I am an NHS speech and language therapist AMA

[starbrightstar]

Inspired by a similar-ish thread. AMA

[doadeer]

Hello 👋
What do you think of the support level for non verbal Autistic children?
I've been so surprised how little my son gets, 45 mins once a week for 4 weeks, then back on a waiting list for 5 months.
Do you think this is enough to make any impact?

[starbrightstar]

@doadeer

Hello 👋
What do you think of the support level for non verbal Autistic children?
I've been so surprised how little my son gets, 45 mins once a week for 4 weeks, then back on a waiting list for 5 months.
Do you think this is enough to make any impact?

Hello.

The difficulty with Autism is that it's such a complex disorder. We are still trying to figure out what best approaches work best with those who have Autism.

But to answer your question. No. I do not think it is enough to make an impact. We already know from research that environmental and communication modifications are successful with this those with Autism (and for many to be in fact). As to why Autism is mainly worked on at a universal model (i.e. we teach- no wrong word, we collaborate with parents/teachers/families/staff on how to modify their communication and environment in order to make an impact and support their children with Autism).

I think the problem with utilising this approach alone is that it does not take into account the co-morbidity that a persons with Autism usually has. I.e. depending on the age, the universal approach may be "enough" for a very young child or a student whose Autism is more at the social level and they do not have any other areas of difficulties... but if you have a child who is Autistic+non-verbal+learning difficulties+motor and sensory needs+ ADHD etc. Then in my opinion, the child needs a greater amount of support which cannot be provided from the universal approach alone.

[Domesticdrama]

Can you tell me what qualifications you took to get into this field?

[starbrightstar]

@Domesticdrama

Can you tell me what qualifications you took to get into this field?

Well... my first degree is completely unrelated to speech and language therapy. So I undertook an MSC in speech and language therapy. Which took 2 years to complete.

If your going down the undergrad route- you will need to undertake the BSC in speech and language therapy.

[DrDiva]

Would you expect a school to inform parents of selective mutism in the school setting, and would this pass the threshold for SALT intervention?

[starbrightstar]

@DrDiva

Would you expect a school to inform parents of selective mutism in the school setting, and would this pass the threshold for SALT intervention?

I would expect the person who made the diagnosis, i.e. the speech and language therapist to inform parents of the diagnosis. Only because we are able to answer tricky questions that the staff may not know the answer of- particularly as we have undergone training in Selective Mutism. But yes! Selective Mutism we definitely qualify for treatment.

[littlebluetrain]

Do you ever feel like speech and language therapy reinforces the idea that white, middle class, neurotypical, able-bodied communication styles/language use are "best" and "normal", and that anything outside those styles is pathologised?

I don't ask this question to be difficult, but out of genuine curiosity. I've been considering a career change to SLT but these sorts of issues have been holding me back.

[chompin]

Basic tips all parents can implement to improve childrens speech?

Also I have an 18 month old who can babble, make some animal sounds, but struggles to say words and often says 'eh' a lot when trying to speak

[turtleturtle]

At what point would a referral to a SALT be necessary?

5yo struggles with pronunciation of particular letter sounds, and some words would not be understood by someone who didn't know him. School have been working with him e.g bingo games focussed on certain letter sounds but I'm still worried.

[starbrightstar]

@littlebluetrain

Do you ever feel like speech and language therapy reinforces the idea that white, middle class, neurotypical, able-bodied communication styles/language use are "best" and "normal", and that anything outside those styles is pathologised?

I don't ask this question to be difficult, but out of genuine curiosity. I've been considering a career change to SLT but these sorts of issues have been holding me back.

Recently, there has been a push to include more diversity in the profession. Particularly since the Black Lives Matter Movement. But not only in terms of race, but also to include LGBT, career majors, disabilities experiences and hopefully moving away from the stereotypical face of SLT being the white/middle class profession.

I am in two minds about the Neurodiversity movement but that's for a while other thread.

[Bluepolkadots42]

My DC is 4 this month, they were talking well relatively early, however recently I've noticed they aren't pronouncing 'r' properly: 'wed' instead of 'red' and also incorrectly saying 'lellow' not 'yellow'. When I hear them doing it I correct it and say some other words that begin with same sound eg 'it's r for red, like r for robber or robot' they will then correctly pronounce these words parroting me but later in day are back to 'wed' and ' wobber'. Why does this happen? Is it just habitual now? And how can we as parents best tackle it?

[MassiveSalad22]

My son is starting school i sept, he’s November born so one of the older ones. Been wondering if it’s normal to do the following or if I should get him to see someone - can’t remember how my eldest spoke at this age!
Can say Ts when on their own etc time, but not if in a dipthong eg truck becomes fwuck, trousers = fwouwsers. Normal?

[Spudlet]

Do you get to do any actual therapy? The NHS therapists in our area seem only to do assessments - they never get to deliver any therapy. I remember asking one about this, and she said ‘It’s not the job we trained to do’ with a bit of a wobble in her voice. I think she spent the whole time being shouted at by frustrated parents - it wasn’t her fault but getting any support in this area for SEND is horrifically difficult and disheartening, and exhausting. If you can’t pay, you’ll get nothing. It’s so sad and wrong and infuriating. Trust for the local authority and by extension community health services among the parents of SEN children is basically non-existent.

[MassiveSalad22]

• eg not etc!

[starbrightstar]

@chompin

Basic tips all parents can implement to improve childrens speech?

Also I have an 18 month old who can babble, make some animal sounds, but struggles to say words and often says 'eh' a lot when trying to speak

I would not focus on speech. I would focus on communication and play. So for a child whose at your sons age, I would be asking you, how is he communicating? How is he telling you his needs and wants? How is his play? What is he playing with? Does he use gestures/facial expressions.

All children go through typical speech errors which are aligned with normal speech development. It becomes a concern when they are making unusual speech errors and if they are making speech errors over a certain age and of course dysfluency.

[MassiveSalad22]

• and I don’t mean dipthong, bloomin heck.

[starbrightstar]

@turtleturtle

At what point would a referral to a SALT be necessary?

5yo struggles with pronunciation of particular letter sounds, and some words would not be understood by someone who didn't know him. School have been working with him e.g bingo games focussed on certain letter sounds but I'm still worried.

It's difficult to know without having an assessment. Have you been referred for SLT. Can you give me some examples of your child's errors?

[MayorDusty]

Do you work with older adults too or is it pretty much just children?

[Hannahthepink]

My 5yo, year1 daughter has just developed (a couple of weeks ago) a stutter where she repeats words or the beginning sound of words.
How long should I wait before I ask for help for her? At the moment we're just trying to help her speak calmly and show that we're listening carefully to her.

[littlebluetrain]

@starbrightstar

Recently, there has been a push to include more diversity in the profession. Particularly since the Black Lives Matter Movement. But not only in terms of race, but also to include LGBT, career majors, disabilities experiences and hopefully moving away from the stereotypical face of SLT being the white/middle class profession.

I am in two minds about the Neurodiversity movement but that's for a while other thread.

Thank you for your answer😊

What about in terms of practice though? For example, using metrics/assessments where the baseline is white, neurotypical etc?

[Appleseesaw]

Are there any guidelines for how frequently speech therapy should be offered for a toddler who isn’t talking?

[starbrightstar]

@Bluepolkadots42

My DC is 4 this month, they were talking well relatively early, however recently I've noticed they aren't pronouncing 'r' properly: 'wed' instead of 'red' and also incorrectly saying 'lellow' not 'yellow'. When I hear them doing it I correct it and say some other words that begin with same sound eg 'it's r for red, like r for robber or robot' they will then correctly pronounce these words parroting me but later in day are back to 'wed' and ' wobber'. Why does this happen? Is it just habitual now? And how can we as parents best tackle it?

I wouldn't be too concerned. He is 'gliding' which is a typical speech process. Gliding tends to stop around 5 years of age. If your son is still gliding at over 5.7 years, then I'll be concerned.

You can do minimal pairs therapy? So you present two pictures of the target sound and the error he is making, i.e. red vs wed. It is difficult to explain without demonstrating. But here is a link which explains it much better than me:

speechtherapisttools.com/story/minimal-pairs-more-gliding-speech-therapy-phonological-disorders-cycles-by-the-pedi-speechie/

But I'm honesty. Your son is young. I wouldn't worry.

[starbrightstar]

@MassiveSalad22

My son is starting school i sept, he’s November born so one of the older ones. Been wondering if it’s normal to do the following or if I should get him to see someone - can’t remember how my eldest spoke at this age!
Can say Ts when on their own etc time, but not if in a dipthong eg truck becomes fwuck, trousers = fwouwsers. Normal?

How old is he?

[Parryon]

Do you think it’s a good career? And roughly how much can you earn?

[starbrightstar]

@MayorDusty

Do you work with older adults too or is it pretty much just children?

Children but I have worked with adults- but only for a short amount of time. I worked with Adults who developed Aphasia have a stroke or a head injury.