Speech and language therapists (SLTs) play a vital role in helping children and adults with speech, language and communication problems. What you may not realise is that SLTs also help people who have eating, drinking and swallowing difficulties.
In this article we’ll look at what speech and language therapy involves, the type of person you need to be to work as an SLT and the routes into this career. Along the way, we’ll hear from Sabrina (not her real name). She explains a little about her role and training, and provides some useful advice on work experience.
What does speech and language therapy involve?
An SLT’s work is very varied but may include supporting, for example:
- infants who have problems with early play and communication because of conditions such as a cleft palate, cerebral palsy or Down syndrome
- children with primary speech, language and communication problems (e.g. a stammer) or who have difficulties as a result of hearing impairment or learning disability
- adults experiencing communication and swallowing difficulties after a stroke or as a result of cancer treatment, Parkinson’s disease or dementia
SLTs make an initial assessment to identify the nature of their client’s difficulties, devise an individual treatment plan, deliver the plan and monitor progress. Treatments may include helping their client use electronic communication aids, sign language or symbol charts, or giving them exercises. SLTs have to keep records and write reports.
Sabrina is a children’s SLT. “I am a band 6 SLT working for the NHS in special schools in Birmingham. I support individual children and their families. I assess each child’s communication skills and needs, and help their families and school staff implement strategies and various communication systems to develop their communication skills.”
As Sabrina mentions, SLTs work with families and school staff. This is because, for treatment to be as effective as possible, it is essential to involve key people. Carers, doctors, nurses, psychologists, dietitians and social workers, for example, may also have an input when developing treatment plans, and SLTs will provide them with advice and training on treatment strategies.
Where could I work as an SLT?
SLTs work in a wide range of settings. You might work on a hospital ward, in an outpatient clinic or at a community health centre. Some roles involve visiting clients at their homes, day centres, care homes, nurseries, schools, rehabilitation centres, prisons or secure units.
Most SLTs are employed by the NHS, but some work for local authorities or directly for special schools or charities. Experienced SLTs can also work for themselves in private practice.
Sabrina explained, “Since training at the University of Manchester I have worked for three different NHS Trusts. I have experience in a number of different areas and have specialised in working with young people with learning disabilities, physical disabilities and autism. During the Covid pandemic I was redeployed to an adult community SLT team. This experience reminded me how varied an SLT’s role can be!”
Would I suit a career in speech and language therapy?
Alongside an interest in science and learning, you need to be a caring person with plenty of patience – it can take a long time to see the results of your work. You must have excellent communication, listening, observational and organisational skills. SLTs need to work well on their own as well as in a team.
SLTs are creative problem solvers – able to think on their feet to come up with the best activities to support their clients.
Before being accepted to training, you will undergo various background and health checks.
How do I get into speech and language therapy?
To work as an SLT and call yourself a ‘speech and language therapist’ you must be registered with the Health and Care Professions Council (HCPC). In order to register, you have to pass an HCPC-approved course. You can find a list of approved programmes and links to institutions through the website of the Royal College of Speech & Language Therapists (RCSLT).
TIP: Research speech and language therapy programmes carefully. Although all will cover certain core topics and include clinical placements in a range of settings, the exact content, focus and structure can vary. Also check what sort of facilities are available at the university and any particular areas of expertise.
There is considerable competition for SLT training places and you should check the entry requirements for individual courses carefully. In your application and interview you will need to convince admissions staff that you understand the role of an SLT, as well as demonstrate your ability to communicate with clients and understand their needs. You can do this by visiting a speech and language therapy department to observe their work and/or through relevant paid or unpaid work experience.
Sabrina’s TIP: “If you haven’t already got experience of interacting with people with communication difficulties, I would recommend volunteering. Charities such as Mencap or Afasic may have opportunities or you could help out at an after-school or holiday club at a special school, for instance. The people we work with are at the heart of what we do and you’ll find this sort of thing invaluable when you come to your university placements.”
Approved degree courses take three or four years but there are a few part-time programmes. (Note that some courses are called ‘speech and language pathology’ or ‘speech and language science’.) For entry, you need high grades in your A-levels/Highers. Subjects such as psychology, English language, biology or a modern foreign language are useful or preferred and, in some cases, one of these subjects may be specified.
An equivalent qualification, such as a relevant BTEC Level 3 National, T level or Access to HE Diploma, may be accepted for entry, but do check. You also need GCSEs/Nationals in English, maths and possibly science.
If you don’t hold the necessary academic entry requirements, some courses are offered with a foundation year and consideration may be given to those who have significant relevant experience.
TIP: Make sure you investigate your entitlement to funding and apply as soon as possible. How much you get, what type of support and any commitments involved will depend on where you study. You can find information through individual universities and the relevant funding authority, such as the NHS Business Services Authority in England or Student Awards Services in Wales.
If you want to keep your options open, you could take a degree in another subject and then do an HCPC-approved postgraduate programme. These normally take two years (longer if taken part-time). Some universities accept any degree for entry, but others require a relevant subject, e.g. psychology, a biological science, linguistics or education.
In England, it’s possible to train to be an SLT through a degree apprenticeship lasting around four years. You would be employed and attend university part-time to achieve an HCPC-approved degree or postgraduate qualification. Vacancies are limited, but when available are advertised on the NHS jobs site. You can find out more through the RCSLT.
You spend your first year under supervision as a newly qualified practitioner, usually in a generalist role within the NHS.
To keep up your HCPC registration, you have to undergo continuing professional development. As Sabrina says, “Throughout my working life I have received training to keep developing my skills. This has ranged from specific communication approaches, such as Picture Exchange Communication System (PECS), to more general things like presentation skills. There’s always something new to learn, either formally or from the children and families themselves.”
Bodies such as the RCSLT and ASLTIP (Association of Speech and Language Therapists in Independent Practice) offer courses, events, conferences and other opportunities for development.
What opportunities are there to progress in speech and language therapy?
With additional training (sometimes through postgraduate study), SLTs can specialise in working with a particular client group or certain disorders. Apart from progression to more senior clinical posts, there are also opportunities in management (where you are likely to have responsibility for staffing, budgets, strategic plans etc), teaching or research.
Other ways in which your career can develop is to work abroad, possibly in a developing country, or move into general healthcare management.
How can I find out more about careers in speech and language therapy?
The RCSLT website has useful information as have the various healthcare careers sites: NHS Health Careers and Step into the NHS (for young people) in England, NHS Scotland Careers or NHS Wales Careers. Also see SLT career profiles through Prospects, the National Careers Service, My World of Work and Careers Wales.
If you want to work in speech and language therapy but don’t have the necessary academic qualifications, you could consider working as an SLT assistant/support worker. Opportunities may be limited and roles vary, but you would normally work with individual clients under the direction of a qualified SLT, as well as providing more general administrative and practical support.
If speech and language therapy isn’t the right fit for you, you could consider one of the many other careers in health. According to NHS Health Careers there are 350 roles in the NHS, so there’s bound to be something to suit you.
If you do decide to pursue a career in speech and language therapy, you will get a lot of satisfaction from seeing your clients improve and, as Sabrina says, the career offers plenty of variety.
Debbie Steel, October 2023
With a background working with apprentices and teaching in further education, Debbie was employed as an in-house careers author before establishing herself as a freelancer. As well as co-authoring numerous careers books, Debbie has produced resources and web content for a range of high-profile clients. She is an enthusiastic proponent of impartial and reliable careers information.