Speech, Language, and Communication in a Public Health Context: A UK Perspective with Potential Global Application – An Opinion Piece

Abstract

Speech and language therapists often contribute to public awareness campaigns as well as supporting, teaching and promoting the facilitation of speech, language, communication, and safe swallowing with the general public and health and social care professionals. These are sometimes considered as public health interventions. It is important to consider the objectives, costs, and impact of this involvement in the same way as reviewing the evidence associated with the more personally targeted interventions with individuals or groups of clients with specific conditions. This opinion piece discusses speech and language therapy in the context of public health, clarifies the terminology, and proposes different approaches to demonstrate its influence associated with its objectives. The content has been informed by a Working Party of the Royal College of Speech and Language Therapists (2017–2018).

A randomized controlled trial of the effectiveness of teacher continued professional development on student language outcomes

“…While many studies have used strict inclusionary criteria, often targeting children with, or at risk for, language difficulties, we chose a public health approach, with no preselection of participants, and invited all students in the teachers’ classes to participate. Our choice was based on previous studies showing gains from intervention for all participants, regardless of language or cognitive level (e.g., Throneburg et al., 2000), and an interest in evaluating the possibility of using teacher CPD to improve the universal provision, or primary prevention, offered to students to reduce the risk of adverse development (e.g., Enderby & Law, 2019).…”

“…Directing SLT speech and language services at all levels is, according to Law, more important than ever before, as an increasing number of SLTs in many Western European countries hold positions where they are required to guide their instructions to other professionals, rather than themselves perform individual assessment and intervention. In addition, including all levels in SLT service provision could lead to a much‐needed raise in awareness of language disorder and its consequences among, for example, teachers and other school personnel (see also Enderby & Law, 2019, for a clarification of the terminology surrounding public health SLT services).…”

“…While evaluations have found specialized one‐to‐one intervention to improve, for example, narrative ability (Gillam & Gillam, 2016; Gillam et al., 2018), receptive vocabulary and word‐finding ability (Wright et al., 2018), and verb argument structure (Ebbels et al., 2007) for students with language needs, fewer studies have investigated whole‐class interventions for this population. Below, studies evaluating teacher‐delivered targeted intervention (using the terminology recommended by Enderby & Law, 2019) are summarized followed by studies of population or universal services (provided by teachers to students with increased risk, or to help all students reach their potential, respectively).…”

“…Ebbels et al's (2019) recommendations are not uncontroversial. In a comment to the article, Law (2019) objected to the idea of allowing the current evidence-base to restrict SLT service provision to individualized intervention. By pointing out that 'lack of evidence should never be confused with negative evidence' (26), Law stressed that the competence of SLTs is needed across all levels of service provision, including universal services to all and targeted intervention to at-risk populations.…”