What happens when you meet the speech and language therapist

All therapists will have their own way of working but generally common features occur in their approach. Your first appointment is often an initial screening session where the therapist will consider your child's needs to make sure that the referral is the correct one for him. If you have collected information, that could be offered to support a referral for stammering. You may be asked if you are able to keep appointments regularly, should they be needed. The next step will then be an appointment for a full speech and language therapy assessment.

The Assessment

If possible when both parents are involved with the child, they should go to this with their child. For part of the session, the therapist may need to speak to the parent(s) without the child. You should explain this in advance to your child so he does not get concerned.

It will be help the therapist to understand your child's dysfluency if you have brought some information with you, either in your own personal record or, if convenient, on the forms provided above. Additionally, if you bring a small notebook with you in which you have written down any questions or concerns that you have, you are less likely to forget what you would like to ask or say.

Current research is clear that the cause of stammering has a physiological basis in the brain structure. The BSA:Research has the details of all the latest research and information. There is no single or definite cure and there is no single best strategy for supporting children as they all have individual needs. Parents cannot cause stammering but there is thought to be a family link in some cases, as where a close adult relative is stammering a child is more likely to stammer. While the underlying cause of stammering is now understood what is also certain is that stammering speech is affected by a complex combination of environmental, inherited, linguistic and physical factors that are unique to the individual in their form and effects. The therapist will take a holistic approach, examining all the factors that may be contributing to dysfluency.

Your child's case history

The therapist will take a detailed case history about your child's life so far by talking with both parents, if they both attend the appointment. This will include the child's medical details, family background and history and information about his development and progress. This discussion will be quite lengthy and may involve questions about the family situation that some parents have told the BSA they could not see the necessity for. However, it is important to remember that therapists are bound by the same rules of patient confidentiality as any other medical professional, such as a doctor. Any information acquired during a therapy session may not be passed on to anyone, other than another medical professional, without the explicit consent of the parent(s). Questions that appear to be rather personal will be necessary to provide information that is relevant to the therapist's assessment of your child's speech.

Parents who still worry that in some way they have caused the child to stammer should be reassured after talking with the therapist that parents do not cause stammering. However they do have a vital role in helping their child manage the stammer more successfully.

The therapist will ask you for information so she can understand how your child communicates. Any details that parent(s) can provide about their child's fluency, and the situations that affect it are very helpful. If you have completed these details in your own record, or on the forms provided above, these are a basis for further discussion.

The therapist will then assess your child's speech and language skills. It is important to ascertain whether your child has any other speech and language problems that could affect the development and maintenance of the stammer. With young children the therapist will do this through playing and talking informally with your child, to ensure that they don't get unduly concerned or worried about their speech.

The therapist may wish to discuss with you how you respond to any episodes of stammering. Through informal discussion, the therapist will aim to identify factors which might make it more difficult for your child to talk, and explore with you some specific steps that you can take to help your child talk more easily (such as slowing down your own speaking rate by using more pauses).

After the assessment there will be time for you and your therapist to discuss your child's speech and any concerns you have. She will suggest ways in which you can help your child at home. Further appointments may be needed and the therapist will make a decision as to whether therapy would help.

Keeping your own record

It is perfectly acceptable to make brief notes as the therapist is providing you with information. Also, there may be more questions that you wish to ask at this stage, and you might want to make a quick note of these in your notebook with the answers given. If there is anything at all that you are not clear about it is important to ask the therapist for a full explanation of any terms used that you are not familiar with. Every profession has its own jargon words and parents are not expected to know these without explanation. It might be helpful to write down any details of the therapist's advice that you think are especially important to remember. If you do this it is best to check the details of this with her so you are sure that you have got it absolutely right.

The BSA knows from parents that sometimes they leave the assessment room feeling rather overwhelmed by the detail of information provided. This is understandable as there is much for a parent to take in. If you make a brief record of what was said you could look at again at your leisure and have information to hand that you could pass on to other key adults in the home, or the school.

What happens next?

The therapist will compile a summary of all the information gained from the parental interview and child assessment that attempts to account for the child's current stammer. This will be shared with the parent(s) so that they are able to understand why their child is vulnerable to stammering and can work collaboratively with the therapist to support their child's speech.

After the assessment, a confidential report is prepared that summarises the assessment findings and the action that the therapist is initiating. A copy of this is sent to the parents and routinely to the child's GP and any other health professional involved in the child's care. If the referral was made by the primary school, then a copy would be sent to the Special Educational Needs Co-ordinator there and usually filed with the child's SEN records. However, when parents make the referral they may provide a copy of this report at their own discretion to their child's primary school, or ask the therapist to do so.

The BSA would advise parents to ensure that the primary school receive a copy of the therapist's report so they are informed about the management of the child's stammer and able to collaborate with the therapist if required.

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