Department Of Health and Human Services, National Institute on Aging (NIA). NIA AD/ADRD health care systems research collaboratory (U54 clinical trial required). https://grants.nih.gov/grants/guide/rfa-files/RFA-AG-19-009.html. Accessed 1 Aug 2018.

Formal assessment of understanding of spoken language was undertaken using the Test for Reception of Grammar (TROG 2-E). The project also aimed to raise the profile of the Children’s Centre within the local community, encouraging families to access other Children’s Centre services. For the Spirals Parent Workshops, an invite was sent out to the parents or carers of each child. The invite explained the workshop and asked that an adult attend to support their child. It was suggested that if a parent couldn’t attend, an Aunt, Uncle or Grandparent could attend instead. The staff in the schools were very supportive and promoted the workshops to the parents and carers. The Spirals workshop consisted of a fun activity in which the parent worked with their child to make a language game that could be played at home. The parents then had an opportunity to observe or participate in a live example of a Spirals group. Time was given for questions and evaluation and an ‘Ideas for home learning’ sheet was given to each parent, suggesting simple methods for extending their child’s speaking, listening and understanding by using everyday situations and objects. The workshops took place in the schools and were run by Laura Halstead and supported by a teaching assistant or member of school staff. considering the role of comorbidity in discharge outcome, suggested that patients with medical comorbidities, if acceptable candidates for TJA, do not have an increased need for rehabilitation and that the medical criteria seem to have very little influence on postoperative management. This particular aspect could be justified by the long duration of hospitalization that patients had at the time of these studies and the differences existing between health care systems, but remains an interesting field for researchers. In every study, it emerged that patient's preferred discharge destination had a significant influence on LOS and discharge setting, even Oldmeadow el al found that this variable had the highest weighted impact on outcomes

Laura Halstead presented the data and facilitated some discussion around the outcomes of the project and developments for the future. Below are some of the discussion points. The … the basket …. the carrier bag…. with all the tomatoes in, or apples, are falling out because it has a hole in it.” Children with SLCN (Speech , Language and Communication Needs) are at a major disadvantage compared to

PurposeThe Risk Assessment and Prediction Tool (RAPT) is an interesting instrument for predicting the discharge destination and length of stay (LOS) for patients after hip or knee arthroplasty. The aim of this review is to describe its predictive ability, current utilization, and future prospects through the analysis of scientific literature. Dinky was assessed at the request of her mother. The assessments were undertaken in her own home and completed in one session.The above graph shows that Spirals may be helping some children with greater levels of delay, especially more than a one year delay, to get closer to the expected level for their chronological age. However, it is also clear that there are still a large number of children starting school with significant levels of difficulty with communication. The Children’s Centre provides a wide variety of activities and services, as well as Spirals, to try to make a difference to these children; promoting good communication and interaction from birth. These include baby massage, stay and play, creative play sessions, parenting groups and outreach work. It is my experience that children from families who make regular use of these services from an early age do not need to attend Spirals once at Nursery unless there is an underlying disability or impairment.