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What is a Paediatric Speech and Language Therapist?
A Paediatric Speech and Language Therapist is a professionally qualified person who works with children of all ages who have difficulties in any aspect of their communication. The role of a Speech and Language Therapist can vary greatly depending on the communication difficulty. The following are some of the areas a Speech and Language Therapist might work in.
- Speech delays and disorders
- Language delays and disorders
- Stammering/stuttering/dysfluency
- Learning difficulties and syndromes
- Voice disorders (e.g. vocal nodules)
- Hearing loss/Deaf community
- Irish Sign Language users
- AAC users
- Cleft lip and palate
- Cerebral palsy and physical disabilities
- Mental health difficulties in children
- Autism/ADHD
- Speech therapy following head and neck surgery for cancer.
- Eating, drinking and swallowing disorders in children
A Speech and Language Therapist practising in Ireland must hold professional registration with CORU, which is the Irish regulatory body for health and social care professionals.
Reasons to refer for a Speech and Language Therapy Assessment
If difficulties are not associated with underlying diagnoses (such as autism, cerebral palsy, learning needs) the following might be reasons to refer to a Speech and Language Therapist:
A child is experiencing difficulty in any of the following:
- Poor attention or can’t share attention with an adult e.g. if an adult points to something, doesn’t follow the point.
- Not responding to their name
- Does not make eye contact or show interest in adults or other children.
- Not saying any words or not using words for communication by 18 months
- Words used repetitively or echoed after the speaker.
- Doesn’t look to people or objects when named.
- Does not seem to understand what is being said or to follow instructions.
- Has lost language skills or had a regression in skills.
- Little pretend play
- Words are difficult to understand.
- Speech sounds nasal or unusual in any way e.g. speech is ‘slushy’ or ‘lispy’ (air escapes down side of tongue or tongue slips out e.g. for ‘s’)
- Vocabulary is not increasing as child gets older.
- Dysfluency or stammering
- If a child has varied speaking profile e.g. speaks at home but is silent in pre-school/school.
- Child has continued difficulties with producing speech sounds or uses immature speech patterns when they get older e.g. still use ‘t’ for ‘k’ when they are aged 4 years.
- There are comprehension and/or expressive language difficulties affecting access to the curriculum in school.
- Child finds it difficult to get his/her message across
- Child does not have friendships or does not relate to peers as might be expected.
- Difficulties with non-literal language and implied meaning (can’t read between the lines)
- Child has husky/hoarse voice not attributable to a cold.
What to expect in a Speech and Language Therapy Assessment
Depending on your child’s age, the assessment will usually consist of play based activities, observations of you and your child playing or interacting, a detailed case history and formal/informal assessments.
Formal assessment is usually at the table using picture-based materials. If for any reason a child is unable to sit and focus on formal assessment, the Speech and Language Therapist can tailor the session using informal assessment using materials that the child is comfortable with.
The Speech and Language Therapist will make you and your child feel comfortable and the assessment is in a relaxed stress-free environment.
Interventions/treatments following assessment.
If there are any delays or difficulties identified in your child’s communication profile, intervention may be indicated and recommended. The following are examples of different treatments that a Speech and Language Therapist might recommend.
- Language therapy (specific goals might be use of pronouns, or development of linguistic concepts)
- Speech sound therapy (e.g. articulation therapy, phonological therapy)
- Dysfluency treatment (e.g. Lidcombe programme, Michael Palin programme)
- Social communication awareness (understanding the different ways in which we communicate as a diverse population)
- Autism related therapy such as self-advocacy and pragmatic language
- Introduction and trialling of AAC device
- Parent training (early language development such as “Hanen- It Takes Two to Talk” programme)
- Training for schools (e.g. how to support children with speech and language needs in schools)
Occupational Therapy – What to Expect
What is the role of an Occupational Therapist?
Occupational therapists (OTs) work with people of all ages, with any condition, disability or impairment that affects their ability to perform the everyday activities of life. For example, OT’s work with children and adults with neurological conditions (e.g. cerebral palsy), acute medical, surgical and orthopaedic conditions, physical disabilities (e.g. spina bifida), developmental delay and disabilities such as autism and ADHD, mental health difficulties, age-related difficulties as well as those with sensory and attention issues. OTs can assess for difficulties such as Developmental Co-Ordination Disorder and Dysgraphia and make valuable contributions into multi-disciplinary assessments and interventions in many settings around the world.
When working with children and young people, Occupational therapists work in partnership with the young person, their parents and other important people in their life, such as their doctor, teacher and other health professionals. The occupations of young people tend to be centred around play and learning, and include getting dressed, eating, going to school, making friends and being part of a club or group. Occupational therapists working in paediatrics:
· Help children and young people achieve their developmental milestones such as fine motor skills and hand-eye coordination to help with play, school or independent skills (e.g. throwing a ball, getting dressed, holding a pen or utensil)
· Educate and involve parents, carers and others to facilitate the development and learning of children
· Help children with developmental delays learn everyday tasks (such as bathing, getting dressed, brushing their teeth, and feeding themselves)
· Paediatric Occupational Therapists work with children, parents, teachers and other professionals on developing a range of individualised skills for a child in order to allow that child to meet their full potential and thrive in the environments in which they live.
What to expect in an OT assessment?
Your child’s first occupational therapy appointment will be an assessment or evaluation. This may include a standardised test, if appropriate, observation through play, gathering of medical history information, and/or a parent report. If possible, and with parental/guardian consent, information will be sought from a child/young person’s school to find out how they are coping across different environments, and to help formulate a plan to support occupational performance in different settings.
Preparing your child/young person for an OT appointment
Encourage your child to wear comfortable clothing that they can move around in without difficulty, including supportive shoes. Encourage your child to reflect on things they find difficult to manage day to day and any goals they would like to work on, if appropriate. If your child is anxious about going to unfamiliar places or meeting new people, you may want to log onto the company website (https://www.keyassetsconsulting.ie/). Here you will find photos of our staff. You can also request social story resources from our admin team, to help to prepare your child. Your child may wish to bring in a favourite toy or object from home to make them feel more comfortable, and this is welcomed.
How you can prepare for an OT appointment
Reflect on your child/young person’s strengths and any challenges they face. Consider the factors that influence their success and anything that may have had a hindering impact on them. Try to recall your child’s early developmental period. Did they achieve motor milestones on time? Did you have any concerns about their development? Consider their personality and how this affects how they meet the world and the different environments they inhabit. What are your specific goals for your child from OT? Does your child share these? Are the goals achievable and time limited or do they need to be more specific and/or broken down into chunks?
Consider what you want to communicate with the OT and whether this is best done privately (i.e. not in front of your child/young person). Sometimes it may not be helpful for them to hear their difficulties discussed openly with a ‘stranger’. Please consider how the discussion may impact on their confidence, their trust in and relationship with you, despite the fact that you are relaying these concerns with the best of intentions (to help them). Please feel free to request a phonecall at a different time and your child’s OT will be happy to facilitate this.
If you have any specific concerns about how your child will cope with coming into clinic if necessary, please contact the clinician in advance to see if any necessary accommodations can be made.
Sleep Series Tips
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