Speech and Language Therapy Services - children

Speech and Language Therapists (SLTs) are allied health professionals.  They have been trained to assess, diagnose, treat and advise people who have difficulties with speech, language and communication difficulties, or with eating, drinking and swallowing disorders.  Speech and Language Therapists work with children and adults and their families providing a whole life service.

Speech and Language Therapists work closely with parents and carers and with a range of other professionals such as health visitors, school nurses, hospital and community nurses, midwives, play-group leaders, doctors, social workers, occupational therapists, physiotherapists, nutritionists, teachers and teaching assistants and with parent groups in the third sector.

Speech and Language Therapy Services are partners with parents, the Local Authority, the Children & Young People’s Partnerships and the Voluntary Sector in seeking to provide the best possible support for all children, within the boundaries of Swansea Bay University Health Board, who have speech, language and communication needs.

Where do SLTs work?

We work in the following settings:

• Playgroups and nurseries.
• Primary and secondary mainstream schools
• Special Schools
• Child development centres
• Community health centres
• Hospitals
• Rehabilitation units and day hospitals
• Nursing homes
• Client homes

 What sort of work do SLTs do?

We work with the following disorders and difficulties:

• Developmental Speech, Language and Communication Delay / Difficulties
• Specific Speech, Language and Communication Impairments and Disorders.
• Eating and Drinking Difficulties (Dysphagia)
• Acquired and Progressive Speech, Language and Communication Difficulties & Disabilities.
• Stammering / Dysfluency / Cluttering
• Semantic and Pragmatic Disorders
• Social Communication/Interaction Impairments
• Articulation difficulties due to structural, orthodontic or neurological factors.
• Voice and Resonance (ENT) Disorders
• Augmentative and Alternative Communication Needs (High tech & Low Tech communication Aids / Signing)

 With what other diagnostic groups do SLTs work?

We work with the following groups:

• Delayed Development (Paediatrics)
• Cerebral Palsy and other Physical and/or Neurological Impairments
• Progressive neurological conditions such as Parkinsons Disease, Motor Neurone Disease, Huntingdon’s Chorea etc. (Adults)
• Head Injury
• Hearing Impairment
• Cleft Lip and Palate / Velo-pharyngeal Abnormalities.
• Head and Neck Cancers (including Laryngectomy)
• Autistic Spectrum Disorder (Continuum) – including Aspergers Syndrome
• Other syndromes e.g. Downs Syndrome / Fragile X Syndrome / Landau Kleffner Syndrome.
• Learning Difficulties / Disabilities
• Stroke

How do SLTs work?

SLTs work in a variety of ways including:

• Providing individual therapy
• Working in small groups
• Becoming involved in home-based programmes
• Working within a multidisciplinary team
• Providing resources and information
• Supporting teachers and their assistants in school settings (mainstream and special schools)
• Providing school based work programmes
• Consulting with other agencies
• Giving advice and direction to clients, their carers and other professionals.
• Training others including parents

How can you tell whether someone has communication difficulties?

Many people who have communication difficulties do not stand out in a crowd.  Their difficulties are often described as ‘hidden’.  A person with a communication difficulty isn’t just the person who stammers severely, or who can’t string a sentence together, or who is totally unintelligible. Many communication problems relating to “understanding” and “interaction” may be misunderstood and misinterpreted as rudeness or as a personality problem.

Problems in pragmatics affect the social use of language and include poor use of eye contact, not knowing how to take turns in a conversation, not knowing how to correctly interpret the facial expressions of others, using inappropriate tone and levels of intimacy and often appearing rude and inept because the basic social rules of communication are not fully understood. Often they learn how to apply the rules in one situation but are unable to generalise to new / other situations.

Other people (particularly adolescents and young adults) may have communication difficulties that manifest in challenging or unacceptable behaviour. It is now well known that 65% of young people detained in youth offending institutions have undiagnosed speech, language and communication problems.

Fluency problems (called “stammering” in the UK and “stuttering” in the USA) may manifest in the young child (typically around the age of 3 years) who has mild difficulties which with sensible management they will “grow out of” – to the adolescent who because of a severe (and entrenched) stammer does not speak in class - to the adult who is unable to hold down a job that requires fluency in communication skills.

Voice problems can include a harsh, raspy voice due to vocal nodules or a complete loss of voice.  Children who shout a lot and adults who use their voice significantly in their career such as teachers, singers, preachers and lecturers may strain their voices leading to long-term difficulties.

A person with communication difficulties may also have more subtle problems, including:

• Tripping or stumbling over words
• Sounding slurred and mumbled
• Occasionally losing their voice
• Having “word-finding” problems
• Finding it difficult to follow a conversation when in a group or at a party
• Not quite understanding jokes
• Being reluctant to speak to new people
• Acting aggressively because of frustration
• Repeatedly needing directions on how to do something
• Difficulty understanding written material
• Speaking too loud
• Inappropriately interrupting others
• Being a “loner” 

What's it like to have communication difficulties?

For many people communication is a difficult and often frustrating experience. Getting their message across or understanding others is hard work because they have communication difficulties. This can result in feelings of grief, anger frustration and embarrassment.

Many children and young people with communication impairments understand language in a totally “literal” sense and therefore the use of idioms and metaphors can be a complete nightmare. An idiom is an expression whose meaning cannot be inferred from the individual meanings of the words that make it up. For example:

“Pull your socks up”

“She’s big headed”

“Pull yourself together”

“It’s raining cats and dogs”

“Your ears must be burning”

What is the impact of communication difficulties?

At home

People with communication difficulties will probably be least affected at home. Those who are familiar with the person and are family may be able to anticipate needs, however it may still be hard for a person to express his or her preferences and individuality.

Pictured: SaLT Communications Group

At school

Research suggests that 6 in 100 children will at some stage have a speech, language and communication impairment – that’s over a million children and young people in the UK.

Communication is a critical skill for learning, reading, writing and thinking. Children with communication difficulties may experience problems, which lead to poor literacy skills and low academic achievement. Spelling problems are common, as are poor planning and problem solving abilities. The children may have to contend with teasing in the playground or not understand jokes. They may also lack the necessary confidence to join in conversations, become part of a group, make friends, take part in debates or answer questions in class - even though they have something to contribute or know the correct answer. This can result in anger, frustration, behaviour problems or withdrawal and depression. Approximately 50% of children with speech, language and communication impairments will present with behavioural difficulties. Often these children are bullied and isolated.

At work

Problems experienced at school can continue at work. Poor academic achievement can lead to adult illiteracy and difficulty getting employment. Some people may be not able to follow their preferred career choice because of their communication difficulties. They may also experience unpleasant teasing, prejudice and bullying in the work-place. They may become isolated and ignored and not consulted for their ideas and opinions. They may not apply for promotion because they feel unable to participate in an interview, even though they may be the best person for the job.

At leisure

Some people with communication impairments may choose not to get involved in situations that require conversation. They may experience difficulties making friends or participating in clubs and organisations. Many young people and adults with communication impairments stay at home most of the time and experience intense loneliness and disengagement from society as a whole.

In Society Terms

Being able to communicate effectively is something most people take for granted. Few of us have ever imagined what it would be like not to be able to get our message across or understand what is being said. Children, young people and adults who have speech, language and communication impairments may find it hard to make friends, understand lessons at school or college and ultimately find it hard to obtain employment. They may make errors in judging social situations and so become at risk of being taken advantage of by others. Therefore effective communication is the key to educational success and effective citizenship.

In Health Terms

Early language difficulties have been shown to be a predictor of later difficulties including mental health problems. Young people with speech, language and communication impairments are at risk of being taken advantage of both socially and sexually and they often are vulnerable in high risk situations that involve drink and drugs.

Why do we need SLTs?

Speech and Language Therapists are trained to help children and adults communicate as effectively as possible. It is a misunderstanding to assume that someone must first be able to talk before a SLT can help. Many children are referred with no speech at all and with effective assessment and therapy many children can be stimulated to understand others and then express themselves in a manner and to a level in line with their cognitive (intellectual) abilities.

In some cases children and adults are unable to use speech to communicate and SLTs help them to overcome their difficulties by using augmentative and alternative communication strategies (high tech and low tech communication aids).

Once a person has a degree of speech, language and communication competence, the SLT is trained to help people in the following five areas of communication:

• Speech: the physical production of sounds
• Language Comprehension: understanding non-verbal clues, understanding what words mean, understanding instructions and directions in phrases and sentences etc.
• Language Expression: saying words, developing adequate vocabulary, speaking in phrases and sentences, using grammar effectively, conducting conversations etc.
• Pragmatics: using non-verbal communication and understanding the social rules and practices for how we use language to interact with each other
• Fluency: the smooth rhythm and pattern of talking
• Voice: the production of sound by vibrating the vocal cords

SLTs also offer assistance and advice to those who have difficulties with swallowing food and drink.  This often happens to adults after a stroke or to children with complex physical health needs.

Our Mission Statement in SB UHB:

The Speech and Language Therapy Department aims to maximise the potential of all its clients with communication and swallowing difficulties

Sources of referral 

Referrals are received from many sources including from GPs, Health Visitors, Teachers or School Nurses, ENT Consultants or by the clients themselves by means of a referral letter. 

Management

Head of Speech and Language Therapy: Jo Bradburn

How can you contact us?

For further information or advice or to make a referral please contact:

Speech and Language Therapy Services

Room 35, The Children's Centre, Neath Port Talbot Hospital, Baglan Way, Port Talbot, SA12 7BX

Telephone: 01639 862718