Browsing by Person "Dockrell, J. E."

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Early Years Centres for pre-school children with primary language difficulties: what do they cost, and are they cost-effective?
(Taylor & Francis (Informa Healthcare), 2006-01) Law, James; Dockrell, J. E.; Castelnuovo, E.; Williams, K.; Seeff, B.; Normand, Charles
Background: High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children’s needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about the actual and relative costs of early years provision. Aims: To profile the different costs incurred by two Early Years Centres (EYCs) partially funded by the charity I CAN and children receiving what might be termed ‘routine’ NHS speech therapy to provide an analysis of cost efficiency and equity. Methods & Procedures: Costings for service provision for 91 children (mean age 2;9) were collected. The activity of staff at each site and the cost of staff allocated to services were computed. Data on other resources were also collected. Outcomes & Results: The cost per child per session was on average £12. Despite the longer course of intervention in the first centre (10 compared with 6 weeks), the cost of the course per child was of the same order (£245 compared with £253). The annual cost of the early years provision per child was higher relative to the costs of the NHS provision, £645 compared with £181 in one EYC (A) and £462 compared with £173 in the other (B). When the cost of standard nursery provision was factored in, the difference in annual costs was rather less, with £5298 for the early years provision (EYC A) relative to £4276 in the comparison group. By contrast, the annual cost of early provision rises to £5926 relative to £8861 in the comparison group (EYC B).
Measuring and understanding patterns of change in intervention studies with children: Implications for evidence-based practice
(Taylor & Francis, 2007) Dockrell, J. E.; Law, James
Purpose: Comparisons across studies of the effects of intervention are problematic. Such analyses raise both methodological and statistical challenges. A single data set was examined to investigate whether different established approaches to measuring change in children with specific language impairments alter the conclusions that can be drawn regarding the efficacy of an intervention. Methods: Measures of cognitive and language skills were collected at baseline and at six months following an intervention. Reliable and valid psychometric measures were used. Data from the intervention study were used to explore the patterns of results obtained using four different measures of change: change of diagnostic category, differential improvement across assessment measures, item specific changes and predictors of individual change. Results: Associations between different tests purporting to measure similar constructs were modest. The measures identified different children as impaired both at baseline and follow-up. No effect of intervention was evident when a categorical analysis of impairment was used. Both treatment and comparison children changed significantly across time on the majority of measures, providing evidence of development, but specific effects of the intensive intervention were evident using ANCOVAs. Item analysis indicated that one of the standardized language tests adopted in the evaluation was insensitive to change over a six month period. Change in individual children’s performance was predicted by language level on entry to the project. Conclusion: The implications of the results are discussed in terms of the range of analytic approaches available to intervention researchers and the need to consider combinations of methods when analysing outcome data.
Meeting the needs of children and young people with speech, language and communication difficulties
(Taylor & Francis (Informa Healthcare), 2010-07) Lindsay, G.; Dockrell, J. E.; Desforges, M.; Law, J.; Peacey, N.
Background: The UK government set up a review of provision for children and young people with the full range of speech, language and communication needs led by a Member of Parliament, John Bercow. A research study was commissioned to provide empirical evidence to inform the Bercow Review.Aims: To examine the efficiency and effectiveness of different arrangements for organizing and providing services for children and young people with needs associated with primary speech, language and communication difficulties.Methods & Procedures: Six Local Authorities in England and associated Primary Care Trusts were selected to represent a range of locations reflecting geographic spread, urban/rural and prevalence of children with speech, language and communication difficulties. In each case study, interviews were held with the senior Local Authority manager for special educational needs and a Primary Care Trust senior manager for speech and language therapy. A further 23 head teachers or heads of specialist provision for speech, language and communication difficulties were also interviewed and policy documents were examined.Outcomes & Results: A thematic analysis of the interviews produced four main themes: Identification of children and young people with speech, language and communication difficulties; meeting their needs; monitoring and evaluation; and research and evaluation. There were important differences between Local Authorities and Primary Care Trusts in the collection, analysis and use of data, in particular. There were also differences between Local Authority/Primary Care Trust pairs, especially in the degree to which they collaborated in developing policy and implementing practice.Conclusions & Implications: This study has demonstrated a lack of consistency across Local Authorities and Primary Care Trusts. Optimizing provision to meet the needs of children and young people with speech, language and communication difficulties will require concerted action, with leadership from central government. The study was used by the Bercow Review whose recommendations have been addressed by central government and a funded action plan has been implemented as a result. 2010 Royal College of Speech & Language Therapists.