An alternative management of older children with persisting communication problems.

Speech and language deficits frequently implicate accompanying psychosocial problems (such as low self-esteem). An alternative management approach is described which adopts a holistic paradigm and provides a unique opportunity for intensive work on communication within a supportive environment. The residential programme for 8-14 year olds with persistent communication difficulties incorporated cognitive, emotional and psychosocial dimensions of communication, co-ordinated with work on speech features. Although the programmes were developed for children with cleft palate, they have potential for benefiting a wide range of communication impairments of different aetiologies. A forthcoming manual with resource material developed by the research team will be used in studies across these groups.