Country’s speech and language services chronically under-resourced and "cannot cope with demand" — report

Ireland has just half the number of speech and language therapists it needs, with 3,000 children waiting more than a year for therapy and another 2,000 children waiting the same period of time for an assessment.

The findings are included in a working paper on speech and language therapy to be published today and indicate a system that “cannot cope with demand”.

The paper found access to speech and language therapy was effectively a post code lottery, with places such as Wexford and Donegal less likely to have quick access to services than children in areas such as Cork South Lee and Wicklow.

It also states that not one health area in the country meets the recommended case load of between 30 to 65 children per therapist and that as many as 10% of therapists can be on one form of leave or another at any one time. Instead, there is an average of 162 children with complex needs for each speech and language therapist nationally.

The Case of Speech and Language Therapy, was prepared for Inclusion Ireland by researcher Pauline Conroy, aided by Simon Noone.

It has used figures from the CSO and elsewhere to highlight the shortage of services, as well as input from the Laois Offaly Families for Autism group.

It says: “To meet international standards on appropriate caseload the amount of speech and language therapists working in children’s disability services would have to at least double from its current level of 283.3 to 565.”

Participants in the Midlands reported an average of five therapy sessions over a 12-month period, with 25% of participants claiming their child had not seen a speech and language therapist in the previous 12 month period.

It states that in some cases organisations such as Down Syndrome Ireland and Clare Crusaders are providing financial assistance to families to foot the bill for private therapy, which can cost up to €100 per hour.

It also found:

-“Little public data” on the number of therapists working in children’s disability services, the number of vacant posts or therapy contact hours available;

-Assessments are taking, on average, 50% longer than the statutory timeframe to complete;

-Some therapists take an average of 2.5 hours to complete an assessment while others take up to 21.5 hours;

-Some therapists have emigrated amid falling wages;

“Extensive waiting lists for treatment and assessment, coupled with a trend of parents accessing private speech and language therapy are indicative of a system that cannot cope with demand,” according to the report.

The therapy is highly effective, particularly at a younger age, but while the Health Research Board said 6,587 children and young people availed of it in 2012, the 2011 Census identified 14,744 children with an intellectual disability.

www.www.inclusion ireland.ie

Case study: Lorcan’s ‘wasted years’ blamed on therapy delay

When your young son hasn’t even blown out the candles for his fifth birthday, it might seem strange to speak about ‘wasted years’, but that’s exactly how Carol Feery describes it.

Carol and her family live in Tullamore, and Lorcan is her youngest son.

Severely autistic and still non-verbal, Lorcan is nonetheless a happy child, who loves school. Yet communication between him and his mum is done via the medium of pictures.

At two a developmental check highlighted issues and Carol was advised to contact the Early Intervention team.

“I rang for my appointment and was told ‘we can’t see your child, there’s a two-year waiting list’,” says Carol. Fearing delays would hamper attempts to improve Lorcan’s verbal and social skills, the family had him assessed privately, before again seeking therapy from Early Intervention services.

“They said no, that wasn’t our team [that made the diagnosis], that wasn’t our psychologist, you still have to wait.”

Laois Offaly Families for Autism told Carol that an assessment of need should be done in three months and with pressure applied, it was finally carried out, but therapy was still out of reach. Home tuition was arranged amid concerns that Lorcan would not get a pre-school place.

Finally, Carol and her partner were approved for a Hanen programme, where parents are trained in ways to help their child communicate. However, there was no complementary speech and language therapy.

Finally, this summer, therapy began, but instead of 10 sessions, it wrapped up at four, apparently because Lorcan was also availing of the July provision at school.

“I believe if he had had therapy from the first diagnosis in 2011 he would have some speech right now,” Carol says.

“It is wasted years. These are the important years when the brain is absorbing everything.”