Exploiting digital for depression and dementia, Guest blog post from Lola Oyelayo Director of Strategy & User Experience at Head

In November 2015 we were invited to present at Pearson’s Digital Technology in Psychology Conference. This conference was designed to provide a forum for psychology professionals to talk about the impact digital is having on research and clinical practice. As a digital agency, we wanted to share our experiences of digital and the opportunities that we believe exist. We also wanted to share our specific interests in the key areas of depression and dementia.

Understanding the pace of digital change

We started with an overview just how quickly the digital landscape is evolving. Firstly, whilst we have all became conversant with the idea of desktop computers and mobile smartphones, we now have internet enabled devices as small as smart watches and jewellery, and as large as smart televisions. We use the word “app” to describe any application that can run on any of these devices. And the internet or web, is essentially everywhere, as none of us is ever offline anymore. This creates infinite opportunities to build new connected experiences.

Secondly, where traditionally digital insights were separated between quantitative data from analytics and qualitative insights from interviews and surveys, we now have a world of “big data”. With the technologies and analysis capabilities within the big data world, we can draw behavioural and qualitative insights from large sets of quantitative data. Essentially opening up discussions on sampling over comprehensive data collection.

However, with these accelerating capabilities, we also have a rise in digital inequality. We use this phrase to refer to the disconnect between organisations that are highly digitally literate and maintain new technologies and services, to those that are less digitally literate, and face challenges with legacy technology that prevents them from capitalising on new possibilities.

The complexity is significant. But when it comes to examining where the opportunity is to provide new digital services for individuals in the realm of clinical psychology, mobile, and specifically smartphones present the greatest opportunity.

The smartphone is the key to almost all modern day digital experiences

Smartphones have become our constant companions. Their inherent capabilities mean that we essentially have come to rely on them to be our trusted go to source for work, travel, socialising and even family life. We spend 2h26m (Source: eMarketer) on our smartphones per day on average. And although in our current population outlines, smartphone penetration is greatest amongst the 16-24 age group, there has been double digit growth in the 55+ category. This will only increase as our current population ages.

The ubiquity and personal nature of our smartphones mean that they could potentially offer sufferers of depression and dementia the kind of support they need to manage their conditions better. It was this broad premise that we took into a collaborative workshop with conference attendees to explore new ideas for digital services.

Why we focused on depression and dementia

Clearly these are two very large areas of discussion with a number of different conditions and clinical approaches to diagnosis, treatment and management. However, we have seen the use of digital technology increase in these two areas. For example, there has been a significant rise in the use of Computerised Cognitive Behavioural Therapy (CCBT) to treat mild depression, with many app developers launching products that have not been clinically tested or validated. These apps are popular, but it is clear that there is a need for discussion about how outcomes are measured and whether using a bad app can have an impact on a sufferer’s condition. Alarmingly, because clinicians are concerned about efficacy, there isn’t much clinical usage of these tools meaning a lot of sufferers are navigating this space without appropriate support.

Within the dementia area, mobile apps and even games are being used to help sufferers improve memory function and sometimes as assistive aids to give people independence in their environments. The Alzheimer’s Society has publicly stated its focus on exploring solutions to give “every person with dementia…the opportunity to benefit from technology appropriate to their needs:”.

It was with these significant trends in mind that we set our workshop participants two challenges for new digital services:

• How to we solve the problem of efficacy for mental health apps?
• How do we integrate assistive technologies within the dementia care pathway?

Answering the brief with a Product Canvas

The Product Canvas is a tool often used to help express a digital product vision for teams developing using an Agile process. We adapted the template to give us a structure for putting a vision and idea on one page and each workshop group produced their own single page overview in answer to the question.

How do we solve the problem of efficacy for mental health apps?

How do we integrate assistive technologies within the dementia care pathway?

Insights from the workshop

Firstly, our topics were too broad to conclude too much detail in one afternoon, but we knew this would be the case. There were so many interlinked issues raised. Some of these issues reflect significant tensions, E.g. Giving individuals privacy but also ensuring carers and clinicians are kept informed when a patient is interacting with personal technology. We discussed the lack of knowledge and skills within the clinical psychology field that prevents full exploration and exploitation of the latest technology.

We were encouraged by the breadth of thinking and discussion that led us to these very high-level outputs of what can be done in these two areas. We hope that participants felt sufficiently stimulated about what is possible with current mobile capabilities and we look forward to continuing the dialogue with clinical practitioners focused on making a difference through technology.

Lola Oyelayo is Director of Strategy & User Experience at Head.

 

Pressing the ‘on’ switch – the digital future of assessment

Photo by Ruben Alvarado

Google the term ‘digital technology’ and the most common phrase you’ll see is ‘How digital technology will change the way we work’. With greater access to developments in digital technology the way we interact on a personal, social and business level is changing on a daily basis.

Making strides

One article this year that has already caught my eye, was from the Department for Health on ‘How technology is working to support patients and staff’. Here, George Freeman, Minister for Life Sciences, talks about the strides that are already being made by trusts to introduce tablets to reduce paper and help transform outcomes for patients. But how can a company who specialises in pen and paper assessments for over 90 years help achieve this?

Read on via Pressing the ‘on’ switch – the digital future of assessment | Q-interactive UK.

Who’s talking about digital technology in psychology? A look at our first conference in York.

When set the challenge of creating a Digital Technology in Psychology conference, my first response was excitement. It’s such a wide subject there’s bound to be lots to talk about – let’s get everyone involved…this however was closely followed by the thought, What if no one turns up? and Is technology as central as we like to think it is…?

Lucky for me, people did submit papers on a range of topics and sign up to attend. So last week we held our first Digital Technology in Psychology conference at York University. We were delighted to welcome our keynote speaker, Dr Tom Manly co-author of the TEA and the new TEA-CH-2. Dr Manly’s talk looked at ‘What is attention?’ and explored the evolution of technology in delivering assessments. A first look at the exciting new TEA-Ch2 was also provided and we can certainly say the new space dog and alien were warmly received.

First look at the new TEA-Ch2 #Digitalpsych15 pic.twitter.com/svXKqmGAH0

— Pearson Clinical UK (@PearsonclinUK) October 21, 2015

This was followed by Sarah Kate Smith who led a fascinating discussion around Dementia and Assistive Technology; showing examples of how technological interventions can be used to promote conversations, social interaction and leisure activities. Introducing CIRCA, Sarah’s talk highlighted the importance of including feedback from individuals with dementia into the design and functionality plans of technology.

Did you know that about 8% of people will experience problems with #PTSD that persist beyond 3 months? This was one of many areas highlighted during Sara Simblett’s talk, A systematic review of web-based technology to assist emotional adjustment and self-management of symptoms related to post-traumatic stress. Here Sara looked at the different approaches that have been taken to studying the effectiveness of Interapy as a Treatment of Post-traumatic Stress via the Internet.

After the break, Astrid Coxon generated lots of conversation and app sharing ideas with her talk on, The effectiveness of internet-based interventions for managing stress and anxiety in students in higher education: a systematic review. Looking at some of the studies around web-based interventions and where the gaps currently exist. A conversation that then continued on twitter.

An interesting behaviour change app I was introduced to @newshpphn event earlier this year https://t.co/s1L7YN7IN3 #digitalpsych15

— Dr Astrid Coxon (@AstridCoxon) October 21, 2015

This Much!, This Feeling & Backdrop: The development of touch device procedures for the qualitative and quantitative assessment of children’s positive and negative experiences, was an enlightening talk from David Glasgow. Exploring a number of different apps, the accompanying video’s showed a young boys interactions, and revealed how important additional information could be obtained to help shape understanding and care plans.

Lola Oyelayo and Nick Reynolds, then joined us from Head London to run an exciting workshop on exploiting digital for dementia and depression. A session which pulled together many of the threads of conversation from the day. Beginning with a presentation the team highlighted some of the many issues that are affecting the development of technology in the psychology field including:

• How will an increasingly digital literate population will affect how we provide support for individuals with #dementia in the future
• How do we solve the problem of efficacy for #mentalhealth apps?

The smart phone seems to be key to all modern day experiences #digitalpsych15 @wearehead

— Pearson Clinical UK (@PearsonclinUK) October 21, 2015

Lots of exciting conversations around apps for #dementia and #depression #digitalpsych15 @wearehead pic.twitter.com/OcbynaVjGI

— Pearson Clinical UK (@PearsonclinUK) October 21, 2015

I look forward the sharing the outcomes of these workshops in a later blog.

As a first event, we were delighted to see the group so engaged in the topic, we’ll be sharing podcasts from many of the talks over the coming weeks, and so if you were unable to attend, you can sit back with cup of tea and catch up!

I’m also pleased to see that the conversations are already continuing. Sarah Kate Smith will now be joining an exciting line up of presenters for Online Working Memory Week where Sarah will be presenting on ‘Exploiting touch screen tech to promote communication, social interaction & leisure activities with people living with dementia.’

Thank you to all our presenters and delegates who helped to make this first event a success. Watch this space for plans for 2016.

#WMLearn | #DigitalPsych15

The SENCO journey – transitioning to a strategic role: Guest post from Malcolm Reeve, AET

Malcolm Reeve, Executive Director for SEND & Inclusion at Academies Enterprise Trust.

One of the significant requirements of the Children and Families Act 2014 (known in SEN circles as ‘The SEND Reforms’) encompassed the redefinition of the role of the SENCO. Schools are legally required to have a SENCO, and if they are new to the role, they have to attain the National SENCO Award within three years of taking up their post.

Previously, the role of SENCO has sometimes been seen as ‘the person who helps the children with SEN’; they might have had a group of learning support assistants at their disposal to help them with this role. However, the reforms, and the SEND Code of Practice which arose from them, makes it absolutely clear and incontrovertible that SEN is everyone’s responsibility and that the progression of children with SEN cannot be seen as just one person’s responsibility anymore.

The Code of Practice makes it clear that teachers are responsible for the progress of children in their class, even when they are supported by, or working with, a Learning Support Assistant. Thus the SENCO needs to move away from a ‘doing role’ to a ‘strategic role’ where they ‘advise’, ‘liaise’ and ‘ensure’.

The reality is that this aspiration is not easy to achieve and the implementation of this across schools in England presents a significant challenge both for the SENCO, for wider leadership teams, and for the school as a whole.

How the ‘strategic challenge’ plays out

It is often overlooked that the SENCO can run the largest provision in a school; keeping a watching brief on all children and looking after a SEN Support list, which can sometimes contain 20-30% of the whole school.

This year the average SEN Support list in a mainstream school in England is between 14 and 15%. The requirement for the SENCO to adopt a strategic role is to be welcomed, but in achieving it the challenge plays out in four main ways:

1. The extent to which the Headteacher, and whole school senior and middle leadership team, accept their responsibility to ‘lead SEN’ and how much they support the SENCO in achieving a strategic leadership role.
2. The extent to which the SENCO is able to adjust his or her thinking to a strategic perspective and adopt the ‘tools’ of strategic leadership.
3. The extent to which teachers rise to the challenge of being ‘teachers of SEN’ and equip themselves both with approaches and skills which reflect this in practice.
4. The extent to which Learning Support Assistants become more specialist in the support they offer around the four main types of SEN.

This blog is focusing on how the SENCO adjusts their thinking to a strategic perspective and adopts the tools, which will assist them.

SENCO top tips

• The Code of Practice and the law on SEN are your ‘bibles’- know them inside out. IPSEA run an excellent course (cheaply) in SEN and the law.
• Read and understand your school’s strategic development documents (SEF, School Development Plan) and agree with SLT how the longer term vision of SEN is threaded through these and embedded in school improvement thinking.
• Develop a relationship with the SEN governor and discuss the vision of SEN with them. Meet with them prior to full governing body meetings to discuss SEN provision and outcomes.
• Use data on the composition of the SEN support list, and the progress which pupils with SEN are, or are not, making, to inform effective intervention and staff deployment. Discuss these with phase leaders in primary schools and heads of department in secondary schools.
• Use the data to develop an SEN action plan or transformation plan that clearly links with the whole school improvement plan.
• If you are not a part of the leadership team (the Code of Practice states that a SENCO will be more effective in their role if they are), discuss with your line manager how you can influence SEN strategy with their support.
• Establish your role in supporting and developing high quality teaching for all throughout the school by conducting SEN ‘learning walks’ (sometimes with the Headteacher and members of the SLT).
• Prioritise SEN CPD for staff and investigate different models that you could use in your school (coaching, sharing of good practice, Lesson Study etc.)
• Meet with parents and inform them of your strategic role. Invite them to be part of a parents’ forum or ‘SEN Committee’ where they can influence SEN strategy e.g. by reviewing SEN info report / policy.
• If you’ve not done it already, complete the National SENCO award.

Moving to a more strategic SENCO role can seem daunting, but armed with the right approach and with the support of the whole leadership team your school can make a world of difference to the children and young people you support.

Malcolm Reeve is Executive Director for SEND & Inclusion at Academies Enterprise Trust (AET).

Malcolm is a National Leader of Education and was a judge at this year’s Shine a Light Awards.

Follow Malcolm on Twitter

Online Working Memory Week Welcomes Prof Alan Baddeley

We’re delighted to welcome Prof. Alan Baddeley, one of the forefathers of working memory as keynote speaker for this year’s Online Working Memory Week. A week long series of free talks on the topic of working memory and its importance.

Prof. Alan Baddeley was among the first to define the model for working memory with his colleague Dr Graham Hitch in 1974 when they tried to tackle the question ‘What is working memory for?’ The term working memory had already been coined in the 1960’s but there had not been a great deal of research to explain exactly what it was. There were a number of other researchers who were investigating memory and how it worked, this was often completed with amnesic patients as the subject. Finding subjects who had amnesia was tricky as cases of amnesia are quite rare.

Baddeley & Hitch decided to take students and turn them into subjects, not by ‘clunking them on the head’ as Prof Baddeley explains, but by giving them tasks that would work on specific parts of the brain. Students would be given a short term memory task, for example remembering and repeating a sequence of digits, whilst simultaneously asking them to complete a reasoning task. They had anticipated that this would wipe out performance in the participants but it did not, they found that the greater the number of digits they held the greater the number of errors, but the participants were able to complete the tasks.

This then led them to identify three key components of memory that they went on to investigate further:

• Central Executive: Drives the whole system (e.g. the boss of working memory) and allocates data to the subsystems (VSS & PL). It also deals with cognitive tasks such as mental arithmetic and problem solving.
• Visuo-Spatial Sketchpad (inner eye): Stores and processes information in a visual or spatial form. The VSS is used for navigation.
• The Phonological Loop is the part of working memory that deals with spoken and written material. It can be used to remember a phone number.

To learn more about these aspects of working memory, make sure you sign up to Professor Alan Baddeley’s webinar presentation on Wednesday 11th November.

Digital Technology in Psychology Conference 2015

Digital Technology in Psychology Conference

York, October 21

Technology is helping to shape the future of psychology and health care. This October Pearson are hosting a conference exploring the implications of digital technology on tomorrow’s psychologists, including:

• Its role in today’s clinical practice
• How digital can support current or future research
• When is technology helpful and when does it constrain us
• Current technologies that are helpful to today’s psychologists.

We are pleased to announce that HEAD will be running an exciting workshop on Exploiting Digital for Depression & Dementia.

Additionally, confirmed speakers include:

• Dr Tom Manly, Cognition and Brain Sciences Unit, University of Cambridge
• Sara Kate Smith, CATCH (Centre for Assistive Technology and Connected Healthcare), University of Sheffield
• Astrid Coxon, Norwich Medical School, University of East Anglia
• Sara Simblett, Institute of Psychiatry, Psychology and Neuroscience, Kings College London.

Download a copy of the programme or book your place today.

Inspirational Communicators and Outstanding Settings Honoured at Shine a Light Awards

Last Thursday, The Communication Trust and Pearson were proud to announce the winners of the 2015 Shine a Light Awards, a national awards scheme that celebrates innovative work and excellent practice in supporting children and young people’s communication development.

Hosted by comedian David Baddiel, the awards, which took place at Pearson’s headquarters in London, honoured individuals, teams, campaigns, communication-friendly settings and communities that have excelled in their support of children and young people’s communication, particularly for those with speech, language and communication needs (SLCN).

A number of inspiring individuals received awards, including 17-year-old Jonathan Middleditch from Surrey, who was the recipient of the Young Person of the Year Award, and Bev Crisp from Yorkshire who took home the Communication Champion Award.

David Baddiel, Host of the 2015 Shine a Light Awards, said:

“Because of the important work that the Shine a Light 2015 winners and highly commended finalists have achieved, children and young people’s language and communication development, especially for those with SLCN, has been supported.

“Speech and language problems too often goes under the radar, so everyone should not only be congratulated for their work but for bringing this important issue to the attention of others. I would like to say well done to all those shortlisted who have shown true grit and determination to better themselves and others. They are all a true inspiration – keep up the good work.”

In addition to these awards Pearson awarded Lord David Ramsbotham GCB CBE the Pearson Outstanding Achievement Award for his transformational impact on SLCN and activity related to the Children and Families Act.

A full list of all the winners can be found at www.shinealightawards.co.uk

 

More funding has just been announced for children’s mental health services, but there’s a long way to go…

Fergal Roche, CEO of The Key, writes about school leaders’ concerns about pupil wellbeing

At the end of last month, the government announced that it is to invest £143 million in improving children’s mental health services in England this year – welcome news, surely, but will it make enough impact?

In the school year just gone, The Key asked some of the country’s school leaders what health and safeguarding issues affecting their pupils they were concerned about, if any. Top of the list was children’s mental health, with 67% of those surveyed saying this was a worry. Domestic violence and cyber bullying were next, of concern to more than half of those surveyed (58% and 55% respectively) – followed by bullying and obesity (38% and 36%).

All such issues not only have implications for the classroom – affecting pupils’ concentration levels and consequently their grades – but also life beyond the school gates, with unresolved issues likely to have a serious impact on children’s prospects.

School staff work tirelessly to do the best for their pupils, and increasing numbers of schools are employing their own counsellors or drawing on voluntary services to tackle the complex issues they’re facing. We, too, have seen leaders coming to The Key for help with things like writing a mental health policy, how to boost children’s self-esteem and what to do if a pupil is self-harming.

However, many of the school leaders my team and I speak to are frustrated at not having access to the professional support they need to best help their pupils.

Gary House, headteacher of Lady Hawkins’ School and Sixth Form in Herefordshire, explained that as well as a range of social factors, he sees his pupils contending with pressure after pressure in a school context. He’s also worried about the impact of the extra pressure on school staff who aren’t equipped to provide specialist help:

“With declining social services support due to diminishing council budgets, more and more is having to be dealt with in schools. We take our duty of care seriously, but to do the best for our students, specialist mental health support services are needed. If we are not careful a dangerous cycle will develop; students worrying and teachers suffering as they worry about not having the specialist skills to support students in need of mental health care.”

Our survey found that Gary’s view is mirrored across primary and secondary, maintained, academy and privately-funded independent schools; the profession wants to help but specialist support often isn’t available locally.

I know of a secondary school in north London that is fortunate to have a CAMHS (child and adolescent mental health services) worker based in school once a week to help identify and support students in need, as well as train and supervise staff. The school has other fantastic initiatives too, such as non-teaching managers for every year group, who carry out daily check-ins and build up good relationships with students and parents. It also has an effective transition programme which ensures its pastoral team receives essential information from primary schools, so it can make appropriate support available to incoming students as soon as possible.

Sadly, not every school has the resources to offer this type of support structure, but there are other things schools can realistically do – for example:

• Collaborate with other schools locally and look into jointly hiring a specialist
• Arrange wellbeing training for staff from multiple schools locally, and/or hold regular cross-school meetings to share experiences and views
• Dedicate some form/tutor time to discussing subjects like cyber bullying, keeping safe and managing stress

Even with such measures, there’s only so much that schools can achieve alone, and our survey findings on school leaders’ concerns suggest that there is a long way to go. The government’s promised investment in addressing children’s mental health issues is a good start; let’s hope it’s directed in such a way that all schools up and down the country can call on high-quality specialist support to protect the wellbeing of children and young people in their care.

For further information on The Key visit www.thekeysupport.com or follow on Twitter @TheKeySupport / @TheKeySL.

 

Follow Fergal Roche on Twitter @FergalRoche

Parents as partners for better speech, language and communication outcomes

Shona Crichton from The Communication Trust writes about ‘Parents as partners for better speech, language and communication outcomes’ 1

We know that children make progress in any area of their development when they can be supported to thrive in the place and with the people where they spend the most time and who know them best. Parents are experts on their children and provide information that is integral to ensuring that a child or young person makes the best progress that they can. However there may be challenges when striving to achieve good practice for including parents in supporting children’s speech, language and communication development.

The new SEND Code of Practice highlights the importance of engaging and involving parents and families. Those working with children and young people with speech, language and communication needs (SLCN), or any SEND, have a responsibility to ensure that parents are engaged with and involved in decisions that affect their child.

It’s likely that every practitioner reading this blog has examples of times where we achieve true collaborative working with parents, and times when it doesn’t work so well. What is it that we need to be aware of when working with parents to support their child’s speech, language and communication at home?

Ensuring parents are real partners – Parents want to be included as real partners, with true collaboration taking place. The challenge is not only that every child is different, but every SLCN is different, and every family is different. Taking time to share with parents their experiences of home life and their child’s SLCN, and your understanding and perception of the child’s strengths and needs will help towards partnership working that is meaningful to both parent and practitioner.

It doesn’t have to be extra – Discussing what home life is like with parents provides an opportunity to think about how language and communication can be woven in to elements of daily life that are happening already. For some parents, the thought of squeezing extra in to busy lives is just not manageable. However, the beauty of speech, language and communication is that it’s part of everything that we do. Discussing what life is like for families and working together to think about where and how speech and language targets might sit in their daily routine can be a great first step to integrating targets in to daily life. Prepositions in the bath or practising turn taking during tea-time means that speech, language and communication targets can become part of daily life.

Consider parents’ views and wishes – The Better Communication Research Programme sought views of parents with children with speech, language and communication needs. Findings from this paper show that parents are generally concerned with long term outcomes for their children – parents want their children to be included socially and to achieve independence. As practitioners working with children and young people with SLCN, our skill is in understanding parents’ long term wishes for their children. We can then break these down in to manageable, attainable short term targets that link with the long term aims that everyone can work towards achieving.

Keep parents informed – The same research also highlighted that parents like to be kept informed of how children are getting on in achieving their objectives, and that this was different across the parents who were interviewed – some wanted a weekly update on progress, others were happy to meet to discuss targets on a 6 monthly basis. Discuss with parents how and when they’d like to discuss their child’s progress with you.

The Communication Trust is a coalition of over 50 not-for-profit organisations with expertise in speech, language and communication and SLCN. Although our main audience is the children and young people’s workforce, we also have some information that’s useful for parents as do many of our members. Take a look at our website for more ideas and resources to help you encourage parents to support their children’s speech, language and communication development at home

www.thecommunicationtrust.org.uk

[1] Throughout this article, the term ‘parent’ refers to any person who is the child or young person’s main carer

When Appearing to do Nothing is the Strongest Intervention | Pearson Blog

Shelley Hughes, SROT, Senior Product Manager, Pearson Clinical Assessment talks on ‘When Appearing to do Nothing is the Strongest Intervention’ via our US blog.

Something I am regularly asked is how to intervene with particular profiles derived from administering a clinical assessment. To clarify: I am an occupational therapist working in the publishing sector, developing assessment materials for clinicians and educators to support children and adults in their everyday life; my occupational therapy background serves me well in this endeavor. So…back to the question…it is a relevant question of course; you have administered an assessment, which in itself yields useful information, and so… WHAT do you do next?

Ahh…now here’s the trick! To consider your options you need to contemplate why you are administering the assessment, and what it means to the individual involved. Some assessments take a top-down approach, i.e. they focus on the person as a whole within the context of their everyday occupations and roles important to them. The risk being that this approach does not always take into consideration how task components may be impacting roles and everyday occupations. Conversely, impairment or diagnostic level assessments can be helpful in determining how task components may affect performance and/or participation, but risk overlooking what is important to the individual in terms of roles and everyday occupations.

via When Appearing to do Nothing is the Strongest Intervention | Pearson Blog.