Sleepwalking into a disaster with SEN

We're now running at a 40% vacancy rate in my team. The fact we've kept the service running as well as we have done so far is a bloody miracle.

My 4y6m DS was referred aged 3 and has had his assessment and just one speech therapy session in that time. I actually first raised concerns about his speech at 27 months. I believe he has 3 separate diagnoses contributing to his speech delay, one of which is glue ear. He's been waiting for grommets for a year as well. So yeah it's horrendous.

Oh I get messages every day from private companies who'd like to recruit me - but unfortunately I love my own little area of SLT which is adult LD - and that's pretty much NHS, or care-chain providers. Actually I really like the team I work with as well but that's another story.

There was one NHS trust who wanted me to join on graduation but they didn't have the available staffing to cover newly qualifieds at the time.

@CoffeeWithCheese I know lots just left NHS and do private SALT work. Enough clients for it what with the state of NHS provision.
Surely the graduates will also need on the job training and that's not going to happen with the lack of NHS SALTs

My own daughter (the reason I went back to retrain) lost a good year of speech therapy progress during the lockdowns - despite having a mum who was an ex primary teacher, then a student SALT and absolutely everything that would tick all the boxes from a home environment to support language development. I simply could not become all the different levels of language that she experienced on a school day as a one-woman band and she regressed massively.

She's clawed it back - but as a combination of being a tenacious stubborn daughter of a tenacious stubborn mother. Friend's daughter had a couple of SALT sessions - in the middle of a bloody field. It did not work well.

As for vacancies - we're currently 3 full time staff members down and can't fill the posts... I'm currently doing 3 people's jobs in an area with massive massive deprivation and social problems and I'll burn out eventually if I keep on at that pace. It's the same everywhere.

There are a couple of universities who have just started SLT degree courses - but they'll take a couple of years to start producing graduates into the system and placements are the real logjam when everywhere's running with massive vacancy rates anyway so people are doing multiple people's jobs filling in holes to start with. I stick with it because I love my colleagues and client group - but it's not a fun place to be at work at the moment.

The impact covid had in my area was that there were a whole cohort of mums who were kicked out of hospital and then couldnt access health visiting service. They got a phonecall noyhing else. People think health visitors do little but they were very often the people who picked up problems early and then referred to other services, then before school even started SaLT might have been up running. Even the newborn hearing checks and the pre school checks stopped.

The salts also stopped face to face clinics and started online things with tiny children and it wasnt as good.

I also think parents didnt have normal to reference against as they werent out and about as much and also lots of things like church toddler groups folded. The volunteers didnt come back. These were where lots of youngster practiced language and where parents sought advice.

But there also was an issue before covid with rising language issues and i dont know the cause.

@GoodnightAdeline I agree, although I appreciate this is entirely separate to the point of this thread, it would be interesting in future to see if studies are done on what's caused a societal rise in the need for these services. The fact they are unavailable in my opinion is entirely linked to the sad state of local council finances and unfortunately probably will only get worse.

I don't think we are sleepwalking into it, we are already in it, schools are full of children with unmet needs. The government thinks giving teachers a performance management target of 'progress of children with SEN' each year is going to fix it all. If only it were that easy to do in a class of 32 where half the students have a different need.

SaLT here. Our local community paeds service doesn’t offer intervention at all and hasn’t done since before Covid. There is a recruitment and retention crisis in our profession - the situation is very bleak. It’s a shame as we are a highly skilled workforce who can make such a difference if we were adequately resourced. I’m so sorry this was your experience.

Years ago I taught a boy who had a speech issue. After several months he got an initial speech appointment, oh we think it is his hearing. months later a hearing test. Oh he might need grommets we need to wait to see. Months later retested .
It ended up being nearly 18mths before he was diagnosed with significant hearing loss in one side and slight loss in the other.
That was a yr and a half he struggled in early schooling. The effects that has on young kids is immense.

OP I really feel for you (and the others posting similar). I know the NHS is massively overstretched, but by NOT dealing with these things early and quickly it is costing us so much more, both financially and in the mental health of our children, in the years that come.

How though? I’m not being difficult just asking.

I would write to your local council head of children's services outlining your experience

I agree with the first response. It must be a postcode lottery as our support has been great. Dc have had speech therapy on and off for years - weekly sessions and they also went into school multiple times.

They were instrumental in getting a diagnosis, EHCP and finally DLA.

And so it ever was.

The Allen report from years ago made it very clear how important early intervention is but the sad reality is that unless you’re living it, no one cares.

In fairness it sounds like the waiting lists are marginally shorter than they were twenty years ago. We waited over two years for an OT assessment, in the meantime he’d been sent to special school but he was not affected by his autism and LD enough to receive any support from the NHS. So too affected to be in mainstream but not affected enough for help. I think we’d already waited three years for the ASD assessment by this stage.

All I can hope for now for him is that he is happy and safe, we’ve learned what helps and doesn’t by a process of elimination and me paying to go on courses to help him. He’s been badly let down by services.

@GoodnightAdeline Covid and complete lack of therapy?!

This is not new and not a COVID thing. There used to be so many primary schools with SALT units, basically all closed. We've had this fight since 2010 when DD was 2. It's only got worse.

*child with SEN.

What a twatting shambles, I'm annoyed for you. Your son, and every child deserves better.
My friend's child need an SEN assessment and the specialist doctors thought a fucking video call with a child on the spectrum who couldn't sit down was appropriate.
It's not just that, a video call is not a good way to get a decent representation of a cold with SEN. Terrible.

Between 3yo and 5yo, my non verbal child was allocated 3 x 30 minutes A YEAR of speech and language therapy. It was shocking. Just before he started school at 5.5yo, we got an EHCP and that allocated more hours but dear god I was jumping about the three half an hours. This was 8 or so years ago and things haven’t got better.

Why are there so many children with speech delays now?

It’s definitely a postcode lottery as someone else said.

I'm in Devon and 4 year old DS has just started SALT after a year long wait. I had a TEAMS meeting with the therapist which was great and then he gets 12 sessions with her, which he is having in school.

if he’s still struggling after that then I’ll scrimp & save to continue privately.

I’m so sorry to read all of these stories; I really do think we’re storing up serious problems a decade or so down the line, when all these children we’ve failed are expected to enter the workforce.

I’m lucky enough to be unaffected with my own DD, but I have several close friends who are currently struggling to access help for their DC with speech delay, and it’s been a nightmare for them; all have given up on the NHS and resorted to paying for private speech therapy (running to thousands of pounds), and they are the lucky ones who can afford to do this. As a former primary teacher and current governor I know all too well that the less fortunate ones are turning up in Reception pretty much non-verbal and utterly unable to cope with the demands of school.

I’d also echo what a couple of PPs have said about training as a SALT; I’ve looked into this as an option myself, but while I’m super keen, have pondered it for years and on paper would be an ideal candidate I just don’t think it would be feasible - courses are few and far between and heavily oversubscribed, training would potentially involve placements a long distance away and it’s very intensive and workload heavy, which with a young DD I just don’t think I could manage. And then there aren’t even guaranteed jobs at the end of it, as I know from experience that many areas can’t afford to fund them.

It just seems that there are so many obstacles being put in the way of increasing the SALT workforce, when it’s a massive shortage area and thousands of families are desperate for the help.

The NHS has about 23% empty SALT positions.

One of my DC was looking into doing it at university- the intake of most courses seems to be a max of 35 per year, most subject talks said they could teach more but didn't have the placements available. And there's only about 20 universities that do the course. That's just not a large enough throughput.

@IanCurtisdancing it's a degree or a masters. The degree used to be 4 years in many places (it was when I trained 25 years ago) but it went down to 3 years a while ago.

As well as being a SLT, I'm also a parent of a child who needed SLT. We had a pretty crap service through the NHS 10 years ago but the situation is 100 times worse now.