Speech and language therapy is the health care profession which is specifically concerned with the assessment, diagnosis and management of communication and swallowing disorders. A professional qualification in speech and language therapy is achieved through a university four year honours degree programme or a two year masters programme.

ASSESSMENT
The speech and language therapist will assess your child’s communication skills by asking you questions about your child’s development, by talking to other professionals, by observing your child when playing alone and when interacting with you.  She/he will interact with your child through play and may use pictures and objects and books. She/he may ask you to complete checklists of questions that will help her/him understand how your child communicates at home and with other people.

THERAPY PROCESS
You and the speech and language therapist will decide on the communication goals for your child.  Goals should be specific, measurable, achievable, and realistic and within a timeframe (SMART). How these goals will be achieved can involve direct therapy or indirect therapy.
Direct speech and language therapy involves individual therapy sessions with your child or group therapy sessions (your child and other children together).  The location of the therapy can be in clinics or in the home or in schools.
Indirect speech and language therapy involves helping those who interact with your child to enable your child’s communication environment. This involves parent/carer education programmes; teacher training, parent training, school programmes to be carried out by school staff, home programmes to be carried out by the family. Examples of parent training are ‘It Takes Two to Talk’ Hanen programme and the Lámh family course.

A speech and language therapist

• Works with children and adults who have difficulties communicating (talking and understanding)
• Works with children and adults who have difficulties eating, drinking and/or swallowing.
• Enables people with communication disorders to achieve their maximum potential to communicate.
• Assesses what the difficulties and abilities are and makes diagnoses
• Plans and implements an intervention programme with a client. This may involve direct work with the child or adult or indirect work with the family or significant others in the individual's environment
• Helps manage and improve the person's difficulties and abilities
• Works as part of a team which may include: parents, carers, teachers and school staff, psychologists, occupational therapists, physiotherapists, doctors, nurses, dieticians, social workers, audiologists.
• Provides services in community clinics/health centres, child development centres, mainstream and special needs preschools, mainstream and special needs schools, training centres, adult centres, and hospitals or in people's homes.
• Is employed by the health service executive or a voluntary organisation or is self-employed.

Yes because many people who have a learning disability have difficulty communicating.  Children and adults with Down Syndrome have varying levels of learning disability. A person with a learning disability

• May find it hard to understand what is said to them
• May be difficult to understand when they are talking
• May not develop speech
• May have difficulty expressing themselves and getting their point across
• May have difficulties with feeding and/or swallowing

The speech and language therapist will help the child or adult to improve their communication skills and will also help parents and carers to develop their skills to encourage the child or adult's communication skills.

Communication pattern 1:

What can happen if communication is ineffective…?

Communication Pattern 2:

What can happen when communication is effective:

• Verbal communication - communication using speech, words, sentences
• Non-Verbal communication- communication using pointing, gestures, body language, eye contact.
• Comprehension of language - understanding of language; receptive language
• Expression - expressive language using both verbal and nonverbal means to get a point across. This includes grammar and vocabulary and speech.
• Pragmatics - social use of language; language in context or in the environment; functional communication, why we communicate, for example, starting a conversation; answering a question, requesting, clarifying, telling a joke, making a statement, asking a question, staying on a topic. Using words/sentences/signs/gestures appropriately in a conversation.
• Speech sound development - the sounds we use, speech production and also phonological development
• Attention/Listening - ability to attend and listen to instructions and spend time on one activity jointly with another person.
• Fluency - when we speak how fluent is the flow of the words. When the flow is broken we become nonfluent also called a stutter.

• Any behaviour we use to send messages back and forth between 2 or more people
• We communicate all the time
• Speech is the most convenient and most effective way to communicate

BUT NOT THE ONLY WAY

• Tone of voice
• Body Posture
• Facial Expression
• Sarcasm
• Humour

Other ways . . .

• Pictures
• Gestures
• Symbols
• Written words

Communication involves signals and messages:

• Nonverbal signals include head signals, hand signals and whole body signals.
• Verbal signals include words and sentences.
• Vocal signals include noises and sounds.

We use communication . . .

• to make choices
• to form relationships
• to regulate the behaviour of others
• to make friends / social contacts
• to satisfy needs
• to reduce feelings of isolation
• as well as requesting, get / give information

THEREFORE the ability to communicate effectively and having a desire and need to communicate are very important.

There is a lot you can do to help your child's communication.

You can develop your understanding of how your child communicates and why they communicate by watching and looking at them during different activities, during communication with different people and in different places.  The speech and language therapist will ask you these questions.
You can also look at the stages of speech and language development and see what level or stage your child is reaching. This is useful information as you can monitor how your child's communication skills are developing. Children with Down Syndrome experience delays in the development of their communication skills.

You can encourage your child's development by responding and interpreting what they are trying to say.  Even though you may not be able to understand what they are saying try and add meaning to it, for example, child points and says ah, ah while looking at cows in a field; parent could say a cow, I see a cow, the cow says moo moo.

You can use Lámh signs along with your words to help the child have a visual symbol to attach to the word and over time maybe they will copy the sign and then use it.  The Lámh office has contract Lámh tutors that can provide training to parents and centres to get you started with Lámh signs.  A speech and language therapist who is trained to use Lámh can also show you signs.  Other parents may show you signs too.

Useful websites
www.lamh.org
www.hanen.org

Written by
Clare Carroll, BSc., Msc., MIASLT, MRCSLT.
Lecturer,
Discipline of Speech and Language Therapy
School of Health Sciences
NUI Galway