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Summer 2010

September 2010 Volume 7 Issue 1

ECRIP: Merging Research with Clinical Education
Author: Katie Laukys

Version française

When one enters into the graduate program for speech-language pathology as a new student here at McGill there are two things that you become very familiar with: research and clinical education (known to students as practica, or stages). Recently, the two areas have been brought together in a project known as ECRIP: Essai Clinique Randomisé sur les Interventions Phonologiques. The ECRIP program is designed to investigate which combination of interventions is most effective to help children with speech sound disorders achieve age-appropriate phonological processing skills before school entry. Children first receive either a traditional articulation intervention or a speech perception intervention, and then a phonological awareness intervention. Their parents receive training on how to conduct articulation activities at home, or how to use dialogic reading to enhance their child`s vocabulary and language skills. The program targets francophone children and their families, who have been wait-listed through the Montréal Children’s Hospital for speech-language pathology services and is planned to continue through to 2011.

In addition to providing francophone children and their families an opportunity to receive speech therapy, the ECRIP project has also taken on a major role in the clinical education of many of McGill’s graduate speech-language pathology students. Former Head Coordinator of Clinical Education, Jeanne Claessen, has found there are a few benefits to having such a program affiliated with the school: “With recent increases in student enrolment the School is always looking for new and high quality student placement sites. ECRIP so far has offered 6 additional student placements over just 2 terms,” and with an expected end date of 2011, the program has the potential to have provided a total of 20 placements from start to finish. Another benefit of having the ECRIP program is the opportunity it provides for the francophone students enrolled in the graduate program at McGill: “There is a great lack of francophone placements for francophone students in our program”. With ECRIP our francophone students now have access to a high quality French-language practicum experience, which allows them the opportunity to work with a francophone population and in their own language. [The students] get used to the French SLP terminology, French developmental milestones, some of the French tests;” which helps make ECRIP a great learning experience for those who will go on to work in Quebec with a francophone population.

So what is it that makes ECRIP such a good practical experience? According to Ms. Claessen, there are two reasons: “The ECRIP Project allows the students a unique opportunity to be directly engaged in clinical research, which allows them to use outcome measures to gauge a child’s progress. This is of course the substance of academic courses and the ideal practice standard but it can rarely be attained as closely in traditional clinical settings. In sum, the ECRIP practicum prepares the new generation of SLP clinicians for state of the art therapy intervention with their future clientele. [Secondly], ECRIP [exposes the students] to state of the art research on early literacy and the relationship between phonological awareness and articulation.” Alla Sorokin, who completed part of her final internship with the ECRIP program, felt that the experience was excellent because, “…it is quite challenging. The more challenging something is the more one ends up learning from it. It gives a good basis in therapy for students (not only in production therapy but also in perception and phonological awareness)… It allows the students to be involved in doing everything from A to Z (from goal selection, to therapy planning, to execution, to writing up reports). Since the activities ought to be highly creative, it allows the students to exercise their creativity. The students may leave this placement with a database of activities as well as materials in French. Furthermore, the therapies are all executed in French [allowing] students to gain practice in being a therapist in French, which may be very useful later upon graduation.”

What kinds of activities have the students who’ve been placed with ECRIP been asked to do? Marianne Paul, another student who completed her internship with the project, states that “the main role of the student clinician is to conduct 4 individual therapy sessions of 45-50 minutes. Each student [can expect] to be in charge of the therapy for 4 children, working on three specific targets that must be worked on at every session. After these 6 individual therapy sessions, there are 6 group therapy sessions that target phonological awareness abilities. The targets are already determined as well as the type of activity to conduct, but we have to determine the details of the activity. Finally, we had to write progress reports for the 4 children we have seen regarding their individual goals and the phonological awareness goals worked on in group. Throughout the sessions, we take notes on the type of feedback we provided, the results of the child on the task, and his/her cooperation.”

But every new project has challenges and I asked student Annie Ladouceur what she felt was one of the most challenging aspects of the ECRIP project: “As a student doing direct intervention with children, I think we had to be really independent…we have to show initiative, creativity (planning interesting activities), and be able to adapt,” all necessary skills one needs to develop in order to become a successful speech-language pathologist.

I also asked the three students what they liked most about working with the ECRIP project. Annie Ladouceur enjoyed “the time spent working with children; I learned a lot! Everyday was interesting and different even if the population and type of intervention is pretty similar...I also appreciated the opportunity we had of intervening on the speech perception level.” Alla Sorokin said, “I enjoyed being a “therapist”…the independence and the direct contact with children and the parents were very positive learning experiences.” Finally, Marianne Paul felt that she “… really liked the fact that we had to strictly follow the type of activity and feedback depending on the child's group assignment. It makes you realize what you are doing, and makes you think of why you do it. It is nice to follow the same child for 6 weeks and being able to see the progress, and also to see them in a different context (in the group therapy). It really helps [you] to realize how different a child can be in different setting. I also appreciated the completeness of the work (therapy, assessment, notes, and report).”

But, one should not forget that the project is not simply a way to provide clinical experience for students; it also has a community benefit. Annie Ladouceur explained that, “some of the children seen at ECRIP would have never had the chance to have therapy [outside of] their participation in the project. Parents are very often overwhelmed by the situation, the lack of resources, waiting lists.... they are SO greatful for our work! Also there is so little research done in clinical SLP... in French! C'est un merveilleux projet de recherche!”

On a final note, I was able to ask the students what advice they had for the students who will be placed with the ECRIP project in the coming years:

- “Read the manual carefully and keep the guidelines in mind while preparing the sessions.” (Marianne Paul)

- “Be prepared for your intervention (one week at a time).... it goes so much better when you actually know what you are doing, because if there is some kind of hesitation... the child will take [advantage] of it!!!!.” (Annie Ladouceur)

- “Staying organized can really help, even though it may be challenging because of the multitude of materials and things that are involved and that are to be kept track of. Remember that in the end, this project (with your contribution) may lead to important changes in treatment delivery in Quebec.” (Alla Sorokin)

The ECRIP project is clearly a unique experience for any student looking for an opportunity to work with the francophone population and students who are bilingual or francophone are welcome to express their interest in the project as a stage option. Many thanks go to Dr. Susan Rvachew, the principal investigator for the project, and Françoise Brosseau-Lapré, the project coordinator, for bringing the ECRIP project to McGill.