A two year evaluation project in East- and Midlothian
Between 1997 and 1999, 25 children in East Lothian and Midlothian, Scotland participated in a specific auditory stimulation program (JST) (1997-1998: 11; 1998-1999: 14). The group comprised 10 girls and 15 boys and the mean age was 8 (range 5-12). Children were selected according to the following criteria:
· pesenting with a primary speech and language/communication disorder or specific learning difficulty/dyslexia
· capable of following a programme with the help of their parent(s) at home
The aim of this project was to carry out an evaluation of the progress in children on the auditory stimulation programme in order to assess its value as part of the speech and language therapy on offer to this client group (Leslie, Robinson and Fletcher, 1999; Leslie 2000).
Speech and language therapy assessments were carried out before and after the stimulation period to measure written and spoken language skills, and audiometry was attempted to record hearing profiles and auditory dominance.
Pre- and post-therapy information relating to attention, behavior and co-ordination was collected from the children’s parents and teachers, using a formal questionnaire (the ABC), asking parents to keep a diary of their child’s progress, and obtaining a final report from both parents and teachers.
The stimulation programmes lasted for a complete academic year, and all the children exept one completed the full course of therapy. The treatment required continuous participation from both children and parents so the fact that only one child dropped out was a positive indication of the perceived value of the therapy.
Based on the speech and language therapy assessments which were made before and after the stimulation period, some children showed a marked improvement in areas of reading, writing or spelling but there were not enough data to draw any valid conclusions about the cause and effect of the specific auditory stimulation on these results.
The data from which the stimulation program has been evaluated were contained in the ABC questionnaires and the various comment sheets which were completed by the parents and teachers. For almost every child there was an ABC form which was filled in by a parent before the stimulation period and a further one which was completed after the stimulation period, plus a final report. In addition, an ABC or other assessment was carried out by the child’s primary and/or learning support teacher.
The observations of both parents and teachers were analysed by counting the number of times an area of improvement was noted. Eleven categories were identified and the results for the first year of the project are shown in fig. 4.
In the second year of the project, a new section was added to the ABC, dealing specifically with language. Pre- and post-therapy information was collected on various aspects of communication, and improvements were recorded in almost all areas. The greatest improvements occurred in pronouncing sounds and words; learning new words and using the correct ones; constructing sentences accurately; and having self-confidence, both when speaking and in general.
The observations are clearly subjective and the parents and teachers may have preferred to concentrate on the more encouraging aspects of the children. Nonetheless, the comments from both parents and teachers are overwhelmingly positive, and all the children had shown some degree of improvement in most areas.
It is important to bear in mind that the children were assessed over a year and would be expected to mature during that period. The children came from a fairly wide age range and the recorded comments indicate that their increase in maturity was greater than might have been predicted. The same is true for the improvements in motor skills which were noted in a majority of the children.
The following extracts from comment sheets completed after the stimulation period give an indication of the type of improvements which were recorded:
· her speech has improved enormously
· less impulsive now than before
· her confidence has developed well this year
· much better at waiting for his turn
· attention span has improved
· not as clumsy as he used to be
· her social skills have improved greatly.
Discussion of the East- and Midlothian evaluation project
It is difficult to separate the effects of one form of communication therapy from other treatments, or to measure the changes in a child’s development against the normal maturation process. The sample size was necessarily small and limited by the availability of equipment and staff resources and thus no statistical analysis of the data was attempted.
The conclusions are drawn from the observations by the children’s parents and teachers, based on their knowledge of the children’s previous development and anticipated progress. Although it can not be proved that the specific auditory stimulation was a contributory factor in the improvements shown by all the children in this pilot study, it is felt that there is sufficient observational evidence to support the view that specific auditory stimulation is a useful tool for Speech and Language Therapists.
More research is necessary to evaluate the influence of specific auditory stimulation on children’s behavior in order to answer question five - and research has been planned.