Speech and language therapist

Also called SLT, SALT, Speech therapist, Speech and language pathologist

What a speech and language therapist actually does, across speech, language, communication and swallowing, and what is not their job.

What it is

A speech and language therapist is a degree-qualified, HCPC-registered health professional who assesses and treats difficulties with speech, language, communication and swallowing, in people of any age. The title is protected in the UK: nobody can call themselves one without registration. "Speech therapist" is the same person; "SALT" and "SLT" are the same abbreviation.

They work in the NHS, in schools, in care homes, in prisons and privately, and their professional body is the Royal College of Speech and Language Therapists.

Who it can help

Children with delayed or disordered speech or language, autistic children and adults, people who stammer, people with aphasia or dysarthria after a stroke or brain injury, people with progressive conditions such as motor neurone disease and Parkinson's, people with a learning disability, people with voice problems, and people who need AAC. Also anyone with a swallowing problem, which in a hospital is often most of the caseload.

What they are not: a teacher, a psychologist, an audiologist, or an occupational therapist. They do not diagnose autism alone, prescribe medicine, or fit hearing aids. Nor do they hold the purse for equipment; see funding a communication aid.

How it works

The therapist assesses (see communication assessment), sets goals with the person and family, and then chooses the approach. For many people that is not weekly one-to-one sessions but a programme: the therapist trains the people around the person, parents, teaching assistants, care staff, and reviews progress. That is deliberate, because communication happens all day, not in a clinic.

Specialisms exist within the profession. AAC, dysphagia, stammering, voice, cleft, hearing impairment and deafness, and neurology are all recognised specialist areas, and a generalist therapist will refer on to a specialist when needed.

Getting started

Before the first appointment, write down what the person can do as well as what they cannot; therapists set goals from strengths. Bring anything the person already uses to communicate. Ask the therapist three things at the end of the session: what is the goal, what should we be doing at home or in class every day, and when will we review it.

If you have been given a programme, do it, and record it. A therapist who sees a filled-in record book at review can change the plan; one who sees nothing can only repeat it.

If you cannot get an NHS therapist for months, an independent one can assess and set a programme that the NHS therapist can pick up later. Ask for a therapist who is RCSLT-registered and, for AAC, who names AAC as a specialism.

Where to get help

RCSLT explains the profession and how to find an independent therapist. See referring to speech and language therapy for how to get one.