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 would say we mix it up - but we're currently so blooming short of assistants that we don't really that much anymore!

I work in adults, so very very different (and I'm a new B6, so slightly more responsibility... allegedly, in reality I've been basically doing B6 work since I started - just now I get paid for it), but basically within our team we work to our strengths and interests. One of the assistants is utterly utterly amazing with sign, so she does lots and lots of Makaton training and interventions; another is from a mental health background - so she might do a lot of direct work with clients who are experiencing MH issues and who have LD; we do an online clinic once a month for quick things like support with developing social stories etc - and while a SLT leads that, one of the assistants sits and starts collaboratively developing resources on the fly... but the SLTs hold the caseload and maintain clinical oversight of it all - but we all know our assistants are so good that we can essentially ask them to step in with a client and do the bulk of it if required.

Within the team - we have some SLTs who absolutely hate delivering training and find it really stressful, whereas others have a bit of a teaching background at various levels - so we'll try to make sure someone is there who is confident with the delivery; and some of us are much more confident and keen on dysphagia work than others who are utterly superb with communication in ways that most of us can only dream of - so we do tend to allocate cases accordingly as much as possible (although all of us will do everything when the need arises).

I know that my client group is very very different work to what people traditionally think of as what SLTs do though - much more indirect intervention, assessment, working with MDTs and producing accessible resources - and lots and lots of mealtime dysphagia work. Ironically I originally started retraining with the view I'd work in-school as a SLT but found I enjoy adults much much more!

@DoNotScrapeMyDataBishes so cool to have another SLT on this thread! I started studying SLT knowing I wanted to work with children...even doing my adult placements, I knew it just knew it wasn't an area of SLT that was for me. I still love working with children.

@KeepSmiling89 iwantsunshine1
My ds got referred on his 2nd birthday. He's now 3.7 and has only had 3 sessions of verve with someone who's not a speech therapist in a year and a half. I've been told he's still on the waitlist, what can I expect next? Verve did not help, have you found this a good method?

I had to look up "Verve" as it's not something I've heard of before. It's definitely not something we use in our team (or the 2 other teams I've worked with in the last nearly 10 years). From what I gather, is it to support children with social communication difficulties?
What were the concerns raised when your son was referred and what are your main concerns at the moment? Do you have any expectations of what you're hoping to get from SLT input?

My ds barely talks, he says singular ones and only a couple 3-4 word sentences. You can't have a conversation with him and he can't communicate his needs through speech. If you ask do you want this or that he just points to the one he wants. You can only ask him yes or no questions but that doesn't always work. I've heard of lots of different reasons for speech problems and I would like SLT to help identify what the cause is. Ultimately I want a diagnosis so we know best how to help him moving forward. He is also delayed in all areas but it's hard to know how much he understands as he can't talk

He's on the SLT waiting list so that's a good start. The fact he's got some single words and phrases is encouraging- is he using them functionally (I.e. to get his needs met or to communicate sonething to you/someone else)?
Keep responding to his nonverbal methods of communication- pointing, gesture etc and model at 2 word level (so if he says "car" you could say "red car/fast car/big car/mummy's car")
Sometimes there is no diagnosis and sone children just need more time to let their language develop. Hope that's been a bit of help and you're not waiting much longer for your SLT sessions.

Hi again,
My daughter is thinking of going into slt.
She has the oppurtunity to do work experience next year. However, no slt practices do work experience for teens.
Do you have any advice on what to get experience on, to help her decide on slt or not please?

🙋Hi, I have a quick question. How important is it that the school aligns themselves with the recommendations of the SLT in order for the child to progress, and what can be done to support the child if the school is not as engaged as they ought to be? Thank you

If you lived near me (NW), your daughter would be welcome at our house (DS 14 has cluttering and CAS so plenty to work on at home as well as to observe in online therapy sessions)! Parent groups on FB/Mumsnet might help?

For example, there is a FB group for Childhood Apraxia of Speech/Developmental Verbal Dyspraxia. Edythe Strand has some wonderful lectures and therapy session examples on YouTube.

Any nearby Unis doing SLT degrees that might provide a way in or shadow a HLTA who is experienced in delivery of SALT in a local school?

My son is 3.5 and says a lot of words now despite a slow start but his pronunciation isn't great and few people understand him. I've been told it's 'back sounds' he struggles with more. Any tips to help him with this please? We're on the NHS waiting list but he'll probably be in reception before we see anyone.

Thank you. Will look into that

Hi, dd is 2 yrs 8 months, non verbal and on asd diagnosis. Im currently doing the more than words Hanen course, i work full time and am a lone parent.

I sing nursery rhymes to her with gestures at home as much as i can, and i narrate what shes doing when i can but no words as yet and im totally exhausted.
Do you think its worth it getting a SLT for dd ? as some may consider her too young, furthermore, how many hours a week would she need do you think?
what type of SLT do you think would work best?
Im totally at my wits end trying to do all myself with nothing achieved as yet. thank you so much.

DS has been under NHS speech therapy for 18 months or more and only had 1 appointment in that time - is that normal? He's 4y9m, speaks in sentences but called himself by his name until maybe 6 months ago and his speech is unclear, lots of sounds missing. He is making progress at his own pace but I'm sure he's not getting anything gold standard which I saw you mention further up in the thread.

I'm chipping in to respond to this. I'm a SLT who specialises in autistic language development.

It sounds like you're doing a great job in trying to support your DD's communication development, but you would definitely benefit from some SLT input.

I'd suggest making a referral to NHS SLT now, as you might be waiting a long time for this to come through (2-3 years in my area ☹️). You can ask your HV/GP/nursery for support with this, or self-refer.

In the meantime, find an independent SLT who specialises in gestalt language processing and natural language acquisition. You can find a registry through these websites - meaningful speech or communication development centre.

Autistic language learners generally need different support from SLT so find a therapist who really understands that.

In terms of frequency of input, the therapist will be able to advise you on that. But the important thing is that you feel confident in using the most appropriate communication strategies for your DD at home.

Best of luck with it all.

Thank you so much.

Ive got in touch with an SLT , my best mate who has 3 asd kids feels that my dd is too young to get the most out of this as she wont be as engaged. But i feel i must try.

@Lostmum1906 a big proportion of my caseload are autistic littlies your daughter's age. So I definitely don't think she is too young. Any therapy for her should be child-led and play based.

Best of luck.

Thanks for this thread, it’s really interesting.

I’m curious about SALT and autism. I’m a late-diagnosed high-masking autistic woman. Since my diagnosis last year I’ve started to recognise things in my speech and language, like the use of verbatim scripts (echolalia?) and changing my accent completely to fit in, etc. Now I’ve noticed them, I really dislike these things about myself but I don’t know how to find “my voice” any more. I wondered if, and what sort of support SALT could offer here. Not NHS obviously. Or is this just me now?

@brogueish I'm the autism specialist SLT who posted before, with a name change.

Congratulations on the start of your journey of autistic discovery.

I would suggest some peer support would be incredibly helpful. So working with an autistic peer support practitioner who can help you in the process of unmasking.

There's a few independent organisations that offer this.

Using echolalia/scripting is part of autistic communication. It's different from NT communication but different doesn't mean less. Look up gestalt language processing.

Good luck 🍀

Ive Been told my son has ‘speech related anxiety’ but not situational Mutism, could you tell me what the difference is?

Is it common to have DLD without ASD or ADHD?

It's very common.

In fact, you can't have a dual diagnosis of DLD and autism. You can have "language disorder associated with autism" but you can't have DLD and autism together.

You can have ADHD and DLD diagnoses together but the 2 are commonly seen separately also.

I'm not sure. Maybe he doesn't meet all the criteria for a SM diagnosis. But it's not particularly helpful to use this descriptor for a child and not fully explain it to a parent so they understand it.

Does he have any other diagnoses or difficulties with communication?

@ItsCasual thank you for answering.

He has a speech delay- can’t pronounce /SH /TH and consonant deletion. He will talk in small group work with his TA, but not when in the main classroom, in which he’ will also put his head down and not make eye contact.

@lollilou2 does he talk in other situations? Like with relatives you don't see very often or to children at the park?

@lollilou2 www.selectivemutism.org.uk/ there's some really good information on SM here that you might find useful.

@lollilou2 to see if you think that diagnosis is a good "fit" or not.
Apologies for the string of posts!

@ItsCasual thank you for the resources. He doesn’t talk to people he doesn’t see often (or it’s a whisper if he does), and doesn’t talk to peers at school etc just uses body language.