Speech and Language Therapist

What does a Speech and Language Therapist do?

Speech and Language Therapists are trained in assessing and treating swallowing and communication problems.

Why might I need to see a Speech and Language Therapist during or after Intensive Care?

It is not uncommon for patients who have spent time on a ventilator or breathing machine to develop short term problems with swallowing or with their voice. Temporary changes to the sound and strength of the voice can occur, with it sounding quieter, hoarse or breathy.  This is due to being attached to the ventilator or breathing machine by a breathing (or “ET” or endotracheal) tube in the throat and a weakening of the throat muscles. Problems with swallowing or voice changes are more common among patients who’ve spent longer on the ventilator or breathing machine, although not everyone is affected in this way.

When might I expect to be seen by a Speech and Language Therapist?

Not everyone needs to be seen by a Speech and Language Therapist. If swallowing or communication difficulties are picked up in Intensive Care, patients can be seen by a Speech and Language Therapist while they are still in Intensive Care. It is not always obvious that patients have a problem with swallowing or communication until they go to the general wards and begin to eat and drink normally. You might cough or feel like you are choking when you eat or drink and should let the staff know. They will ask for a Speech and Language Therapist to see you on the ward.

What is involved in the various assessments, tests and recommendations?

There are a number of assessments, tests and recommendations that the Speech and Language Therapist might do and provide. These include:

• Simple swallowing assessment: The Speech and Language Therapist may ask you to try foods and liquids of different thicknesses while they check how well you are able to swallow. 
• Swallowing assessment using barium and X rays (videoflouroscopy): This test is done in the X ray department. You will be asked to sit or stand beside an x-ray machine while you are given food and drinks of different thicknesses mixed with barium.The barium will allow us to see on the x ray how well you are able to swallow the various foods and liquids.The test may be recorded so it can be watched again later. 
• Swallowing assessment using a special scope (Fiberoptic Endoscopic Evaluation of Swallowing or FEES): This test involves passing a small tube (a fibreoptic scope or camera) into the nose and throat. You might be given a local anaesthetic spray to make passing the tube more comfortable.You will be given food and drinks of different thicknesses while the Speech and Language watches the pictures from the camera on a screen.The test may be recorded so that it can be watched again later.
• Swallowing exercises: The Speech and Language Therapist may give you some exercises to practice which will help strengthen your swallow.
• Information and advice: The Speech and Language Therapist will give you information and advice on which types of food are safe for you to have until your swallowing gets better or back to normal.

What kind of help can I get after I go home?

If you are seen by a Speech and Language Therapist while in hospital and you need follow up after you go home, she or he will refer you to a local community Speech and Language Therapist.

Who can I contact if I need more help than I thought I would after I go home?

If you have any difficulties with swallowing or communication after you get home, you  should see your GP. You can also ask to have an assessment by contacting your local community Speech and Language Therapist (see useful links, below).

Useful links

www.rcslt.org is the official website of the Royal College of Speech and Language Therapists. Although the website is more likely to be used by Speech and Language Therapists themselves, there is some useful information on finding contact details for Speech and Language Therapists in your area. There is also advice on how to find local Speech and Language Therapists who work privately and how much it is likely to cost (you will have to pay for this yourself).