Humans are born hard-wired to be able to communicate, be social and interact.
Communication is hugely important in the workplace and at school, where inquiry and problem-solving skills play such a huge part. Consequently, when aspects of communication are disordered, it can have a big impact on those affected.
Our ability to communicate is more than just words and can be impeded by a range of issues, from medical needs to developmental issues. Being able to communicate effectively can increase confidence and the ability to interact with others.
A speech-language therapist can wear a number of different hats within the role. Our basic remit is to carry out full assessment and intervention in communication and swallowing disorders.
We cover a variety of areas from children to adults, working with those with autism spectrum disorders and Down syndrome to those with voice disorders and swallowing difficulties. I work both with adults following a traumatic brain injury and stroke and with children, both preschoolers and school-age. This leads to an variety of challenges and activities, which keeps the role hugely engaging.
Increasing family focus
With children, therapy is becoming more and more family focused, often working on the parents’ interaction as their child’s ‘model’, encouraging more talk, more shared reading, following the child’s lead and focusing on adapting the environment to give maximum opportunities for engagement.
With speech sound disorders, children can often struggle to produce certain sounds, be difficult to understand and become very frustrated.
With language, parents often ask, ‘Is it too early for therapy as my child cannot speak yet?’
In fact, the initial period before a child talks is hugely important and contains the building blocks for verbal language and interaction.
Non-verbal communication, showing intent to want to communicate (even if it’s just a pointed finger or a child following your gaze to a toy) is a part of communication we can also work with. A speech-language therapist can also assist if a child or an adult may need an alternative means of communication. This can also be high-tech or low-tech and is part of augmentative and alternative communication.
Therapists do lots of work around literacy for school-age children; at the pre-literacy stage we focus on oral language as this is the basis for literacy later on. This includes the skills that let kids recognise and work with language (phonological awareness). Parents often develop these skills instinctually by singing and rhyming together, clapping out the syllables of words and drawing attention to the sounds in a word.
Parents: “go with your gut”
If a family is ever concerned about the way their child is communicating, whether they are unintelligible, stuttering, or they are frustrated over not having enough language, I would always say, “Go with your gut and seek help”.
As parents or carers, we know our children best and know when something doesn’t feel right. The earlier the intervention, the better the chance of the child catching up to peers. Children will often be seen before they start school, when parents are aware of the big jump in demands that comes in a classroom.
Also, parents should look for frustration, for a child being unable to communicate and negotiate with their peers or teacher, family and friends. Discussions with early childhood teachers can be great to get an idea of how the child is managing and communicating at kindergarten or daycare.
If a child has the tools to allow them to communicate the way they want to, whether that is by being able to be intelligible, have more language or be more specific in the way that they talk, it leads to better social communication, learning, listening skills and comprehension.
Impacts for adults
Changes in an adult’s ability to communicate can have enormous impacts on their career, their role in their family and their social inclusion. These changes may occur after a stroke or other brain injury or as a result of a degenerative disease such as Parkinson’s or Motor Neurone Disease.
Speech-language therapists focus on what a client can achieve to try and increase their participation, increase their communication and assist to reclaim the activities they enjoyed before their stroke or head injury, for example.
Many clients following stroke will have aphasia, a language disorder that can affect all modalities of language: understanding, talking, reading and writing. Aphasia can be chronic, but significant gains can be made after the initial hospital rehabilitation period.
Similarly, adults may come to a therapist due to concerns about their swallow, such as an increase in choking or food going down into their lungs and causing an aspiration pneumonia.
Anyone who feels they have had a change in their ability to communicate – whether that’s a change in their voice or language, finding words or understanding conversation, or their ability to swallow – should ask their GP about being referred to a speech-language therapist.
As stated on the Universal Declaration of Human Rights, communication is a fundamental human right. As speech-language therapists, we can help our clients exercise that right.