I'm a paediatric speech and language therapist... AMA!

[SpeechandLanguageTherapist]

12 years NHS experience working with children aged 18 months to 18 years.

Acutely aware that actually being able to speak to an NHS therapist these days is getting harder and harder.

Happy to answer anything I feel able to - I've worked with most areas of need over the years, but if not in my remit I'll say I'm not sure 😊 Maybe someone else who has more experience will be able to answer instead.

Both my DC had a lot of speech therapy for developmental verbal dyspraxia (mix of NHS and private). I found working on their sounds so boring. My question is - do you ever find it boring?

What number or words and sentence structure would you hope for 2 year olds and is it true that twins often have delayed speech? Thanks.

Would you recommend it as a career? What do you think is a good route in - what do you think of a 4 year MSci SLT university course?

Are you told to not make your reports specific and quantifiable or to limit your recommendations to what can be provided in the area/ trust?

Generally, no, I find my job really interesting. My roles have always been generalist rather than in a specific area, so I'm lucky to rarely see two similar children in a day. I know some therapists who find speech drills really boring but personally I find speech really rewarding to work with because you often see progress very quickly compared to other types of therapy. I'm sure if I had to do speech drills with the same child every day I might get tired of it though!

Argh wrote a post and lost it!

DS2 is 5 (November born). Can’t say lots of sounds eg

push = puss
three = free
this = vis
jelly = thelly

Jusy tried him with sounds in isolation and he can say th, but can’t say J at all.

Anyway, just wondering if that sort of thing is normal at this age. I always thought school would bring it up if so but realising that I shouldn’t rely on that these days!

DS is almost 4 and has a pronounced lisp; we were thinking it would probably go away in time. It doesn't seem to be, so should we be thinking about seeing someone about it?

Do you think there has been a big rise in young children with language delays due to covid lockdowns and mask wearing so children have not learnt mouth movements and watched others speak? I am a SEND teacher and convinced we are going to see more of this in children born in or just before covid years.

My DS (3) has quite a pronounced lisp (th for s). Should I see someone or will it naturally sort itself out? He had quite a severe posterior tongue tie which I suspect wasnt fully resolved after we had it cut, could that be linked?

An average child would look something like this:

2nd birthday - around 50 single words
2.5 - starting to put 2 words together
3rd birthday - around 300 words and starting to combine 3-4 words

But there's a LOT of normal variation either way.

We do often see twins with communication difficulties but that's because they're more likely to be born prematurely, and prematurity is a big risk factor. There's nothing inherently in twins that puts them more at risk.

Any tips for encouraging clear speech with no hesitation?

my 3 year old takes a long time to get her words out sometimes, she will repeat the same word or phrase 4/5 times before she can then say her whole idea.

Should I be worried about 21 month old DD who only says mama, dada and no? She's learnt no new words in 3 months and won't attempt to copy words or animal noises but is good at learning signs

Is it a cause for concern if a child only had about 5 words at age 2 (just turned 2)?

No other causes for concern, understands everything, copies noises, makes animal sounds, communicates what he needs without the actual words? Seems to be NT.

I am a SAHM and we don't have any friends and family nearby so my 2 year old and I are on our own for 5 days a week, 10 hours a day (with the odd toddler group thrown in) I'm worried this is impacting his speech development as we understand each other perfectly so maybe he doesn't need to try? I am doing all the things the NHS says I should be at this age but it's just not happening.

I saw a SALT recently for my 4 year old and she said she could see dc was very active and sensory seeking and they would assess further then give advice or refer. Who might she refer us on to?

What ways can speech and language therapy help an autistic child?
Are there ways you can help those who are classed as 'high functioning' too?

Yes! I love it. Can't speak to any route other than the one I did which was a 2 year MSci. It was extremely full on, but I couldn't have bared 4 more years at uni.

No, personally I've never been told to do that.

Is having a speech problem only with vowel sounds common and is it linked to anything?

My just turned 3 year old (December birthday) isn’t pronouncing some sounds (cl, cr, th, st) clearly. Particular ones I’ve noticed today are he’s saying cween for clean, behicle for vehicle, dey for they.
Is this within the normal bracket for this age and is there anything I should be doing except repeating the correct pronunciation back to him?

DD is 10. Has had a mild stammer on and off since she was about 4. Have been through the NHS referral process twice but both times she was assessed and almost immediately discharged with some leaflets and websites to refer to for advice.

previously, the stammer has disappeared for periods of time (probably why she was discharged so early as often it’s not evident at all for several months at a time). However, it has returned and this time it has persisted longer than any previous incidences and she is more self conscious of it . She will be moving up to secondary school in September and I don’t want this to be knocking her confidence.

The NHS referral route seems pointless. We have read and taken on board the advice provided but it’s not improving the situation for her. Should I consider going private? I’ll happily pay for a therapist to work with her but don’t want to pay if I’m going to get sent away with leaflets and websites again.

Nursery says my 3 year old gd never speaks at nursery apart from the occasional whisper. She is loud and happy with family. Shy and clingy with unfamiliar people and won't talk to them. I'm worried and wondering about asking for a referral from gp for selective mutism. What do you think and do referrals come just from gps?

three = free - age-appropriate
this = vis - age-appropriate

Should have the sounds 'sh' and 'j' by now so this is a little delayed. I wouldn't rely on the school to notice anything.

Thank you, good to know! Really appreciate it!

This may be off topic a bit so ignore if you're not sure - when someone has a fixed retainer (bonded behind their teeth) can it make them spit a bit more when they speak? and if so can anything be done about it?

My daughter is 2.5 but was 6 weeks premature, all caught up now developmentally. She can do 8-9 word sentences, has a good vocabulary ie, violin, fairy, mermaid. However she doesn't enunciate all her words correctly and some words like cheese sound guttural, like nnngggeese. Sometimes she is hard to understand because she doesn't say full or distinct words so og for dog, but I feel she is making progress for example can now say yellow distinctly.
The health visitor has referred her for speech and language assessment but of course there is a bit of a wait for this -what would your thoughts be on this and is it likely to improve with time? We have read to her from a young age, pointed things out , where's the green bunny etc, we always repeat what she says back correctly but it doesn't seem to be helping. She understands absolutely everything. I'm pretty sure she can hear correctly but will take her to the GP to get them to check her ears. Any help much appreciated!