Hi everyone, I’m Gemma, Xavier’s "Speechie" covering the Southside of Brisbane.
When I say I’m a “Speech Pathologist” to someone, I get a variety of questions about what I do. For example, do I help children with a lisp? Or do I help with changing the diets of stroke patients? Or with stuttering? The answer is that while yes, I am qualified to work in these areas, these three things take up a very small (if any) part of my day. I work with disability, and complex disability at that. My caseload can stretch from extreme to extreme. I work with newborn babies who have just been diagnosed with a life limiting illness through to a 21 year old living in supported accommodation. While the goal for the famliy of the infant may be to improve their quality of life, the goal of the 21 year old may be to learn to use Alternative and Augmentative Communication (AAC) more effectively so that they can order a drink for themselves at the football, without their support worker needing to do it for them. And I work with a huge variety of children and young adults in between.
This begs the question, “What do Speechies actually do?”. If you look up the guidelines of Speech Pathology Australia, you’ll find a general statement about speech, language, literacy, voice, swallowing and fluency. Just like any other health discipline, we also have our own niches. Areas that we’re passionate about and experienced in. While I am technically qualified to treat a paediatric stutter, it isn’t an area I have had a lot of practice in and I would probably need some support to do it ethically and well. Similarly, those who love to work with fluency may need the same support if they wore my shoes for a day.
As parents of children with complex needs, your main priority is often on life, comfort and quality. How a Speechie can support you or your child is one of the last things to cross your minds, and rightly so. Up until the recent introduction of the NDIS, speech services have really only been available through school (where the focus is on academic inclusion) the hospital, DSQ or in some cases, through funding. Given this situation may have recently changed for some of you, I would love to tell you what our profession can offer.
AAC (Alternative and Augmentative Communication): this is an area that stretches anywhere from switch selection (how can we enable someone to independently activate something when they can’t move their hands?), to learning cause and effect, to signing, to eye gaze, to learning to us a switch to activate a toy, to the selection of language systems on high tech devices, to picking the initial high tech device, to prescribing PODDs, to figuring out what language systems can support a visual impairment. AAC is a limitless area, and thankfully AAC is becoming more and more accepted in the general community as access to it increases. This is from infancy to adults.
Swallowing/Mealtime Plans: for those who have trouble swallowing, or have a deteriorating condition, fatigue quickly, have abnormalities in anatomy, or any situation where they may be limited in what they can eat safely, we can provide support and advice for management. That may not necessarily mean we say “you can only feed puree”, it may mean education on when is a better time to try certain foods, how some foods could be changed or substituted or, in some situations discussing quality of life factors versus risk of aspiration and possible problems which may occur from some foods.
Feeding/Mealtimes: I put this into a different category because therapy can also help with mealtime difficulties, not just giving advice on management. This may be behavioural or a greatly reduced range of foods being eaten due to oral aversions, among others. We can also support difficulties with anatomical features which may impact on breast and bottle feeding, such a cleft palates or other syndromes impacting on structure and function. We can provide support by giving ideas on different spoons and cups which may make transitioning and independence a little easier, for example looking at the shape and/or weight of spoons. This also encompasses teaching straw drinking, chewing, biting, building jaw strength and providing options for oral development items which are not food based.
Visual supports/following directions/routines: this one can fall into a bit of a developmental Occupational Therapy realm, so the line can get blurry. However, when it comes to making visual prompts to support following directions, understanding what is expected (e.g. social stories), Speechies can definitely help.
Everything else: I also love working with developmental oral speech and language, looking at functional communication, literacy and improving independence. Most of us became Speech Paths because we believe that communication is a human right and we want to support that in the best way we can.
That is a very brief snapshot of what can be offered, some families have found it beneficial to sit down and chat about the type and amount of support that might be required for their loved one. It can be a very confusing and stressful time transitioning to NDIS and figuring out what sort of supports you’re wanting to access and what that may mean ongoing. We are here to help as best we can.
Article written by Gemma Cameron, Xavier Speech & Language Pathologist