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.

No reason to be particularly concerned about that that I know of. It's much more rare though.

Nothing you've written here is of any concern whatsoever 😊

Yes, echolalia can be one indicator, particularly at age 10 (it can be more common in toddlers). A lot of other factors go into a diagnosis though.

Is that what the teacher thought or what the therapist told the teacher to tell you? I'm not sure how the teacher would be qualified to make a judgement like that, regardless of how your child is accessing the service. Seems very odd for a teacher to make that call.

My team covers our NHS Trust, which for us is the whole county. Our entire caseload as a team is around 1000 children. Personally I have around 100-130 children on my caseload at any given time (you can see how stretched we are). I have a mixed role currently of preschool/primary aged children so see children in schools and in clinic as well as in nursery settings. I sometimes see up to 20-25 children directly in a week, but my time is also made up of meetings, phone calls, report writing etc. so usually it's more like 15 or so children on a typical week.

2.5 is still early days so I wouldn't worry too much, however not speaking outside of the house is more of a concern to me. If she won't answer yes/no when you speak to her, if usually she would do this easily at home, I would wager that she is feeling anxious even if she doesn't look it on the outside. Anxiety around talking isn't always obvious and sometimes the only clue is the fact that the child isn't talking.

Whether you choose go private is completely dependent on your own personal circumstances. As I'm sure has come across in this thread, personally if I were concerned about my child's communication, I could afford it, and I was being subjected to waiting lists of up to 12 months plus as some have mentioned on here, then I wouldn't hesitate to go private, as early intervention is known to be really important for developing communication skills. However it's very situationally dependent. If your area has a less than 6 month waiting list and it's going to be a huge financial stretch for you, then it might not be the right choice for your family, for example.

SOME GENERAL POINTS RE: SEEKING PRIVATE SALT

• No one (including myself) can tell you whether seeking private SaLT input is the right thing to do. Yes early intervention is important, but private therapy is generally expensive and we're all going through a cost of living crisis. Feeding your family and keeping the heating on is also important. There is so much free information online about things you can do to support your children to develop their communication skills for free. Find advice websites and charities, follow social media pages. Your local NHS SaLT service may have online resources you can look at.

• If you can afford private therapy without stretching yourself too thin and NHS waiting lists in your area are ridiculous or the NHS aren't providing the input you feel your child needs, then by all means go for it. Don't forget that you can still keep your child on the NHS waiting list/caseload as they also receive private input. The therapists should be able to work together to support your child.

• If you're looking for an accredited private therapist in your area, ASLTIP is a good place to start. You can filter by areas of specialism. Most private therapists will offer you a free telephone or video consultation to discuss your child's needs, so you can assess whether they would be a good fit.

• Please remember that NHS therapists are humans who are doing the best job they can with the time and resources they have. If you think that local waiting times or the service provision is unacceptable, contact local and national politicians who may be able to do something about it. Don't take it out on your local team who are underfunded, overworked, and likely agree with you that waiting times are less than ideal 🙏🏻

Thank you so much!

Hi OP- I hope you don't mind me asking because you've had loads to answer on this thread!
My son is just over 2.5 and I don't think he needs speech therapy but his nursery think he does. He has hundreds of words and is linking 2 words, starting to link 3-4 words. He was a late speaker though and only started 6 months ago.

He doesn't seem to speak as much at nursery which is promoting them to think he needs a referral. I think he's most likely overwhelmed by all the children there and they don't seem to do activities around the alphabet and numbers which he thrives in.
Should I do the therapy on their recommendation?
Thank you

@SpeechandLanguageTherapist Thank you so much for taking the time to respond to all these queries when you're so overstretched at work already! You be saved me a lot of worry 😊

Do I need to be concerned that my 17 month old can’t say any words yet?

Thanks so much for your response to my question about your caseload and the geographical area you cover

Hi OP! I just saw your post and probably you’re not taking any more questions, but just thought I would try :) I just wanted to ask how SALT can help an 8YO with mild ASD (Asperger) with social interactions. Thank you