Speech and Language Therapy

Dr Sean Pert is a Consultant Speech and Language Therapist (SLT), researcher, trainer, and Senior Clinical Lecturer at The University of Manchester. Since qualifying in 1995, he has specialised in Developmental Language Disorder in bilingual children, completing a PhD on the lack of code switching as a clinical marker of DLD. His publications include research papers, book chapters, clinical assessments in multiple languages, and influential textbooks. Sean established the first website for SLTs in the UK, www.speechtherapy.co.uk.

• Chapter 1 – introductionIntroductionWhat’s in a name?What is speech, and how is it different to language?Speech therapist, speech and language therapist or speech and language pathologist?A protected titleA relatively new professionWho do we work with and where?Client mixCommunication disordersAutism / autistic spectrum conditions (ASC)Hearing loss and deafnessAdults Can I choose just to work with one client group?Does this book cover all the conditions and clients I might encounter?What qualifications do you need to be an SLT?Applying for a speech and language therapy pre-registration courseHow do we work with service users?Diversity in speech and language therapyDiversity within the workforceBilingualism and multilingualismSummaryReferences Chapter 2 – core skills for speech and language therapistsBiomedical sciencesLinguistics: the anatomy of languageSyntax GrammarMorphologyWhy do SLTs need to know about linguistics?Adults with acquired language disorders such as aphasiaTranscribing speechPhonetics versus phonologyEating, drinking and swallowing (eds)Psychology, sociology and educationResearch skillsProfessional skillsEvidence-based practice and your own viewsEmotion, empathy and supporting clients‘I know it works!’ is not evidenceColloquial and professional languageYour social media identity and presenceEthical dilemmasClinical skillsCombining clinical and academic learningTravel as a student and therapistMeeting your own needsIs working harder more professional?SummaryReferences Chapter 3 – the care pathway: from referral to dischargeDevelopmental and congenital conditions Progressive conditionsAcquired conditionsAssessment Informal assessmentInterviews and impact on the client and familyDiagnosisDifferentiating diagnosis from aetiologyDifferentiating risk factors from aetiologyReferring agentsTherapyTherapy packages Where is therapy delivered?Who delivers therapy?What does therapy involve and how is it different to teaching?Outcome measuresTypes of outcome measurePatient reported outcome measures (proms)DischargeOther SLT rolesSummaryReferences Chapter 4 – professional organisations and equity, diversity and belongingProfessional organisationsWhich organisations exist?Are membership organisations trade unions?Is the HCPC a membership organisation?Student membershipPreceptorshipCosts and benefits of membershipPrivate practiceMembership organisation web sites Equity, diversity and belonging (EDB)What is equity?What is diversity?What is belonging?Current challenges: the workforceSummaryReferences Chapter 5 – learning: academic learning, clinical skills learning and reflective practiceSimulated learningReflectionWritten case studiesClinical placement learningI don’t know about this caseload. How can I complete a placement before I’ve received the teaching? How can I engage with a clinical placement I’m not interested in working in after I qualify?Portable skillsPlacement settingsMaking the most of a clinical placementActivities during clinical placementInnovative placement experiencesDress code for clinical placementsReligious needs during clinical placement Making notes in lectures, seminars and tutorialsSession recordingsMaking notesWorking with your peersA typical timetableHow will I be assessed?Specialist competencies, including eating, drinking and swallowingSummaryReferences Chapter 6 – speech sound disordersSpeech sound disorders (SSDs)Acquiring speechSpeech versus languageAre words a figment of your imagination?The speech codeVoiced versus voiceless contrastsTry this!Contrasting the place of articulationContrasting the manner of articulationPhonemes, phones and allophonesAccent and dialectsAge of acquisitionSpeech sound disorders (SSDs)Assessment of speechIPA scriptTwo ‘n’sThe IPA chartUpside down ‘r’Prevocalic /s/ di-clusters and tri-clusters with voiced second segmentsDenoting syllablesTypes of speech sound disorder (SSD)Articulation disorder - distortionsArticulation disorder with phonological implicationsPhonological processesHow many examples of a phonological processes are needed to confirm its presence?Is the struggle real?Phonological delay (pd)More complex SSDsConsistent phonological disorder (CPD)Inconsistent phonological disorder (IPD)Therapy for SSDsSuccess in treatmentTherapy aims: Children don’t ‘stop stopping’!Phonological awarenessPhonological awareness tasks in speech therapyListening tasks in therapyIs phonological awareness helpful for children with SSD?Dummy (pacifier) usageTongue-tie (ankyloglossia)Cleft lip and palateVelopharyngeal incompetence or insufficiency (VPI)Bilingualism and speech sound disorders (SSDs)Case studySummaryReferences Chapter 7 – language: children’s language difficulties, DLD and adult aphasiaLanguage difficulties, and developmental language disorder (DLD)Language difficulties under 5 years of ageCurrent language diagnosesSpeech, language and communication needs (SLCN)Developmental language disorder (DLD)Languages are all valid, including signAssessment of language skills: verbal comprehensionAssessment of language skills: expressionA language sampleVocabulary (semantics)Poverty, deprivation and language developmentTherapy for language disordersTechniques you may encounterAdults with language difficulties: DLD, aphasia and dysphasiaAphasiaSummaryReferences Chapter 8 – bilingualism and speech, language and communication needs (SLCN)Speech and language disorders when speaking two or more languagesMonolingual speaker Bilingual speakerLanguage other than English (LOTE)English as an additional language (EAL)Code switchingSpeech and language therapy: a home language, holistic approachBilingualism is never the cause of an SLCNDo you need to be bilingual to work with bilingual clients?I’m bilingual, do I have to specialise in bilingualism?What’s your language called?Speech sound disorders (SSDs) in a bilingual or LOTE contextLanguage difficulties or developmental language disorder in a bilingual or LOTE contextThe role of poverty and deprivation (socio-economic status or SES)Should children speak English, the language of education?Working in the child’s home language: working alongside an interpreterStyles of interpreting Translating informationChallenges of working with interpretersWorking in a child’s home language: assessment and therapy materialsOutcomes of therapySummaryFurther readingReferences Chapter 9 – specialisms within speech and language therapySpecialisms within speech and language therapyThe generalistSpecialist, and highly specialist rolesWhat counts as a specialism?ConsultantsSpecialism case study example: voice exploration for trans and non-binary peopleVoicePhonation, pitch, loudness and resonanceTrans and non-binary people and vocal changesAssessment of the voice for trans and non-binary peopleObjective, computerised assessment of voiceVoice exploration: making the changeExample of an exercise using visual feedbackCultural awarenessIntersectionalityFurther readingReferences Chapter 10 – frequently asked questions (FAQs)Studying speech and language therapyClinical placementsSpeech and language diagnostic termsAetiologies Care planningThe team around the clientService deliveryTechnical terminology relating to speech and language therapyFrequently encountered assessments and therapy programmes Assessments and therapy packages for language difficulties or developmental language disorder (DLD)Assessments for speech sound disorders (SSDs)Example of an assessment for aphasiaReferences AppendicesAppendix 1 – list of membership organisations across the globeAppendix 2 – brief procedure for assessing children’s speechAppendix 3 – the international phonetic alphabetIndex