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if you want to tackle non-attendance raise awareness of speech, language and communication needs share skills more effectively with other professionals Alex Jack is a specialist speech and language therapist - Sure Start Scunthorpe, with North Lincolnshire PCT. Further information from Alex on 01724 298100. Tom Morris is a speech and language therapist with Sure Start West Green & Chestnuts, Haringey Teaching PCT. Beryl Hylton Downing is speech and language therapy coordinator for Gateshead Sure Start Partnership.

How I am makin
Alex Jack outlines how Sure Start in Scunthorpe is raising awareness of speech and language development in the wider community, and making core speech and language therapy services more accessible.
The nursery staff were asked to identify children they felt would benefit from small group work (6-8 children in each group), and to provide a member of staff to help with each group. This was to develop joint working and sharing of skills. The nurseries were keen to be involved but disappointed that some children missed out, as the groups were initially limited to one afternoon or morning per week due to restrictions on therapists time. In October 2002 we were lucky enough to employ a speech and language therapy student having a year out from her course. She eventually took over the running of the groups with supervision from the therapists, and was able to spend a whole day in each of the nurseries. This meant that more children had the opportunity to be part of the groups, and she also provided invaluable feedback about the programme, which has since been amended. As a result of the success of these groups, we have obtained funding for a full-time assistant to carry on this work, which has been well received by staff, children and parents. 2. Home visits To access hard to reach families who generally dont attend clinic appointments, I have developed a home visiting service to screen children for speech and language difficulties, offer advice to parents, and refer on to the main speech and language therapy department where necessary. These visits help to demystify the role of the therapist, and can also be used to encourage parents to attend Sure Start groups and events. Joint visits can be arranged with other members of the Sure Start team such as health visitors. Children are usually referred to this service by the Sure Start family link workers who visit all two year olds to carry out the Sure Start Language Measure. If appropriate, I can also offer the family a course of parent-child interaction therapy (Kelman & Schneider, 1994). 3. Drop-in sessions There are several one oclock clubs run by Sure Start staff in various venues and these are generally well attended by parents and children. During the holidays, play schemes provide parents with a place to take their children while the schools are shut. I provide a drop-in service at these sessions to give parents information about speech and language development and discuss any concerns. 4. Booklets The previous therapist began a series of Time to Talk booklets, which provide advice about language stimulation from birth to 9 months and 9 to 18 months. I have updated and extended the series to include 18 to 36 months and 36 months plus. They are designed to be parent friendly, have proved extremely useful during home visits and drop-in sessions, and give parents something concrete to take away. I have also developed a Dump the Dummy leaflet, which is promoted at Sure Start events such as Fun Days. Children are invited to throw away their dummies in exchange for a bottle of bubbles, and the parents are given a leaflet. Although we know many children who use dummies have more than one, this process helps to raise awareness about the sensible use of dummies and the conse-

Nationally, approximately 10 per cent of young children suffer communication difficulties but, in areas of high socio-economic ne clinically significant (Locke et al 2002). Communication difficulty in social adjustment in adolescence and adult life (Clegg et al, 1999). and children to provide services that are tailored to individual nee and on ways of working which are customer and community driv So, how does this focus alter speech and language therapy practic their experiences. Further information on www.surestart.gov.uk a

Turning the future around

While, as with any post, it takes time to understand the politics and to develop the relationships necessary for effective multidisciplinary working, Sure Start gives you a tremendous opportunity to learn about different working cultures and to try new things. We are fortunate that the Sure Start Programme Manager in Scunthorpe is committed to supporting and funding speech and language therapy input, and we value the opportunity to work flexibly and innovatively in this exciting new area. This is the story so far... 1. Nursery Programme When the Sure Start programme for Scunthorpe Old Town was initially set up, a speech and language therapist was employed on a part-time basis. She carried out baseline assessments of all the children in the four nurseries in the area, and found that 30 per cent had a speech and / or language delay. She then ran listening and attention groups in the nurseries with a member of staff. When she left in May 2002, two therapists from the main speech and language therapy department took over these groups on a part-time basis as an interim measure. I joined the team on a full-time basis in September 2002 and, in consultation with the local nurseries, we decided to develop and pilot a programme for the whole academic year to include other areas of speech and language development: Term 1: Ten weeks promoting vocabulary development Term 2: Five weeks of listening and attention activities Five weeks of language activities based around the senses Term 3: Five weeks of phonological awareness / Jolly Phonics (Lloyd, 2001) Five weeks of Story Sacks (Griffiths, 1995).

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ng a Sure Start
Clegg, J., Hollis, C. & Rutter, M. (1999) Life sentence: what happens to children with developmental language disorders later in life? Bulletin of the Royal College of Speech & Language Therapists 571: 16-18. Locke, A., Ginsborg, J. & Peers, I. (2002) Development and Disadvantage International Journal of Language & Communication Disorders 37 (1): 3-15.

eed, around 50 per cent of children have communication needs which are n early childhood is positively correlated with poor mental health and The Sure Start programme focuses on prevention. It works with parents eds and designed to encourage access. It places high value on outcomes, en and professionally coordinated. ce? To mark National Sure Start month (June 2004), three therapists share and www.nationalsurestartmonth.com.

Practical points: making a Sure Start (whatever your client group)

quences of overuse. As preventative measures, the Sure Start midwife distributes the birth to 9 months booklet during her antenatal visits, and the dummy leaflet is given to parents by the family link workers as part of the 18-month book bag visits. 5. Training I have developed a training package for all members of the Sure Start team, which broadly aims to: inform about the role of the speech and language therapist give an overview of speech and language development and how to identify children with potential speech and language difficulties provide ideas about early language stimulation. The package is divided into two sessions, the first of which is available to all members of the team (including office staff), and the second more practical session is aimed at team members who have direct contact with children. I have found it difficult to pitch this training at a level suitable for everyone due to the variety of backgrounds and experience, but overall feedback has been very positive. Although not all Sure Start team members have provided formal training, my knowledge of diverse issues such as welfare rights, breastfeeding and personal safety has increased as a result of working alongside a welfare rights advisor, midwife and community policeman. 6. Joint assessment sessions In conjunction with the main speech and language therapy department, we have developed joint screening sessions with health visitors for all children under four identified as having speech and language difficulties. We are currently piloting this scheme, and early indications are that it has improved attendance. The general consensus is that the sessions provide parents with a less

1. Capitalise on the expertise, resources and community penetration of other organisations. 2. Consult with service users to understand where they are coming from. 3. Establish baselines so you can monitor change. 4. Make and take opportunities to try new things. 5. Recognise when you are in a position to fulfil mutual objectives. 6. Consider a variety of changes to make your service more accessible. 7. Use a least effort approach to maximise uptake. 8. Ease entry to specialist services for those in need.

intimidating, more holistic approach. In addition, we have jointly produced a health visitor induction pack, which was distributed at a training session with information about speech and language development and the referral process. We plan to invite all new health visitors to shadow a speech and language therapist for a session to observe how we work and discuss the induction pack. So, what next? The two part-time therapists returned to the main speech and language therapy department at the end of April 2003, leaving one full-time therapist and an assistant working in the Old Town programme. A second Sure Start programme has recently been launched in Scunthorpe (the Cloverleaf Patch) and we have recruited a part-time therapist and two more assistants for this area. We continue to develop new ways of working which include: 1. Training for preschool staff in conjunction with the main speech and language therapy department. 2.Dump the Dummy days in nurseries and preschools. 3. Meet the Parents days in the nurseries to keep them informed about the group sessions and discuss any individual concerns. 4. Involvement at the antenatal stage through

multi-agency parent classes called Ready Steady Baby, which start in June. 5. Sing and Sign sessions (Felix, 2001). 6. Joint working with the main speech and language therapy department to develop early intervention including parent workshops, early language groups, early sound awareness groups, and further parent-child interaction sessions. 7. A multi-agency project to develop early rhyme bags. Our next major challenge is to look at mainstreaming services, and I am working in close collaboration with the main speech and language therapy department to plan future early years services which build on the preventative work piloted within Sure Start.

References
Felix, S. (2001) Sing and Sign. www.singandsign.com Griffiths, N. (1995) Story Sacks. www.storysack.com Kelman, E. & Schneider, C. (1994) Parent-child interaction: an alternative approach to the management of childrens language difficulties. Child Language Teaching & Therapy 10 (1): 81-94. Lloyd, S. (2001) The Phonics Handbook. Jolly Learning Ltd: Essex.

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Turning up or turning off?

ne of the primary difficulties facing the childrens speech and language therapy service in Haringey has been the poor rate of attendance. Data collected by Sure Start from the community service found that, of children under four discharged from clinic caseloads, 62 per cent had been due to a failure to attend. A subsequent survey found that over 30 per cent of initial appointments were not attended, rising to 50 per cent in some clinics. This had significant implications. First, the cost of the time and resources allocated and subsequent financial justification for the use of the service in this format. Second, the problems arising for children and relevant services when recurring communication difficulties begin to be picked up at a later stage, for example the increased resources required to meet the childs educational needs. A common attitude from therapists has been both frustration and relief; the first for the time wasted on non-attendees, the second for justifying discharge from the caseload, so reducing the waiting time for others, as well as giving extra time to carry out the administrative and non-clinical duties that have become increasingly demanding. However, one of the key principles of Sure Start is to take a client-focused approach to service development. This meant looking beyond the immediate results of non-attendance, instead focusing on some of the potential causal factors, and giving potential users of the service the opportunity to express their own ideas on any changes that could increase accessibility and reduce the likelihood of families missing appointments in the future. Our study was largely qualitative, intended to reflect the views and experiences of parents. The interviews were broken into two sections. The first was semi-structured with open questions, such as: I see that that you had an appointment on _________ but you didnt attend. Why was that? Where would be the best place for their initial assessment and then therapy if s/he needed it? What else might make it easier for you and your child to access the service? These were gradually pared down, taking into account relevance, redundancy, or adaptation needed as core themes emerged. The second included closed questions to gain relevant background information on the families. The telephone was used for purely practical convenience, although home visits were made for those with no phone line or for families who required an interpreter (figure 1).

Non-attendance is frustrating and wasteful. Working with a community clinic service, Sure Start therapist Tom Morris identifies why it is so common and what can be done to address it.
community of diverse linguistic, cultural, and social backgrounds. At least half, including the area covered by West Green & Chestnuts, has a population with significant socio-economic needs, such as a high rate of unemployment, temporary accommodation, and one of the largest numbers of refugees and asylum seekers in the country. This has implications for attendance, where many residents are unaware of the range of services available. As a family in temporary accommodation has a higher likelihood of moving between referral and initial appointment than someone in permanent accommodation, this may also present the possibility of failure to receive appointments, resulting in non-attendance and subsequent discharge, although this could not be confirmed. The low economic status of both those attending and not attending reflected high rates of unemployment, but also suggested that this may not significantly affect a familys likelihood to attend. However, there were signs of a potential influence on attendance from the familys primary home language (figure 2).
Figure 2 Background details

We therefore decided to look more closely at the views from both sets of users on the way the service as a whole is delivered, and key themes emerged: 1. Waiting Times Waiting times had sometimes reached up to 21 weeks and beyond for initial assessment due to the high referral rate and subsequent large caseloads. Both attendees and non-attendees identified this as being unsatisfactory. For example: [I was] quite annoyed it would take so long...I felt it was quite urgent so it made me uncomfortable knowing itd be months away. [The service was] very good, but we were very unhappy at the wait between therapy sessions. [He] could have done with going back sooner as he definitely benefited from speech and language therapy. One parent just expressed disillusionment with the service as a whole after having waited so long. In a further community clinic review, an audit showed that 26 per cent of children on the caseload were being monitored rather than discharged. As this increased the number of children on the caseload, it had a direct affect on the waiting time for both assessment and therapy, which could have had a subsequent affect on attendance. It also may have led to an increased likelihood of non-attendance at review appointments due to a lack of parental concern or a spontaneous resolution without intervention.

3. Location For initial appointments, the most popBlack A-C 4, Somali 1, ular location for non-attendees was the White UK 2, Mixed clients home, not only for convenience, White UK/Black A-C 1, Black African 1, Irish 1 but also due to factors such as other Black UK 4, Somali 1, siblings, and parents views on the White UK 1, Mixed importance of making clinical judgeWhite UK/Black A-C 2, ments in a more natural environment. Mixed White UK/Irish 1, Black African 1 [The best place would be] at home because I cant speak English and I have English 9, Somali 1 Primary language English 15, Arabic 1, three other children. Turkish 1, Kurdish 1, Twi 1, used at home In the Health Centre he wasnt acting Lingala 1, Fanti 1, Punjabi 2 normally because of the environment. Interpreter needed 1 Turkish, 1 Kurdish 1 Somali Not in a strange place, better to have 10/23 Car owners 4/10 home visits... more natural for a child...get At least one parent 9/23 3/10 Figure 1 Interviews a better example of what theyre like. employed For attendees, a clinic setting was preNumber No. Non- No. Interviewer Interviewer Telephone Clients Clinic ferred, emphasising recognition of different needs Interviewed Attendees Attendees 1 2 Home for different families. 33 23 10 29 4 24 6 3 For therapy, most parents said that both clinic and / or From the initial interviews, the need for the service and Samples of both attendees and non-attendees nursery settings were appropriate, although many its overall quality was, in general, appreciated. Ninety under the age of four were taken from lists of those stated a preference for an environment promotnine per cent could remember the actions to be taken given appointments by the community clinic team. ing interaction with peers. after initial assessment, with 76 per cent happy with While effort was made to choose the participants Its best to mix with people...now I think therapy the advice given. Even for non-attendees, 87 per cent randomly, this proved difficult due to the high rate would be better in nursery to get the benefit of thought the referral had been appropriate. of mobility within the population. Haringey has a other children.

Non-Attendees Parent Interviewed 21 Mothers, 1 Mother & Father, 1 Stepmother Childs Gender 14 Male, 9 Female No. of children at Average 2.25 home Black A-C 6, White UK 6, Parents/Carers Black African 4, Asian 2, interviewed Kurdish 2, Sikh 1, Irish 1, Ethnic/Cultural Moroccan 1 Group Black African 4, White Childrens UK 4, Mixed Black/White Ethnic/Cultural UK 4, Black A-C 3, Mixed Group (as defined White UK/Irish 1, Irish 1, by Parents) Asian 2, Kurdish 2, Sikh 1, British Muslim 1

2. Communication Some parents without English as a first language stated that appointment letters in their first language would have increased their likelihood to attend. The majority of families said that a Attendees reminder by phone nearer the time of 10 Mothers the appointment would be helpful as a prompt to attend.
7 Male, 3 Female Average 2.25

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...when he goes to nursery there are other children who talk really well. At speech and language therapy, the other children werent talking either. He needs to hear other children talk. Assessment at home to see how she interacts at home, or in a drop-in centre to see her with other children. Best place for therapy is the clinic. Again, this stresses the need for a variety of options depending on the clients wishes. 4. Flexibility The traditional times offered for appointments were seen by some parents, particularly those working, as being inconvenient, with either evenings or weekends preferred. Its not convenient for working families - outside working hours would be better. 5. Childcare For families with siblings, the provision of childcare facilities was suggested. Couldnt attend because have a younger son and no-one else to look after him. Maybe a cr` eche would be ideal. 6. Awareness Unfortunately, family awareness of the nature of the speech and language therapy service and what it could offer was poor, even though almost all the parents had identified communication difficulties in their children. This relates directly to the need

to raise the service profile through both publicity and the promotion of preventative approaches with key stakeholders.

Direct implications
One of the measures of the success of Sure Starts third objective, to increase achievements of children through play and learning opportunities, is to reduce the number of children in need of referral to speech and language therapy. However, this objective cannot be met until there is a clear recognition as to what this indefinite amount might be, given the number of potentially appropriate users who are not currently accessing the service. The interviews conducted have direct implications on the form and nature of future preschool speech and language therapy provision. Based on the information gathered and discussion between Sure Start and the community clinic coordinator, a number of adaptations are to be implemented by the Early Years and Community team therapists supported by us. These include: Asking the health visiting service to identify hard to reach families who may find it difficult to attend and note this on their referral form. This will then lead to a home visit rather than an initial assessment in clinic. Offering more individual family work through the Sure Start community team to address other social issues that can act as barriers to attendance.

Arranging a convenient time with the family before making an appointment for an initial assessment. Where possible, contacting the family by phone or text nearer to the day of the appointment to confirm attendance. Providing a telephone helpline for families unsure as to whether or not an appointment is necessary, or seeking advice on activities to continue while awaiting an appointment. Translating appointment letters into a variety of community languages. Working more closely on site with playgroups and nurseries, making joint decisions as to the appropriacy of referrals and subsequent actions to be taken by all parties. This emphasises the importance of close collaboration between Sure Start and core services, and other professionals involved in both referral and follow ups. Subsequent outcomes will be closely monitored and evaluated over the forthcoming year before any permanent changes are made to childrens speech and language therapy service delivery in the community.

Acknowledgements
With thanks to Jane Dixon, Sure Start speech and language therapist and Liz Stein, Early Years & Community speech and language therapy coordinator.

Turning out for Chatterkids

For two years I was in the fortunate position of working full-time within a single programme to achieve Sure Start objectives, particularly Improving the ability to learn, (No. 3), the proxy measure for which is a Target of A 5 per cent reduction in those children requiring specialised intervention at the age of 4 years. Whilst I did not quite have a carte blanche, I did have the opportunity to think creatively about how to achieve the objectives and overcome probable barriers. As speech and language therapists, it is incumbent upon us to ensure early and accurate identification of those with speech, language and communication needs. Given the scale of the problem, this has to be done indirectly through the people who have contact with children in their earliest years. Nevertheless, however good our training of parents and practitioners is, we have further obstacles to overcome. Training is a two-edged sword. Having established relationships with key people and taken steps to increase awareness of childrens language development amongst early years practitioners in the Sure Start area, there was an inevitable increase in referrals. Given that language delay / disorder was hith-

When needs are under-reported, families are hard to reach and professionals are overstretched, innovative methods are called for. Beryl Downing sets the context for the development of Chatterkids and considers why it has got everyone talking.
erto greatly under-reported, this was welcome. However, we then had the task of responding to the increased demand for over-stretched services. Furthermore, there was still the problem of engaging families sufficiently to work with their children. Despite a network of local speech and language therapy clinic bases, a high proportion of families in the Sure Start areas do not attend even for initial assessment and are discharged unseen. Some are referred and discharged several times - a familiar tale to many readers, and one that contributes further to waiting lists. It has become fashionable to call these hard-to-reach families, and Sure Start is meant to find out how to reach them. A further complication was that the local health visitors and associated community nursery nurses,

our main source of referrals, had in the last few years changed their patterns of contact with young children. Developmental checks, previously carried out at 18 months and three years, are presently offered by way of a home visit between 24 - 30 months of age. The highly variable nature of language development at this age had led to an increase in the number of children who, whilst exhibiting little language in the course of a home visit, when later seen at the speech and language therapy clinic had apparently caught up and did not require intervention. Even more alarming than this false positive rate, the paediatric service noted an increase in referrals of school-aged children who seemed to have slipped though the child surveillance net (false negatives). Clearly, there was scope for ongoing dialogue and training but, in the meantime, what was to be done? Chatterkids emerged as a means of dealing with the issues.

Challenged
Well, thats the official version, but theres always the personal story that runs in parallel. Shirley, manager of the local family centre, challenged me repeatedly: Whenre you going to do speech therapy at the centre then? Were sick of referring the bairns to the clinic and finding out months

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Figure 1 Equipment

Figure 2 Documentation

later theyve been discharged, cos their Mams never took them to the clinic, and we know they still need it. Whats the point? Its a waste of time for all of us. How true! Local health visitors had a similar lament. After consultation with colleagues, I told the family centre manager that, if she could find me a co-worker from the centre, I would run a language group there, where many of the hard-toreach families already attended. The family centres in the borough were undergoing a reorganisation and losing their childcare remit in favour of outreach to families. Their management was prepared to consider new ventures to support children in need. The centre workers themselves were very well aware of the prevalence of language needs and they were open to anything that might help. We were in a position to fulfil mutual objectives. I met my new collaborator, Andrea, and we decided upon a weekly group for up to eight prenursery children for six weeks. The main aim was to differentiate those who were simply somewhat delayed from those who had significant developmental language or other difficulties requiring specialist intervention. We hoped that the existing relationship with the family centre might help families to trust our judgement and bridge the gap to existing services where required. We ran the pilot course together in the family centre with children nominated by staff from amongst those referred to them by social services for a variety of reasons, all under the banner of children in need. I devised a least effort programme using adaptations of typical preschool practice in circle-work (figure 1), particularly musical activities and interactive narrative, which are thought to improve linguistic and social skills. The emphasis was upon facilitation and observation of communication skills, with minimal perturbation of normal practice, since I knew that - quite rightly I was unlikely to find a warm welcome for anything that appeared to be too technical. I developed documentation to facilitate observation, recording and family involvement (figure 2).

Sparkly cloths Glove puppets, esp. crocodile, monkey, mouse Finger puppets eg. IKEA pack Large doll with clothes Teddy & monsters Rainsack Sound-effects ball, bean-bag Bubbles & bubble wand Range of childrens texts Video camera & tapes

Waiting-list form Introductory letter Welcome letter Participation / emergency treatment consent Video-recording consent Session plans Weekly individual record Detailed individual record Parent feedback forms

Wonderful
Despite our doubts, the families brought their children, the children had a wonderful time and we all loved doing it. Of eight families invited to

bring a child, seven did so on a regular basis. Five of the families attended for the feedback session and another attended later. We felt that three of the children needed speech and language therapy intervention and they subsequently attended the local clinic for individual therapy. Of the others, one needed referral to the child development team and, although the parents disagreed initially, they did attend and the child was subsequently admitted to a specialist school unit. The remaining children made substantial progress during the course of Chatterkids and needed no more than recommendation to general Sure Start activities. The family centre staff felt that they were much more able to home in on the nature of the childrens problems and strengths. Encouraged by our success (the engagement figures were far better than wed hoped for), Andrea and I discussed ways of opening Chatterkids to a wider group in the Sure Start area, from amongst children referred by other agents. We began by presenting Chatterkids to family centre colleagues and they agreed to take Chatterkids forward with Andrea (a trained nursery nurse) taking over as group leader and working with another member of the centre staff. This freed me from weekly sessions, and I was then able to concentrate on other aspects of Chatterkids. I could now select children from those referred by health visitors with speech, language and communication needs. I saw all the families prior to the group to explain its purpose, discussed progress with the leaders and observed initial and final sessions to assess progress. I was responsible for verbal and written feedback to parents as well as referral and liaison to other agencies where required. The family centre provided psychological and practical backup support to families, for example by offering inclusion in a behaviour group where parents voiced concerns, or perhaps in assisting with siblings. Many of the families had social services

involvement and the family centre staff were ideally placed to deal with matters relating to this. As I write, Chatterkids has completed its sixth cycle and dealt with more than 40 families who might previously have been labelled hard-to-reach. In each group we have had at least one child with active social services involvement. The structure and content has gradually evolved and we feel that it provides the youngest children and their families with a high quality service, reducing inappropriate referrals to overstretched clinicians and enabling hard-to-reach parents to access specialist services such as the child development team and speech and language therapy clinic. The local health visitors now refer to Chatterkids as the standard response to apparent speech, language and communication needs in children under four. We are about to start three new Chatterkids rolling programmes across the borough, covering all four Sure Start areas. If we find that this works for this cohort, then we will proceed to mainstream Chatterkids as an entry to the service for the youngest children. Chatterkids is very much in harmony with current policy in relation to the kind of multi-agency working described in Every Child Matters (DfEE, 2003) and the Sure Start / Childrens Centres Guidance 2004-2006 (see www.surestart.gov.uk). Our local speech and language therapy department is looking to Chatterkids as a means of reshaping services to the youngest children referred. We feel that other speech and language therapy departments may well want to collaborate with colleagues in family support services, capitalising on the expertise, resources and community penetration of such organisations. I feel privileged to have worked with my family services colleagues who have added another dimension to the services we might otherwise have been offering to families in disadvantaged areas. I strongly commend exploration of the possibility of establishing similar collaborative relationships and would be happy to share details of our experience with others.

References
DfEE (2003) Every Child Matters. Green Paper. The Stationery Office.

..resources.....resources.....resources...
Leadership tool
The NHS Leadership Centre has launched a 360 assessment tool to support leadership development for individuals, teams and organisations in the health service. Anyone in the health service who is interested in participating should contact Anne-Marie Archard on 020 7592 1021, e-mail anne-marie.archard@doh.gsi.gov.uk. 45 plus VAT, www.nhsleadershipqualities.nhs.uk

SEN books
New books from David Fulton include a second edition of Planning the Curriculum for Pupils with Special Educational Needs (Richard Byers and Richard Rose, 17) and Moving On: Supporting Parents of Children with SEN by Alison Orphan (17.50). www.fultonpublishers.co.uk

Child brain tumour

Multimedia health information for children who have a brain tumour aims to help them find out more about their illness and cope with their treatment, thereby lessening their anxiety. The folder, magazine, CD-ROM and website have been heavily influenced by advice from children with brain tumours and their parents. Headstrong - see www.headstrongkids.org.uk

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