Speech and language therapy

Speech and language therapy is a diverse clinical field that offers a cradle-to-grave service for managing difficulties with communication, speech and language, and eating, drinking and swallowing (EDS). Therapists can choose to specialise in early years, childhood or adult disorders.

All cases start with a referral, which is followed by a detailed case history and assessment. This includes investigating family history, environmental factors or an injury that provoked an adult condition, as well as a clinical assessment. Speech and language therapists often work closely with other healthcare professionals such as paediatricians and clinical psychologists to determine problems and develop a co-ordinated programme of care. Therapists provide direct intervention, working with a client one to one or in a small group. Indirect intervention focuses on helping parents and carers to work with their children or loved ones, and to provide as supportive an environment as possible. Cases are closely monitored so that therapists can see whether there has been any long-term improvement or if the client needs ongoing support. Not all conditions can be remedied, so therapists may also help clients to develop strategies to manage their problems.

Therapists work in clinics, health centres, hospitals, day centres, schools, nurseries and homes. Therapy does not work on its own: for it to be effective you need to work in partnership with families, parents and carers, as well as a team of other therapists, healthcare professionals and agencies such as social services and education.

New developments

Therapists are constantly adapting existing techniques to find ways of improving clients’ lives. NHS initiatives such as Agenda for Change are changing working practices and there is a national drive to incorporate flexible working.

Skills required

• Analytical skills to assess cases.
• Well developed communication and interpersonal skills.
• The ability to assume responsibility, to work independently as well as under supervision.
• Professionalism and the ability to follow policies and procedures.

Starting out

Speech and language therapists need either a three to four-year undergraduate degree or a two-year postgraduate qualification and must register with the Health Professions Council. Newly qualified therapists assume responsibility for part of the caseload under close supervision and responsibilities will increase. There will be opportunities to develop your skills, such as negotiation and liaison, which can be transferred to another area if you choose to change client groups. A good service provides well structured support – so look for one that has therapists at a range of grades, opportunities for ongoing development, support from peers and opportunities for continuing professional development (CPD).

Get further information from the Royal College of Speech and Language Therapists or the Health Professions Council.

In brief

• Best bits
  There’s a real buzz in knowing that you’ve improved a client’s quality of life.
  Using your diagnostic skills to pick apart assessment information and put together a clear action plan is very satisfying.
• Worst bits
  The long-term nature of some conditions can be difficult when change is a slow process.
• Don’t bother if...
  ...you find change difficult – the work is very dynamic so you need to be flexible.

SARAH HULME is a clinical manager in the early years speech and language therapy service at ISLINGTON PCT. She graduated with a BSc in speech sciences from University College London in 1988, and has worked in this area for 18 years.