Neera Malhotra - North London Speech and Language Therapist  

The objective of speech and language therapy

Speech and language therapists aim to identify and successfully treat any speech and/or language difficulty in a child's home language(s). This difficulty can manifest itself in a number of different ways. Children may know what they want to say, but be unable to produce clear speech. Alternately, children may have difficulty making sense of the language used around them, and find it hard to learn new words or to speak in sentences. Other children may have a communication problem that is part of a wider difficulty in learning.

Having a difficulty in speaking clearly or being able share your thoughts with another person can be extremely frustrating for the child, and those around him. This can lead to social isolation and behavioural difficulties. Potentially, it can also impact on a child's educational attainment, as he or she may find it difficult to participate in the full range of classroom activities.

How do speech and language therapists work?

Some speech and language therapists specialise in working with adults with communication impairment and others in working with children. Few speech and language therapists work with both client groups. Speech and language therapists also have additional practice specialisms (e.g. autism, dyspraxia or specific language impairment).

(A few speech and language therapists work in the area of accent retraining or elocution. In the main, though, if you need this kind of input try drama teaching or a professional voice coach. The Mary Ward Centre, in London, runs courses to improve the accent of non-native English speakers.)

Speech and language therapists assess a child's speech and language skills, and his overall communication, using a range of informal and formal assessment techniques.

Informal assessment consists of watching and interacting with the child in a play setting, while formal assessment involves the use of a test or set procedure to probe specific skills.

Whatever the method employed, speech and language therapists assess the child's development in five main areas:

  • social development
  • attention and listening skills
  • play skills
  • understanding of the child's home language(s)
  • the child's ability to express himself using his home language(s)

Information from the child's parents/carers is also vital in building a picture of the child's prior experiences, development in all areas and any relevant medical information. Parents/carers can also provide information on the child's ability to communicate on a day to day basis.

Speech and language therapists use all of this information to determine if the child's level of skill in communication is at the level expected for his age or his overall ability. (In the main, overall ability is judged by the child's play skills.)

Your therapeutic options following assessment

Once the speech and language therapist has discussed the diagnosis of the child's language/speech difficulty with you then he/she will recommend a type and frequency of therapy that is determined by the diagnosis. Some of the intervention options are listed below.

  1. Home or school programme. Typically, this consists of a number of aims and suggested activities drawn up by the speech and language therapist together with the parent/carer or teacher. The parent/carer or teacher is responsible for giving the child the practice in the different activities to help the child make progress. The programme is monitored according to an agreed time scale by the therapist, and new aims set if appropriate or necessary.

  2. Direct therapy in an individual or group setting. This is provided by the speech and language therapist. Again the speech and language therapist would be aiming to achieve certain aims to help the child's skills progress through a range of activities. It is also important that the parents/carers or teachers are also kept informed of the child's progress, so they can help reinforce the child's skills on a daily basis.

    It is useful in the majority of cases for the child to have a break from therapy from time to time. The length of the break could vary between one and six weeks, depending on the child's progress and skills. This gives the child the opportunity to consolidate the new skills learnt before the next level of skills is taught.

  3. No therapy required. If the child's skills are progressing as expected for his age, or his language skills are at the same level as determined by his/her play skills, then therapeutic intervention is not required.

It is important to note that the ongoing involvement of the parents in supporting and reinforcing the therapy recommended is essential. This helps give the child the daily practice needed for the new skill to become ingrained.

Criteria for choosing a qualified speech and language therapist

All UK speech and language therapists must have a four-year undergraduate or two-year postgraduate degree, plus a licence to practice as a speech and language therapist. The Royal College of Speech and Language Therapists (RCSLT) is the sole professional body responsible for overseeing and accrediting speech and language therapist training.

It is advisable to use a speech and language therapist who is a member of the Royal College of Speech and Language Therapists and registered with the Health Professions Council. The HPC is a regulatory body with the responsibility of protecting the public against bogus health professionals.

The Association for Speech and Language Therapists in Independent Practice requires all speech and language therapists listed on their database to be registered with the HPC and a member of the RCSLT.

You will find more details of my academic qualifications and clinical experience here.