To self refer DC to SaLT?

[Spareincoming]

DP thinks I am, and should go via the health visitor.

DC is 15 months old and struggles with drinking. They don’t seem to get a good lip seal around a straw, beaker, sippy cup or 360 type cup. They take sips then a large amount of liquid comes over the upper part of the straw etc.
There has been no sign of improvement in 4.5 months. DC often ends up soaked as liquid goes all over, under bibs, down aprons etc.

I suspect either a level of dysphasia, or poor tongue positioning. (I have an SEN background but not with wee ones like DC)

For full disclosure, DC was under ENT until Christmas, having run the consultants secretary last week, she said SaLT referral via the health visitor.
I have not got on with DCs Health visitor from day one, so was less than thrilled.

But on googling, our trust has a parental referral system as well as health care provider referral.
DP is very keen on me ringing the health visitor and going through their hoops to get a referral.

I’m right to self refer, not go through the health visitor, aren’t I!
And DP is wrong isn’t he!

I'm a SaLT - if you can self-refer then do that. You won't get seen any quicker with a health visitor referral than a direct one!

If self referral is allowed, self refer. If there’s nothing to worry about, SALT won’t accept the referral.

Do it. Waiting lists are awful.

Do everything in Your power to get the referal Asap. Why wait any longer than you need to ‘jumping through hoops’ ???

always taken the view that if I can do it myself I do - much quicker as I have a case load of 2 kids rather than 22….

Total no brainier to start the process asap to get help they need.

Yes. Self refer. Through GP I think. Research where your local referrals go to and ask for that. Don't bother with mardy HV. Good luck. Xxx

Yes do your own referral! You'll be able to give a lot more details than the HV would. Make sure you add in all the ENT involvement, say if there are any signs of difficulty swallowing (coughing, eye watering, flushing) or history of chest infections/chronic cough.

I work in paediatric dysphagia and the health visitors seem to know very little about it.

We would accept a referral for the issues you describe but I know some services referral criteria are very strict.

This. We accept self referrals and all sources are treated equally. However in our service we wouldn't accept this referral without more overt signs of dysphagia and you would be advised to go back to the HV. If you have wider concerns he has swallowing issues then include it in the referral. (If you don't there's still no harm in referring.)

If there is self-referral route then, by all means, do that. It makes no difference where the referral comes from. The triage will either accept it or rejected based on referral criteria. Having a health visitor sign off on one makes no difference. If anything, it causes more stress for you as you never quite sure if they sent it and for them as it takes time away from other tasks.

Are they choking on food or swallowing larger bits of food whole at all or is the issue only drinks? Are they getting chest infections which might reflect food or drink getting into the lungs? They often need to know that eating/ drinking is causing some level of risk.

It’s definitely worth a try but I expect this issue by itself may not be enough for the referral to be accepted.

DD2 was referred to the SALT feeding team as a baby by our HV but they were very clear to me after she was discharged that if we had more issues in the future to just self-refer back and no need to go via the HV. So if you have a similar system, I'd say make the most of it!

Thank you so much everyone, I’ve just read your replies to DH, and he thinks direct referral is the way to go now!
DP has a lot of faith in following the “rules” and that I push too hard at times (not limited to healthcare!) so felt HV was the way to go as that’s what ENT secretary has said…

@Hopefulbride18 Can I ask if it worth mentioning that DC has had 2 lingering chest infections, both have needed steroids and antibiotics courses repeated. I suspect DC has inhaled fluid on several occasions which contributes to the lingering infections.

Definitely mention the chest infections. That will be the bit that gets the referral accepted.

My son had similar issues drinking. At 6 it's still something of an issue.
I think different trusts have their own criteria, but our experience was that SALT wouldn't accept a referral until 18m and the wait list was 8m minimum. In the end we ended up getting a GP referral for a nutritionist who referred us to infant feeding - worth understanding whether there are multiple routes where you live so you don't waste time! Do you have a SALT hotline? Your HV can give you and you can ask questions of the team to understand if there is a different or better way to get help with this specific challenge

@Spareincoming yes definitely that is really important and implies that there could be a swallowing difficulty.