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Introduction

The Patients' Charter emphasises the importance of customer satisfaction in outcome measurement. For those therapists working with children with statements of special educational needs under the 1981 Education Act, the opinions of staff in special schools, mainstream schools and resourced units, are an additional aspect of customer satisfaction. Dissatisfaction may result if schools' expectations of a service are different from the actual type and style of speech and language therapy service delivery or the schools have misconceptions of the role of a therapist. Studies by educational psychologists have shown that delivering what schools wanted, could lead to:

an absence of any overall agreement as to the most effective means of support or analysis of what support, in the light of professional expertise, school should receive rather than what they wanted to receive (Fletcher-Campbell and Hall, 1993, p. 72).

Speech and language therapists need to deliver an effective service. It is therefore important that good communications are established between any speech and language therapy department and the schools which they service.

The action research study followed an initial survey of the expectations of the speech and language therapy service from the point of view of four different types of special school staff. This had shown that it was the unqualified support assistant who was most dissatisfied with the style of service that her school received (Dobson, 1995). This support assistant had questioned the emphasis that the speech and language therapist placed on the development of functional communication skills. She believed that articulation work was the best therapeutic approach for children with severe learning difficulties. Her initial response, when asked to describe the work the speech and language therapist in a special school, had been:

But you don't do proper speech therapy. Do you mean what you do or what a speech therapist does? (Special needs support assistant.)

She then went on to indicate, that for her, this meant programmes to improve children's articulation.

At first, it was felt that the therapist's working methods, might have caused the SSA's dissatisfaction with the speech and language therapy delivery at her school. However, discussions with other therapists in the same service showed that misunderstandings of the therapists' roles by education support staff was a common problem. Since 1989, the implementation of the national curriculum for children with special needs had been a major all consuming task for schools. HMI Review (1992) had found that The National Curriculum and delegation of financial management to schools have increased the need for non-teaching staff. (p. 20). Therapists were, as a consequence, reporting a general difficulty in liaising with teachers. Clayton (1993) had noted a similar trend of more unqualified support after an earlier education act and stated that:

There is indisputable evidence of a substantial increase in the number of assistants employed by LEAs since the implementation of the 1981 `Education Act` (p. 38).

The support assistants' opinions of the speech and language therapy service has therefore become a significant factor in schools' level of customer satisfaction.

Parents of children with communication disabilities have the right to expect that their children receive good quality support in their schools. Fox (1993) states:

Parents need to know their children are being supported by people who know what they are doing. Schools need to be sure that children who need assistance are given informed and confident support (p. 50).

National surveys have found that there is very little evidence of planned training for support assistants. Most of their training occurs through the teacher and Clayton (1993) has stated training, whether pre- or in-service, is rarely available (p33) for support assistants. The value of a child's support assistant becomes questionable if they are generally untrained for their posts. The therapists surveyed had suggested that it was the lack of confidence exhibited by some support assistants that limited their usefulness. Thomas (1986) states that parents helping in schools tend to rigidly adhere to instructions to minimise the likelihood of making mistakes. If unqualified support assistants, who are often local parents, react in a similar way it is understandable that their usefulness in supporting therapy programmes will be limited. Van der Gaag and Davis's (1993) study of speech and language assistants has suggested that lack of off-the-job training was possibly associated with poor job satisfaction. Since support assistants rarely receive any form of training it is unsurprising that they undervalue their role in language input to the children they support.

Therapeutic emphasis has evolved from the expectation of `giving the child therapy' to that of improving the child's communication environment. From this stance, schools' support assistants have a particularly important role in developing a child's communication. It therefore became obvious that our department needed a new training strategy: a package of courses which was tailored specifically for support assistants' needs. These courses could then be used as a medium for the therapists to define their own perception of their role in schools. An investigation was therefore undertaken involving the planning, delivery and evaluation of training for support assistants by the speech and language therapy service.

Methodology

The investigation attempted to answer four questions:

1. Can speech and language therapists provide courses about communication disability which meet the training needs of local education authority support assistants?
2. What aspects of the training courses are perceived as successful by the therapists presenting them and the support assistants who attended them?
3. Does the provision of training enhance the support assistants' awareness of the speech and language therapists' role in relation to children with SEN in schools?
4. Does the provision of the training enhance support assistants' perceptions of their own role in improving the children's classroom communication environment?

It was decided that qualitative research techniques were suitable methods for collecting the data for most of this study. Vulliamy and Webb (1992) particularly recommend the use of qualitative research methods for investigating the views of staff on special education. They cite Hegarty as arguing that:

qualitative research is known to be particularly suited to a number of topics in special education. These include investigations into pupils' and teachers' perspectives and experiences of special education programmes ... and providing detailed accounts of various forms of special education provision (p 6).

The data sought for this study was about staff's experiences, impressions, attitudes and perceptions of a speech and language therapy training package. A type of data which does not easily lend itself to quantification. A literature search suggested that action research was therefore the most appropriate approach to investigate the proposed questions.

The action research cycle for the study

There were three parts to the cycle:

1) Planning the courses

The courses were planned by investigating the perceived training needs of the support assistants. This was achieved by use of a questionnaire which utilised open questions. Forty questionnaires were distributed to the support assistants in the local special schools and units. There was a 90% rate of return. It was realised that:

Exclusive reliance on one method, therefore may bias or distort the researchers' picture of the particular slice of reality he is investigating. He needs to be confident that the data generated are not simply artefacts of one specific method of collection. (Cohen and Manio,1989, p.269)

Interview data was therefore used to triangulate and cross check the questionnaire data. As the quality of information gained in an interview is largely the function of the skill of the interviewer, semi-structured interview schedules were used in all the interviews, to minimise the effects of the interviewer's level of proficiency. The education manager for special needs and the officer responsible for planning training at the curriculum development centre were interviewed about their views as to how the speech and language therapy services proposed training dovetailed with the education authorities training policies and plans. The opinions of the therapists working in the paediatric section of the speech and language therapy service were included. All these responses were then co-ordinated and used to plan the delivery of the courses.

2) The delivery of the courses

Five separate afternoon sessions were planned over a five week period. Each twenty place course was on a different day of the week to accommodate the varied part time working patterns of the support assistants. The courses requested were on language development speech development and autism, and communication development and sensory impairment. A sixth and final course, a summary of the support assistants' courses, was planned for the teacher/ managers of the support assistants but was later cancelled due to lack of interest. Each school determined the number of courses that their staff attended. Sixty support assistants attended accounting for eighty-seven course places. Fourteen support assistants attended several courses. Most vacant places were short notice cancellations due to the mass measles inoculations that were occurring at the same period. The course on communication and feeding attracted only a limited number of applicants who supported physically disabled children.

3) Evaluation of the courses

People's perception and recall of a situation, knowledge and levels of skill will vary according to the way they work, the situation in which they work and the time when they were asked for the recall (Van der Gaag and Davis, 1994). The timing of the evaluation interviews was therefore important. The seven therapists who had presented the courses were all interviewed within a week of their presentation. The interview questions related to their style of presentation, choice of content and impressions of how successful the course had been. Triangulation of the data gained from the therapists presenting the courses was achieved by some of the questions asked of the support assistants being the same. The other questions were an attempt to elicit the support assistants' views on their role in relation to children with communication disabilities. It was hoped that these responses would indicate the value they gave to the speech and language therapist's role in an education setting.

Those schools, which had sent several support assistants to more than one course, agreed to help evaluate the courses. This meant group interviews were able to be used. Twenty-four support assistants who represented 28% of the course attendance's were interviewed. A structured sampling technique was therefore not used. Group interviews helped schools in that they were less intrusive to classrooms' organisation (Lewis, 1992). These interviews differed from those with qualified staff. For as Lewis (1992) suggests group talk may ... be very natural and less stilted than individual interviews (p. 417). The interviews were with groups of 3-5 support assistants in line with the group numbers suggested as ideal by Barnes and Todd, and Waterhouse as cited by Lewis (1992, p 418).

Analysis

The interview transcripts were annotated with margin notes categorising the responses in relation to the topics of the interview. Further notes were made, giving brief comments over the text, as to any sub-category identified. Some evidence of changes of practice and increased awareness of the importance of enhancing the language environment was gained. The bulk of the material, however, related to the content of the courses. Once the initial analysis had been completed, material from literature on training programmes for support assistants, training practices and the evaluation of education training was related to the report. The final report with arguments supporting or refuting the findings was then concluded with a section on future possible actions and plans.

The Evaluation of the Course Content and Presentation

Presland (1994) states that:

Unfortunately, there is little in the research literature that provides any detail about how any particular profession might use learning styles effectively ((p.179).

This meant that there had been few guide-lines available about how to plan courses for support assistants or suggestions about a suitable style of presentation. Presland (1984) cites Doyle and Rutherford as arguing that for quality learning:

The critical factor is the quality of instruction in terms of task clarity, feedback and opportunity for practice (p. 180).

In the case of these courses the evaluation can only cover task clarity and feedback. Opportunity for practice must be a long term strategy. This evaluation was therefore only covering a limited part of a much wider long term process.

Numbers attending each course

A course organisation issue for both the therapists and the support assistants had been the numbers involved in the small group exercises. Smaller sized groups of 3-4 people were considered best. Balshaw's (1991) work in support assistant training reflects how important course size is as a factor. The participants saw the courses as a forum for personal discussion of their own work situation or their own experiences as parents. This did not occur as easily when the attendance was larger than fifteen. The presenters had wanted the support assistants to interact with them throughout the courses. The perceived benefits of smaller courses would therefore appear to outweigh the costs involved for the therapy service.

The format of information presentation

The introduction of the training strategy had generally been considered successful by both the presenters and the participants. The courses had been popular. They seemed to have been delivered at an appropriate level for the support assistants and their method of presentation had been enjoyed by the majority of the participants. These affective factors, emotional responses to delivering and attending the courses, appeared to have been the main effect of the introduction of the training strategy. Kinder and Harland (1994) found that INSET training often had such initial short-lived effective outcomes but they concluded that such outcomes may be a useful, and even necessary, precursor for changing practices (p.37). The introduction of the courses had therefore provided a basis for further possible change.

The presenters had been aware that the terminology used about language could be a barrier between them and the support assistants. Some support assistants acknowledged the attempts by the presenters to establish agreed definitions of the use of terminology. They felt they benefited from the frequent explanations of terms that accompanied most of the presentations. However, even the presenters themselves had no real consensus as to how they should present their information. They showed an awareness of what they had done but little accord. For example two gave conflicting views:

I didn't want the feeling to come over that communication meant speech. That's why I used the word interaction a lot. I deliberately didn't use communication (Presenter course 3),

or

I did wonder if how many times I used the word communication will have an effect. I think communication is a dodgy word. Education think communication is speech (Presenter course 1).

All of the courses gave part of the information in a variety of formats. The support assistants acknowledged that the presentations aimed to supply information:

It was nice to have a lot of input. I get so fed up on courses where they just ask you to come up with the answers and all they do is write on a flip chart ... You come away thinking they haven't told us anything (Mainstream 1).

Presenters had felt this to be a necessary approach because:

if you work with a child who had language impairment you will need to know what particular programme is relevant and why (Fox, 1993, p. 52).

Most support assistants felt:

The videos were good. A different kind of input broke the course up. It provided something visual and provided a kick start when you started to shut off (Mainstream 1).

The quality of the videos was not seen as an important factor, whether commercial or locally made.

Role play was universally disliked and the support assistants they felt detracted from the enjoyment of the learning processes that it was intended to highlight.

Cullen, 1988, states that:

Role-playing is commonly used in staff training workshops, but is probably used more because it is interesting to participants rather than for any demonstrable benefits on the staff training process (p. 315).

He suggests that there is little evidence that role-playing how you should behave is any more effective than telling people how to behave. He also casts doubts on the benefits to staff role playing a person with a disability.

Other exercises which had involved simulation had been popular. One such exercise had involved the wearing of goggles to simulate various forms of visual impairment and following non-specific instructions such as `put it over there'. These exercises had created enthusiastic responses and active discussions of the importance of specific language use.

Changes in perceptions of role of speech and language therapist

Examining comments on which courses were considered to be the best showed that it was the ones that:

Reassured us that what we're doing is good. Using our common sense is right. A lot of what you said was about that. You told us something and I thought we do that already. It helped (Mainstream 3).

Kinder, Harland and Wootten (1991) suggest that for training:

The degree of impact seems to relate to a combination of the length (ie the substantialness) of input and commitment to the messages conveyed (p.52).

It became apparent during the study that misconceptions of the speech and language therapist's role in a school setting had not been caused by just a simple misunderstanding which could be solved by the provision of information. Thomas (1991) suggests that in the absence of a formal set of professional expectations in education teams there is a reliance on:

being able to laugh, joke, muddle through and generally `get on with each other' in order to submerge tensions (p. 197).

This had been very evident in discussions with support assistants; a lot of good will and good intentions but little true understanding of a speech and language therapist's role in schools. The information given in the courses, however, had been insufficient stimulus to alter existing role expectations. The courses had attempted to address only one aspect of a complex set of interacting processes. There were several other influences affecting role perceptions in SEN teams over which the therapy service had little or no control. These had been identified as:

1. Lack of institutional provision for facilitating SEN teams.
2. Lack of planned training and development for support assistants.
3. Established attitudes and beliefs about language and speech development and its remediation.

It is acknowledged that the process of change is rarely simple. It is usually a far more complex process than anticipated. The fact that the change in the training strategy had been the direct result of the therapists and the support assistants jointly identifying problems was an advantage. The change in the training strategy had been introduced voluntarily without external pressure. This change had elements of success. However, as Fullan (1986) indicates unless the process of change is supported and facilitated by a management structure, pressure for change alone is insufficient.

Holding the courses as off-the-job events had been advantageous for the support assistants but had created the disadvantage of isolating the training from the school environment. It meant the courses did not include the whole school SEN team membership. The SENCOs (special educational needs co-ordinators) had not applied in sufficient numbers to run the final course and they had not received a summary of the information given to their support assistants. It was the lack of this type of institutional support that had restricted the impact of this action research project.

The limitations of the courses

Fullan (1986) stresses that successful change and implementation is a process of learning and doing. The introduction of the new training strategy was part of my own learning and development process. It had also been an opportunity for speech and language therapy staff to develop their presentation skills. The therapists had believed that support assistants should have the opportunity to learn about language acquisition and patterns of `normal' development. They had felt that shared knowledge would promote success in joint discussions and informed working practices. However, the support assistants had seen this as unnecessary aspect of courses. They had preferred learning about `abnormal' patterns of language development. This aspect of the course evaluation must shape the design of any future courses and probably suggests that a `Supporting with children with ...' format would be more favourably received.

The support assistants had liked the reassurance that their experience as mothers and their existing practices were valued. There had been appreciation of being told that their natural use of language was an important factor in the children's language environment. This had led to a realisation that the social use of language in the classroom was an important skill. However, it appeared that some support assistants had not wholly accepted that providing a structured language environment was preferable to language exercises or speech correction.

The provision of a set of general principles on language use in a variety of situations had been seen as unhelpful by some support assistants. They had difficulty generalising the principles and had failed to see their application to a child's specific problem or to their classroom situation. This had led to requests for prescriptive and situation specific solutions. A requirement which is common to primary school INSET training in general (Kinder, Harland and Wootten, 1991). These courses had been of necessity general and non-specific and had not met this primary school INSET preference.

The need to be told what to do was a common theme from each school visited even though there was an acknowledgement that:

I always feel I'd like someone to tell me how to do this (work with children with communication disabilities). You want the answers even though you know there probably isn't one (Special School 2).

The lack of provision of prescriptive specific information for working with children with communication disabilities was seen as a fault in the Therapists presentation for:

They were so embarrassed. Its almost like they were embarrassed at telling us what they knew. They've obviously so much knowledge and experience. I was just waiting for them to tell us what to do (Mainstream 1).

It was apparent that the therapists were often expecting the mainstream support assistants to take on roles about which they were relatively unsure. Support assistants are usually unqualified and are employed because of their parental experience. Those support assistants who lacked confidence in their role or any training for it, had therefore wanted prescriptive solutions to children's difficulties. These courses were therefore only a beginning. Further continued training must be offered in the future to raise support assistants' confidence about working with children with communication difficulties. These short courses could not have been expected to have a major impact on well established beliefs. Attitude change is a learning process too, one which could only have been achieved by a much more substantial, long-term organised training programme. Fullan (1986) states that:

It is not easy for people, even if willing, to change their behaviour and thinking significantly ... it is for this reason that effective professional development goes hand-in-hand with effective implementation (p.322).

Achievement of the courses

These courses had allowed a large number of support assistants to choose to attend 1-3 courses on topics of immediate personal interest. They had given them the opportunity to discuss attitudes, beliefs and values which had previously been unvoiced. Those support assistants who disliked the type of service provided by the local speech and language therapy service were unlikely to have submissively altered their views. However, the courses did allow such views to be voiced, listened to and openly discussed with the therapists. The courses were therefore a positive experience for both the therapists and the support assistants. They have provided a basis for joint working practices which may mean future co-operative teamwork is easier. For;

The problems with teams seem to be centrally located in a) not knowing (or agreeing about) what you are supposed to be doing (role ambiguity, role uncertainty); or b) having conflicting demands on your effort, time or loyalty (role conflict), (Thomas, 1986, p. 187).

Off-the-job training for support assistants had provided them and the therapists with time to build a positive attitude towards each others work. The courses had provided time and an opportunity to consider a range of different communication disorders and their various effects on learning in the classroom. It had enabled the more isolated support assistants to meet and interact with more experienced colleagues. Those attending the courses had been given access to the same level of information and knowledge. The courses acknowledged and recognised the important and valuable role that support assistants have in providing an enhanced communication classroom environment .

There were however other issues that indicated the off-site training (as opposed to off-the-job) had not necessarily been wholly advantageous. Schools varied in their policy as to how they employed or used support assistants. Individual teachers managed their classrooms very differently. The teachers, who managed the support assistants, also had varying levels of knowledge about speech and language disability. However, it was also clear that a joint SEN team training programme would have placed the support assistants at a disadvantage. These institutional factors had restricted the success of the introduction of the training strategy. These issues had needed a planned long term response and had financial implications for both education and health services. It had been reassuring to realise as the action research process progressed that:

the main task is not to implement every single change possible but to implement a few important changes very well (Fullan, 1986, p321).

Conclusion

The alteration to the way the training was delivered by speech and language therapists and which staff groups received the training, had been achieved. As a consequence of the courses, relationships between the two services have continued to develop. There have been requests for further courses. The way forward would seem to be to build on these positive results by targeting specific SEN team issues. Thomas (1991) suggests that successful teams work because all the members:

1. know the ideology of the classroom
2. know the purpose of the team
3. know in which specific activities, team members will be involved

Future developments should therefore include similar courses, but ones which would try to incorporate the necessary institutional and organisational factors, that were absent in this initial training strategy. For we need:

to develop `modest' implementation plans, try them out build on them and, in effect, develop our planning capacity as we go along by planning and action (Fullan, 1986, p.325).

The joint identification of a small, immediately solvable problem, for example establishing a feeding and communication policy for profound and multiple learning difficulties (PMLD) children, would seem to be suitable. Such an activity would facilitate a team building process which would directly benefit the children, have a recognisable product and should, according to Thomas (1991) reduce the stress engendered by role assumptions and role ambiguities in team settings.

References

• Balshaw, M. (1991). Help in the Classroom, London: David Fulton Publishers.
• Clayton, T. (1993). From Domestic Helper to `Assistant Teacher' - The Changing Role of the British Classroom Assistant, European Journal of Special Needs Education, Vol. 8, no. 1, p. 32-43.
• Cohen L. and Manio, L. (1989). Research Methods in Education, London: Routledge.
• Cullen, C. (1988), A Review of Staff Training: The Emperor's Old Clothes, The Irish Journal of Psychology, Vol. 9, no. 2, p. 309-323.
• Department of Education and Science, (1992). Non-teaching Staff in Schools: A Review by HMI, London: HMSO.
• Dobson, S. (1995). Outcome Measurement in a School for Children with Severe Learning Difficulties, College of Speech and Language Therapists Bulletin, Issue no 517, May, pp. 13-14.
• Fletcher-Cambell, F. and Hall, C. (1993). LEA Support for Special Educational Needs, Slough: NFER.
• Fox, G. (1993). A Handbook for Special Needs Assistants Working in Partnership with Teachers, London: David Fulton Publisher Limited.
• Fullan, M. (1986). Improving the Implementation of Educational Change, School Organisation, Vol. 6, no. 3, p. 321-326.
• Kinder, K. and Harland, J. (1994). Changing Classroom Practice Through INSET: Towards a Holistic Model, in Constable, H. Farrow, S and Norton, J. (Ed), Change in Classroom Practice, London: The Falmer Press.
• Kinder, K. Harland, J and Wooten, M. (1991). The Impact of School-Focused INSET on Classroom Practice, Slough: NFER.
• Lewis, A. (1992). Group Child Interviews as a Research Tool. British Educational Psychology Journal, Vol. 8, no. 4, 1992, p. 413-421.
• Presland, J. (1994). Learning Styles and CPC, Education Psychology in Practice, October, Vol. 10, no. 3, p. 197-184
• Thomas, G. (1991). Defining Role in the New Classroom Teams, Educational Research, Winter, Vol. 33, no. 3, p. 186-198.
• Van Der Gaag, A. and Davis, P. (1994). Following the Dolphins: an ethnographic investigation of speech and language therapists, European Journal of Disorders of Communication, Vol. 29, no. 2, p. 203-223.
• Van Der Gaag, A. and Davis, P. (1993). The Training of Speech Therapy Assistants, Human Communication, Vol. 2, no. 3, p. 12-14.
• Vulliamy, G. and Webb, R. (1992). Teacher Research and Special Educational Needs , London: David Fulton Publishers.

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