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.

Re @Hunkyd0ry - my little boy just turned 4 and did this for a few months a while back at 3, and has just started again. We googled and saw to treat it like a regular stammer, give him time to finish his sentence and ignore it's an issue, not to help etc. Is it a problem that it's come back @SpeechandLanguageTherapist ? He did see nhs speech and language at age 2 and passed a hearing test then too, he was just a late starter. He was already under the dysphagia team for eating difficulties - no physical (no allergy or reflux anyway) problem detected in the end.

So many questions, wow! I will try and get round to answering as many as possible but may take me some time! Will keep coming back and answering a couple in the order they were asked whenever I get a moment. Hope that's okay!

Do you ever meet some children who just won't ever talk? My child can't talk yet and is primary age. We are trying to remain positive but don't know if it will ever happen 😔

Honestly it's very hard to say who they might refer to without knowing your child or what was said. Possibly a paediatrician who could consider different developmental diagnoses that may be appropriate. Probably best to ask your child's therapist if unsure.

Ooh thanks for the tip!

If a tongue tie is causing speech problems what sounds would you expect them to struggle with?

I know my son has a tongue tie and he's delayed in his speech (been referred with a 30 week wait) but I can't get a straight answer out of anyone as to what I should be looking out for in terms of determining weather his delay is to do with his tongue tie.

Thank you so much in advance!! 💐💐💐

In so many ways honestly, this is a very broad question. With attention and listening, social skills, language skills, functional communication, routines, behaviour (related to communication difficulties). And yes we help children across the autism spectrum.

My 6 year old lisps s as th, says th as f or v, L sounds a bit like w, and r also sounds a bit like w.

Are we now passed the point where we can correct this without him seeing an SLT?

My area are still doing speech and language therapy on video call! They still haven’t returned to face-to-face since covid began.

The sessions feel a bit silly, they were trying to do a pop-up pirate game with my little boy over the video call and it just wasn’t right🙄

Is this the same where you are? Any idea why they’re so slow getting back to normal compared to everyone else?

It's not as common as having difficulties with consonants, but common enough that we work with vowel errors fairly frequently. It can be associated with a couple of different speech disorders, but it's really something that needs a speech and language therapy assessment to get to the bottom of what's going on.

This is all completely age appropriate! Clusters are hard and it sounds like they're starting to resolve. 'R', 'l' and 'th' are the hardest sounds in English and not in place until age 6. Please don't worry! Keep modelling back correctly 😊

My DS was an early and articulate talker and by the age of 3 had an established stammer. Our speech and language provision was great and we were under their care until DS chose to not attend any more. He is now 24 and still stammers but he manages it and all my fears when he was little have not come to pass - he was never bullied, he went to Uni, he landed himself a brilliant grad job, he has loads of friends and tbf has always lived off his confidence.

I guess I'm saying 2 things, firstly thank you for your work, the therapists we saw helped me as much as DS. Secondly, if your child stammers it's ok and that took me a long time to accept.

A persistent stammer at this age is unlikely to fully resolve, but there are things you can do to maximise communicative effectiveness. A lot of work will be on accepting the stammer, reducing anxiety and learning to live with it in a positive way. Reducing anxiety can play a huge part in reducing the severity of the stammer. If you have the means to seek private support, I'd recommend finding a stammering specialist SaLT.

It sounds like a referral would be very beneficial for her. It depends on the area, but nurseries, HVs and GPs can all refer. HV and nursery would be most common. In most areas parents can also self refer, which many people don't realise.

Honestly I have no idea! I recommend speaking to an orthodontist!

Without seeing her and listening to her speech it's really hard to give any specific advice, but she's very young and there's always a good chance in such young children of their speech improving. Always useful to have hearing checked. Keep modelling, modelling, modelling those tricky sounds, and don't explicitly correct or do anything to make her self conscious of the errors she's making.

I will never recommend a programme or app for speech and language development - children need human, face to face interaction to develop their communication skills. More screen time is not the answer (can stress this enough).

Without knowing what speech errors their making it's really hard to comment on whether they're likely to improve by themselves I'm afraid. If in doubt, seek a referral to SaLT.

Can't*

My 7 year old has a mild lateral lisp (as did I at his age which resolved with speech therapy). I haven’t taken him to salt yet as was doing OT and I thought that was enough for the moment but he’s been discharged from them. I was going to see a SALT privately this year about it but now he’s started losing his front baby teeth. Just wondering whether to go for salt anyway or wait until the teeth situation has resolved somewhat. Thanks so much.

Hi, thanks for doing this.

My grandson has just turned 2 (last week) and all he says is Mama, Dada and no, I look after him 2 days a week and try to get him talking or at least trying but he won't even try. He has a lot to say but it's all babble!

His parents brush it off saying "oh he'll get there" but I'm not sure if he needs some intervention now or if he really will get there in his own time without help?

He starts nursery in July (2.5) so will they pick up on it and provide help?

Thanks again!

Intubation has a high correlation to vocal cord injury but this causes your voice to be hoarse or husky and any damage can be seen by scoping by ENT. SLTs can work on voice production. This isn't the same as unclear speech though, that would have a different cause. (ICU SLT here)

Thanks OP - I am reading this with interest as have applied to start an MSc in speech and language therapy later this year (am early 30s, seeking a career change). I'd be really interested to know how you found the degree? The website for the course I have applied to describes it as intensive. Did you/would you have had time to work part-time on the side?

I love my job. The challenges I face come from working in the NHS. As a service we're chronically underfunded, managing huge caseloads of children with very few members of staff. As a result we're stretched extremely thin and able to provide the bare minimum to each child and family (and some services aren't even able to provide that). Parents, nursery staff and teachers can sometimes get angry at us as individuals, which is very hard when we're overworked and trying our best. We're fully aware of the limitations of the service and at the mercy of politicians.

Given the right resources I would have very little to complain about, I feel so lucky to be in such a rewarding and interesting job and would recommend training to anyone.

Sorry, should have mentioned that I have applied for the two-year course, same as you did.

And another question (if you have time): how/why did you decide to specialise in paediatric work?

Thank you!

Yes I've seen childrens' speech and language skills improve dramatically once temporary hearing problems are resolved. It's very hard for me to comment on why her referral was rejected without knowing any details. But mixing 'y' and 'l' wouldn't be a concern at her age.