Thousands of children in need of speech and language therapy are waiting years for intervention which could change their lives, writes Carl O’Brien, Social Affairs Correspondent
Lesley, a 15 year old with Down syndrome, never ceases to impress her mother. She gets up in the morning with a smile on her face. She can’t wait to go to the special school in Inchicore. And by the time she gets home in the evening, she’s still full of mischievous good humour.
But there is something which gets her down regularly, even though she tries hard to put a brave face on it. Lesley has a speech and language impairment. Despite being diagnosed at the age of three or four, she has never had any meaningful access to speech therapy in her life.
The result is that when she speaks, she finds it almost impossible to be understood.
While her thoughts and feelings are perfectly clear in her own head, all people seem to be able to hear when she speaks is a jumble of noise.
“She’s a happy-go-lucky girl, but she can get very annoyed and frustrated when we don’t understand her,” says her mother, Geraldine.
“She can be very standoffish when strangers are around as well, even though that’s not her personality. I’ll often have to get her to respond when someone says ‘hello’ to her.”
Geraldine has been fighting for services for her daughter even since she was a toddler, but feels she has been abandoned by the State. She lives in a local authority house and is reliant on the lone parent’s allowance and half a carer’s allowance as her sole source of income, so getting private speech and language therapy was never an option.
“If she had proper intervention, I think she would be able to communicate with people,” says Geraldine. “I don’t know exactly what her speech would be like, but I know she would have improved. She’d be more outgoing, she’d be able to get on better in the world around her.”
Thousands of other parents have similar stories. Many know that with early intervention and a structured programme, children can make huge progress in their ability to communicate. Yet, the waiting time for an assessment is a minimum of nine months in most parts of the State, while it stretches to more than a year in others.
The effects of these delays can be profound. Dr Siobhán Barry of the Irish Psychiatric Association said speech problems could quite quickly develop into serious behavioural problems if children couldn’t express themselves properly.
What puzzles many in the health sector is that problems regarding the lack of speech and language services were supposed to have been solved years ago, after the Government agreed to fund extra training posts to try to keep up with the growing demand for intervention.
But the combination of the staff recruitment embargo in the Health Service Executive (HSE) and poor pay and conditions for therapists in much of the public sector means the services are under unprecedented strain.
The head of Inclusion Ireland, the national association for people with intellectual disabilities, says the inadequacy of speech and language services is now the biggest issue of concern among parents.
“We’ve been highlighting these problems for years,” says the group’s chairwoman, Finula Garrahy. “We were told the numbers of university places were insufficient, these have now been increased. The latest is that there are not sufficient senior therapists to monitor new graduates post graduation. These are just excuses.
“Something could be done about it if there was the will. The real reason is the embargo on recruitment. I now understand that young speech therapy graduates are working in fast food outlets in Dublin.
“That is reminiscent of the bad old days of the 80s.”
One of the biggest pressure points in the system is as a result of a provision in the Disability Act, which prioritises the assessment needs of zero to five year olds. Frontline staff say the legislative obligation to provide this needs assessment for young children means work with older children is being interrupted.
The older a child is, the more difficult it is to get a service, while those over 18 may as well give up on expected input from therapy staff, they say.
The only option facing many parents is to opt for private services.
Fidelma Healy Eames, a Fine Gael senator and mother of a seven year old in need of speech and language therapy, felt she had no choice.
“I chose to pay the €400 for a private assessment for my seven-year-old child. What about the parent who can’t afford it? It’s clear that other children are being left behind.”
Already her child is making significant progress and has become much more confident.
“My own child had a verbal comprehension difficulty which was diagnosed and is being successfully remediated with speech and language therapy,” she says.
“Interestingly, there was no learning difficulty but a verbal comprehension blockage was preventing my child from learning.
“It’s led to major gains in my child’s competence and confidence. It’s proof of what an appropriate quality intervention can make.”
In the meantime, there are thousands of children like Lesley McCabe, still waiting for a service which could help transform her life.
Following the intervention of her local Labour TD Pat Rabbitte, her mother has been told that the special school Lesley attends has recently recruited two speech and language therapists.
Last week Geraldine received a phone call to say her daughter will have access to therapy in a few weeks.
“I’m hoping it happens, but we’ll wait and see,” she says. “For it to work, it can’t be just a few weeks here and a few weeks there.
“She needs structured , on-going support to help her reach her potential.
“It’s the least she deserves.”
“She’s a happy-go-lucky girl, but she can get very annoyed and frustrated when we don’t understand her