Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, and /or eating, drinking and swallowing difficulties.
Just like speech and language therapists who work in the NHS, our independent speech and language therapists support those who, for physical or psychological reasons, have problems speaking, communicating, eating, drinking and swallowing.
Our client range is therefore very diverse: from children whose speech is slower to develop, to older people whose speech, language and swallowing abilities have been impaired by illness or injury, and everything in between!
Many children have communication problems. Sometimes the reason has been identified, but on many occasions, it may not be easy for family members to name the problem or identify the cause.
Not all independent speech and language therapists will have specific expertise or experience in treating all speech, language and communication needs (SLCN), including eating, drinking and swallowing difficulties.
When considering which independent speech and language therapist to support you and your family, the following questions may help you to guide make your decision:
Additional specialist training in a specific condition is not always necessary as experienced therapists will have learned many strategies of support over their years of practice, but there are some conditions (e.g. stammering/ developmental verbal dyspraxia/ ASD etc) where there are particular programmes a therapist may use – it is important for you to understand a therapist’s approach before you engage with their service and they should be able to give you a clear clinical rationale for their approach/es used.
It is a good idea to let a therapist tell you what SLCN they are not comfortable or experienced helping with. All our independent therapists have a duty to know the limits of their practice and be transparent about this. A therapist without lots of experience in a particular area may still be able to help you as long as they have appropriate supervision from another, more experienced/ specialist therapist, but this is ultimately your choice to make and you should do so knowing the full circumstances.
ASLTIP has a code of conduct that requires its members to publish the scales of charges for their therapy, including all associated costs such as any applicable travel costs, initial assessment costs, reports and therapy sessions. You should be fully aware of what is included in a therapy session and what you will be charged for before you have your initial consultation.
All members of ASLTIP must be registered with the Information Commissioners Office (ICO) as per the GDPR Act 2016. They should publish, or be able to give you, a copy of their data protection and privacy policies which state their legal bases for holding your data on file, how they store your data and how long they are legally obliged to do so.
Some independent speech and language therapists have a specialism in other areas:
Speech and language therapists who work with children will have significant post-graduate experience working with these problems.
This refers to other ways of communicating, not speech. Augmentative communication usually refers to non-verbal communication used together with speech. This could be the use of signing, picture symbols or software alongside talking. Alternative communication usually means using an alternative means of communication instead of speech.
The use of AAC can help children by reducing their frustration when trying to communicate, helps them to develop their learning and ability to interact socially. It also helps others understand what the child is trying to say. More information
This is a lifelong condition covering a whole range of social communication difficulties. Every child with this disorder will have a slightly different presentation. The main characteristics of this disorder are:
Children with this condition may have a mix of all three main characteristics and can also present with a predominant deficit in one particular area. Children with autism may also have other associated problems. Anxiety problems, clumsiness and attention problems e.g. being easily distracted are common for children diagnosed with an autistic spectrum disorder. More information
Any injury to the head can cause brain injury. There are a variety of causes such as a fall, a road traffic accident, infection and disease which can impact adults.
When an injury has been caused by an external force or mechanism, the term used is Traumatic Brain Injury.
The problems arising from brain injury will vary depending on which part of the brain has been damaged and the extent and severity of the damage.
Difficulties may include:
Bilingual children are just as likely to experience communication impairments as their monolingual peers. However, in some communities bilingualism may be viewed negatively. As a result, the home language is often blamed for the communication impairment and professionals encouraging the abandonment of bilingualism in favour of a monolingual majority language (such as English).
Our main message is ‘…bilingualism in a child is an advantage and does not cause communication disorders ‘ The Royal College of Speech and Language Therapists (2006). Communicating Quality 3, RCSLT’s guidance on best practice in service organization and provision (London: The Royal College of Speech and Language Therapists). More information
This is the general term for a number of neurological conditions that affect movement and co-ordination. Cerebral palsy is caused by a problem in the parts of the brain responsible for controlling muscles. The condition can occur if the brain develops abnormally or is damaged before, during or shortly after birth. There can be several causes for cerebral palsy such as a difficult or premature birth or an infection but sometimes the cause is not known. Cerebral palsy can occur with other problems such as epilepsy, hearing and/or vision problems.
Cerebral palsy normally becomes apparent during the first three years of life. A child with cerebral palsy has difficulty in achieving the normal developmental motor milestones. They are usually slower to crawl, walk and or talk. The physical movement difficulties vary according to the type of cerebral palsy a child has and the severity of the movement and co-ordination problems vary considerably.
Children with cerebral palsy may attend specialist educational settings or mainstream school. More information
Cleft palate is a condition a child is born with where the hard palate in the roof of the mouth does not form properly. Cleft lip is when the upper lip does not join properly, leaving a gap between the sides of the lip, sometimes extending to the bottom of the nose. Some children can have both cleft lip and cleft palate. The cleft itself is usually rectified early on in a baby’s life through surgery.
Cleft lip and palate can occur in isolation or together with other medical and dental conditions.
Other palatal problems involve the soft palate at the back of the mouth which is made of
muscles. This may not work properly.
Speech and Language Therapists are involved in multi-disciplinary teams and children are usually regularly reviewed by the team if they have a history of palatal problems. The amount of speech and language therapy a child may need will vary and can continue into the teenage years.
Like stuttering, cluttering is a fluency disorder, but the two disorders are not the same. Cluttering involves excessive breaks in the normal flow of speech that seem to result from disorganized speech planning, talking too fast or in spurts, or simply being unsure of what one wants to say.
By contrast, the person who stutters typically knows exactly what he or she wants to say but is temporarily unable to say it. To make matters even more confusing, since cluttering is not well known, many who clutter are described by themselves or others as “stuttering.” Also, and equally confusing, cluttering often occurs along with stuttering. More information.
A cochlear implant is a special type of hearing aid. It is an electronic device that is surgically implanted and it provides stimulation directly to the auditory nerve. It is a medical procedure.
Children with severe to profound hearing loss can be assessed by a specialist multi-disciplinary team to see if they are suitable for a cochlear implant.
Children who suffer a sudden loss of hearing through trauma or meningitis can also be assessed by a specialist multi-disciplinary team. Some Speech and Language Therapists have extra specialist qualifications to work with deaf children e.g. Auditory Verbal Therapy Approach Children with a cochlear implant need to learn to listen and understand sound. More information.
Developmental language disorder (DLD) is a condition where children have problems understanding and/or using spoken language. There is no obvious reason for these difficulties, for example, there is no hearing problem or physical disability that explains them.
In the past, DLD was known as specific language impairment (SLI) but recently the name has changed so that it better reflects the types of difficulties children have.
A child can be diagnosed with DLD if their language difficulties:
• Are likely to carry on into adulthood
• Have a significant impact on progress at school, or on everyday life
• Are unlikely to catch up without help
Dyslexia is a term given to a range of difficulties involved with learning to read. Acquiring the skills to read can be complex and many children who find reading difficult have a history of early speech and language difficulties. Some of these difficulties may persist.
Dyslexia can be a specific difficulty on its own or it can present alongside other difficulties like autism and attention deficit disorder. The problems that may arise for a child will vary as some children have considerable difficulty acquiring fluent reading and writing skills, while other children have less marked problems, but their reading skills are still of concern at school.
This term covers a wide range of developmental learning problems. Children with these difficulties may be described as having a global developmental delay. This can occur on its own or with other problems such as hearing, vision or physical problems.
Some children may have profound multiple developmental difficulties and this often means they have complex needs. Every child with learning disability is different. Like with all children, no two children are the same. The cause of learning disabilities may be unknown or it may be related to a syndrome.
Stammering is sometimes referred to as stuttering. Speech and Language Therapists often refer to it as dysfluency. This is because the flow of speech is not fluent.
Many young children go through a period of ‘non-fluency’ while their speech and
language is developing. This period of dysfluency often disappears when speech and
language skills have developed and are established but most commonly under the age
of 5. However, in some children dysfluent talking can persist. Over time, this can lead to low
confidence, being teased at school and avoiding speaking to others.
This term refers to eating, drinking and swallowing problems. Babies, pre-school children, school-aged children and teenagers can have problems with eating and drinking.
There are many reasons why eating and drinking difficulties can occur, these include:
If eating and drinking problems are not dealt with appropriately then a child may be at risk of:
Selective Mutism is an anxiety-based disorder which prevents children from being able to talk in some specific situations. For example, a child may speak naturally and freely at
home with their family or with their friends in the school playground but be unable to talk
with teachers in the classroom. Whereas this may seem, to some, to not be a significant problem, it is often very distressing for a child and has serious implications for a child’s ability to demonstrate
progress in their curriculum if they cannot verbalise their learning in class.
Like most SLCN, the earlier the problem is identified and supported, the better the
outcomes. Selective mutism can co-occur with other conditions such as ASD but can also occur as
an isolated condition.
The term ‘visual impairment’ is used for a number of different vision problems which may be present at birth or acquired later. People may be partially sighted or severely sight impaired. Common ‘reduced vision’ problems (like low levels of short-sightedness) corrected by wearing glasses are not included.
(However, young children may show some delayed development with language skills when a correctable problem is not recognised. Minor problems with reduced vision and hearing – both of which could be corrected – can appear to have a disproportionate effect on language development.)
Children present with voice problems for a variety of reasons. Children can have voice problems due to illness, infection, trauma, surgery, shouting, screaming or talking too much. The most common cause of voice problems in children is that of vocal abuse – shouting and screaming. This can lead to vocal nodules – a swelling on the vocal cords – which in turn lead to deterioration in the quality of the voice. Not all children with poor voice quality have vocal nodules but if shouting and screaming persists then nodules may develop.
It is usual to have ENT involvement if a child has poor voice quality. This is always the case if there is a serious illness, trauma or surgery involved. In such cases, Speech and Language Therapists will be part of a multi-disciplinary team.
Once direct multi-disciplinary involvement has finished, parents may still feel it would be beneficial to have speech and language therapy input.
In cases such as vocal abuse and misuse, some parents may choose not to have ENT involvement in the first instance and seek the advice and involvement of a Speech and Language Therapist.
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