As a sole independent Speech and Language Therapist I am a limited resource. I cover the whole of the UK but live in Caerphilly, South Wales. I have four little ones who’d like me to be at home as much as possible and whilst 99% of my reports are written between the unsociable hours of 8pm and midnight I like to squeeze in Love Island / Cheer and re-runs of Friends most evenings.
When a family approaches me I first ask for the urgency of their report / evidence deadline. Due to all of the above I don’t stretch myself too thinly and I don’t see children that fall outside of my clinical experience and/or additional training.
Want someone who does TalkTools? Not me, go to SkyBound Therapies. Want someone who can do a weekly home visit in Newport/Cardiff? Not me, go to Sarah Murphy (SLT). Want someone who can do a regular school whole day in Worcester? Not me, go to Summerhill Speech Therapy. Want someone who can assess Pathological Demand Avoidance up North? Obviously go to Libby or Natasha at Small Talk Speech Therapy (I can do the one’s closer to me!).
Once a parent decides to commission me to assess their child my allegiance switches to the child; their needs and how to best support them at home and school. I’ve written quite a bit about my assessment approaches here (amongst other posts) so won’t cover that here.
Following a thorough assessment, preferably at school, my recommendations for therapy will reflect all current international evidence on approaches & frequency and my personal experience in ‘what worked’ with a child of a similar profile (i.e. a needs-led clinical decision). My recommendations never consider how much time I personally have available to see said child (this would be a resource-led clinical decision).
As part of my role I spent a hell-of-a-lot of time reading past SLT reports where a child is offered a “6 week block” of direct intervention (there’s absolutely no evidence base for this and 6 week blocks arose from the school SLT’s need to ‘fit’ therapy within the school term timetables) or any other multiple of 6 weeks (same same). Again, this was most likely a resource-led clinical decision.
I also read a lot about how “Joshua’s speech and language needs are part of his Autism” etc etc as such said therapist’s / service’s policy is not provide any direct or indirect Speech and Language Therapy as “Autism is life long”. I’ve seen this excuse used many times as a reason not to explore a parent’s or school’s concerns about a child’s ability to follow instructions; make friends or put grammatical sentences together. Again, this is most likely a resource-led clinical decision.
It’s like saying:
Language Disorders can exist in addition to other diagnoses, i.e. they can be “co-morbid” when in fact, following a thorough assessment and where present, the SLT can write “language disorder associated with Autism”. This means the language disorder is not part and parcel of the Autism but is related and separate. If you have a spare few mins here’s a helpful summary by RCSLT.: https://www.rcslt.org/-/media/Project/RCSLT/revised-catalise-2017.pdf.
Honesty really is the best policy. Let’s start being honest when it comes to limited resources and not hiding behind mistruths and misunderstandings when it comes to assessments and intervention.
Have a lovely weekend!