The New Idea

Tara is making the delivery of speech and language therapy accessible to caregivers—parents, teachers, and special-needs assistants. By shifting the focus of service delivery from the professional therapist to the parent and/or teacher, she has found an inexpensive, fast and effective model to change a dysfunctional and expensive system that is unable to meet the needs of people with communication difficulties.

Through a methodology built around weekly group therapy sessions, caregivers and children gain the practical skills and techniques they need to overcome communication difficulties and reach their fullest potential. As a shortage of speech therapists continues to grow globally, Tara is mobilizing a new generation of certified speech and language professionals and engaging academic institutions, citizen sector groups, and funders around the world eager to find solutions.

The Problem

Across the globe there are long waiting lists for speech and language therapy. About 30,000 people—almost 1 percent of Ireland’s population—currently are on waiting lists for speech and language therapy. Similar situations persist around the world. In Ireland, caregivers and children wait one to three years for an assessment and an additional one to two years for the often ineffective service offered by the state—just nine hours of therapy annually. Rather than wait years for this service, parents want to learn how they can work with their child; however, the current system excludes them from the process. The frustration of caregivers provides the insight behind Tara’s idea.

Long waiting lists are the result of a number of systemic problems. First, professionals in Ireland spend just 33 percent of their time providing therapy because of excessive administrative burdens. The traditional one-to-one model (professional therapist to child) is insufficient to meet children’s needs and underproductive work practices are frustrating for therapists. The current vacancy rate for therapists in Ireland is 72 percent, and vacancy rates in the United States have increased from 25 percent in 2002 to 40 percent in 2005. Even if the market could meet the demand for therapists, pouring more frustrated professionals into a broken bureaucratic system would be expensive and ineffective.

The Strategy

After speaking extensively to the parents of children with communication difficulties, Tara recognized that they have the motivation and ability to do much more when it comes to improving their child’s speech. Since the pilot program in 2005 Tara has perfected the methodology of therapy provided by Release Communication Intervention (RCI), the organization she founded. The caregiver and therapist enter a joint contract; underperformance can result in dismissal for either party. Caregivers are contracted to attend one hour of group therapy each week and complete an additional three hours of work with the child each week outside of scheduled therapy time.

Since 2005, one RCI therapist has worked with 560 children in both private and public settings. With three additional therapists, RCI worked directly with over 1,000 children and caregivers in 2008. To demonstrate the methodology broadly, RCI pilots have taken place in schools, hospitals, and private clinics—with parents, teachers, and therapists—and across disabilities ranging from stammers to severe autism. Approval ratings among teachers, families, and therapists have all exceeded 95 percent. The Irish government, through the ministers of both health and education, want RCI to demonstrate its successful methodology in the public health system, and the citizen group, Irish Autism Action, has also contracted RCI as its exclusive speech and language therapy-delivery partner in Ireland.

To build credibility, Tara secured certification for RCI from the American Speech-Language-Hearing-Association (ASHA), the most respected international credentialing association in the field. Tara also developed partnerships with New York University, George Washington University (GWU), Kennedy Krieger Institute, and the Eden Institute at Princeton, among others. Those partnerships provided essential credibility to RCI in the early stages of development. RCI is building an irrefutable fact base through its research partners to facilitate the expansion of its methodologies internationally, initially through its university partners in the United States. Current quantitative research is being conducted in conjunction with GWU.

The RCI methodology has proved to be immensely successful. It allows therapists and caregivers to operate at up to fifty times the productivity of their public service counterparts and children with communication difficulties can expect more than fifteen times more therapy-hours per year with RCI (160 hours) than through public service (9 hours). In Ireland, private one-to-one speech therapy sessions cost between €75 (US$99) and €130 (US$171) per hour. RCI currently is able to break even at €75 per hour with free scholarships for those unable to pay. If applied nationally, the RCI methodology could eliminate waiting lists and dramatically increase the number of hours of therapy delivered to every child, without additional cost.

To spread her methodology, Tara is building an entrepreneurial and creative team of experienced professionals with a strong work ethic and commitment to Release’s innovative methodology. Each candidate must go through a rigorous four-stage process to ensure quality control. The RCI team will continue as service providers until the methodology is irrefutable and fully developed. Ultimately, RCI aims to become the standard, dramatically improving the productivity and impact of speech and language therapy across the world.

The Person

Tara was born in 1974 and raised in a first-generation Irish-Italian family in New Jersey. With a strong family work ethic, Tara and her siblings did well in school and earned their keep through various evening jobs. Having developed an interest and significant profile in politics at a young age, Tara studied history and political science at Rutgers University. Disillusioned with politics, Tara shocked those closest to her by deciding to leave a burgeoning political career to join Ellerby Beckett Architecture in Washington, D.C., as an international marketer. In 1998, Tara traveled across Europe and after a six-month stint in Dublin, she moved to Ireland. She initiated and led a number of innovative marketing campaigns during the subsequent years at Baltimore Technologies, ICAN and Ogilvy Interactive. Her fast-ascending career in marketing coincided with an increasing dissatisfaction with her work and a desire for more meaningful work.

After a number of years volunteering with children from disadvantaged communities, Tara decided to take her energy and entrepreneurial skill to the citizen sector. She joined the development effort at Down Syndrome Ireland in January 2003. It was there that she learned about the problems in speech and language therapy. As she traveled around the country parents explained their relentless struggle to gain access to speech and language therapy for their children. After bearing the full brunt of a parent’s frustration at a meeting, she decided to find the solution.

Tara spent months meeting with parents and children with communication difficulties, grappling with the bottlenecks underlying the problem and subsequently traveled to the United States with the outline of a new and simple model. The resoundingly positive response from ASHA and various universities gave her the confidence and support she needed to realize her model and Tara launched Release Communication Intervention as a social enterprise in November 2004. She funded RCI through her own savings and has worked unpaid since its launch.

Tara lives in Ireland with her husband, Mark Cunningham, and two sons.