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What do Speech and Language Therapists Do?

What do Speech and Language Therapists Do?

When looking into getting help for a child, it can be difficult to know who to approach for advice. It can be hard to identify what the problem is, which makes it harder still to know who is best placed to support your child.

Within Speech and Language Therapy (SLT), sometimes it's obvious that a child might benefit from our help, but other times a child may be very good at masking their difficulties. This might mean they're not referred for support until much later, if at all.  It’s really important therefore, that the speech therapist's role is understood, so they can reach all of the children that might need them.


What issues do speech therapists work with?

Some areas might be really obvious, but a lot of what speech therapists do might come as a surprise. There's lots of presentations they work with:

  • Receptive Language Skills

Put more simply this is a child's understanding of language, and speech therapists almost always include this as part of the initial assessment. They'll do this even if there are no concerns, as some children can be very good at hiding difficulties with understanding. SLTs often look at children's understanding of language concepts (for example: big, little, long, short, etc) as well as the number of key words in a sentence that they can understand. If there are difficulties with their understanding of language, working on this is key and can often improve their speaking abilities as a result.

  • Expressive Language Difficulties

For some children this may mean they are not saying any words yet and the SLT may work with the parents to develop ways to help their children learn their first words. Other children might have specific difficulties with vocabulary or word finding difficulties, or find it difficult to sequence sentences and stories coherently. These areas all come under expressive language difficulties and are a big part of the work of a speech and language therapist.

  • Speech Sound Difficulties

These can occur in children who may have a wide vocabulary, who can form elaborate sentences but find it really difficult to make themselves understood because their speech sounds have not developed in the right way. Other children may have less severe difficulties with their speech sounds but have a specific difficulty with one or two sounds. This can be referred to as an articulatory difficulty, such as finding it difficult to produce ‘s’ in the right way (often referred to as a lisp).

  • Stutters and Stammers

With young children, this usually involves working with parents to help them learn about stuttering and what they can do to help their child. We can also work with older children to learn strategies that can help with their fluency. In addition, we work with these older children on acceptance of their stammer and making sure it does not stop them from doing anything they want to do.

  • Social Communication Difficulties

Social communication difficulties are sometimes part of Autism Spectrum Condition (ASC) or are sometimes present without this condition. SLTs will work with a young person on their conversational skills or work on specific situations which are relevant to them.

  • Voice problems

A more unusual but still important part of the work SLTs do is with children with voice problems. For example, this is where a child may have a hoarse sounding voice or lose their voice all together for a prolonged period of time. Working with the child and family to work out what is contributing to the problem is an important first step when working with voice issues.


Can a child have more than one speech and language difficulty?

The above have been listed as distinct entities and sometimes these difficulties do exist on their own, but many children have difficulties in more than one area. When this is the case a thorough assessment is key to really look in detail at a child’s communication profile and then prioritise areas for therapy.


Can SLTs make diagnoses?

Some children who are referred to us have a diagnosis of a specific syndrome or condition and others may not. It doesn't matter to us whether a child has a diagnosis or not as we would always do a thorough assessment irrespective of this.

It's important to note that SLTs can diagnose difficulties which are specific to communication such as a speech disorder, language delay or selective mutism but cannot diagnose wider conditions such as Autism Spectrum Condition. However, they can provide useful information for other professionals by writing a report showing our assessment, observations and documenting other’s concerns.


Do SLTs work with attention and listening skills?

Attention and listening skills are crucial to good communication and are always commented on in an assessment report. This is because it may impact on therapy if a child with attention and listening difficulties need certain adaptations to allow them to access therapy.

Attention and listening difficulties on their own would not usually be appropriate for speech and language therapy. In order for it to be appropriate, a child would need to show more specific speech or language difficulties in addition to their difficulties with attention and listening.


Is there anything SLTs don't work with?

  • Accents - changing someone’s accent is not part of the role of an SLT. This is because having an accent is normal and should not cause a communication difficulty. Just be aware that some children do develop their vowel sounds incorrectly leading to their speech being unclear and sometimes this does make them sound like they have an unusual accent.
  • Difficulties with reading and writing - on their own these are not part of the role of an SLT. If you are concerned about this, speak with a Teacher or the Special Educational Needs Coordinator (SENCO) at your child’s school.
  • Some children with stammers - Sometimes we are referred to work with older children with a stammer who are aware of their stammer and it does not bother them in any way. They are often referred by well-meaning teachers or parents who may be desperate to help them. As part of the assessment we would always ask an older child about their thoughts and feelings relating to stammering and if they do not want support it is definitely not appropriate to make them attend sessions as if this is the case they will not be effective.


Is it better to work with a specialist in a specific area of SLT? 

While many SLTs enjoy the variety that comes with the role, over time they generally develop specialisms for whatever parts of the job that they really love. This is also helpful for the young person, as it means they're getting an expert in that specific field.


If you're looking at making a referral, at Mable it is easy to see which therapists cover which specialisms and the website will match you with a speech and language therapist appropriate for your child's needs. You can book a consultation appointment with a qualified therapist here. Or if you have questions, why not get in touch.