I am a speech and language therapist. AMA

[KeepSmiling89]

I like to have a browse on here during my lunch break at work and whenever I get a spare minute so please feel free to ask me any questions. Will get back to you when I can!

I don’t really have a question but am envious of your career! I wanted to be a SALT but never managed to get my shit together (I have always been an underachiever). I still like to occasionally bore my family by talking about phonetics and phonology which was my favourite part of my degree.

Do you get to spend time thinking about phonetics in your day to day job? If so, I am envious.

Not sure if this is something you can help with but if you can then I'd be super grateful! We moved to a different country when DS1 just turned 3. He's starting school in a few months. He will be 4. His new language is progressing pretty well, nursery don't have concerns but he's obviously a bit behind others his age. Any tips for how we can help him progress with 2nd language? His English is great.

I hugely benefited from a fantastic speech therapist as a teenager, and she genuinely instilled a confidence in me that went further than just speech-related.

My pre-schooler is now following a similar path and I just find it incredible how much care and support is genuinely there. So firstly thank you.

It is one of my “if you had to change careers, what would you do?” answers, so going to lurk with interest!

I've worked with a few bilingual families in my current role and the best piece of advice I can give you is to continue speaking your mother tongue with and around DS1 as that will give him the best language model (grammatical structures, sounds etc) - I'm guessing this is English? It's important to keep your mother tongue and cultures alive so keep reading stories, singing songs and nursery rhymes to him in English.
He'll pick up his 2nd language through nursery and it sounds like he's doing a fab job of that if they've got no concerns. Children learning 2 languages do sometimes have a bit of a delay, but they usually catch up and it often puts them at an advantage in terms of learning etc. They're like little sponges the way they pick these things up!

I'm currently working with a bilingual boy whose dad left his mum and his mum didn't speak much English (she's now taking classes to learn English) - he was like her wee translator at times. It's amazing to see him switch between languages (appropriately!)

I have a few families I work with in terms of speech sounds and it's one of my favourite areas to work with, although it can be a bit frustrating if the child struggles with a particular sound (through no fault of their own - some just need a bit more support than others). I'm also part of my department's speech network so we set up things like CPD opportunities, reading journal articles, preparing resources all to do with speech sounds (more phonology than phonetics).
We've actually got a big training event on the next 2 days by someone well known in the field of speech sounds so going to learn a lot about the latest evidence base and therapy approaches.

Aww, that's lovely to hear!
We are a very caring profession - I don't think I've met any SLT in my career who didn't have the child's best interests at heart. A lot of what we do is looking at what's having the biggest impact for the child/their family and what we can do to support them.

What are the downsides of the career?

hello! I have a 3.9 year old - ASD and gestalt language processor. She’s coming along leaps and bounds but still cannot answer open questions or any sort of concept - how would I build up to this?

Also - sorry double question - have you ever heard of a child changing their pronunciation of a word? DD used to say milk boy for the past year she says MELM. Hasn’t happened to other words (her pronunciation improved l)

Thank you for doing this, OP! My 3.5 year old has been stammering for the last few months. It seems to happen the most when she has lots to say. Is this something to be concerned about? Or at what point would it be a concern?

Thanks for this! My 6yo still doesn't pronounce her Rs, she'll say "fwum" for "from". We're Irish living in NI, so no non-rhotic influences and I would have expected her to pronounce her Rs.

She also muddles th and f sounds (again, not our accent or the accent of those around us).

Should I be doing anything about this? Is this likely to stick at this age or is she likely to find her Rs?

My DD started stammering since my father and her split up in 2020. Very little therapy on offer during the COVID period. She still stammers when she’s anxious and doesn’t want therapy. Will it go on its own or do I persue therapy for her. She’s 12 now and it can be quite bad at times and now she’s conscious of it. Feels cruel not to push for therapy

DD is 22 months and still only saying a few words. Bilingual (French and English) house and her dad speaks to her in French. Are the two things related?

I can help with this one as my daughter is the same. She can't say L and R sounds correctly. R comes out as W. They won't accept a referral until they are over 7 for the R sound. We are awaiting our appointments as school did a referral a couple of months ago. It is at least a 20 week wait locally for us sadly.

We think our 11 year old has situational mutism, she is on the waiting list for camhs, who would be the best service to help assess, diagnose and form a treatment plan?

I'm jumping in to respond to this as I'm a SLT who specialises in autism and gestalt language processing.

It depends what stage your daughter is at in the Natural Language Acquisition framework? The stages go from 1-6 and it's only stage 3+ that children can start to consistently respond to questions (particularly open ones).

If your daughter is mainly using delayed echolalia to communicate (words and phrases she has heard elsewhere), then your main communication priority at the moment should be to increase the amount of gestalts (language chunks) she has in at her disposal and to ensure she can communicate a wide range of functions with them.

So in short, just keep going with lots of language modelling at this stage and responding to questions is something to focus on later in her development.

The Meaningful Speech website has great resources and signposting, including a free online introductory course.

Have you noticed a general difference between boys and girls? Do a higher number of boys develop speech a bit later?

Is selective mutism something that you think children do overcome?

Thank you for jumping on!

She has been piecing together gestalts for a few months now to make new sentence both functional and in play. Our aim as you said is to just keep giving her new language to acquire and use so she has more at her disposal.

We did have one massive milestone a few weeks ago when I asked 'Did you eat pasta at nursery today?' And rather than just say 'Yes' She said 'Yes, red pasta, yummy!' So simple, but it felt huge. Like a part of her brain has opened up to us to share her experience.

@KarenOH that's great! It's so exciting to see these jumps in development isn't it?

It sounds like she's at stage 2 currently, so I'd advise focusing on easily mitigable gestalts - ones that are going to be easily chopped and changed/mixed and matched.

She's making good progress, which is a great sign so just keep on keeping on for now. Model, model, model. She's taking it all in.

Quite specific question from me! Could SALT help me as an adult to deal with an open bite (in conjunction with orthodontics)? Embarrassingly, my tongue sits in the middle when at rest against my teeth and because of my openbite, the inside of my lip 🙈 I also have a slight lisp and it would do wonders for my confidence if my tongue could maybe, hit a difference place against my teeth when I say s or th xx

Do you have any experience of sever Trismus in adults? To the point that it's not possible to eat? If you do, I'd be really grateful if you'd pm me.
Thanks

I’m a Reception teacher and if I could make a career change, this is what I would do! I find it fascinating.
My question is personal though… my 7.5 year old still has a bit of a lisp. He can make the sound, but needs constant reminding and it’s an effort for him.
DH is concerned, I’m less so as I can hear that he can do it. When does it become a concern?

Sorry, not an area I've got much experience in as I work with children.

DD age 4 can't pronounce the syllable 'er'. She pronounces it 'or'.

Bird = bord
Thirteen = forteen (this really confuses her and she often misses one of them out when counting).

Etc.

She also pronounces L and R as W.

Should I see someone about it or will it go away by itself?