keen to create a piece
by those affected by MND, either
a call for solidarity so that we can move • Work towards having measurable just for us. So, if you have any creative
currently or in the past. It was moving to
forward on this journey, together. outcomes to track progress, success, ideas regarding what speech-language
so many of our patients and their families
and areas for improvement. therapy and the NZSTA means to you,
participating in this walk. • He waka eke noa
• Employ an active kaumātua or kuia for then please let me your thoughts.
We are all in this together
NZSTA who will support, guide, and This mauri will be a handcrafted object
Find out more www.mnd.org.nz I’d equally like to thank all of those of who (yet to be decided) representing the
ensure consistency with overall tikanga
came forward with such lovely positive practices, kaupapa, and te reo Māori NZSTA and its members, so your input
feedback and encouragement. I think translations relating to the association, will be greatly appreciated.
we all do the best that we can regarding as well as support the above goals. Ngā mihi,
equity issues within speech-language
Left: If anyone has any suggestions, Renee
therapy, however there’s always room
Members from the concerns, questions, comments or
to improve. I hope to be able to change
Midcentral DHB are interested to know more, please
the way we think in a positive and safe
team ready to Walk get in touch. The more collective
way, and to incorporate a te ao Māori
to D’Feet MND.
16 • Communication Matters Communication Matters • 17NZSTA Board Member update A: The NZSTA already holds all the Q: A member reported seeing a Continuing professional
requirements of a self-regulating body. speech‑language therapy diploma development (CPD)
Member networks Few changes are expected now that the
substantial work of developing the self-
available on the GrabOne website for
$34. Can NZSTA do anything about this?
Q: Are members in isolated areas still
able to apply for a travel grant to support
regulatory process has been completed. attending CPD events and is there a
Jodi White membernetworks@speechtherapy.org.nz A: Thank you for bringing this to our
Q: Will there be any new costs to us? attention. NZSTA has contacted GrabOne deadline? MoE Tairawhiti has brought
and outlined our concerns. They were this to their managers who responded
A: No, there will be no substantive that overseas travel is not supported.
very responsive to these concerns and
Registration Q: Will there be changes in the additional cost. We have avoided this We suggest that NZSTA meet or
removed the offer from their website.
continuing professional development by taking the self-regulation option. encourage MoE leaders to support
Q: Is there anything we need to inform This provides many of the benefits of Q: There have been discussions
our non-NZSTA colleagues around this? (CPD) requirements as a result of NZSTA CPD events.
the self-regulation process? There registration without the additional cost amongst other health professionals in
How does this affect our practice and of a registration board. the field such as occupational therapists A: You can apply for a NZSTA funding
non-members of NZSTA? has been talk of observations for grant. See the awards and grants page
meeting competencies – will this be and physiotherapists regarding a merger
Q: Is the main difference that other on the website.
A: We want to encourage current implemented? What is the implication between MoE and MoH (Ministry of
speech-language therapists can’t call
members to promote membership to of this in terms of CPD requirements for Health). If this is happening, could Q: A member requested a fuller,
themselves registered?
Kia ora koutou, non-members. Please see the board Ministry of Education (MoE) speech- the NZSTA Board please advocate for more formal, clear and transparent
update you will have received via email language therapists who work in a A: Upcoming editions of speech‑language therapists to be audit process.
Thank you all for your continued support
for further information. generalist capacity going forward as part Communication Matters will involved in this process and provide
of the area meetings and feedback on A: Members who are audited receive
of the new Learning Support service? provide more information about the feedback to members?
the information provided. We have had Q: It was noted that NZSTA members feedback as to the success of CPD audit.
self‑regulation process and should
some very constructive feedback and were the last stakeholders to be A: There will be a review of the CPD A: We wonder if this is a misunderstanding
answer your questions. Q: Can we have evidence of the audit
answered some challenging queries consulted in the registration process, process, but no substantive change in around the intentions of the new Learning
below. I wish you all a relaxing and happy and that board initiatives appear to be Q: What is the phrase we can use to Support Delivery Model, i.e. one plan and process being a reflective process with
professional development is expected. feedback collated and reported to
festive season. shared with members after they have identify that we are registered with NZSTA? one facilitator. This part of the plan means
been completed or when well under Q: Does self-regulation hold any more liaison and flexible working between members? For example, the number
Ngā mihi, authority around employment? A: Registered Member of NZSTA. of members audited, the outcome,
way. Members would appreciate earlier MoE and MoH in order to streamline
Jodi CPD trends.
notification and transparency in terms of A: We are trying to make it have as General queries support processes for children with
sharing information. much authority as possible. For many learning support needs, however it won’t A: Members are responded to
Q: Is it possible to purchase articles from
district health board employees involve a merger. Please let us know if this individually and areas for development
A: We believe this is a misconception. other organisations that are relevant for
covered under MECA (multi-employer answers the question. are highlighted. We audit 10% of the
Members’ input had already been speech-language therapists and print in
sought prior to consulting other collective agreement), this is supported. Communication Matters (with permission Q: Can a different platform be considered membership each year.
stakeholders via a survey a few years We are progressing discussions at the from authors)? for area meetings because MoE does not Q: Do new graduates need to complete
ago. We have provided regular MoE to a national level and we are allow Zoom?
A: This depends on copyright laws the online CPD log as well as their hard
updates via Communication Matters. hopeful for a positive outcome. We will
as they do not allow the copying and A: Members can join in by bringing copy paperwork?
We consulted leaders annually at the keep you updated on the progress of
these discussions. circulating of publications. We are their own device and connecting to A: No, this is not a requirement.
leadership summit. The NZSTA Board,
looking into some options for including Wi-Fi. MoE does not support Zoom on Please see the new graduate framework
leaders’ groups and employers are Q: Will the registration self-regulatory links to articles in upcoming editions of their network, however it does allow for full details. •
primarily members and speech-language process result in more work for the Communication Matters. employees to use their own devices on its
therapists. No decisions were made NZSTA Board? Wi-Fi. This will not affect your own data.
without considerable consultation.
18 • Communication Matters Communication Matters • 19NZSTA Board Member update
Communications
Amy Oughton communications@speechtherapy.org.nz
Article 19 of the UDHR was one of the comprise the Mutual Recognition Engaging Collaborating Empowering,
first contemporary expressions of the Agreement (MRA) launched the ICP to June 2 to 5 in Brisbane, and the
right to communicate: help raise awareness of communication professional development day and
disorders around the world. annual general meeting in July.
Everyone has the right to freedom
of opinion and expression; this right Last year, the ICP submitted an article to The festive season is a great time to
includes freedom to hold opinions a special edition on human rights of the reflect, evaluate your practice and
without interference and to seek, International Journal of Speech-Language make plans for the year ahead. In
Tēnā koutou, receive and impart information Pathology. This article describes the work 2019 we will continue our quest to
and ideas through any media and of the ICP to date, with an emphasis on create a more accessible and inclusive
Meri Kirihimete me te hape nū ia. regardless of frontiers. the place of communication disorders in Aotearoa, build relationships with
December 10, 2018 marked the 70th current international policy and potential more companies, partner associations
This authoritatively states that all
anniversary of the Universal Declaration pathways for advocacy. and government officials, and be a
people have the right to communicate.
of Human Rights (UDHR). This is one of part of other national and international
Regardless of status, age, or We urge those who haven’t signed the
the all‑time leading rights documents in awareness campaigns focused
communicative capacity, all people pledge to do so on the ICP website. Their
world history. on communication, accessibility,
have the right to receive and convey newsletter will keep you informed of the
inclusiveness and human rights.
The International Communication Project messages, to hold opinions, and to amazing work happening around the
(ICP) marked this anniversary because express themselves. Everyone should world, the latest resources, upcoming If you would like to join us and be a
communication is a basic human right, uphold others’ rights to communicate as awareness days and ways to participate. part of a working party, become a
and the Declaration sets out, in one they interact with people in daily life in Giving Voice Aotearoa champion
2019 will be a busy year. Starting us off
document, that fundamental human order to enhance equality, justice, and or be a part of the ICP, please get in
is the Giving Voice Aotearoa workshop
rights are to be universally protected*. human dignity. While recognising this touch.
for the NZSTA Board in January, where
The ICP celebrates the Declaration as a right, the ICP is built on the premise that
we will create a blueprint for our national Take care until we catch up again.
common standard of achievements for all communication is essential to life and yet
campaign. In February the first consumer Aroha nui,
nations and their peoples. largely ignored as a disability.
focus group meeting run by Geneva Amy
While communication as a human Hakaraia-Tino will be held in Auckland
right is embedded within the UDHR, and the new Giving Voice Aotearoa
there remains a need to raise global Lead Champion Georgia Hollibar and
awareness of the needs of those with myself will be present in Christchurch.
* Extracts adapted from “70th Anniversary of communication disorders. In 2014, The board will meet in March and Above: The International Communication Project marked the 70th anniversary of the
the Universal Declaration of Human Rights” from the six national speech-language and May to plan for both the NZSTA Universal Declaration of Human Rights with this snapshot of communication disabilities
www.internationalcommunicationproject.com audiology professional bodies that and SPA Collaborative Conference, around the world.
20 • Communication Matters Communication Matters • 21Contact details
NZSTA Board Members Area representatives
President • Annette Rotherham Northland • Caroline Bartholomew
president@speechtherapy.org.nz ar.northland@speechtherapy.org.nz
Communications • Amy Oughton Auckland • Akshat Shah
communications@speechtherapy.org.nz ar.auckland@speechtherapy.org.nz
Member networks • Jodi White Waikato/Bay of Plenty • Gwen Kerrison
membernetworks@speechtherapy.org.nz ar.waikato.bop@speechtherapy.org.nz
Professional development • Claire Winward Central • Elisa Mynen
professionaldevelopment@speechtherapy.org.nz ar.central@speechtherapy.org.nz
Professional standards • Anna Miles Wellington/Nelson • Shannon Hennig
professionalstandards@speechtherapy.org.nz ar.wellington@speechtherapy.org.nz
Māori and cultural development • Renee Taylor Canterbury/Westland • Kate Cook & Ruth Ramsay
culturaldevelopment@speechtherapy.org.nz ar.canterbury@speechtherapy.org.nz
Otago/Southland • Meryl Jones
ar.otago.southland@speechtherapy.org.nz
Other contacts Student representatives
National private practitioner members’ representative Massey University • Jacqui Morgan, Brianna Oosterbroek & Bo Young Choi
Bridget MacArthur • privatepractice@speechtherapy.org.nz sr.massey@speechtherapy.org.nz
Administrator • ONZL Limited University of Auckland • Nicole Liley & Shauna Pali
admin@speechtherapy.org.nz • +64 9 475 0214 sr.auckland@speechtherapy.org.nz
Speech, Language and Hearing Journal of APSSLH, HKAST & NZSTA University of Canterbury • Livvy Pride & Helena Sincock
Editor: Anna Miles • professionalstandards@speechtherapy.org.nz sr.canterbury@speechtherapy.org.nz
NZSTA • www.speechtherapy.org.nz • admin@speechtherapy.org.nz
PO Box 302469, North Harbour, Auckland 0751
Communication Matters editor • Karen Watson
editor@speechtherapy.org.nz
www.speechtherapy.org.nzYou can also read
