An independent Speech & Language Therapist will always make their own assessment of a child before offering any further input (even if the child has already seen a SLT through the NHS). It is essential that they get to know the child and make their own professional judgement about the support the child needs and how they can add value.
I always do the initial assessment in the child's home. I start by taking a detailed 'case history' so that parents can tell me about their child's developmental milestones, medical history, communication development and their interests, motivators and unique personality. I listen to their views and concerns. I observe and assess the child’s speech, language and communication skills through play, and use standardised or informal screening assessments appropriate to their age and stage of development.
I also ask if anyone else is working with the child so that, with parents' permission, I can liaise with them after the appointment if this is appropriate, e.g. Health Visitor, teacher, nursery staff. If the child attends nursery or school it is important to find out the teacher's view on whether the communication difficulty is having an impact on their learning or social interaction.
At the end of the initial assessment I will talk with you about your child's speech, language and communication needs and options for further support. This will, of course, depend on what the assessment has shown but can include a nursery/school visit, further detailed assessment, weekly therapy, or advice and a progress review.
After the appointment I will write a detailed report which addresses the following areas: Attention and listening, understanding of language, expressive communication (talking), speech sound development, play and social interaction, and functional use of communication skills. The report also provides a clear summary and detailed recommendations for targets to work on, useful strategies, and activity ideas which you, and nursery/school staff, will be able to implement.
My approach to assessment and therapy focuses on identifying the child's current speech, language and communication skills - through play, formal and informal assessment and observation - and identifying how those around them can support them to become a happy, confident and successful communicator.
My post-graduate training reflects my passion for child-led play-based interactive approaches.
Initial assessment is always carried out in the child’s home – the place where they are most relaxed and confident to communicate. Further appointments can also be provided in your home, especially if your child is a pre-schooler or Home Educated.
Parents are always present for assessment and therapy sessions to ensure they understand what I am doing, and why.
Therapy always includes working with parents; involving them in activities, modelling and explaining techniques, providing training and, sometimes, using video feedback to support your learning.
Parents are able to apply the strategies they learn to every day real life communication situations - bath-time, meal-time, dressing, doing family work together - as well as to play and therapy activities.
Parents need good information, ideas, advice, and sometimes reassurance too. They often talk to the Speech & Language Therapist about other concerns they have about their child. This might include behaviour, eating habits, sleeping, and education.
Whilst I can only give professional advice relating to communication development, I am always happy to listen and be aware of other challenges you are facing. I am happy to share my own experience from working with, and raising, children.
I will do my best to signpost you to other professionals who can help you when your questions are outside of the scope of my knowledge and expertise.
I work from home and can be available for telephone bookings or consultations in the evenings and at weekends. I also offer appointments on Saturday mornings.
I keep my caseload small so that I am able to provide the level of therapy each child needs and follow and review their progress.
There are many types of speech and language difficulty. Some resolve quite easily, with the right input and advice, and so for some children therapy can be a short term solution - for example a mild delay in speech sound development.
For other children speech, language and communication difficulties are associated with complex needs (e.g. autism, special educational needs) and they will need support over a longer period of time, monitoring their progress and adapting approaches and therapy input as their needs change.
A change in education setting, or from pre-school to school, or accessing different types of therapy group, can mean a frequent change of Speech and Language Therapist. In choosing to work independently it is my goal to provide good continuity of care and support you and your child from the initial telephone enquiry, through the assessment of their needs and throughout the time for which therapy is needed.
If, after the pre-school years, your child is Home Educated I can work with them in their home environment.
Speech & Language Therapists are qualified to work with children and adults with a wide range of communication difficulties but after they graduate most choose to work with either adults or children, a smaller number do both.
Depending on where we work, we develop clinical experience and expertise in specific, specialist areas. We continue to undertake post-graduate training to support our clinical practice.
Speech & Language Therapists have detailed knowledge of speech and language development and, when undertaking an assessment, refer to ‘developmental norms’.
Every child is different, and they all develop at slightly different rates, but these 'norms' allow us to identify whether a child has a speech and language delay or disorder and whether this is 'mild' 'moderate' or 'severe'.
Formal assessments are also used to baseline a child’s language level and identify areas where support is needed.
This developmental approach allows us to ensure that the therapy we provide is appropriate to the child's stage of development. When a child has a 'severe-moderate' delay we tailor our approach to facilitate their progress to the 'next step' to ensure aims are achievable.
A horizontal approach gives equal value to the knowledge and skills of each person who works with the child, making sure that joint-working facilitates a creative, problem-solving approach.
I have worked closely with parents, health visitors, teachers, specialist teachers, TAs/LSAs, nursery staff, other Speech & Language Therapists, physiotherapists, and paediatricians.
Combining my knowledge and experience, with each person's unique knowledge of the child, ensures that assessment is comprehensive and therapy is effective and tailored to the individual.
Speech & Language Therapists spend a lot of time liaising with other professionals to ensure we work in a joined-up way to the best interests of the child.
As an independent therapist I always liaise closely with the child’s NHS SLT too. Time spent on liaison (as well as preparing resources, planning therapy, and travelling) all adds up and so is reflected in the price you pay for independent SLT support.
Please contact me if you have any questions.
Copyright © 2019 Gillian Bolton