This article provides a comprehensive overview of speech and language disorders and which service is appropriate for which condition. This will be of help to anyone who is looking for advice and information in accessing a speech and language therapist.
- What happens when I have been referred?
- Who would benefit from speech and language therapy?
- How do I know a preschool child needs help?
- How do I get help for a school-aged child?
- Help for adults
- Learning difficulties
- Mental health issues
Speech and language therapists deal with a very wide range of communication and swallowing disorders. They will hold a first degree in Speech and Language Therapy. All therapists must be registered by the Health Professionals Council. To check that a therapist is registered visit the Health Professionals Council.
As with all services they vary widely in all geographical areas. There is currently a national shortfall of speech and language therapists and therefore some services will be limited as to what they can currently offer. However that does not mean that you cannot campaign for a better service and you should strive to find a service that meets your individual needs.
Accessing a service depends on where you live and whether the therapy is for a child or an adult. All services should have an “open referral” service which means that you can refer yourself or your family member/client directly to the service yourself. To find your local speech and language therapy service visit the Royal College of Speech and Language Therapists website.
You can also access private therapy which you fund yourself and you can locate a therapist in your area by visiting the Association of Speech and Language Therapists in Independent Practice website.
You will wait for an assessment appointment and the time that you wait will depend on where you live. If you make a self referral ensure you ask for acknowledgement of the referral by email or letter and ask what the waiting time is. Keep a note of when you expect to be seen and if you do not receive an appointment by this date then contact the service. Once you have been assessed you will then almost certainly be put on a waiting list which, at the time of writing, can be quite long which is why early referral is very important.
Speech and language therapists assist in the following cases :
- Childhood speech and language delay.
- Childhood disability e.g. cerebral palsy, autism, hearing and visual impairments.
- Learning difficulties.
- Brain injury including stroke, brain tumours, head injury.
- Voice disorders.
- Mental health issues e.g. dementia.
All children follow a normal pattern of speech and language development. Some children will show a mild delay and will “catch up” on their own. However there are some signs that indicate that your child may need further help. These include :
- A baby who does not babble or make speech-like noises.
- A baby/child who has difficulty feeding, chewing or swallowing.
- A child who is not using a wide range of single words and joining two words together by the age of 2 – 2 ½ years.
- A child who does not initiate communication and shows a lack of interest in others.
- A child who shows unclear speech or dysfluent speech (stammering) at the age of 4-5 years.
- A child who cannot listen very well and has difficulty concentrating.
A child of six years should be talking fluently and clearly, using lots of vocabulary with good sentence structures. They should be able to engage in conversation and be able to make their needs known. The referral process is the same for a preschool child.
However it may be that you have already sought help are not receiving the help that you expect. You can go back to your local speech and language therapy service and ask for further assessment or therapy. If your child has some level of special needs you can secure therapy input through getting a statement of special education needs for your child which involves a local authority assessment. If the local education authority refuses to assess your child you can appeal. If your child already has a statement of special educational needs and you do not agree with it you can also appeal. In the first instance contact your local Parent Partnership service. Some solicitors offer a free initial advice to assess if you have a case to go through the appeals process. You can also visit http://www.ipsea.org.uk/ for independent advice.
To check your child speech and language development a useful guide can be found at: http://www.ldonline.org/article/6313
Parents may also find AFASIC a helpful website.
The first port of call is your health visitor who will have been keeping a check on your child’s development. He or she may be able to give advice to you as to whether your child is developing in a typical manner. If you are still concerned you can go to your GP who should make a referral to the local speech and language therapy service or refer your child yourself.
In adulthood there are a range of communication and swallowing disorders that can develop. Common causes are:
Some adults may experience a stroke or other type of brain injury which affects their speech and/or swallowing. If the adult was admitted to hospital then they will have already be seen by a speech and language therapist and on discharge be followed up with an outpatients appointment. It is important to check that this is the case and, if not, to contact your GP for a referral or contact the speech and language therapy department if you still have concerns about your speech or swallowing.
Sometime adults can lose their voice or it may become croaky or hoarse sounding. If you have changes in your voice that do not clear up following a cold or if you completely lose your voice for more than 3–4 days, then you must see your GP to be referred to an Ear, Nose and Throat consultant. They will determine the cause and may refer you for speech and language therapy.
Useful website: http://voiceproblemsupport.com/
If you develop difficulties with swallowing e.g. choking on food or fluids on a persistent basis then you must see your GP to be referred for an x-ray to determine the cause before you see a speech and language therapist.
Useful website: www.swallowingdifficulties.com/
Many adults who stammered as a child may go into adulthood without it being resolved. It is worth being referred to a speech and language therapist even if you have tried therapy in the past as new techniques are developing all of the time.
Useful website: The British Stammering Association
All local services will have a service for adults with learning difficulties and if you know someone who has learning difficulties it may be worth referring them for an assessment to see if there are any ways of assisting their communication skills. It may be that the person may benefit from a communication aid or a form of sign language.
Speech and language therapists can have a role in helping people with mental health issues communicate more effectively and more therapist are now specialising in this area. If a person is in a hospital setting you can enquire about a speech and language therapy assessment or if they are at home refer them to the local service.
There is a huge range of treatments available and the key to progress is for the client and their family/carers to fully engage in therapy activities and advice for maximum progress to be made.