What do adult acute speech and language therapists (SLTs) do?
We work with adult patients in hospital. We specialise in the assessment, diagnosis, and management of swallowing and communication problems.
We work with other staff in a multidisciplinary team. This includes:
- medics
- nursing staff
- dieticians
- physiotherapists
- pharmacists
Swallowing problems (dysphagia)
Adult patients in hospital can have difficulties with swallowing. This is known as dysphagia. It is common in patients with the following conditions:
- stroke
- head injury
- progressive diseases such as Motor Neurone Disease, Parkinson’s disease and myasthenia gravis
- infections or sepsis (chest/urine infections)
- frailty
Symptoms of a swallowing problem that we can help with include:
- coughing / throat clearing during swallowing
- a feeling of things going down the wrong way
- choking
- feeling short of breath during swallowing
- repeated chest infections
Communication problems
Communication problems are also very common in patients with the conditions listed above. We divide these problems into:
- Language - trouble understanding what other people are saying. Trouble finding words or connecting words to express yourself.
- Speech - trouble with pronouncing words. This can result in slurred or ‘stuttery’ speech.
- Reading/writing - trouble recognising words or understanding what is written down. Finding it hard to form words to write a message.
- Cognition or ‘thinking skills’: Trouble with things like humour, multi-tasking, memory and problem solving.
You can have either communication or swallowing problems on their own. You may also have both at the same time.
The adult acute SLTs only work with patients who are in hospital. You or your family member must be an inpatient to access our service.
If you have any concerns about communication or swallowing while you are in hospital, or of a family member who is in hospital, speak to the nurse or doctor on the ward to ask for a referral to SLT.
When we get a referral, we aim to complete our assessment within 2 working days.
The SLT will come to the ward where you are an inpatient. They will take a case history from your medical notes before assessing you. This will include:
- your background health issues
- any medications you are taking
- reason you are in hospital
The SLT will talk to you about your symptoms and experiences. This is to get a better understanding of what is happening and how you are feeling.
With communication problems, the SLT may use a range of tests to check your understanding, your speech and your reading/writing.
With swallowing problems, the SLT will try you with a range of food and liquid textures. This is to see what is safe and comfortable for you to eat and drink.
The SLT may talk to you about more in-depth tests. This could be a FEES (a small camera passed through the nose to check the swallow from the inside) or a video-fluoroscopy (a moving x-ray of your swallow).
With communication problems, the SLT may ask you to say certain things. This could be:
- naming objects
- automatic speech such as days of the week / counting
- more complex language like describing how to make a cup of tea
The SLT may also get you to follow instructions that get more complicated. They may ask you to read or write words or sentences.
With swallowing problems, the SLT may ask you:
- how long you have been having problems
- what it feels like when you are having a problem with swallowing
- if you’ve noticed any specific things being harder to swallow than others
The SLT will ask how you feel about the textures you try. This is to find which ones you are most comfortable with.
With communication problems, the SLT can offer targeted therapy. They can teach you strategies to 'get around' the problems you are having. They can teach your family / support network how best to support you with your problems while they last.
With swallowing problems, the SLT can offer targeted therapy. They can change the textures and consistencies of what you eat and drink to find the best options for you. They can teach you and your family / support network how to support you with your problems while they last.
You can access our service for as long as you need while you are a patient in hospital.
If you still have problems when you are ready to go home, we can arrange to transfer your care to one of our community services near where you live.
Unfortunately, it is not always possible to get rid of your communication or swallowing problems completely.
We will offer you rehab where appropriate. But sometimes the SLT will help you adjust to your ‘new normal’. They will give you knowledge and support to learn to cope with any ongoing problems. This is to help you maximise your comfort and quality of life.