I am an NHS speech and language therapist AMA

[starbrightstar]

Inspired by a similar-ish thread. AMA

It does sound like a language delay and children go through typical speech development where certain sounds are not mastered by a particular age. I would definitely ask the SALT if your DD can access Language enrichment groups in addition to Bucket. Some local children centres offer communication style groups where they have an SALT delivering groups. You can definitely explore this option.

Apart from /r/. Your son should be able to say /ch s l: by his age. Google cued articulation (a list of signs which visually represent sounds) and use these during any phonics work and direct work.

For therapy, work on articulating the /ch/ as a single sound. Tell him where he needs to position to tongue/mouth and use a mirror to help with this. Once he knows how to produce /ch/ get him to produce /ch/ within vowels, like /cha cho che ich ach och/ then within single words at the beginning/middle and final words, I.e. chair, latch, lurching and then within sentences.

I had a private SALT and OT assessment as the LA wouldn't do their own.

Therefore those reports had to be used to form part of his EHCP.

I then had an SEN specialist solicitor to write his EHCP and argue it with the LA.

Outcome is that DS1 ... who has no problem's with talking and alternating OT and SALT on a weekly basis.

He has SALT from an ASD trained SALT professional and for him it is gaining communication skills eg talking as part of a conversation...not just at people boring them rigid with his latest obsession

...who has no problem's with talking HAS alternating....

DH can't say "th" but substitutes "f"or "v" (despite having had some kind of SALT as a child). Is this likely to affect our baby's speech? Should I worry when he is doing the baby's "barf" and singing songs about cleaning "teef"? What can I do to help baby learn properly?

I'm a late diagnosed autistic adult (diagnosed aged 40) and I've always struggled with selective mutism. Would this be something that could be helped by SLT or is it dealt with by strategies to manage anxiety? As a child it was very pronounced and I've managed to overcome it in some situations (largely because the fear of looking stupid at work overrides the fear of speaking) but under certain stress I shut down and cannot make words come out of my mouth, even when I can think the words in my head or type them without any issue.

SALT won't see her and the LA won't ask SALT for advice because they aren't already involved with her 😣I've emailed the specialist teaching and advisory service language and communication team to see if they will pick her up.

Thanks for this, this is very interesting. My son, nearly 6 has a speech and language delay, no formal diagnosis, but has an EHCP and attends a SALT resource base in a mainstream school.

Before attending the school, we felt completely let down by NHS SALT, rarely seen, only ever seen in person to do a quick chat maybe one a year/six months about progress, no formal sessions. The speech therapist assigned to him I think just assumed he was autistic, knew nothing about him. I do appreciate that the system is over subscribed and underfunded but we did feel completely abandoned.

DS only started with single words about 3, and two words together at 3.5 and now at nearly 6 never stops talking, admittedly still has some way to go, plus he didn't receive an autism diagnosis last year after a 3 year wait. We were fortunate to be able to pay for 18 months of weekly private SALT who introduced PECS which were then not needed after 6 months or so, which along with a fabulous preschool, who got him the EHCP and ultimately the place at his school, is where we are today.

You sound like a fantastic therapist and I'm sure the families are lucky to have you.

@starbrightstar

Thank you

Quite a lot, especially in terms of establishing what is "normal/typical" development/speech/language - it tends to be based on what is normal for non-marginalised people. It's an ineffective and unfair measurement. Lots of work done on this by SLT Warda Farah, amongst others twitter.com/WFarahslt.

One of my DC did this for a while. They have other speech issues, this was never a priority, it usually meant for our DC that they'd hit a limit and needed some quiet time, or a rest or leaving whatever activity they were at or needed a break from school. It could be that she's tired, the school year can be exhausting. The only response we ever gave was to encourage them to slow down. It seems to have resolved on its own. I don't know if it's different in the UK, from what I know here no all SALTS can treat stutters, it's fairly specialised.

Sorry I just saw you had a reply ☺️, please ignore, I hadn't seen any in the first couple pages.

That's interesting. It's the parents who do the extra practice sessions here, but none of these things are part of educational provision where I live. My DC have had many hours of speech therapy and many more in practice, it's taken a lot from all of us.

It has been fascinating seeing it in action, all the things that go into making a sound correctly, how lips and tongue and teeth all have to work together, be in the right shape, move in the right way. I'd never thought of it before, broken down to the way in which a sound is made, how complex it is.

Thanks for setting up this thread.

I haven't read it through, but 2/3 of my children have lisps and I wonder if it's a problem or not? They don't seem very obvious but maybe that's because we are used to it.

Thank you for your honest answers, you sound passionate about your role and the families on your case load are lucky to have someone like you.
My son has seen many professionals over the years and one of the SaLTs really made a huge difference. She was passionate and a fabulous advocate for my son, she helped fight for the provision he needed and I really believe that without her my DS wouldn’t have the level of intelligibility he has now.

My nephew developed a stutter and we were advised to stop asking him questions as his brain was processing the answers more quickly than he could say them. We all backed off and allowed him to speak without so much pressure and the stutter went away.

Hi @starbrightstar do you have any advice about my dd aged recently 3 who does not speak at all at nursery? She has been going for 3 months and will nod/ wave etc there but no words. She talks a bit to the other children but is silent around adults. At home she is chatty and confidently speaks in full sentences. She initially said 'I don't want to' when I asked why she doesn't speak there then she agreed with me that she is scared to speak when I asked if she is scared when the teachers speak to her.

I have a thread actually on my sons speech ( no replies ha ha). He has a nasal quality as in speaking down through his nose on Ch/ sh/ dge, j, g. It's so hard to correct, he is having speech therapy, and can say it normally in session ( so I assume doesn't need an operation?) but can't seem to put it into practice in everyday speech. Do I continue therapy? It's costing me ££££££. The therapist gave him flash cards to practice and he can do it but not in a sentence. I'm just confused on what to do to help him. ( He's nearly 6)

Hmm.... any child is having difficulties with their nasal sounds, I would query cleft palate,
There are so many different approaches when it comes to speech, where I feel the UK isn't up to date with. I would ask the therapist to try the complexity approach if your son is not really making any progress. Not all therapists know about this approach, again, hence why it's important to ask the qualifications and experience of the SALT. Does she have experience of working with children with speech disorders, what courses and additional qualifications has she undertaken which are relevant for updating her skills with treating those with speech sounds disorder. Honestly, the quality of therapy is down to the speech and language therapist.

@starbrightstar thanks for the reply. I think I need to work more with him as once a week for therapy is such a short time really. It's hard to help your own children. If money were no issue then of course I wouldn't worry about the rate of progress so much. The therapist seems very up to date, my I will look into it.

I was thinking was if my DS can say these sounds in isolation then it's not a physical issue? But then I'm not a doctor. My Ds has had tonsils and adenoids out at 3, so surely they would have spotted a cleft palate then? I would hope.

Thank you so much for this. Mostly with questions but I have noticed once he learns a new sentence he will repeat this back too. His understand when I ask him to do things, brush teeth, take shoes off, put something in the bin etc seems fine and he will do it. I will seek a referral for SLT. Thank you again

If you are still taking questions then I have two . I would like to know why my daughter can say certain sounds on words, but then she can't on others. Is it just a case of learning something wrong and she's ran with it ( like when people say pacific instead of specific?) An example would be she says "Dat one" for that one, but can say "this one" perfectly. She's nearly 3.

I also have a sweet, shy 6 year old who talks really slowly. It's quite painful to listen to and in comparison to his friends very noticeably slow. I wonder if this is an issue or just his confidence ?