I often get asked “What are the benefits of an in-house Speech Therapy Team?”

Over the past 16 years as a qualified Speech and Language Therapist I have had the pleasure to work in a variety of settings across the world.

Location wise I’ve worked in:

The UK
Across the UAE

Clinically I’ve worked in:

State and Private mainstream nurseries and schools
State and Private mainstream specialist schools
NHS and Private Community clinics
Private secure hospitals
Family homes
Nursing homes
Supported living homes

I’ve been employed by the NHS and commissioned by Local Authorities; the NHS; private hospitals; state and private schools; overseas embassies and individual families. Oh and my youngest client was 18 months and my eldest was in the mid-70s.

Why tell you all this? Well to set the scene so to say. I’ve seen what works well and what does not work so well.

When considering the most appropriate means of delivering SLT I often reflect on what ASHA says “Selecting the most appropriate service delivery model is a fluid process” (https://www.asha.org/slp/schools/school-based-service-delivery-in-speech-language-pathology/) and remind myself that, like individual children’s needs differ, the SLT approach needs flexibility and this can be very difficult for large services to encompass in their Service Guidelines.

For the purpose of this post I want to think specifically about in-house SLT where the school themselves either employs or commissions a SLT to become an integrated part of their teaching team.

When I recommend in-house SLT I am doing so used on the child’s individual SLT profile and what my experience tells me about how this service delivery model would reasonably meet the child’s SLT needs.

Why do I recommend in-house SLT for some children? Well my experience is that the in-house SLT approach is:

More flexible – the children I tend to work with can be very dysregulated at times and this can be unpredictable. Booking a 9.15am direct SLT session with the child every Wednesday might logistically be best for the SLT’s diary but the child might not be conductive to SLT at the particular session. In-house SLTs can re-jig their diaries and see the child later in the day / week and see an alternative child so that the SLT time is not wasted.

Easier access to the Team Around the Child – families of children with SEN / SLT needs often find it difficult to make contact with members of the multidisciplinary team working with their child. When everyone is based at different clinics; offices or schools the task of getting much needed feedback can be very challenging for families. When the whole team working with a child is in-house the family has one single point of contact and much easier access to feedback about their child’s progress.

More training opportunities – the duration and frequency of direct SLT I tend to recommend is a drop in the ocean in a whole week of school. I do this as I am a huge believer in up-skilling teachers and teaching assistants to be part of the SLT programme. In-house SLTs tend to have more opportunities to provide on the job practical training to the teaching team to improve consistency for the child I’m working with.

Easier MDT working – when the Teacher; Teaching Assistant; SENCO; SLT and OT are frequently in the same place at the same time (e.g. the staff room or inset days) there are increased opportunities for each member of the Team Around the Child to be able to speak to each other about a child’s SLT / Holistic development. Yes more formal meetings are certainly required at times but I’m sure we’re all more than aware of how challenging organising diaries are and in addition to this impromptu meetings can be very beneficial.

Consistency of language used – as someone who is Solihull Approach trained I am very aware that MDTs working with children can really benefit from a shared vocabulary when talking about children as this assists in reducing confusion when one person might use more archaic language like “challenging behaviour”. Shared vocabulary across teams assists consistency.

Joint planning – where the class Teacher; SLT and OT have increased opportunities to plan lessons together and embed SLT and OT targets in a more functional manner (i.e. moving away from the “SLT session approach” to “embedded SLT throughout the day”).