Clinical Services

Assessment can often take a number of sessions in order for us to find out what your individual communication and swallowing needs are in the context of your daily life. We can then use this information to make predictions about the sorts of difficulties you may face in different (often future) situations whether it is returning home from hospital, returning to work / education, interacting with family, friends and getting on with day to day life in the community. Assessment is therefore the path to treatment.

A common assessment method may be as follows:

• A review of the case history (pre-injury status, academic / employment status, medical & rehabilitation history, etc.)

• An informal interview of the individual, their family, or important communication partners.

• Comprehensive assessment of the following (always adapted depending on client level):

  • Receptive Language Skills (listening, understanding, processing information within different contexts – conversation, instructions, discussions, lectures, new information, films, meetings.)

  • Expressive Language Skills (both non verbal and verbal expressions, eg choice making, expressing concerns, requests, opinions, ideas, instructions, rationales.)

  • Reading skills (comprehending texts, emails, websites, social media sites, letters, newspapers, books, work materials or academic materials.)

  • Writing skills (formulating written letters / words, messages, essays, assignments, reports, notes or meeting summaries.)

  • Discourse and Conversational Interaction (participating in conversation, social interactions, work discussions or academic presentations.)

  • Social communication (reading social cues, interpreting another’s point of view, disagreeing in a tactful manner).

  • Play skills (paediatric clients)

  • Speech and Voice production (clarity, precision, intelligibility of speech, voice quality changes, posture etc). Talking to friends and family, coping with the telephone, speaking at presentations / meetings as appropriate.

  • The face – the symmetry, sensation and muscle function of the face.

  • Cognitive skills required for communication (attention, memory, organization, reasoning, problem solving, executive functions, self-regulation). Observations of a client remembering what is heard, discussed, read, or taught are often made.

  • Swallowing (as indicated) including a cranial nerve assessment and observation with food / drink as appropriate. We may use aids to supplement our knowledge such as cervical ausculation (using a stethoscope to listen to the swallow) or cough reflex testing (CRT). We may recommend instrumental assessment to enhance our knowledge (eg videofluroscopy or FEES).

  • Consideration of potential contributing factors (visual, hearing changes, stress, fatigue, sleep disturbance etc) to all of the above.

These areas would be assessed both informally and formally (ie specific standardized tests would be selected, administered and interpreted). We have specific adult and paediatric tests.

Other Assessment Considerations / Expectations

• A functional evaluation of communications at home with family, in a healthcare facility with staff, at school / university / work or in the community is always beneficial.

• Consultation with other professionals involved in the case is paramount (following a client’s consent).

• Preparation of a comprehensive report.

• Summary of the assessment findings (especially strengths and weaknesses) for the client and family.

Assessment is always conducted in a positive manner. When we know what is breaking down, we can help.

Multilingual Services

Depending on our capacity levels, we can offer:

• high quality interpreting by a Speech and Language Therapist / Assistant SLT

• multilingual assessments and therapy

The languages we can cover are:

• Spanish

• Italian

• Russian

• Maltese

• Urdu

Neurological rehabilitation aims to improve function, reduce symptoms and improve the wellbeing of people with diseases, trauma or disorders of the nervous system.

Speech and language therapist are experts in communication and swallowing. We support others to access communication and return to communicative activities and participation in life. We educate family members and healthcare professionals on overcoming communication and swallowing challenges and rehabilitate complex impairments as a consequence of neurological conditions. We select from a range of theoretically driven, complex intervention approaches and tailor them to an individual client’s needs and abilities.

Our aim is to promote clients’ communication and swallowing recovery, maximise their potential, facilitate functional independence, and enable a quality of life that brings fulfilment and life satisfaction.

We find creative and often non-traditional methods to improve someone’s skills. We keep up to date with all new developments in our field and love to try new evidence based techniques.

We are a flexible team, seeing clients in the context that works best for them and where the goals are being targeted, whether it be at home, at work, in an educational setting or out and about with friends and family.

We do not believe in uni-disciplinary or lone working. We always work with those closest to you (friends, family) and our Neurology colleagues, such as Psychologists, OTs, Physios, Case Managers, Doctors, Dieticians, Counsellors, Support Workers, Carers, Rehab Assistants, Brain Injury Counsellors and Music / Art Therapists to gain the best results. We provide interdisciplinary working with the Allied Neuro Therapy (ANT) Team www.alliedneurotherapy.co.uk.

We are used to working with solicitors on medico-legal rehabilitation cases and with different types of education departments from nursery and school up through to university.

Our SLT Assistants deliver treatment programs that are written by the neuro-specialist SLT. They are well trained and supported by the SLT team, attending joint sessions and reporting back to the leading clinician each time they see clients. They are steered in the background by the Neuro-SLT and gain specialist skills quickly on cases.

SLT Assistants in Linguistic Resolutions are generally newly qualified SLTs looking to develop skills in neurology or SLT students who are working through the degree to become a qualified clinician.

Our SLT Assistants are also experienced in being more generic neuro-rehabilitation assistants where appropriate. This has worked well for many cases:

• They are more qualified and knowledgeable than the average support worker, having particularly good knowledge of brain injury secondary to this being the area of company specialism.

• Our NRAs are used to delivering more complex MDT therapy programs as they have a clinical / relevant educational background.

• Our practice manager is able to suitably match cases and assistants and assist with shift coordination, covering of any leave and overall clinical supervision.

“I have been so pleased to work with SLTAs from Linguistic Resolutions who have provided an excellent service for my clients. Each SLTA has been able to develop a lovely rapport with my clients enabling a positive environment to work on therapy goals.

Following the initial assessment period the Speech and Language Therapist has developed a range of stimulating activities for the client to work on with the SLTA on a regular basis. The SLT provides regular supervision and ongoing guidance to the SLTA, ensuring that goals are being addressed and issues arising can be considered.

Sally and Claire provide an efficient referral pathway and find the most suitable SLTA for the client to ensure a good match and working relationship. Each SLTA comes to the role with a broad range of learning and work experience.

This approach has enabled many of my clients to have access to speech and language therapy over a longer term basis as an effective approach to manage costs. Having a mini team from Linguistic Resolutions means there is consistent therapy provided over the course of treatment.

This model of therapy can work very well for clients, providing a more intense period of treatment if required, from a friendly and highly trained and skilled team”.

Zoe Leigh (Case Manager, Neuro Health Case Management Services)

Linguistic Resolutions have been asked to provide assistance in many different kinds of departments over the years. Sally and the team have supported the NHS, Ministry of Defence, Headway, Brain Injury Rehabilitation Trust (BIRT) and private in- and out-patient departments during periods of staffing issues.

Depending on our capacity levels at any one time we can assist with providing a number of days’ service per week or per month in your particular service. We are used to working in the statutory and private sector across inpatient and residential settings (hospitals, rehab units, residential and nursing homes) and outpatient settings (clinics, day care centres) to name a few.

Feel free to ring us if there is an SLT need in your service that you would like to discuss. We may be able to help.

"Sally was an asset to our speech and language therapy team and wider neuro team for the duration of her role with military personnel. She was a natural at building professional relationships with the service men and women we see following brain injury. Sally demonstrated specialist knowledge, skill and expertise with this client group. She took a detailed and methodical approach to her work which massively benefited our patients who often thrive on this level of structure.

Sally's role involved assessment and treatment of patients with complex communication difficulties primarily following traumatic brain injury (TBI). Much of this work involves education and awareness raising with the patient about their problems which often the person themselves struggles to see. Sally was able to work with the patients and as part of the team to help realistically shape their future goals and pathways. This was not only specifically to do with their communication needs but also was in relation to their wider future roles and opportunities, and any restrictions or limitations which needed to be considered for this.

Sally also worked closely with families and relatives of these military patients, aiming to help them better understand the longer term prognosis for improvement with the communication difficulties experienced. Educating employers about how communication problems can impact on work roles was also a factor. Educating inexperienced staff about the communication difficulties common after brain injury was also something that Sally undertook confidently.

Sally was a team player and contributed significantly not only to patient care but also to service and staff development within speech and language therapy and the wider neuro team."

Gayle Chandler, Former Head of Speech and Language Therapy, Headley Court, Ministry of Defence