A CHALLENGE TO INNOVATION AND CREATIVITY AT UNIVERSITY FERNANDO PESSOA (PORTO, PORTUGAL): ACTING UPON SPEECH-LANGUAGE DISORDERS AS A TECHNIQUE AND AS AN.

A CHALLENGE TO INNOVATION AND CREATIVITY AT UNIVERSITY FERNANDO PESSOA (PORTO, PORTUGAL):

ACTING UPON SPEECH-LANGUAGE DISORDERS AS A TECHNIQUE AND AS AN ART

Alexandre Frey PINTO DE ALMEIDA, M.D., Ph.D. Associate Professor / Head of Department

Dep. of Speech TherapyHealth Sicences Faculty

University Fernando Pessoa Porto / PORTUGAL

[email protected]

THIRD ANNUAL CONFERENCE of the

‘Innovation, Creativity and Culture’

Vilnius Gediminas Technical University and Mykolas Romeris UniversityVilnius, Lithuania – European Capital of Culture 2009

22-23 October 2009

Conference track: “Creativity and Innovation in University Culture”

UFP

University Fernando Pessoa is a Portuguese private foundational Higher Education institution located in Porto, the 2001’ European Capital of Culture.

University Fernando Pessoa - Porto, Portugal

Its motto is "nova et nove", which means in latin "making new things in a new way".

University Fernando Pessoa is devised in three faculties (Health Sciences, Human and Social Sciences, Science and Technology), one School of Health Sciences and one autonomous unit (Ponte de Lima College).

School of Health Sciences Undergraduate Programs:

- Nursing

- Clinical Analyses and Public Health

- Psychomotor Rehabilitation

- Physiotherapy

- Speech TherapyA detail of UFP Faculty of Health Sciences(the entry of the Pedagogical Clinic of Odontology)

SPEECH THERAPY

Portuguese framework for the professional definition

Speech Therapy

«The Speech Therapist is responsible for the development of activities in the domain of prevention, assessment and treatment of human communication disorders, including not only all functions associated to verbal oral and written comprehension and expression, but also other forms of non verbal communication»

(Dec.-law n.º 564/99, 21 of December 1999)

TRADICIONAL CONCEPTIONS AND MODERN CONCEPTIONS OF SPEECH THERAPYTHE UFP MODEL

TRADICIONAL CONCEPTIONS MODERN CONCEPTIONS

Speech Therapy centred on verbal oral communication Speech Therapy open to communication of every kind, verbal or non verbal, oral or written, and also to augmentative and alternative forms of communication

Speech Therapy having as main goal the treatment and rehabilitation of communication disorders

Speech Therapy open to normal communication as much as to disturbed communication – including in its aims screening, prevention, preparation, diagnosis, evaluation and not only rehabilitation

Speech Therapy having as its proper object  the clinical approach from the point of view of emission

Speech Therapy open to clinical approaches acting on emission or on the reception, and also on central processing

Speech Therapy centred on a few techniques and protocols of rehabilitation

Speech Therapy involved with protocols of screening and evaluation in the same way it is interested at protocols of rehabilitation

Speech Therapist as a technician who helps medical doctors in the therapeutic achievement

Speech Therapist as a technician able to do a functional diagnosis of communication disorders and to develop a therapeutic plan and strategies in order to obtain an adequate rehabilitation

Speech Therapist more interested in certain techniques than in their corresponding foundations

Speech Therapist interested in several techniques in function of their corresponding foundations

Speech Therapist in the basis of a hierarchical pyramid having doctors at the top: ST as a final executor of a decision taken by someone else

Cooperative model of  the Speech Therapist, engaged in an individualized approach of the patient within an interdisciplinary team

In Portugal, the model of Speech Therapy developed by UFP since 2002 helped to change social and professional conceptions of the role of speech therapists.

Bologna Process compelled to a curricular reorganization centered on student work and responsibility, and encouraged a new competence-based model for pedagogical methods and techniques.

UFP - BACHELOR IN SPEECH THERAPY(approved by the Ministry since 2002 and recognized by the Professional

Association since 2003 as suitable for the formation of speech therapists) OBJECTIVES

Students should develop specific competences of

● Prevention

● Evaluation

● Treatment

● Scientific study

of Human Communication Disorders, including

- All the processes and functions inherents to expression and comprehension of oral and written language;

- Other forms of non verbal and verbal communication (for instance, using structured symbols and gestures);

- Other related functions, such as swallowing.

BACHELOR IN SPEECH THERAPY CURRICULAR ORGANIZATION AFTER BOLOGNA

1st-2d Semesters

Anatomophysiology I

Methods / Techniques of Communication

English Language I

Biostatystics and Epidemiology

Basic Gestures in Health

Theories of Language and Communication

Anatomophysiology II

Biophysics and Biomecanics

English Language II

Psycholinguistics and Language Development

General Microbiology

Observation Training

3d-4th Semesters

Phonetics and Phonology

Biochemistry

Politic Organization of Portugal and EU

Voice, Orofacial Motricity and Swallowing

Applied Psychology

Applied Psychopathology

Neurosciences and Neurolinguistics

Applied Otorhynolaryngology

Communication and Language in Children

Neurology and Neuromotor Pathologies

Ethics and Professional Deontology

Integration Training

5th-6th Semesters

Audiology

Communication and Language in Adults

Applied Psychopedagogy

Methods and Techniques of Evaluation and Intervention in Speech Therapy

Construction and Validation of Instruments

Clinical Learning I

Professional Training I

Alternative / Augmentative Communication

Foreign Language

Psychomotricity

Early Intervention in Neonatology and Pediatrics

Graduation Project

Clinical Learning II

Professional Training I

7th semester Professional Training II

A Pedagogical Clinic of Speech Therapy was provided within UFP in order to ensure students’ supervised clinical practices in real and authentic situations – a pioneer project, completely new in Portugal and rare even in Europe, where comparable units are yet quite hard to find.

This kind of assistance is offered to the academic community itself, but there are also two mobile units of an Ambulatory Project of Oral and Public Health that offer many screening services to the surrounding community in different clinical valences, thus contributing to the signalling of patients and draining a part of them to the Pedagogical Clinics of the University, including the one of Speech Therapy.

MASTER IN SPEECH THERAPY

OBJECTIVESStudents should develop specific competences of this post-graduate level, such as:

● Administration of Health Units

● Intervention in the Community

● Scientific Research

● Education and Formation

● Training Orientation and Supervision

● Improvement of Basic Knowledge

● Specialization in two main Domains:

– Language in the Child

– Language in the Adult

More recently, a Master in Speech Therapy and a Doctorate in Language Development and Disorders were created, and the Pedagogical Clinic is also the place for the main part of the corresponding research.

CURRICULAR ORGANIZATION OF THE MASTER IN SPEECH THERAPY

1st Semester

Administration of Health Services Speech Therapy in Educative Contexts Psycholinguistics and Neurolinguistics Functional Neurology and Speech Therapy Research MethodsApplied Phonetics

2d Semester

Specialization in Language in the Child Communication and Swallowing in the Preverbal Period Disorders of Oral Language in the Child Autism Spectrum Disorders Speech Therapy in Multideficiency Disorders of Written Language in the Child

Specialization in Language in the AdultVoice and Dysphonias Communication and Interaction Gerontology and Speech Therapy Acquired Disorders of Communication and Language Speech Therapy and Neuromotor Pathology

3th Semester

Hearing Processing and Speech Therapy Expressive Therapies Orofacial Motricity and Swallowing in the Child

Speech Therapy and Neuromotor PathologyClinical Cases, Orientation and Supervision of Professional Training

Professional VoicePhonostomatologyExpressive TherapiesNeurogenic and Oropharyngeal Dysphagia Clinical Cases, Orientation and Supervision of Professional Training

4th Semester

Project / Dissertation

DOCTORATE IN LANGUAGE DEVELOPMENT AND DISORDERS

OBJECTIVES

Students should develop knowledge and competences allowing them to deal with problems of language, either concerning its development, either its disorders.

The doctorate provides two differentiation areas: ● Psycho and Neurolinguistic Development ● Language Disorders.

These specialities fall within the general scope of the thesis to be developped, corresponding to main areas in which the teaching staff has been involved, engaged in projects of national and international research, and resulting in a very considerable number of scientific papers and "products" such as new diagnostic, therapeutic and educational approaches.

CURRICULAR ORGANIZATION OF THE

DOCTORATE IN LANGUAGE DEVELOPMENT AND DISORDERS

Curricular Part (Doctorate Course)

1st Semester

Research MethodsLanguage and Verbal CommunicationParalanguage and Non Verbal CommunicationLanguage ProcessingBrain and Language

2d Semester

Language Development Language Disorders in Educative ContextsLanguage Disorders in Clinical Contexts

Doctorate Thesis

RESEARCH GROUPS Advisors work several lines of research in labs of different Faculties and different University institutions, such as screening mobile units of the Ambulatory Project of Oral and Public Health, Pessoainhas kindergarden, Pedagogical Clinic of Speech Therapy, and others – where students can obtain data and some kind of support.

UFP is the Portuguese Higher Learning institution with more publications in this field.

Cadernos de Comunicação e Linguagem (“Notebooks of Communication and Language”), for instance, is a periodical publication of UFP Press (1 volume, several numbers each year) which presents not only the best works of UFP researchers and students, but also those of other national and foreign prestigiated institutions (works in English and French are welcome!).

A large interdisciplinary team with six speech therapists, two psychologists and three doctors acting in different domains provide most part of the clinical work with patients, which are sometimes examined and treated in cooperation with professionals from other Pedagogical Clinics of the University.

For some patients, this kind of approach is unique in the town and even in the country. University Fernando Pessoa do it with no more taxes than public hospitals, and accomplishes in this way very important tasks of academic extension and social engagement with health and social problems of its surrounding community and the town in general.

A large swiming-pool provides new contexts for the approach of some selected patients (e.g. autists)

UFPSPEECH THERAPY AFTER BOLOGNA

Curricular changes

- A continuous debate on Bologna objectives was carried out with other national and foreign Higher Learning institutions (e.g. Speech Therapy working group within the Group implementing Bologna in the country as a whole, according with CPLOL definition of skills, etc.)

- An attentive internal reflexion was made, since 2002 (when the Bachelor in Speech Therapy started), about Bologna objectives, in order to set up common criteria in that field

• The obtention of a national consensus among Higher Education institutions about the main goals for the formation of speech therapists

• The construction of a common space for European Higher Education institutions, allowing the effective mobility of students

UFPSPEECH THERAPY AFTER BOLOGNA

Curricular changes (cont.)

• Not forgeting the aim of building up a common space for Lusophone Higher Education institutions (together with other countries speaking Portuguese): Fortaleza Declaration, 2004

Fev. 2003 (UFP, Porto, Portugal): I Luso-Brazilian Symposium of Speech Therapy / Phonoaudiology and Lusophony

Fev. 2005 (UFP, Porto, Portugal): II Luso-Brazilian Symposium of Speech Therapy / Audiophonology after Bologna

Fev. 2007 (UFP, Porto, Portugal): III Luso-Brazilian Symposium of Speech Therapy / Contexts of Audiophonology

Aug. 2009 (UMESP & UFP, S. Bernardo do Campo, SP Brazil): IV Luso-Brazilian Symposium of Speech Therapy • I Luso-Brazilian Symposium for Health

• A model of Competence Based Learning (centered on student’s work)

Some UFP events in the area of Speech Therapy

Curricular changes (cont.)

Consequently, the weight of certain components was reinforced:

- Experimental work

● Skills in research methodologies and experimentation developped in each curricular unit

● Specific curricular units conceived to reinforce such skills, e.g. “Construction and Validation of Instruments” (5th semester), “Project of Graduation” (6th semester) - both recently introduced in the curricular organization

● Scientific articles written in response to the “Call for Papers” of a periodical publication of UFP Press in this area - with a good structure and respecting the Editorial Rules of UFP and its Manual for Monographs (in several moments along graduate and pos-graduate programs)

● Experiences in the classroom: a part of daily academic activities since the 1st semester (for instance, in the matter of “Theories of Language and Communication”)

UFPSPEECH THERAPY AFTER BOLOGNA

Curricular changes (cont.)

The reinforcement of certain components (cont.)

- Work of Project

A whole work to develop, but also a curricular unit (with specific formation on research and presentation of scientific works). In the end, there is a presentation, discussion with the jury and defense.

- Work within an interdisciplinary team

Speech Therapy is based on different scientific domains: biomedical sciences, language, behaviour and educational sciences. Teachers are then asked to integrate knowledges coming from many different areas, supporting this practice on the Pedagogical Clinic of Speech Therapy. This one articulates clinical activities of speech therapists with those of psychologues, psychomotricists and doctors of different specialities.

UFPSPEECH THERAPY AFTER BOLOGNA

UFPSPEECH THERAPY AFTER BOLOGNA

Speech therapy in UFP: theoretical, practical, contact, project, experimental and training components in the curricular organization pre and post-Bologna (comparing both plans).One can see the reinforcement of experimental components (practical courses, training…), leading to an increased ratio between experimental and theoretical courses (results from the Working Group for the study of the Concretization of Bologna in UFP).

Curricular changes (conclusion)

Pedagogical Clinic of Speech Therapy

- Clinical practice • Supervised clinical practice and training along the Bac. in Speech Therapy • Training orientation and supervision during the Master in Speech Therapy

- Assistencial work • Academic community • Surrounding population • Cases refered by the staff or by accredited / partner institutions - Scientific research • Bachelor (individual works and group works, Project of Graduation) • Master (individual works and group works, Master Dissertation) • Doctorate (individual works and group works, PhD Thesis)

UFP

SPEECH THERAPY AFTER BOLOGNA

UFP: Directions for Scientific Research in Speech Therapy

- Hearing and Equillibrium

- Phonation and Speech

- Oral Language and Communication

- Written Language and Communication

- Non Verbal Communication

- Swallowing and Stomatognatic Functions - Epidemiology and Community Intervention

UFP

SPEECH THERAPY AFTER BOLOGNA

UFPSPEECH THERAPY AFTER BOLOGNA

More success!

- A good predefinition of expected competences for each curricular unit (coordination work)

- Recovery and stimulus to the participation in the classroom (more control upon presences, more learning opportunities)

- Debate of the most important notions - Tutorial sessions to inform, to discuss and orient works, to

indicate sources and references, to give access to materials, train selected techniques, reinforce some competences, obtain counselling, provide remediation of certain deficits, and a second chance if necessary

- Frequent practical works for training of most important skills - A continuous evaluation as the general rule; formative Vs.

summative, auto Vs. hetero-evaluation

UFPSPEECH THERAPY AFTER BOLOGNA

More success!

- More extra-curricular work (events, PASOP, screenings outside, etc.): considered as relevant in the scope of certain curricular units and as a Supplement to Diploma

- Validation of competences acquired elsewhere (more than one itinerary to obtain competences)

- Project methodology: a specific curricular unit

- Publication of the best works

- New chances by means of the internationalization of the institution: training, orientation and supervision received from other national and foreign institutions who set bilateral agreements (e.g. UNIMESP), formal exchange programs (Erasmus, Alban, Erasmus Mundus…); participation in NETQUES, the CPLOL proposal for Academic Networks to the European Commission (“Network for Tuning Standards & Quality of Educational programmes for Speech Language Therapy in Europe”)

UFPSPEECH THERAPY AFTER BOLOGNA

The professional focus of learning

- Observation training (2d semester): by means of an unidirectional mirror, placed between contiguous cabinets in the Pedagogical Clinic of Speech Therapy (observers follow real consultations in an authentic context of clinical work)

- Integration training (4th semester): students observe different contexts of work of speech therapists

- Clinical Learning I and II (5th and 6th semesters): supervised clinical practices in the Pedagogical Clinic of Speech Therapy (students consult, make clinical registers, organize clinical files, reports and forwards); screenings supported by PASOP; projects and partnerships with other centers, providing new working contexts (e.g. advertisements about the profession of speech therapist to the population served by PASOP, assessment of communication skills of students of Journalism who are acting in the TV lab of the UFP for reports, newscasts, etc.)

- Professionalizing training (6th and 7th semesters): screenings within the population who seeks the services of the Pedagogical Clinic of Speech Therapy (in order to obtain a convenient selection of patients); seminars and case discussions; supervised clinical practices in authentic contexts of clinical work (being oriented in training centres and supervised by the training coordinator of the department of Speech Therapy)

UFPSPEECH THERAPY AFTER BOLOGNA

The professional focus of learning (cont.)

- Psychopedagogy: this curricular unit prepares students to integrate interdisciplinary teams acting in kindergardens, schools and centers dealing with individuals who have special learning and educational needs

- New careers and innovative areas: students are stimulated to develop their academic works in new and challenging domains, and originality is welcome!

- Master: providing competences of orientation and supervision of clinical work and training (clinical practices in the Pedagogical Clinic of Speech Therapy)

- Stimulating, on one hand, a personalized approach and the perfect adaptation of the therapist to the limits and remaining capacities of his client, and, on the other hand, the construction of his own instruments and techniques when necessary, the formation provided by University Fernando Pessoa is not quite only a matter of applied sciences and techniques, it is also the practice of a clinical art.

The professional focus of learning (conclusion)

- To learn how to learn, that’s the main competence!

The End