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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:
nettytree · 02/02/2023 14:51

No questions. But as a mum with a boy who never spoke til 5, he attended a mainstream school with a speech unit attached. He is now expected to gain top grades in his GCSEs. Thank you for all your hard work and dedication in your work.

Original poster
SpeechandLanguageTherapist · 02/02/2023 14:51

iloveyankeecandle · 29/01/2023 14:58

My 22 month old has about 50 single words that he uses. Will also put together some three word sentences but seem to be the same repeated. Very rarely seems to be adding to his vocab. He doesn't always finish whole words. Say "chee" for cheese. He grunts and points mostly instead of talking. Should j be worried?

All sounds typical for a 22 month old. 50 words is the average number to have by 24 months (normal variation either way) 👍🏻

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Original poster
SpeechandLanguageTherapist · 02/02/2023 14:53

Thatboymum · 29/01/2023 15:43

My ds5 was on the wait list from age 3 till now and after one visit signed off on the basis his speech will improve and generally come on if he has his tonsills and adenoids removed but I really don’t understand how having his tonsills etc removed will help him speak, can you please help me understand more

Having his tonsils and adenoids removed is likely to impact his voice positively (presuming he's quite hyponasal right now because of excessively large tonsils), but I can't imagine it improving his language skills. You might need to ask for more info from whoever wrote the report.

OP posts:

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Children's health General parenting
Rebootnecessary · 02/02/2023 14:55

My dd is interested in a career in SLT and is currently looking for jobs as an SLT Assistant. Do you need an assistant.....?! Or any tips on entering the career? She already has a degree in English Language and her dissertation was relevant to SLT.

PragmaticWench · 02/02/2023 15:01

Hi, My DS is 8 and has a mild lisp, the same as my father. DS also has an unusual mouth issue where every few minutes during speech, he seems to suck excess saliva back in his mouth. His lips are drawn back, teeth together, middle of the tongue raised to the roof of his mouth and he sort of sucks back saliva quickly. It's not a swallowing or gulping action, more in the mouth.

I've never commented on it to him but am aware that friends might start to as he gets older. Does it indicate something might be structurally wrong?

GordonGarden · 02/02/2023 15:29

@SpeechandLanguageTherapist This is an amazing thread! I've learned so much - thank you!
My question is about a sort of stammer but at the end of words, not the start. DS turned 3 in November and will say things like "let's go to the park...ark...ark...ark", "maybe we...ee...ee...can" etc. Sometimes he goes a bit spacey when he's doing it. I haven't noticed any real pattern in when it occurs, but it's probably only once or twice a day, maybe a little more if he's frustrated. Never if he's singing, which he does a lot!
I did have an ill-advised Google and everything mentioned ASD or Tourettes but he doesn't have any other behaviours to indicate either of those. Can it also be part of typical language development?

LBB2020 · 02/02/2023 15:39

@SpeechandLanguageTherapist thank you for putting my mind at ease 😊(my eldest has additional needs and is pre-verbal so I think I’m hyper aware with the little one!)

Original poster
SpeechandLanguageTherapist · 02/02/2023 20:04

justdone3 · 29/01/2023 16:00

I have a 4 year old with a severe speech delay. He does try to say a lot but his speech therapist says only 2 or 3 words can be understood out of context. In context it's slightly easier to understand him. He was non verbal pretty much until he was 2 1/2.
We've recently been told that he uses the back of his mouth to make his sounds and he is also making a noise before his speech.

Im basically wondering if there is a reason why? Like could it be a condition that is making him form his sounds like that or is it just something we will never know?

Sometimes speech disorders are for a known reason or something we think may have caused it (for example a structural issue like cleft palate, a genetic condition, dummy overuse, hearing difficulties), but a lot of the time we don't know why a child develops a speech disorder. They can run in families but this isn't always the case.

OP posts:
Original poster
SpeechandLanguageTherapist · 02/02/2023 20:07

MGMidget · 29/01/2023 18:40

Do speech therapists get involved in teaching written sounds/phonics for spellings as well as the spoken sounds? My daughter's speech problems have translated into misspellings as she has got older (now 7) as she will spell words in a way she mispronounces. Would this be something speech and language therapists would work on with a child?

We can work with some aspects of literacy, in particular some preliteracy skills such as processing speed and phonological awareness (knowledge of the sounds that make up words and the ability to break words down into their sounds and build them back up again) - these skills underpin literacy abilities. We also work on things like reading comprehension which are associated with language skills. Personally I wouldn't teach phonics sounds as such, other than integrating them into some other goal I was working on.

Many children with speech difficulties do have underlying difficulties with phonological awareness, which can cause them to develop literacy difficulties.

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Original poster
SpeechandLanguageTherapist · 02/02/2023 20:10

GailTheSnail · 29/01/2023 20:11

Hi
Our little boy (just turned three) has initial constontent deletion. He's on a waiting list but i get the impression it will take a while. On the plus side he has a decent vocabulary and it doesnt seem to affected his confidence in speaking- at least within the family. I can't be sure in nursery. But he is hard to understand sometimes and gets very frustrated when we don't get it. Would you advise trying to go private? Or will he kind of grow out of it on his own? Thanks

It's really hard to predict if he'll grow out of it on his own or not. He's still really young, and some children will grow out of this sort of pattern and others won't. If he's getting really frustrated and you have the means, private therapy is never a bad thing if your child needs it imo.

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Original poster
SpeechandLanguageTherapist · 02/02/2023 20:15

jamrolypolyandcustard · 29/01/2023 20:33

@SpeechandLanguageTherapist thank you very much for your reply and advice, it's very much appreciated.

for the issue around D & G sounds, it's usually when he's saying "dog" it'll be "gog" - due to the waiting list being 12 months long in my area for NHS speech and language therapy, do you think it's worth going privately?

The pattern you're describing is called backing and it's an atypical pattern, meaning it's not a pattern we typically see in development. Personally, if you're able, I would go privately.

OP posts:
GailTheSnail · 02/02/2023 20:16

@SpeechandLanguageTherapist

Thank you for that. It's really good of you to take the time to reply to all these!

Emerald237 · 02/02/2023 20:30

Hey,

My child is 2 1/2. Was diagnosed with glue ear (unsure when it started - possibly 12 months ago). She got grommets about 5 weeks ago, so far more response to sounds such as banging or clanging, but not as much progress with talking or listening.

She has no conversational speech, communicates most through actions. She is a placid and affectionate child.

How can I help her speech, I have been trying to follow the guidance, however, when I am narrating and talking actions and things to her she almost doesn't seem to be listening and a lot of the time and doesn't repeat back to me. I feel at a loss.

Any tips for helping with building the gaps in receptive language would be greatly appreciated.
Thank You

Tbird5 · 02/02/2023 21:15

Hi
My 2 year old (just turned) has a speech delay. Have been told it's due to him being a bilingual child but judging with your answers on some of those questions that might be a bit not true? He is saying words in both languages but only about 15 words. Some words he has stopped saying altogether. Some of the words he was saying last summer, he doesn't say them at all. Should I be worried and what can u do to help him get those back?

Jk24 · 02/02/2023 21:22

Thank you for this thread. My ds is 3 next month and is pretty much non verbal. Has said words and regressed. Sometimes says mama, dada, no etc. He has social communication disorder with speech and language delay. In your experience do children like my ds gone on to talk/ communicate well?

Emerald237 · 02/02/2023 23:12

LicketySquid · 28/01/2023 20:56

Also, in your expensive can glue ear mimic autism? There were a few concerns which have now largely disappeared as his speech and general responsiveness have improved but just wondering if glue ear is sometimes mixed up with autism

Hi @LicketySquid how long did you think it took after grommets to see good progress with talking and listening? My daughter was pre-verbal before grommets. Only in a few weeks and hearing (sounds) has improved, however talking and listening to us speaking has been quite slow.

LicketySquid · 03/02/2023 07:52

@Emerald237 it's now been 8 months since surgery. My son has definitely improved in listening, following instructions and speaking but is still 9-12 months behind his peers I'd say. He can say a few 3 word sentences and we're hoping to keep seeing progress. If you're already seeing improvement in your daughter after a few weeks, I'd say that's really good!

Emerald237 · 03/02/2023 11:15

LicketySquid · 03/02/2023 07:52

@Emerald237 it's now been 8 months since surgery. My son has definitely improved in listening, following instructions and speaking but is still 9-12 months behind his peers I'd say. He can say a few 3 word sentences and we're hoping to keep seeing progress. If you're already seeing improvement in your daughter after a few weeks, I'd say that's really good!

Thanks for the reply, your experience has been reassuring. I was expecting the 'light switch' moment when she got them in which has yet to happen.

As I say she was pre-verbal before getting them in and if she had hearing loss for a long time what we say most likely sounds like a foreign language as she wasn't exposed to it for god knows how long with the glue ear.

Original poster
SpeechandLanguageTherapist · 03/02/2023 15:39

MaryBerrysCamelToe · 29/01/2023 21:02

With twins do you find one develops speech significantly faster than the other or do they both hit milestones around the same time?
Thankyou

It really depends on the twins! I've noticed that identical twins tend to present similarly and develop at similar rates, whereas with non-identical twins it's more varied, which isn't unsurprising. Often if there's a pair of boy-girl twins the girl will develop a little faster than the boy, which is also unsurprising given the overwhelming evidence that girls meet their developmental milestones earlier than boys on average.

OP posts:
Original poster
SpeechandLanguageTherapist · 03/02/2023 15:42

DanceMonkey19 · 29/01/2023 21:16

Is/has makaton fallen out of favour for non verbal asd children? DS is at a special school where they are using pictures/symbols (soundswell possibly?) alongside signing makaton but there has been no training offered to parents. I'm going to do a makaton course myself and looking into putting a book/folder together with actual photographs of objects/places for ds to help him communicate but I feel completely in the dark about how best to support him.

No I don't think it's fallen out of favour. It's maybe slightly less 'trendy' than a couple of decades ago when it first came on the scene and was the exciting thing for schools to be embracing. But we still support it just as much as ever - it's highly effective for the right children!

OP posts:
Original poster
SpeechandLanguageTherapist · 03/02/2023 15:46

Ahappyface · 29/01/2023 21:41

Hi,

Have a son who will turn 3 in August. He communicates well and speaks non stop at home, however he does not speak in nursery. He has attended this nursery since he was 1 and appears to really enjoy it. We are not sure what the reason for not speaking there could be. We have discussed this with GP and Heath visitor, referral for a speech and language assessment has been made but we will not be seen until he turns 3 and have been advised they may not offer support until he starts school at age 4... the waiting list is long and resources limited in our council. Any advice on what we could do? Considering looking for private options but feeling lost as we are not sure what support we should be looking for.

Appreciate any advice anyone can offer.
thanks.

Early intervention is important for toddlers at risk of selective mutism. This website offers some really helpful advice for parents:

www.selectivemutism.org.uk/info-supporting-children-with-selective-mutism-advice-for-parents/

There are a few UK charities that might be able to help. It's important that all adults working with him follow advice around giving opportunities to communicate but not putting pressure on him to speak.

If you decide to look for a private therapist, try to find someone that specialises in selective mutism. ASLTIP is a good website to go to to find private therapists in your area - you can filter by specialism.

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Original poster
SpeechandLanguageTherapist · 03/02/2023 15:50

earsandhours · 29/01/2023 22:30

Hi thanks for doing the thread, it's very kind of you. Can I please ask, If one parent can't say "th" but substitutes "f"or "v" (despite having had some kind of SALT as a child), and does daily barftime, teef clean and counting practice one two free etc is this likely to affect our toddler's speech and is there anything the other parent can be doing to help toddler avoid developing the same problem? Toddler is currently very advanced in speech with quite long phrases while not quite age 2 yet, does come out with f/v instead of th but I know that can be normal at this age, not sure when to worry! Should one parent correct the other in front of the child? Thank you.

Producing th as f/v/d is completely typical until the age of 5/6. There's probably not a 2 year old in existence who can produce that sound correctly, it's one of the hardest in the English language.

It's also a feature of many British accents and one of the most common sounds for adults to produce 'incorrectly' - I say that in quotation marks as personally I wouldn't view an accent feature as incorrect.

To answer your question, yes, if a parent models the sound 'incorrectly' (again, I'm not making a judgement on the correct use of that particular sound), there's a higher chance the child will also learn to produce the sound that way.

OP posts:
Original poster
SpeechandLanguageTherapist · 03/02/2023 15:54

malteaserlover · 30/01/2023 17:23

Hi my son is 27 months and only has 3 words. He babbles a lot but doesn't make any animal noises or anything. We've been referred to salt and he's had a hearing test which came back fine. Is it common to just have a speech delay with nothing else i.e autism, adhd? At what point should I be worried? I've taken all the advice and nothing I do helps and we're both getting extremely frustrated as unable to know what he wants a lot of the time

Sometimes we know why a toddler has delayed language and they may have a known or suspected condition. Probably more commonly don't know why a toddler is late to talk. For some children there is nothing 'wrong' underlying, and most of these children will catch up with their peers before they start school. For other children there is an underlying condition (e.g. autism, developmental language disorder) that becomes more evident as a child ages and the gap between themselves and their peers widens rather than closes. One of the hard things about our jobs is that often we can't predict which children will catch up and which won't unfortunately.

OP posts:
Original poster
SpeechandLanguageTherapist · 03/02/2023 15:55

Commonsensitivity · 30/01/2023 17:25

What would you recommend for an 11 year old with high frequency hearing loss whose "s" sounds are still quite slushy. Will we ever get them sounding crisp?

Are they having speech and language therapy regularly?

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student26 · 03/02/2023 15:55

Hello, my three year old son is speech delayed, as in, the only word he can say regularly, or at all, is ‘yeah.’ Speech and language here tell me they only work with parents and the nursery, not with the child themselves at this age. We are in Scotland. He is now on the list for speech therapy, which as I’m told, is just support for the nursery. What actually can be done for him? The drop in appointments are few and far between and don’t ever tell me anything new! I don’t know what else to do. I’m a teacher and my first child speaks very well ( she doesn’t speak for him as everyone tells me) so I’m at a bit of a loss of anything different to try as I do know what it’s like with children with speech problems. What would you recommend, please? His other communication skills are amazing and we have no concerns for autism, etc. Thanks so much for this thread.