I am an NHS speech and language therapist AMA

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Inspired by a similar-ish thread. AMA

Hi, thanks for posting!

DD is 8 and still can’t say some sounds including “sh” 🙈 am trying to find a speech therapist but also can you suggest any good youtube videos or sites that may help? I watched some but they didn’t help at all, DD just couldn’t say shhhh.

Hi! I’m so glad I found this!

my 11 year old has a stammer. He has been through 3 lots of ST now with little success. I think the problem is that the techniques (breathing before speaking, slowing down, bouncing on sounds at the beginning of words etc) feel too hard for him to incorporate into busy conversations in the playground etc.

Is there another way or is this the only route to easier talking?

Hi, my dc age 3 is chatty and talks in full sentences at home. At nursery 3 days a week for the last few months they do not speak at all and rely on body language. What is the best way forward to support my dc with this please?

What the hell has race got to do with it

Hi at what age should I ask for help if my son isn't talking? He's 18 months and has no words yet other than mama and dada. He points to things he wants but other than that it's hard to communicate with him and know what he wants. Anything you can suggest to help communication?

What age is the earliest you would become concerned over lack of speech? My son is 18 months and only says one word. Personally I'm not concerned yet but had a few people mention to us and seen some other parents who are concerned that their child is only saying 5 or 10 words at the same age.

Separately I have a five-year-old who turned five in March, he is unable to pronounce 'R'. Is there anything we can do to support him with this? Nothing has been raised as a problem at school so not sure if this is common for his age.

Thank you!

My son was non verbal and wd didn't use pecs as he wouldn't engage with it. Like your son he loved his ipad so we started with words for life. This was about 7 years ago. He is now classed as a verbal communicator and although he uses symbols and pictures still for reinforcement he does not use his app any more. The AAC device was one of the best things we did for our son. Get it wrote into section f of the ehcp with the slt hours, training, equipment (ipad and app), that the ta has to be trained, model use and the ipad has to go everywhere him.

My daughter is 4 in Sept, been told she has speech dyspraxia. Had 3 30 min sessions of SLT until next school year. Any tips to support? She's otherwise ahead of most of her peers with everything but speech and this is leaving her so frustrated despite doing the "homework" set and her nursery also giving her 1:1 time to support.

Do you know what has caused the issue as that will also be a factor i.e is it nerve damage from the surgeon...or from the breathing tube by the anaesthetist...

We moved to Germany when DS1 was 5. He had trouble with the sounds th and R for a long time, longer than most children I think and still can't say th properly and he's 13. He says "dat" and "fink" and "wiv". This has never been picked up because the th sounds doesn't exist in German. For R he was substituting the sound w (twee, wobot) and then for a while he said Y instead (ch for tr, and really couldn't hear the difference between eg trees/cheese, yobot) which I'd never heard anyone do before. This was probably when he was about 7.

I'm just curious whether that would have triggered speech therapy in the UK and whether I should have looked at doing something privately. It's probably a bit late now

My son is 6 has struggles with C K G sounds, I have always been told he will grow out of it. School aren't worried and all private options are full with closed waiting lists near me. Is there anything I can do to help him.

@iRun2eatCake No we don’t know, it was a huge op he wasn’t expected to survive. It was urgent surgery not routine.

He said he heard a crack when they intubated because there were doubts he’d be easy to intubate so he had LA, they intubated then when it was ok he was given GA.

I’m not ungrateful because he survived and that was the first hurdle.

This would definitely trigger an SLT referral. It sounds as if he may have an articulation and/or phonological disorder of some kind. Speech can have an impact on a child's reading and literacy which is why it is important to seek treatment.

Sounds like he had an awake fibreoptic intubation.

Mine is the same but he was diagnosed with a severe and persistent speech disorder at 5 and has an ongoing complex speech disorder - he has salt once a week but this will be on going up to at least year 6.

I don’t know, the goitre was huge and his airway was closing over so it was do or die time.

There was about 30 clinicians in the room. Every dr he saw for the first two weeks told him they were there during his operation.

Do you get bored during therapy sessions? Both my children were diagnosed with verbal dyspraxia and I found the sound work sooooo tedious :)

Do you enjoy your job? (Sorry if that's already been asked)

My daughter has a moderate speech delay '12 months' delay. I was told that she doesn't qualify for help with the NHS community centre because it's not severe and they can't help everyone.

Is this something that you have to tell parents often?
Where should I go from here?

She's 3, in pre school 3 mornings a week, we go to a local childrens centre where they do bucket time but it's hard not to feel left behind somewhat.

I don't get the reasoning behind it, it feels like " it's bad, but it's not bad enough yet, let's wait until it's really bad to help!"

Ps speech therapists do a fantastic job. At aged 4 we called my son a pterodactyl as that’s what he sounded like and we couldn’t understand him never mind anyone else. In 4 years he’s gone from that to above expected reading and despite a complex speech disorder he can at least be understood not just by us but by his teachers and friends and goes to a main stream school. Unfortunately lock down had a terrible impact on speech services.

I was lucky mine loved Peter Rabbit & mr men so we ready the Beatrix potter books over and over again in lockdown.

he went from 1/40 in year 1 phonetic at the start of year 1 to .34/40 in the December of year 2.

I found it an enormous fight to get him assessed and he was mute by the end of reception as - why talk if no one can understand. The waiting time between blocks was 6-12 months (!) and that 6x 30 min sessions. I felt awful as I kicked up a massive stink got the local mp involved and all sorts and 4 weeks later he had an assessment with the head of our local salt and he score it so poorly he went the following week on a year long intensive speech and language school
place - despite the lack of funding I’ve found all his salt therapists to be like patient gods (!) mine was almost mute and struggling with everything as he is now confirmed as autistic and each and every one has made him so happy and confident 💐💐💐

My son is 5 and a half and can’t pronounce ch, sh, l and r. His school say they’ll do some intervention work but this hasn’t happened. He struggles with phonics because of this. Any ideas of how to help? He’s been on salt won’t list for 20 months and had an assessment but then got moved to school years wait list! Thanks

Have you got a patient / patients / a certain case that you have found really memorable?

is there any part of the job you don’t like?

I was furious when my DS EHCP specifies he only gets an hour a term, but it was explained that this is because he attends a special school, the 1 hour a term is with the in-house SALT and she will assess him each term and direct the staff on what to do. Is that usual or just at his school?

we have the frustration that DS does not shut up, but it is all parroting and he cannot use the words from the songs / phrases he knows outside of that context.

so he can recite an entire episode of props pig but can’t ask for a drink! Have you met any children who at year 3 cannot string 2 words together and have they eventurally been able to have some sort of conversation skills?

DD1 is 16. I've been saying that she has a S/L disorder (in my view) since she could talk. She used to use her own descriptions of things like 'it pink and it go weeee' (slide) and 'I want bowl eat' (hungry). She went to special school and I was always told by SALT that she was simply delayed with some articulation difficulties.

Roll on until she's 16. Diagnosed with ASD at 15. I ask for a new assessment. Finally get it. Severe speech and language disorder, both receptive and expressive. Core language on 0.1st percentile. Understanding at sentence level.

Is it common to get it so wrong during the formative years??

2nd question - DD2 is 14 and has ASD. Going through EHCP process. A bit of a stammer. Rarely talks to teachers in school. Uses one word but means another. Used to have odd syntax, still does a bit. SALT won't see her because they say it's not functional and is just her ASD. LA won't ask for SALT advice. We feel that she has huge issues understanding her teachers, which will be missed without assessment/advice. What should we do?

Waiting for a SALT assessment but in the meantime what does this sound like to you?

DD 36 months, able to say lots of individual words, knows the words for everything, able to ask for what she wants using individual words or pointing, but no sentences AT ALL. Able to parrot phrases heard from others and repeat entire songs clearly but no independent sentences or spontaneous language. Also looks fairly confused whenever a question is asked and doesn't always know what to say even to simple things. Is this a receptive language issue or something entirely unconnected to speech and language. Quite sociable, reasonable eye contact etc so ruled out ASD

My daughter is 9 autistic and non verbal she is currently receiving ST though her (mainstream) school once a term. We are offered no other support. Is this normal? We now pay for a private therapist to see her once a week but this is so expensive I feel we should be offered more on the nhs?
She was using pecs from age 2 to age 8 when she suddenly decided she wasn’t doing it anymore. She now signs a little and points to communicate she has very few (less than 5) words.

I have a just turned 3 year old DS who still repeats questions back when asked. Echolalia I believe this is called. It isn't every question but most questions I ask I need to follow up with 'yes or no' other things he was answer no problem as in what colour is that. His nursery have said they have noticed he repeats questions but his speech is otherwise very good and clear for his age. The health visitor isn't too sure if he could have autism as no other red flags. She said if he did he probably would never be diagnosed as it's so subtle. Would be interested to hear your opinion on this. Thanks so much for this thread btw. Super interesting