Speech and Language Therapy


GP summary advice for Speech and Language Therapy (SLT)

Indications for referral

  • Adults with acquired communication or swallowing problems (e.g. aphasia, dysarthria, apraxia, stammering, cleft palate, post-laryngectomy, oro-pharyngeal swallowing problems – see below)
  • Patients with progressive disorders benefit from early referral  (e.g. motor-neurone disease, Parkinson’s disease, MS, Dementia)
  • There are separate services for children and adults with learning difficulties (see below).

Please don’t refer…

  • People with congenital hearing loss or a cochlear implant – consider referral to audiology
  • Chronic cough with no voice or swallowing problems.
  • For long-term provision of communication aids. SLT can provide assessment, advice and therapy for communication difficulties and has small number of communication aids are available for short term loan only. Advice is given on self-funding or applying for funding (e.g. charitable / from NHS Kernow)

Primary care management / investigations prior to referral

  • Diagnosis of any organic cause of the symptoms
  • Symptoms suggestive of a laryngeal problem (e.g. hoarseness, pitch changes) must have been reviewed by ENT

Symptoms and signs suggestive of dysphagia include

  • Coughing/choking when eating, drinking or both
  • Recurrent chest infections where causation is difficult to diagnose
  • Reported food sticking in mouth or throat after swallowing
  • Wet/gurgling voice when eating or drinking
  • Upper airway noise in relation to eating or drinking
  • Fear of swallowing because of discomfort, pain or choking
  • +/- Significant unexplained weight loss

Clinics Available

SLT may request GP to arrange:

  • ENT review
  • Gastroenterology review (e.g. for PEG)
  • Video Fluoroscopy Swallowing Assessment (real time video of swallowing)
  • Dietitian review
  • Psychology review