- 02 August 2018
- 17 min read
How I made speech therapy my career
For all ages, I have seen how effective speech and language intervention impacts positively on a person’s quality of life, and it is this which makes speech therapy such a rich and rewarding role
Speech and language therapy offers a rewarding and varied career. If working with adults it tends to follow a more medical model. With children, a more educational model. It offers diverse opportunities to work with a wide range of people with speech language and swallowing difficulties.
Communication is fundamental to who we are, but it doesn’t just include speech.
This was brought home to me on my first ever placement as a student Speech And Language Therapist when I was introduced to a lady in her 60’s post stroke. She had a handful of words she could say e.g. yes, no, thank you, maybe.
However, she was one of the most communicative people I have ever met. She would use her voice to convey emotion, humour and sarcasm.
She used gesture and facial expression to express preferences. She showed me photos, objects and pictures.
Using this “Total Communication” approach meant that we had many long conversations where we discussed her life and experiences with little or no speech.
Since meeting that lady, I have worked as a speech and language therapist (SLT) with people with a range of communication difficulties; From children with speech and/ or language difficulties, to adults with acquired communication difficulties.
For all ages, I have seen how effective speech and language intervention impacts positively on a person’s quality of life, and it is this which makes speech therapy such a rich and rewarding role.
Qualifying as a speech therapist
Qualification as a speech and language therapist requires completion of a degree recognised by the Royal College of Speech and Language Therapists (RCSLT) and Health Care and Professionals Council (HCPC).
You will need to be registered with both bodies, and will also need a Disclosure and Barring Service (DBS) check.
When did you decide on a speech therapy career?
Whilst I had an idea that I wanted to be a speech and language therapist from the age of 14, my initial reasons for this were perhaps not the most noble.
I had an aunt who was a speech therapist in a busy acute hospital. She was dignified, poised and cool and I wanted to be like her!
I drifted through school feeling like I didn’t really have a vocation. I knew I liked being around people and was someone who could communicate well with people of different backgrounds, ages and abilities.
I did my work experience in a nursery which I enjoyed, so I completed a qualification in nursery nursing and worked in an out of school club where I became manager for a short time.
I enjoyed working with the children at the after-school club, but knew it wasn’t quite the area I wanted to be in. After two years at the after-school club, I thought again about speech therapy as a career.
Did I need to study and qualify as a SLT?
I left college with no A-Levels. Once again, I thought about speech therapy, but felt my lack of qualifications would be too much of a barrier.
I also knew that the local university didn’t offer a speech therapy degree, and relocating wasn’t an option for me at that time.
I made an appointment with my local careers guidance centre to talk through options and ideas.
I discovered that my local university wasn’t offering speech therapy currently, but that it was planning too in the following year.
However, I still had the challenge of meeting the entry requirements for speech therapy.
The careers advisor told me about an access course (Access to Natural Sciences) that could be done part time over two years in the evenings.
If I completed this, AND gained a Distinction overall for this course, then I would meet the entry requirements for the speech therapy degree course.
This is what I did, and was offered a place as a mature student on the Speech and language therapy course to start in September 2006. I graduated as a fully qualified speech therapist in July 2009.
What is a speech therapy course?
Speech and language therapy degree courses are structured differently depending on which university you attend.
For example, some put more emphasis on course work rather than exams, and vice versa.
All courses combine academic study with practical experience. As well as modules on specific clinical areas, courses will include modules in relevant areas including:
• Anatomy/ Physiology/ Neurology
• Child Development
• Learning Disabilities
• Research skills and Professional development
Practical elements of a course include placements where students will get the chance to develop their clinical and professional skills.
Speech therapists work in a range of settings, so placements will vary accordingly but include hospitals, nurseries, schools (both mainstream and schools for children with special needs), or visiting clients in their own homes, and care homes.
Speech therapy brings together a range of disciplines, skills and knowledge, one of the reasons it is such an interesting subject to study.
It also means that it attracts people of all ages with a wealth of different backgrounds, knowledge and qualifications.
I returned to study as a mature student and a mum of two, but I trained alongside people of 18 years to 50+.
Some of my cohort had just left school and finished their A levels, so this was their first degree. Some already had first degrees.
My cohort came from a range of backgrounds; youth worker, business manager, shop assistant.
One of them had even given up a successful career as a defence lawyer to retrain as a speech and language therapist.
You can train to be a speech therapist at universities across the country and courses generally last for between 3-4 years.
It is possible to do a 2-year postgraduate course in some places if you already have a relevant degree.
Where can I study to become a SLT?
There are currently 16 universities offering speech therapy courses recognised by the RCSLT.
As from 2018, The University of Essex is planning to offer a 3-year speech therapy degree course (currently pending HCPC approval) bringing the total up to 17. All courses combine academic study with practical experience.
What to expect as a SLT
SLT’s work in a variety of settings, and each role is different depending on the client group.
I have worked both for the NHS and in independent practice, and each role has brought its own rewards and challenges.
My first post was with adults working in the community. This meant that I was working in clinics in community hospitals, care homes and people’s own homes, assessing people’s communication needs and working with them to address these.
For some, this meant direct work on their speech and language. For others, therapy was more indirect, focussing on providing training that could be used by those around them.
This type of input included demonstrating strategies and skills which aimed to create opportunities for communication and support the patient in reaching their communicative potential.
For one gentleman, this meant showing pictures of food items so that he could make choices as to what meal he wanted to have. This post often involved education of others, e.g. recognising that patients may need lots of time to process information.
During conversation, even a 5 second pause can feel like a long time, but may provide a patient with enough time to process what has been said and give them the chance to formulate a response.
Keeping information short and simple, supported by writing key words or using pictures can also be useful.
Speech therapy also covers swallowing disorders (dysphagia). Some individuals may be able to understand and communicate well, but may have difficulty swallowing or feeding.
It should be noted that to carry out swallowing assessments, you need to be dysphagia trained which requires working through a set of competencies supervised by a senior speech therapist. Swallowing assessment is a large part of the work in an acute hospital.
As a community therapist working with children, the work is based in clinics, schools, nurseries and homes, and can be very different depending on the age and abilities of the child.
With children particularly, the distinction between speech and language is an important one.
Children may be referred by teachers due to concerns regarding their understanding or development of language, but this can sometimes create confusion because the child’s speech is perfectly fine.
Other roles may be in colleges and special schools for young people with learning disabilities, voice clinics, language units, rehabilitation clinics, and cleft palate services.
Within my role, the settings may have been different, but a common theme is the need to be an effective, collaborative team player.
This involves working not only with the patients themselves, but also their families, carers and the wider team of health professionals involved in patient’s care.
Is SLT a stressful job?
Speech therapy can be tremendously rewarding but it is not without its challenges, particularly in the current financial climate.
Working within the NHS meeting the demands of a busy caseload and ever increasing waiting lists is no mean feat.
There is a shortage of therapists but also a shortage of funding.
It is frustrating and demoralising to have neither time, nor the resources to provide the level of speech and language therapy that as a trained professional, you feel is required.
Managing the expectations and frustrations of others can require unending patience and understanding at times.
When there is a child who isn’t developing speech or language as would be expected, or an individual who has acquired communication or swallowing difficulties, it can be a stressful and anxious time not just for the person involved, but also for those around them.
There is no magic wand to fix things, and it can be a long and difficult road which may not always lead to the outcome hoped for by the patient and families.
At these times, it is important to listen carefully to those concerned and work closely with other members of the team to build up a comprehensive picture of the patient.
By ensuring good communication across the board, and working collaboratively, expectations can be managed and shared therapeutic goals and interventions can be agreed on.
What Qualifications do I need to be a SLT?
Entry requirements vary depending on the institution, but normally the requirements are 5 GCSE’s at grade A-C (including English, Maths and science) plus 3 A Levels at grades AAB-BBC and one of these needs to be in a science.
Alternatives to A Levels are also accepted for example, Scottish or Irish equivalents, access courses, HND etc.
To train and work as an SLT, you also need a completed DBS check. Health and medical history is looked at, and an up to date hepatitis B and tuberculosis (TB) vaccination is also required.
As with any course, if when applying you can show skills or experience that help you stand out, this is a bonus.
When I applied to my university course, I already had some experience of working with children in schools and nurseries that I could draw upon. I had also volunteered in a hospital for a short period so had a general idea of working in an acute setting with adults.
I happened to know someone working as a speech therapist in a hospital with adults; the “poised, dignified and cool” aunt.
I was lucky I could spend a day shadowing her to gain more specific experience.
I contacted my local speech therapy service, and this opened the opportunity to spend a morning shadowing a speech therapist in a language unit for children with speech and language difficulties.
Even my minimal amount of experience meant I could show a good understanding of what speech and language therapy entailed, and therefore convey my passion for the role.
What kind of person makes a good SLT?
I once read a saying in a GP’s waiting room “I don’t care how much you know, I want to know how much you care”.
Whilst perhaps not strictly 100% accurate, we can all relate to the sentiment. Empathy, compassion and sensitivity are fundamental qualities in a therapist.
Whilst working in an acute hospital, I quickly got used to the pace and surroundings.
It’s easy to forget when working there every day that a hospital can be a bewildering and confusing place for many.
In the paediatric clinic room, speech and language issues that seem low level to even a relatively inexperienced therapist can be a cause for high parental concern.
The ability to keep an open mind, and be willing to make mistakes, that are reflected on and evaluated creates opportunities for learning that otherwise may be missed.
Good written and verbal communication, as well as effective organisational skills are required.
The ability to present information in an accessible way to those it is aimed at is especially important.
Phrases such as “phonological awareness” and “auditory discrimination” are bandied about regularly in a paediatric clinic, but to some people this may need some explaining.
For people where English is a second language interpreters may need to be enlisted. Some parents may have learning difficulties themselves, and this needs to be taken into consideration when presenting information.
Extra processing time may be required for some individuals, and information may need to be presented in other ways than just verbally or written down.
Thinking creatively to problem solve is a useful quality in a speech therapist.
An enthusiasm for the role will help gain the trust of those you are working with, and motivate others.
Ensuring continuing professional development (CPD) is key. The best therapists are the ones that recognise you never stop learning.
What experience will I need for my first SLT Job?
Speech and language therapists working within the NHS are paid according to the Agenda for Change pay scale.
Band 5 jobs are suitable for newly qualified therapists and starting salary is around £21K.
Focus on the skills and knowledge developed throughout the degree course and clinical placements.
Read the job description and person specification, and try to hit every one of the criteria.
Gain an understanding of the values of the organisation you are applying for, and think about how you incorporate these into your practice.
During the post, qualifying year therapists will need to work through the NQP competency framework.
This framework supports the development of skills and learning needed to move into full RCLST membership and needs to be signed off by a fully qualified member of both the RCSLT and the HCPC.
Part time or temporary posts can lead to more hours or permanent work, and are always worth considering.
Newly qualified speech therapists may look to working as an assistant or voluntary work.
These types of roles may offer valuable and relevant experience, but it is important to work within your remit.
These types of jobs will be more restrictive than a fully qualified speech therapy post.
Securing your first post is not always easy. Finding local Clinical Excellent Network (CEN) groups and working as an assistant or volunteering in a relevant area is a good way to develop skills and show enthusiasm to prospective employers. Further training in specific areas may also be useful.
The RCSLT website offers further information and support to newly qualified practitioners (NQPs).
What career options are there for experienced SLTs?
Experienced SLTs may choose to specialise in specific clinical areas. Supervision and management can become an increasing part of role as therapists become more senior.
Moving into teaching or research is another option for experienced therapists.
Service delivery is changing and increasingly therapists are working in independent practice.
The RCSLT recommends at least 2 years post qualifying experience before working in independent practice.
The Association of Speech and Language therapists in Independent Practice (ASLTIP) provides support and information for those who do so.