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Original poster

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

264 replies

SpeechandLanguageTherapist · 28/01/2023 18:30

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.

OP posts:
justcouldntthinkofausername · 28/01/2023 21:52

I am a little concerned as my DS who is 22and half months is still not talking yet.

His first word was 'Daaa' which I know means dog

He says Dada (with context)
Mama (but just randomly whilst playing, and only started this in the last couple of weeks)

He loves numbers, letters and shapes - he understands them and can pick them out no problem, even when putting the flash cards in a mixed order he points them out right everyrime.

He can say ABCDE and also phonics of ABCDEFGHI, he also says Ade (which is number 8)

But this is literally all he 'says'?

His understanding is fine, takes instruction and will point at objects like door, floor, shoes etc if u ask him. I read to him often which he enjoys. He's just really behind with his speech and I'm worried.

Please could you advise 🙏🏻

Oblahdeeoblahdoe · 28/01/2023 21:53

I'm a volunteer with Homestart. I'm working with a young family whose nearly 3 yr old hardly speaks, the only words I've ever heard him say are 'car' and 'yeah', he appears to understand everything that's said to him. I've signposted to SALT and so far they've only had 1 zoom call meeting. His nursery staff are doing 1 to 1 support with him too. I've not come across this level of speech delay before. My questions are can he 'catch up' or will this impede him throughout life? Is it an indication of anything else? His mum is lovely but seems to underestimate the problem.

laptop3000 · 28/01/2023 21:53

Not sure if you know much about the feeding side but my 4.5 year old has dysphasia and is currently on level 1 thickener. We have dropped down from level 2 which he was on since diagnosis at 9 month old. When he was first diagnosed they said he would grow out of it by the times he's 3. Obviously he hasn't done, how common is it to not grow out of it and is there anything that can be done to improve it?

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JarByTheDoor · 28/01/2023 21:53

Rovinonmars · 28/01/2023 20:32

@PaPaturday the 'j' sound is just d-y together. For example 'd..yam' for jam. It's just that we say it faster. You could try working on j words like this for a while, slow it down and see if it helps at all.

It really isn't. J is a combination of d and zh. You might get lucky and force some yod coalescence though (the process of phonological change by which people start pronouncing tune as choon instead of tyoon, or dune as joon instead of dyoon). More likely you'll just end up confusing and frustrating everybody involved.

Original poster
SpeechandLanguageTherapist · 28/01/2023 21:53

bakewellbride · 28/01/2023 19:26

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?

A referral for these errors at this age would likely be appropriate, so I'd seek a referral. Don't worry too much though, keep modelling back clearly.

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Wisenotboring · 28/01/2023 21:56

My 10 year old daughter had periods of speech therapy before and during covid due to poor enunciation of some sounds. A slushy was particularly noticeable. We stopped in the end as the high turnover of therapists and then online sessions really upset her and each therapist just started from the beginning and there was no discernable sustained improvement. She now also seeks quite fast and doesn't articulate very well and I often have to ask her to repeat herself. What can we do?

Original poster
SpeechandLanguageTherapist · 28/01/2023 21:57

QuentininQuarantino · 28/01/2023 19:31

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…

Being bilingual/multilingual is the global norm. Monolingualism is common in the UK but rare globally. Speaking more than one language does not cause communication difficulties. Quite the opposite, the benefits of multilingualism are numerous. Parents should always use the language that they feel most confident and comfortable speaking in to their children.

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Original poster
SpeechandLanguageTherapist · 28/01/2023 21:59

LadyNellCardross · 28/01/2023 19:33

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.

I'm not a voice specialist but I recommend seeking a referral to a voice specialist SaLT, providing any structural abnormalities have been ruled out. Speak to your GP.

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bakewellbride · 28/01/2023 22:01

Thank you.

jamrolypolyandcustard · 28/01/2023 22:02

Thank you for any advice you can give.

My 4yo DS has had a speech delay for a long while and it's only really since starting school Sept 2022 his speech has really come along.

For reference when he was around 3.5 he would say 10 words at absolute most, now at 4 he is a good talker but there are some things he struggles with.
He pronounces "D" as a "G" and for example my name is Molly, he will pronounce "Moy-Yee" if that makes sense. Same as the world lolly.

He saw a speech and language therapist but then went back to needing extra sessions which the waiting list was a year long, by that time he will be 5 and in year 1.

We are considering private speech therapy (due to the waiting list for NHS) but unsure if we should proceed as I'm growing worried that he will find it more difficult as the time goes on.

Do you have any advice on how to encourage and correct the lack of pronouncing the L sounds?
Sorry if this is all a bit of a rambling post x

Sunshineandgin · 28/01/2023 22:03

I've noticed my husbands nephew who is 7 has some speech difficulties but nobody else in the family seems to be bothered and say he'll grow out of it. Is he likely to naturally improve or should I push for his parents to seek support?

He says thinks like "tit" instead of kick and "do" instead of go. Also struggles with "R" and "L" sounds.

justcouldntthinkofausername · 28/01/2023 22:16

justcouldntthinkofausername · 28/01/2023 21:52

I am a little concerned as my DS who is 22and half months is still not talking yet.

His first word was 'Daaa' which I know means dog

He says Dada (with context)
Mama (but just randomly whilst playing, and only started this in the last couple of weeks)

He loves numbers, letters and shapes - he understands them and can pick them out no problem, even when putting the flash cards in a mixed order he points them out right everyrime.

He can say ABCDE and also phonics of ABCDEFGHI, he also says Ade (which is number 8)

But this is literally all he 'says'?

His understanding is fine, takes instruction and will point at objects like door, floor, shoes etc if u ask him. I read to him often which he enjoys. He's just really behind with his speech and I'm worried.

Please could you advise 🙏🏻

To add.. autism has crossed my mind, especially as DH and MIL mentioned it recently but I'm not sure. He doesn't always answer to his name, but then he's confident with others, smiley and engaged

Sometimes I wonder, then other times I'm like nooo he doesn't. Especially after watching videos and reading up on signs etc. it's the speech delay I'm concerned most about, but then again I read so many posts from peoples who's DC were similarly delayed and then suddenly began talking

Brewskipa · 28/01/2023 22:23

DS(6) has just started at a SEN school that has an in-house speech therapist. She has done an initial assessment as as an experienced practitioner says she feels out of her depth and that he is going to need extensive daily speech therapy.

Our local NHS, on the other hand, discharged him from their service last year (despite him NEVER receiving any therapy) because he was technically able to say all of the sounds she asked him to when she assessed him for his EHCP.

so I guess my question is, do you ever feel under pressure to minimise a child’s speech problems or feel frustration that the support parents need for their children just isn’t made available to them?

Justalittlebitduckling · 28/01/2023 22:29

Is it possible that my child is being confused by two English speaking parents with very different dialects and accents (from different English speaking countries)?

RandomlySelectedUsername · 28/01/2023 22:35

Hi 😊 I know you said your experience is with 18 months + so you might not be able to answer this so feel free to ignore it if you want to! I’m just wondering if you have any tips for supporting speech in a 14 month old? My son is almost 14 months and babbles a lot with only a couple of distinctive words (bye bye/ dada). I’d love any advice on helping his speech develop. Thank you!

Original poster
SpeechandLanguageTherapist · 29/01/2023 05:27

Lastminutebride · 28/01/2023 19:34

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

Honestly lateral lisps are a little complicated to treat and there are lots of different methods. I wouldn't want to give advice that goes against the specific method her therapist might be using as she's already having therapy. Sorry!

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Original poster
SpeechandLanguageTherapist · 29/01/2023 05:29

Anothernameanother · 28/01/2023 19:43

Delays because of masks?

Or COVID and lockdowns generally?

Show quote history

Very hard to say. There's some research going on and a few studies have come out that show an impact. My suspicion would be a bit of both. Masks in nurseries/schools (and for SaLTs!) wasn't the best idea imo.

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:30

Jaffajiffy · 28/01/2023 19:43

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.

Thank you! And what an amazing journey you've been on!

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:32

WellTidy · 28/01/2023 19:47

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.

Yes you could relearn this as an adult. I've seen it done several times. You'd need a good private therapist and lots of commitment.

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:33

Toddlerteaplease · 28/01/2023 19:53

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!

Wow! 😳

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:35

GoldenGoose90 · 28/01/2023 19:57

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. :)

I'm sorry, I'm not a voice therapist and this just isn't my field I'm afraid. Hope you get to see a voice specialist soon!

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:36

Zib · 28/01/2023 20:03

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

That's amazing! Thank you 😊

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:38

Elfinaround · 28/01/2023 20:04

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?

Yep lots, this is the bread and butter of my job. With the right level of support for most children progress is fairly rapid. Some children are harder to treat but all should make progress.

OP posts:
Original poster
SpeechandLanguageTherapist · 29/01/2023 05:40

CrabbyCat · 28/01/2023 20:06

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)?

It sounds like he would really benefit from direct SaLT input. If you have the means and the NHS is a no-go then I would definitely look into private therapy.

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Original poster
SpeechandLanguageTherapist · 29/01/2023 06:37

Sandrine1982 · 28/01/2023 20:11

Another one about toddlers with additional languages :)

My DD (3.5 years old) speaks well for her age but I find that her vocab and sentence structure is not as good as those of some of her peers (in English).

So I wonder if it's due to the fact that I speak a foreign language to her 60% of the time? (My mother tongue..)
She doesn't speak the foreign language at all but understands most of it.

I want to persevere, as I firmly believe in the benefits of bilingualism, but it's such hard work, and the benefits are almost invisible at this stage...

What do you think about all this and is it normal?

It's best for you to speak your first (and most comfortable) language to her as much as possible. Bilingualism doesn't cause language difficulties. The only related thing that can is being taught your first language by a non-native speaker. Which is why it's much better for people to speak their most confident language to their children. If growing up in the UK they will pick up English everywhere else.

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