Specialist consultation and assessment
This is a charitably funded individual assessment and advisory service for children and young people with severe and complex disorders of fluency who may be referred from any part of the UK.
Criteria for referral for consultation and assessment include:
- second opinion for specialist speech and language therapists, parents or other professionals; and
- expert opinion for non-specialist speech and language therapists.
- a full clinical report with evidence based recommendations and future action plan;
- on-going support for referring therapists; and
- 6 month follow up review.
Note: The detailed therapy recommendations have ensured that approximately 60% of children who have attended the specialist consultation service continue to access therapy locally, with ongoing support from the Michael Palin Centre.
Specialist therapy packages may be commissioned on a cost-per-case basis, or via service level agreements.
Therapy programmes developed at the Centre are widely used and have been disseminated through textbooks, chapters, academic papers and training both in the UK and internationally.
It should be noted that specialist services for stammering are rare across the UK. It has a relatively low incidence in comparison to other speech, language and communication problems and therefore the recommended care pathway (see RCSLT Communicating Quality 3) includes access to specialist advice and therapy where necessary. While many SLT services provide some level of therapy for stammering, these are often limited to younger children. Current evidence confirms that SLTs generally consider stammering to be a very difficult disorder to manage (Crichton-Smith et al. 2003).
Wherever possible, recommendations will be made for children to attend their local Speech and Language Therapy services to access the support that they require. However, there will occasions when it is recommended that the child and family access therapy services at MPC:
Therapy may be recommended to take place at the MPC for any of the following reasons:
• client's therapy needs cannot be met locally (e.g. group therapy unavailable);
• no local SLT service available for the age group (e.g. secondary school pupils);
• no specialist expertise available;
• complex cases requiring additional qualifications or expertise from specialist therapists;
• lack of progress;
• co-occurring disorders (e.g. Down syndrome, ADHD, Autistic Spectrum Disorders);
• family problems requiring additional specialist expertise;
• related mental health issues (social anxiety, low self esteem, depression); and