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.

My 4 (turned 4 in Nov) had a good vocabulary and shoes good understanding but his speech isn’t clear. I can understand everything but strangers really struggle. He’s very sociable and always wants a chat. Is is pronunciation likely to improve with time or will he need therapy?
Are there any apps or programmes you can recommend for this?

What are some of the challenges you face in this career? Do you enjoy your role? Would you recommend others to train in this field? Thanks!

My little girl is 3.5y and was referred for SLT and a hearing test. She's been 3 times for her hearing test and her eardrum was totally occluded with wax and now partially occluded (even with months and months of ear drops) the test showed hearing loss in both ears. She now has a ENT referral.
She is shy and her speech sounds aren't all very clear (she says let's instead of yes for example).
She asks questions, speaks short sentences and has understanding, she talks a lot less out of her comfortable family surroundings.
Her referral was rejected by SLT, didn't meet criteria?!
She is definitely speech delayed compared to here peers. Have you had experience where is it mainly a physical issue (eg wax) that when resolved her speech should come on or do you think we need to push for her speech referral. I feel she needs both?! Sorry long post x

My 4 and a half year old doesn't quite pronounce all his words properly.

There is 'nair'. Same with other words starting with th.

Fly is 'Bly'. Same with some other words starting with f.

Is this normal or something for me to worry about?

15 year old HFA. Speech problems. Hard to understand sometimes. Discharged from SALT. At a loss. Probably going to have to go private.

I’d love to know your thoughts and experience on how additional languages impact speech delays.

I have two DC who are trilingual, the oldest is austistic (high functioning) and BOTH are with speech and language therapists for speech delays. But I’ve read a lot of literature stating that additional languages shouldn’t mean a delay…

I have a 15 boy who speaks with a high pitched voice quite a lot, to the point that other children are noticing and teasing him. He also has learning difficulties. Is this something that will resolve as he gets older and his voice breaks or is it linked to his learning difficulties? Thanks.

my 5 year old is having speech therapy. They’ve successfully fixed her ‘backing’ issue I think it was called.
they have just started working on really noisy s, ch, j sounds. I think they said it’s a lateral lisp. Basically the air is t being pushed up and over her tongue but comes round the sides causing a lot of noise

any tips for working on this? Thank you so much

There are two types of lisp:

An interdental lisp where the tongue is between the teeth and the 's' sounds a little like 'th' - this is typical until age 4.5 and very common. We would never treat this on the NHS (or at least I've never worked for a service that would) as it doesn't usually interfere with intelligibility. You could seek private support for this if it were to become really delayed. Your 4 year old is likely to develop out of it though.

A lateral lisp where the air escapes over the sides of the tongue. This is much more obvious and impacts on intelligibility. This is never 'typical' and always merits a referral. Your child would be very unlikely to grow out of it.

In either case, keep modelling back a clear 's' sound and don't explicitly correct your child.

Yes, yes, yes, yes, yes.

Yes!

It's a big, big problem.

Curious if delayed speech is more common at the moment due to babies growing up through lockdowns.

Delays because of masks?

Or COVID and lockdowns generally?

I was born with a complete cleft of the primary and secondary palate and Pierre robin sequence. Just popping in to say you do amazing work. My life changed because of my speech therapist.

See my other reply about lisps. At age 3 an interdental lisp is completely age appropriate and nothing to worry about 😊

Missed the other post about this.

Children can go through a period of age-appropriate developmental stammering in toddlerhood. Don't draw attention to it, stay patient, give her the time she needs to say what she wants to say, don't ask her to slow down or change how she's saying it. Try to model calm, unhurried speech yourself.

If it lasts for longer than 6 months and is still significant or getting worse, or there's a family history of stammering then seek a referral.

Neither DS 15yo nor I can pronounce the letter ‘R’. Neither of us are at Jonathan Ross type levels, and I can roll my Rs (but DS cannot). Can we be taught to in speech and language therapy please? I’d go privately for it.

That's a little delayed compared to the typical expectation for a child of her age. The good news is 'late talking' is very common and can often resolve without specialist input. She's still very young and your local service is unlikely to accept a referral until she's at least 2-2.5. Check out the following sites for info about how you can support her: BBC Tiny Happy People, RCSLT, ICan

speechandlanguage.org.uk/talking-point/parents/ages-and-stages/

@Mayalinaballerina see this too 😊

My hospital, which is a big children's hospital hasn't got any SALT service at all. Which is absolutely crap, And I think our Cleft Lip and Palate team hasn't got one either. So you are gold dust OP!

My son has been intubated with bronchiolitis several times, consultant said potentially this will have scarred his vocal chords which is why his speech isn't super clear. Anything we can do to help him in the meantime? He has just turned 2 and we are on the wait list for a speech & language therapist. :)

Same question, my 9 year old does sounds like Jonathan Woss!

OP you and your colleagues do a fab job. DS was referred for his stammer and a few sessions with a SALT helped him through it. It recurred a couple of times in childhood but each time we used the advice we were given at the beginning and he outgrew it. Thank you

My child (5yrs) has severe speech sound disorder - has nhs salt input once a month. Have you worked with children with this? What has their progress been like?

Thanks for doing this, our SALT services have almost entirely disappeared!

DS aged almost 3.5 has speech delay caused by glue ear. He had grommits fitted in October and his speech has come on loads since. His pronunciation at the end of words has massively improved and he is as a result much easier to understand.. His sentences very rapidly got longer and are I think age normal (10 word plus sentences are common). However, he still struggles with most consonants at the start of words (for example, he says 'd' instead of 'k', 's', 'f', 'g', 'l' and 't') although he can say many of those sounds at the end of words. He is starting school in September.

Given his hearing is now OK, will his speech sort itself? Should I be looking into private speech and language therapy for him (all I've been able to get from the NHS in the last 18 months is 2 phone calls)?