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Child speech, language and communication need re‐examined in a public health context: a new direction for the speech and language therapy profession
Author(s) -
Law James,
Reilly Sheena,
Snow Pamela C.
Publication year - 2013
Publication title -
international journal of language and communication disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.101
H-Index - 67
eISSN - 1460-6984
pISSN - 1368-2822
DOI - 10.1111/1460-6984.12027
Subject(s) - psychology , competence (human resources) , population , service delivery framework , public health , communicative competence , context (archaeology) , disadvantage , developmental psychology , public relations , service (business) , medicine , social psychology , nursing , pedagogy , political science , business , paleontology , environmental health , marketing , law , biology
Abstract Background Historically speech and language therapy services for children have been framed within a rehabilitative framework with explicit assumptions made about providing therapy to individuals. While this is clearly important in many cases, we argue that this model needs revisiting for a number of reasons. First, our understanding of the nature of disability, and therefore communication disabilities, has changed over the past century. Second, there is an increasing understanding of the impact that the social gradient has on early communication difficulties. Finally, understanding how these factors interact with one other and have an impact across the life course remains poorly understood. Aims To describe the public health paradigm and explore its implications for speech and language therapy with children. Methods & Procedures We test the application of public health methodologies to speech and language therapy services by looking at four dimensions of service delivery: (1) the uptake of services and whether those children who need services receive them; (2) the development of universal prevention services in relation to social disadvantage; (3) the risk of over‐interpreting co‐morbidity from clinical samples; and (4) the overlap between communicative competence and mental health. Outcomes & Conclusions It is concluded that there is a strong case for speech and language therapy services to be reconceptualized to respond to the needs of the whole population and according to socially determined needs, focusing on primary prevention. This is not to disregard individual need, but to highlight the needs of the population as a whole. Although the socio‐political context is different between countries, we maintain that this is relevant wherever speech and language therapists have a responsibility for covering whole populations. Finally, we recommend that speech and language therapy services be conceptualized within the framework laid down in The Ottawa Charter for Health Promotion.