Dr. Yvonne Lynch:

I would like to come in on the first point about this gate-keeping piece and the need for specialist support. A particular issue arises within AAC. If we think of children learning how to use a communication aid where they are selecting a picture that will speak their message, it is an unusual situation. If you are learning Spanish or Irish or any language, you hear it around you. These children do not see other people using picture symbols to communicate. It is a very challenging task to listen to the language, work out what you want to say and find the pictures on your device to say that and it is amazing that these children can do that. They need particular supports around selecting the correct pictures, the correct language organisation that will support their language acquisition through the spoken language they are hearing and adding that to what they are expressing which is a little bit different. It goes far beyond that initial assessment. Of course we want the individual at the heart of that decision-making process and driving that process with the family, but specialist supports are needed in learning to communicate in this very unusual way that can open up access to education and employment. Speech and language therapists have a particular role in that.

I was lucky enough to spend three years in the UK researching how they recommend communication aids. They have developed a hub and spoke model where they have set hubs all over the country to which a person can be referred and get the specialist knowledge, try out the technology and use their loan bank. Each hub has a dedicated fund and they immediately finance the device once a person has gone through that comprehensive assessment process. We do not have anything like that here and we need it. Those hubs also provide training and support for the local teams so the intervention process is supported. It is not perfect there either and their system has problems but we could gain something from having a network where people go to get specialist help and then work with their local team in their community in the PDS model.

As regards the recruitment of speech and language therapists, we already have a master's programme in Ireland. The University of Limerick has a graduate programme. Just saying we will increase the places is not going to work, however. Currently, we have a crisis in student placements. The colleges that are producing speech and language therapists, including our own, have a real problem finding the placements for students. We do not have enough therapists. They are so over-worked they do not have enough capacity to take on students and help them develop their clinical competencies. That is particularly evident in the disability services where we are seeing a lot of staff leaving. We do not have stability there for students to come in. We cannot create those places in the morning. We need to address retention and the skills around AAC within the workforce so that our students who are currently in education have the opportunity to make sure they graduate.