Prevention

It had clearly become important for CPLOL to place prevention in the forefront of its discussions and activities given the significant increase in attention paid to this area of activity throughout Europe, especially over the past 20 years.

The need to increase work aimed at preventing disorders is partly due to taking on board the research carried out in Europe mainly during the 1980s, which showed that :

• a significant proportion of young children (almost a quarter of the population) presented with language disorders

• for the great majority of these, early screening and a small amount of parental guidance would be enough to ensure that the disorder disappeared

• that those children with disorders who did not receive appropriate treatment would eventually become children at risk and were in danger of developing disorders of written language and anti-social and difficult behaviour

It is also due the increasing interest of governments in pursuing a health policy geared towards containing the cost of care.

The setting up of a systematic policy of prevention of language disorders may appear cumbersome to some people (with its formal early screening and provision of information for health and education employees). However, it seems increasingly clear that such a policy is cost-effective in the long term because episodes of care are shorter, less frequent, and more effective - not to mention the incalculable improvement in well-being for the children and their families.

The committee started by adopting the definition of prevention drawn up by the World Health Organisation (WHO) in 1948. The WHO identifies three successive stages covering the means to be set up to prevent pathologies, therapy and, if possible, the social reintegration of patients:
malades :

primary prevention: this stage of prevention covers all activities designed to ‘reduce’ the instances of an illness in a population and thus to reduce, as far as possible, the risk of new cases appearing; in speech and language therapy this mainly covers information and health education of a population, as well as training all those who have a role to play with the population in question;

secondary prevention: this covers activities aimed at `reducing the prevalence of an illness in a population and thus to reduce its duration’; in speech and language therapy this mainly concerns identification and early screening;

tertiary prevention: this aims ‘to reduce the incidence of chronic incapacity or recurrences in a population, and thus to reduce the functional consequences of an illness’; in speech and language therapy , this relates to care provided, i.e. therapy, various rehabilitation techniques and intervention designed to assist the patient to return to educational, family, professional, social and cultural life.

The committee identified two short-term objectives:

- to organise a European ‘speech and language therapy‘ day;

- to draw up a report on the stage of development reached in the area of prevention in each of the member countries; when completed, this report would provide a base line for determining future activities: harmonisation in the practice of prevention, the creation of evaluation measures and means of sharing information, etc.

The aim was to set up a Europe-wide event, which would be taken up by the media and which would inform the general public about all aspects of the profession and its contribution: the development of voice and language disorders in children, adults and the elderly, therapies and types of care, the extent of speech and language therapists’ competence and their education, etc

The activities: the general public was able to contact speech and language therapists anonymously by telephone. A press pack and press release were compiled to inform the media about the profession. This activitiy was supported by a partnership established under the auspices of the European Helios II programme. A poster, designed in Italy, was produced in Greece and sent to each country to display the telephone details of professional associations.

In total there were 340 radio broadcasts, 506 newspaper or magazine articles, 72 television programmes and more than 100,000 posters which publiicised this event across Europe. Hundreds of speech and language therapists voluntarily provided responses to 7159 queries during the day: 37% related to children’s spoken language, 15% to stammering, 9% to written language and 22% to training and prospects within the profession.

The success of the day was demonstrated both by the involvement of members of the profession and by the number of calls recorded. This underlined the need for increased publicity. Furthermore, it should be noted that the demand for speech and language therapy is still not satisfied in many countries.

A European study has been carried out into the different areas of intervention practised by the profession in order to establish the current state of practice in prevention of speech and language therapy disorders. This survey will enable us to understand better the role of speech and language therapy in prevention, as well as to establish our position within the structures existing in each of the countries of the European Union and Switzerland.

The areas investigated were:

information and health education
parental guidance, advice and early education
early screening for language disorders in children
screening for written language disorders
screening for disorders in adults
general issues

We are able to draw the following conclusions:

Attached to the report are:

Following completion of the report, the General Assembly in Naples agreed the following projects :

These five areas will form the basis of the work of the Prevention Committee over the next few years and will help to fulfil the aims laid down by CPLOL: to work towards harmonising the concepts of prevention across Europe, to set up research projects and to establish shared tools which will enable the common development of prevention in speech and language therapy .