It’s true, the doctor isn’t always right! No-one is always right! So the 3 times you should ignore your doctor are:
#1 When they say you’re harming your child by exposing them to more than one language. Or that being bilingual will confuse them or that it’s too hard for your child to be bilingual. Ignore this completely!
#2 When they tell you to drop a language or languages. Ignore this too- no offence to doctors, but this is not their area of expertise!
#3 When you’re worried that your child may be late talking. They don’t have words yet. Or their speech is hard to understand. You’re thinking about seeing a speech & language therapist and the doctor (insert others here as appropriate: Public Health Nurses, Pediatricians, Health Visitors, well-meaning relatives and friends) tells you not to worry, your child will probably grow out of it and they’re too young to be assessed anyway- B.S.! Once again, not their area of expertise.
So who should you listen to then? Firstly, your own gut feeling about things not being quite as you expected. Or your sense of uncertainty about your child’s development. The professional who is qualified to help you in this situation is a speech and language therapist. (Countries do differ at the ages at which children are seen so you will need to find that out for your country) But what do they actually do? Keep reading to find out!
Speech & Language Therapist or Pathologist? What’s the difference?
It can be confusing as we’re not called the same thing everywhere. Speech & language therapist or speech & language pathologist? Depends on where you are- it’s speech and language pathologist (SLP) in the USA, Canada, and Australia but speech and language therapist (SLT) in Ireland, UK, & NZ. Essentially they mean the same thing.
What do SLPs and SLTs do?
There’s also some variation from country to country in terms of what we do but in general for Ireland, UK, North America, Canada, Australia and New Zealand, things are pretty similar.
Speech & Language Therapists/Pathologists work with individuals and their families across the life-span. From babies who have trouble feeding to adults who have had a stroke that has affected their speech and language. We cover all aspects of speech, language, communication and feeding, eating, drinking, and swallowing. The American Speech & Hearing Association puts it nicely:
‘The overall objective of speech-language pathology services is to optimize individuals’ abilities to communicate and to swallow, thereby improving quality of life’.
They also say that SLPs are committed to the provision of culturally and linguistic appropriate series- good news for bilingual and multilingual families. Although I know the reality is often different.
We assess people for possible speech, language, communication, and feeding/swallowing issues. This involves screening; a check to see if there is reason for concern and need for further assessment and intervention. And indepth assessment of speech, language, communication and feeding/swallowing depending on the situation.
What kinds of problems are SLPs and SLTs qualified to deal with?
The kinds of speech, language, communication and feeding/swallowing issues we are qualified to assess, diagnose, and treat are many and diverse. Here’s a sample focusing on babies, children, and young adults. This is by no means a complete list!
Before having words, children need to be able to share attention using gesture and gaze in relation to interesting objects or things happening- this is called joint attention and SLTs assess this.
We also work with issues of intentional communication like greeting, requesting more food, rejecting food, commenting on something. Either using words or before words appear.
And we work on early play skills too.
And with children who have problems with the subtleties of communication for example knowing that ‘Can you pass the salt?’ is an indirect request for the salt and doesn’t mean ‘Are you capable of passing the salt?’
Language both spoken and written
We work with children who have:
Problems following instructions.
Problems learning concepts like colour, size, location
Difficulty understanding what they’ve read
We work with children who have:
Problems with grammar– saying I sawn instead of I saw, mouses instead of mice at an age where you’d expect them to say it accurately
Not started to combine words into phrases
Only using single words when you’d expect them to be using phrases and sentences
Trouble with story telling
Problems breaking words into syllables
Trouble rhyming words
Difficulties with problem solving & reasoning
We assess, diagnose and treat children who:
Have nasal sounding speech
Feeding, eating, drinking and swallowing
We work with:
Babies with a cleft palate and are having trouble sucking milk from the breast or bottle
Children with cerebral palsy who have trouble with their swallow
Children with aversive feeding issues for example children with autism
Children who have had a head injury after a road traffic accident
And this is only the tip of the iceberg! Not only that but we also have a role in preventing speech, language, and communication issues in vulnerable populations such as children in low socioeconomic environments and in creating awareness of communication disorders amongst the general public.
In many situations where the needs of the child are complex, SLPs/SLTs work as part of a team. The family are central to the team or at least they should be! So for example SLTs/SLPs may work with an occupational therapist to get the optimum positioning of the child with cerebral palsy for feeding. They may work with an educational psychologist if the child has a learning disability or cognitive impairment. They work with teachers and speech and language therapy assistants, social workers, neurologists…..
At what age do SLPs and SLTs start seeing children?
In public services this does seem to vary from country to country. But we can assess children’s communication from as young at 8 months. We have many ways to assess early communication. So if you’re worried, don’t wait because you think they are too young to be assessed.
Who not to listen to about your child’s language development
Lots of people have opinions on your child’s language development. From paediatricians to GPs to teachers and psychologists! These professionals are not trained to evaluate speech, language, and communication. That is the speech and language therapist’s job! Professionals and family/friends may also give well-intentioned but inaccurate advice. Never believe anyone who tells you that you must stop speaking a language. And don’t believe anyone either who tells that your child will grow out of it or that they’re too young to be assessed. Trust your instinct and have your child assessed sooner rather than later. If they are developing along expected lines then you can be reassured that things are proceeding as expected. If it looks like there is a problem with some aspect of speech and/or language, then earlier intervention is better. There can be long waiting lists for assessment and intervention so it’s better to be in the system early.
I’d love to hear about speech and language therapy in your country. What did you find helpful? What was not helpful? Be sure to leave a comment below. If you like this post, please pass it on to your friends.
You might also find this post that I wrote for Multilingual Parenting useful to read before you go to the doctor- it’s about facts and fictions of early bilingual language development. http://multilingualparenting.com/2016/01/27/early-bilingual-language-development-facts-and-fictions-guest-post/
Let’s get talking!
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