Excerpted from Chapter 2 of Speech and Language Clinical Process and Practice, by Monica Bray, M.Phil., Alison Ross, M.Phil., & Celia Todd, M.A.

Copyright © 1999 Whurr Publishers Ltd. All rights reserved. First published for exclusive distribution in North America by Paul H. Brookes Publishing Co. in April 1999. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

Intervention, or what in some instances can be perceived as interference, involves a decisive act to bring about change. In everyday life and beyond, intervention activities can have either positive or negative outcomes. For example:

• Seeking or giving advice
• Planting blame on an innocent person
• Enabling a friend to express feelings of grief after suffering loss or injury
• Introducing new tax laws.

An act of intervention can be carried out on impulse or after careful consideration of the needs of the situation and the likely end result, and either with or without prior negotiation with other parties. In all cases the initiative will be based on a theory or belief that the individual responsible has about what will be achieved by the act taken.

The intervention of the speech and language clinician is founded on professional or clinical judgments, and must be driven by a rationale or hypothesis. That is, the decision to take a particular course of action must be justified in terms of an underlying theory and knowledge of practice and the potential appropriateness of the action for the specific client. There are ethical values that must be taken into account. You would neither decide against treatment nor introduce a particular type of treatment if you perceived that the outcome would be harmful or ineffective. When the speech or language clinician intervenes, it is with a view to effecting positive change, whether in the communication behaviour or attitude of the person themselves, or in altering the way others relate to the person, or in finding out more about the person to further inform subsequent intervention. The following examples illustrate something of the scope of speech and language intervention:

1. Discussing the problems of a non-communicating child with his teacher and agreeing the most appropriate way to encourage his communication.
   
   
2. Setting up a group to develop the communication skills of adults with learning disability within a social context.
   
   
3. Introducing a specific therapy approach such as:
   
   
   • Promoting Aphasic Communicative Effectiveness (PACE) (Davis and Wilcox, 1981, 1985; Carlomagno, 1994), for a person with aphasia
   • Metaphon (Dean and Howell, 1986; Dean et al., 1995), for a developmental phonological disorder
   • Personalized Fluency Control (Cooper and Cooper, 1985), for a person who stutters
   • Specific relaxation (Martin, 1987), for a voice disorder.
4. Referring a child with a phonological disorder for ENT opinion and audiological assessment and the possibility of his being fitted with and trained in the use of a hearing aid to improve speech reception and processing.
   
   
5. Disseminating information packages to care assistants in nursing homes or running workshops to help them to promote an effective communication environment for the elderly people with whom they work.
   
   
6. Providing counselling opportunities for a person to reflect on the factors contributing to his or her voice disorder.