More years ago than I like to think about, I was working as a fairly new lecturer at the University of Reading. Two visitors turned up one day at the department and asked to talk with us about our speech and language therapy courses; they both taught Logopedics at Lund University in Southern Sweden and were on an information-gathering trip with a view to changing and developing their course. I did not realise it at the time but that for me was the start to building a long-term network of academic- and practitioner colleagues across Europe. Not long after their visit there was an international conference on child language acquisition that took place in Lund, one spin-off from which was the formation of a small group of academics interested in specific language impairment: EUCLDIS (European Group for Child Language Disorder). This group met regularly every couple of years or so in a different European location, up until the mid 2000s.
A further personal spin off for me at the time was the opportunity to spend a term on sabbatical in the Logopedics department at Lund University. There I found students doing a four year undergraduate course who all appeared remarkably similar to the students I was teaching at Reading – mainly female and all very bright and highly motivated. I was able to watch clinical sessions and despite the language barrier was able to relate to the communication difficulties experienced by the children and the interventions that were being implemented. Therapists were faced with similar concerns and this continues to the present day. So ongoing issues for us all today include managing bi- and multi-lingual clients, problems around children beginning formal education without adequate language skills, and the need for practice to be based on a robust evidence-base. There are now far more opportunities to explore issues together. Fast forwarding from my time in Lund, we now have EU funding for networks that facilitate research collaborations, most importantly the COST Actions (see James Law’s January post about the most recent one: “Enhancing children’s oral language skills across Europe and beyond: a collaboration focusing on interventions for children with difficulties learning their first language. [IS1406]”).
Working together in this way is not without its challenges however. Training and service delivery varies widely across different countries. The therapists (or ‘logopeds’) I worked with in Sweden do not deliver therapy to children of formal school age (i.e. from seven years old in Sweden) and do not work within schools. A different professional group does this, made up of teachers who do a two-year additional training. So the clinical work I observed only involved children younger than seven. In Germany, SLT is delivered through private clinical practices, with the state funding clients to attend; once qualified, clinicians are either employed directly by a practice or save up to set up one of their own. Not all training across Europe is at degree level and in France for example, ‘orthophonistes’ do a diploma-level training (as was the case in the UK up until then end of the ‘70s; Newcastle was the first degree level programme and remained the only one for many years). One consequence of this is that therapists may have lower status and have limited autonomy to make their own diagnoses and decisions about intervention. Medical doctors, psychologists and/or clinical linguists will be the people doing this.
Terminology and definitions also pose major problems. It is not enough to share the same (English) term for something, you must also check that you share the same concepts and definitions for these terms. Think of the different definitions and terms used within the UK for child language difficulties for example (i.e. specific language impairment, language delay, primary language impairment, etc.) and then multiply by all the countries involved! English is invariably the language used at meetings, but this can sometimes lead to more confusion. For some years I was baffled by the word anamnesis, something that I have been repeatedly told is absolutely crucial for assessment of a client and moreover, is an English term. It seems to be something midway between a case history and a communication profile in ‘our’ terminology. Dealing with these confusions means first of all realising that they exist, and then carefully talking through what both parties mean.
To conclude, collaboration with colleagues from Europe and beyond is only likely to increase as time goes on, so do get involved. It is fascinating, can be frustrating at times, but most importantly it will broaden your professional horizons and constantly present you with new and different ways of doing things!