What do you do? “I’m a Speech Therapist” ….. by Elizabeth

You know how it is when you meet new people and introduce yourself, discuss family and where you live. Then the conversation often ends up being about work, “So, what do you do?”….It’s interesting to hear people’s responses when you answer this question. The most usual response is “I need one of those!” or “Can you make me talk proper then?!” Occasionally you come across people who have heard of the job or someone in the family may have seen a therapist. But the actual day to day work of what we do is often a mystery. Even my husband is sure I just play pop up pirate all day!

So, what’s an average day? One of the things I find is that days are not often the same, which keeps it interesting. You never really know what a child will, or won’t do on any given day or what a new phone call or client will bring. After surviving the school run with my own son and the normal issues of getting him to eat breakfast, get dressed and out of the house on time, you then have the joy getting through the traffic to the first job.

The first young man I see is very chatty with very disordered speech. He is making good progress, but it is always ‘interesting’ trying to keep him engaged in the task. He likes to try and control any game so there is a balancing act of letting him feel like he can make some decisions, but not letting him take over. We draw pictures, hide cards and make up silly sentences. The best being “I ate the goat” which we both thought was hysterical, and he said beautifully. The child earns his sticker and I have a quick catch up with his TA ( the teaching assistant who supports him in class and does some speech work with him). Today, I also have a meeting with his class teacher to review his IEP targets ( Individual Education Plan) as most of his targets are about his speech. Then it’s off to the next job.

Job number 2. I am completing formal assessment with this young man to contribute to a report for his paediatrician. A formal assessment is often made up of pictures with specific instructions where you ask the child to point to certain items or describe pictures. It gives us a score and an often an age equivalent and so gives us an idea about how the child is doing. Now, formal assessments are often hard for the child and there is a fine line between getting the work done and keeping the child motivated. This is a therapeutic skill that comes with practise, but is vital for the child’s performance – knowing when to offer a break, when to check that the child is listening, how to motivate etc. To balance the session out we also play some semantic category games. This type of game helps with vocabulary development and word finding skills. We took it in turns to think up different items in a specific category. For example things with motors, things that fly, zoo animals etc. This young man finds it funny when I put the occasional incorrect answer in when it’s my go- he is very good at spotting them!! Another sticker earned and off we go.

As I have a busy day today, I end up eating lunch in my car in a school car park and then I have a quick 15 minutes to try and return some phone calls. Finding time for admin tasks is always tricky.

Job number 3. More speech work, but at higher level. We practised some pitch and volume work- which I’m sure sounds like strange singing and is rather noisy to anyone listening. Then a little fine tuning on a few vowel sounds, and yes we did play pop up pirate! The issue with any speech sound work is that you need to get the child to say the target sound or words, lots and lots and lots of times, so that they can relearn the correct way of making them. To make this more fun and less like boring repetition, we play games like pop up pirate to help keep the child motivated. Some children are happy just turning over a card, some prefer a board or turn taking game, some make up their own elaborate games involving tracks, cars and transformers – it doesn’t matter as long as they are engaged in the task and saying the target sound/ word. Again this is another therapeutic skill you learn about keeping children motivated and engaged in therapy! Another sticker earned and off we go

Job number 4. A delightful young man who is practising some inferencing and prediction skills and trying to expand his expressive language. To an outsider, this session sounds like a lot of talking, but we are practising specific questions and vocabulary. Many children find it hard to predict what might happen from their own experiences, it is tricky to show them how. It means lots of discussion about different scenarios and working through them. However, good inferencing and prediction skills underpin most of the National Curriculum so are really important.

Then it’s back to the school run and home for tea!! Now as I have a young child, I choose to work within school hours, spend time with my son and then complete all the paperwork after he is asleep. So in the evening I have to make phone calls or send emails to parents of the children I have seen in school, write up all my notes from the sessions and make a plan for the next one and mark the assessment and write the report to go with it.

I have spoken a little of the ‘speech therapy skills’ that you need, but the longer I work I find other random ‘skills’ that also help!

Skills they don’t teach you at university:-
– Trying to keep an eye on where the child is hiding the cards, whilst keeping my eyes covered enough not to be accused of cheating.
– Generating lots of silly sentences without the child using the words fart or poo, or they laugh too much and nothing gets done.
– Random knowledge about a range of topics, particularly children’s TV characters and current toys. I have the best random discussions with children – roller coasters, hamster’s teeth and batman – that was just in one day.
– Having enough different ways of doing the same thing so the child with a short attention span doesn’t get bored.
– Never forgetting the bubbles or stickers – as speech therapy doesn’t work without them!!

So that’s what I do on average day!!