We see children with a number of speech, language and communication difficulties. Those include problems understanding and using language; difficulties with speech sounds; stammering; and social communication difficulties. We may also work with babies and children with swallowing difficulties.
Everyone is supported to reach their communication potential and achieve their goals. We work closely with families, health and social care staff, schools and pre-school settings to achieve the best possible outcome.
To access the children’s speech and language therapy service a request for help is needed.
For pre-school children, most referrals come from a health visitor, doctor or nursery staff, and these are good people to talk to first if you have concerns. We are also happy to receive a referral from you if you are the parent.
For school aged children most requests for help come from schools. If you have concerns please firstly speak to your child’s additional learning needs coordinator. They already have lots of ideas to support communication development and will know when more help is needed. Requests for help also will be accepted from doctors or parents.
Our service runs Monday to Friday between 9.00am and 5.00pm
If you have an appointment you may be seen in one of our locations.
Children are usually seen in a community clinic; nursery or school, and sometimes at home. Some babies and children are seen in hospital.
Appointments may be one-to-one or in a group setting. They will be delivered either face-to-face or online.
Please contact us if you have any questions.
Address: Speech and Language Therapy Service, Glangwili General Hospital, Dolgwili Road, Carmarthen, SA31 2AF
Phone: 01267 227425
Email: SpeechLanguageTherapy.HDD@wales.nhs.uk
Address: Speech and Language Therapy Service, Cardigan Integrated Care Centre, Rhodfa’r Felin, Cardigan, SA43 1JX
Phone: 01239 801562
Email: SALTCeredigion.HDD@wales.nhs.uk
Address: Speech and Language Therapy Service, Pembroke Dock Health Care Centre, Water Street, Pembroke Dock, SA72 6DW
Phone: 01437 773393
Good listening skills are important for being able to join in with activities and interact with others. The development of listening and attention skills is essential to promote a child’s understanding and use of language.
See the useful links section below for ideas on how to develop your child’s attention and listening skills.
Augmentative and alternative communication (AAC) is a range of strategies and tools to help people who struggle with speech. AAC helps someone to communicate as effectively as possible, in as many situations as possible.
Communication can take many forms such as speech, text, gestures, facial expressions, touch, sign language, symbols, pictures, and speech-generating devices. We all use many different forms of communication, based upon the context and our communication partner. Effective communication is when the message is understood by the other person. The way the message is delivered is less important.
Some examples of AAC include:
There is no ‘best’ type of AAC system. Each has pros and cons. The most suitable one for an individual will depend on their personal preference, situation and their abilities and needs. Specialist assessment will help to identify the most appropriate AAC system(s). Speech and language therapists can support this process.
If you have any concerns about your child’s eating or drinking please discuss this with your child’s health visitor or paediatrician.
Deafness, or hearing loss, happens when one or more parts of the ear aren’t working effectively. This can be present at birth or children may acquire it later.
The main types of deafness include:
A hearing loss can be temporary or permanent and can occur in one or both ears. The level of your child’s deafness can be described as ‘mild’, ‘moderate’, ‘severe’ or ‘profound’.
Children who have a hearing loss can experience difficulties developing their speech, language and communication skills. Speech and language therapy will work with you and your child to develop their listening, language and speech through sign and spoken language. We also work closely with other professionals which may include Teachers of the Deaf, Audiologists, your child’s Cochlear Implant Team, school and nursery staff.
Below are some websites with useful information:
National deaf children's society (opens in new tab)
Speech and language therapists (SLTs) who hold a qualification in paediatric dysphagia will see babies, infants and children who have eating, drinking and/or swallowing problems. This may be as a result of being premature, or because of physical or mechanical feeding difficulties.
Conditions in scope
We will see babies and children who:
Exclusion criteria
SLTs do not provide a service to children or young people who:
These websites can provide helpful information:
Infant and toddler forum - look at the section called ‘resources for parents’ (opens in new tab)
BBC Tiny happy people - for information on weaning (opens in new tab)
Kentcht NHS - some information on dribbling (opens in new tab)
ARFID (avoidant restrictive food intake disorder) (opens in new tab)
Social communication refers to how people understand and use language in social situations to develop relationships. When a child has a social communication difficulty he or she might struggle to understand other peoples’ behaviour and interact appropriately.
Features of a social communication difficulty in children may include:
A social communication difficulty can occur on its own. It can also occur as part of another condition (e.g. developmental language disorder - DLD, attention deficit hyperactivity disorder - ADHD). However it is most often associated with autism.
Autism is a neurodevelopmental condition. A key feature of autism is difficulty with social communication and interaction, which occur alongside restricted and repetitive behaviours and interests for example:
For a diagnosis of autism it is necessary to have significant difficulties in the areas above that impact on well-being and ability to function. Each child with autism will have a unique profile of strengths and challenges. Differences in social and flexible behaviour can sometimes be subtle with little impact or cause for concern initially. However the challenges can grow and become more obvious as the child grows older and social demands increase.
Speech and language therapists are uniquely qualified to assess social communication and interaction skills. This may include taking parent reports, observing conversational skills, and using standardised language assessments. They can also advise on how to support a child in developing social communication skills. Take a look at the links on the useful links section for some ideas of general strategies to support a child with social communication difficulties.
Speaking or (expressive language) is what a child is able to say, using words, phrases and sentences and applying rules of grammar. It is how they express their feelings, ideas and needs, how they tell stories and have a conversation.
Speech refers to the ability to combine sounds together to say words. Children may have difficulty producing individual sounds and/or combining sounds to make words in everyday conversation. This can have an impact on a child’s ability to make themselves understood by others.
During typical speech sound development, children often use patterns to try to simplify how they say words. They can replace sounds they find difficult to say with other sounds. An example of this might be a 2.5 year old child saying ‘dun’ instead of ‘sun’ or ‘tea’ instead of ‘key’. Children usually grow out of this but some will need help to change how they say sounds and words as they get older.
Once a child is referred with concerns about their speech sound development, the speech and language therapist will assess their speech. This is done during play, when looking at pictures, and in conversation. This will enable the therapist to establish if the errors the child is making are appropriate for their age. It will also help decide if they require advice/input from the speech and language therapy team.
Intervention sessions for speech sounds involve the development of the child’s ability to listen to and hear the difference between sounds. It will also involve producing their target sounds on their own and/or in words and sentences. These skills will be developed through play and fun activities suitable for each individual child.
If a child is unable to communicate effectively due to their speech sound difficulties, alternative modes of communication may be introduced to help them. This includes encouraging the child to use gesture, signs, and pictures to communicate and express themselves whilst their speech sounds are still developing. This can reduce feelings of frustration and upset for the child and those around them.
Advice and resources will be given to parents, carers, nursery, and school staff so that they can practice between sessions. Daily practice and reminders from those closest to the child result in the best outcomes.
A stammer is a change in the flow of words due to words getting stuck. People might also talk about ‘stuttering’ and ‘dysfluency’ as well as ‘stammering; all of these words mean the same. Stammering may include repeating sounds or words, prolonging (stretching) sounds, and blocking sounds (no sound coming out at all). The effort put into getting words out can lead to physical tension which might be seen as movements in the face or body. Negative feelings about speaking (e.g. frustration and embarrassment) can develop over time. This can lead to the child giving up on speaking and withdrawing from social situations.
Stammering usually begins in childhood between the ages of 2 and 5 years, when the child is learning lots of new skills. It can vary and be unpredictable; it might come and go, change from one day to the next, or between situations. For some children stammering is a phase that eventually passes by. For others, it continues into adulthood.
The way other people respond when a child stammers can have an impact how easy it is for the child to get their words out. It is important to be patient and supportive, and acknowledge the child’s challenges without drawing negative attention to the stammer. Below you will find links to some leaflets with information about how to respond when a child stammers and support the child in speaking. There are also links to some websites that have additional information and advice.
Stamma - British Stammering Association (opens in new tab)
Michael Palin Centre for Stammering Children (opens in new tab)
Stuttering Foundation (opens in new tab)
Stuttering Foundation - help my child stuttering (opens in new tab)
Understanding language and what words mean helps a child to:
Some children have difficulties understanding spoken language and may need extra support and strategies to help them.
Afasic Cymru (opens in new tab) - Information, advice and resources from parent-led organisation Afasic Cymru to support children and families of children with speech, language and communication needs.
British Stammering Association (opens in new tab) - (known as stamma since 2019) provides information, resources and support to children, adults, families and professionals about stammering/stuttering/dysfluency.
Centre for autism (opens in new tab) - Useful videos explaining how to support skills and implement strategies such as reward systems, dealing with change, encouraging turn taking.
Cleft Lip and Palate Association (opens in new tab) - CLAPA is a UK-wide voluntary organisation specifically supporting those with, and affected by cleft lip and palate.
DLD and me (opens in new tab) - A website for children and young people to learn about developmental language disorder (DLD) and to share how they’ve told others.
The Michael Palin Centre for Stammering (opens in new tab) - Guidance from a specialist centre providing assessment, therapy services, information and resources for children and adults who stammer/stutter.
I CAN -Talking Point (opens in new tab) – I CAN is the children’s communication charity. Access speech, language and communication factsheets for parents here.
National Autistic Society (opens in new tab) - The leading UK charity for autistic people and their families.
National Deaf Children’s Society (opens in new tab) - Providing support, information and advice for deaf children and young people.
RADLD (opens in new tab) - Raising awareness of developmental language disorder. Includes resources explaining what DLD is, the impact it can have, how to get help and support.
Selective Mutism Information and Research Association (SMIRA) (opens in new tab) - A website supporting children and young people with selective mutism.
Signalong (opens in new tab) - Information for families and professionals about the main signing system used within the hywel dda region.
Tiny Happy People (opens in new tab) - BBC website which provides evidence- based information and advice for families about communication.
Words for Life (opens in new tab) - Words for Life is the National Literacy Trust’s website for parents. It gives information on communication milestones and ideas for fun activities to support communication development.