SALT - when do you decide it's not working and enough is enough?

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DS2 is 3.6 so still young. He's been under SALT since he was 2 and has been having private SALT weekly for 8 months as well (plus whatever he gets from the NHS). He's made almost no progress.

He'll be going to a nursery in September that specialise in SALT. Everyone is very hopeful that this will help. But in my gut (which has been right every single time) I think he'll make little to no improvement.

I'm starting to think that he just doesn't have the ability to talk properly and it just isn't going to happen. Sorry if this seems really negative but I know him well enough to know I'm being realistic.

So at what point do you say enough is enough, stop the SALT (or at least not see it as the only thing to concentrate on) and look at other ways for him to communicate?

I think you know your child best.

We stopped salt for ds at about the same age. He had been going for about a year and was actually becoming very stressed and upset by it all despite two changes of therapist and having both individual and group therapy. It got to the point where he would have a meltdown when the salt just came out to the reception area to get him! So we decided enough was enough and stopped.

His speech hasn't really improved all that much since, but then salt wasn't helping either. He has made lots of other improvements though through his special needs nursery which is very supportive and gets him doing all kinds of things which help his learning.

My dd is a slightly age. Was diagnosed with autism today and complex language disorder. She barely sees salt. Like you the uncertainty with her speech worries me a lot. Hugs.

His understanding is delayed but not too bad, expressive language is delayed and articulation is disordered. Private SALT has said phonological disorder. It's looking increasingly likely that's it's part of a bigger picture and part of a genetic syndrome.

He has maybe 5 words that other people can understand. They can get the gist of what he's saying sometimes if they have the context. But in all honesty it's like another language. I'm the only person who understands him and even I struggle sometimes.

He definitely says more than he used to and puts more words together but they're just as disordered and just completely not understandable to anyone but me.

I'll have a look at that - thank-you. Think I'll ask speak to SALT about looking at other ways of him communicating. He'll be getting SALT for another year at nursery anyway which is fine. But I do think we need to start thinking a bit more outside the box for him.

I'll have a look at that app too - thank-you. It could be helpful with him hearing what he sounds like.

I think I'd like to take the pressure off him a bit. He really doesn't like SALT. If it was making a difference I'd carry on pushing it but it doesn't seem fair when it isn't helping.

He's a funny little thing - is very expressive and acts things out to try and get people to understand And he signs a little but is quite reluctant to and his signs are mostly his own versions too. So like his speech you really have to already know them to understand them.

Hmm speech and language therapy has helped DS tremondsley, mainly in terms with communication though. Makaton was the thing that gave DS his voice and helped him to speak.

I agree about stopping private speech and language therapy; I think it's one of those things that if you want your DS to progress with; it's best done everyday; rather than twice a week at a therapist office... But having private salt everyday is expensive. What's best is to implement speech language and communication skills In the home; everyday. So say like you want to work on your DS understanding; you say things like "DS get the clothes and put it inside the washing machine".. Or break down the instruction even more; or you can play social games at him etc etc.

It's definitely something we do every day anyway. He's quite resistant to it so for a long time now I've just been dropping little bits in here and there!

Why do you think his resistant to it? Do you think it's to do with rigidity? Someone close in his space? Or just the techniques they use are not helping your DS.

Have a look on this site www.teachmetotalk.com ( or google it) the therapist is really good and explains in depth what your child must be doing before he/she can talk. She has free videos and tells you what you should do with your kids at home.

Hard to tell tbh. Possibly because it's hard work for him. Possibly because he really struggles to sit and concentrate.

I'll have a look at that website in the morning - thank-you.

Just had an interesting chat with private SALT. She thinks it would be fine to introduce another way of communicating now alongside what we're already doing. We're going to try apps as he's much more likely to be motivated by that.

I was going to say why can it not happen all together

We have signed and used AAC alongside SALT, although as d s had no speech at all until he started school, actual therapy was mostly advice on how to encourage communication and alternative ways to communicate. Now he has some speech but it is severely disordered so unintelligible to most, he does some speech sound work as part of his school day.

Has AAC (signing, electronic devices, PODD) been mentioned by SALT at all?

Yes, I think both together is best. He obviously needs SALT but I wasn't sure if it should be either/or or could be done together.

Only thing that has been suggested is tablet and apps.

D s was seen by an AAC SALT (NHS) who assessed his eligibility for a device, it took some time, but he now has an electronic talker (a tablet, with a programmable app) fully funded by the LEA, which he uses at school and home. It might be worth asking NHS SALT if there are any AAC SALTs that could assess him.

D s has his AAC device and Makaton in written into his EHCP, and when he was at preschool everyone there had Makaton training in order to sign with him.

He's got NHS SALT next week so I'll definitely ask. Can I ask how old he was when he got the AAC device?

He's got very little NHS SALT left now - a couple of sessions this term and possibly a bit over summer but not sure yet. As of September he'll be getting SALT at nursery so won't be seeing NHS.

If it is a special needs preschool/nursery it should be an NHS salt, I would have thought. D's had a clunky plastic box called a Go Talk - which he and I found very frustrating - when he was still at preschool, so assessments started then (about 3 and a half), but he was issued his talker when he was at school (aged 4 and a half) - all the stuff about training for staff and use of the device was written into his EHCP (which was sorted out when at preschool).

thinksmartbox.com/product/grid-pad-pro/ This is the device he has - the company has some good information and are very supportive.

If you want to read some more stuff about using a device, this blog is good niederfamily.blogspot.co.uk/

Makaton iis also crucial for D s, as it is so immediate - do the nursery do makaton? Also ask your NHS SALT if there are any courses you can be sent on. D s was very unclear with his signs, and often uses his own signs, but he would be lost without it.

It's a regular nursery with a group within it that specialises in speech and language. They have a SALT there part time and all the staff have training.

I'll definitely be speaking to the NHS SALT next week to see what can be done. I think sometimes that people are so focused on being positive and saying that he'll get there that they overlook the fact that maybe he won't (or at least won't for a long time yet).