Child speech therapy services ‘a lottery’

Report says young people missing out as system struggles to cope with demand

Paddy Connolly, Inclusion Ireland: “The failure of the public system to provide adequate speech and language therapy to children with special needs is an enduring crisis.”  Photograph: Cyril Byrne
Paddy Connolly, Inclusion Ireland: “The failure of the public system to provide adequate speech and language therapy to children with special needs is an enduring crisis.” Photograph: Cyril Byrne

Thousands of children are waiting years for speech therapy, even though experts acknowledge delays are robbing young people of the chance to reach their full potential.

A new study to be published today indicates that extensive waiting lists, combined with a serious shortage of therapists, are signs of a system not able to cope with demand.

The report, commissioned by disability group Inclusion Ireland, states that access to services depends on a "postcode lottery", with dramatic differences in the number of therapists employed in different parts of the State.

In Wicklow and parts of Cork, for example, there are 100 children who require therapy for each therapist employed. By contrast, in Wexford and Donegal there are more than 300 children per therapist.

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In the absence of being able to access timely services, many parents are making financial sacrifices to obtain services privately, which can cost between €80 and €100 an hour. Many also fundraise for special schools to hire private speech therapists.

For those who access services publicly, the provision of speech and language therapy is often limited or sporadic.

A survey by Laois Offaly Families for Autism, for example, found that most children received just five sessions over a 12-month period.

International standards

The report states that the number of speech and language therapists in the system would need to be doubled if Ireland was to meet international standards on the appropriate caseloads for therapists.

Nationally, some 1,940 children have been waiting for assessments of their needs for more than 12 months. A further 3,000 have been waiting more than a year to access speech and language therapy which they have been assessed as needing.

There is also evidence that health authorities are failing to carry out assessments of needs for hundreds of children with special needs within legal time frames.

Under the Disability Act, children have a statutory entitlement to an assessment of their needs within a six-month period if they were born after 2002.

Figures for the the first quarter of this year show that some 1,200 children were still waiting for an assessment after six months, a 60 per cent increase over the same period in 2012. Average waiting times are now in the region of nine months.

The figures are contained in a working paper, Progressing Disability Services for Children, written by researchers Pauline Conroy and Mark O'Connor, and commissioned by Inclusion Ireland.

The HSE has pointed out that the number of applications for assessments has been rising year-on-year since 2010, but no additional resources have been provided. It said initiatives were under way, including targeted recruitment, to reduce waiting lists “within the resources available”.

Effect of cutbacks

Paddy Connolly

, chief executive of Inclusion Ireland, said the delays facing children were the result of cutbacks to vital supports.

“The failure of the public system to provide adequate speech and language therapy to children with special needs is an enduring crisis for the families affected,” he said.

“It is neither sustainable nor acceptable that families are borrowing money, depending on charity or fundraising to provide what is a critical intervention for children with speech and language difficulties.”

He said the Government needed to act urgently to remove the pressure on parents of children with a disability. “The upcoming budget should commence a multi-annual investment to at least double the number of speech and language therapists in the public system.”

Part of the increase in the number of children seeking services is due to a widening of eligibility.

While originally the Health Service Executive interpreted the 2005 Act as only applying to children under five, the High Court ruled in 2009 that all children who were born after June 1st, 2002, were eligible to apply at any time, regardless of age.

The HSE said 30 additional speech and language therapists had been recruited so far this year, though campaigners said it was unclear if any of these were in position yet. The HSE said that, in addition, 50 other therapists were at “various stages of recruitment”.

Carl O'Brien

Carl O'Brien

Carl O'Brien is Education Editor of The Irish Times. He was previously chief reporter and social affairs correspondent