Speech therapist: communication

By : Amélie Lombard and Justine Poigné, speech therapists.

“Speech therapists generally focus on re-education to treat congenital, developmental or acquired disorders affecting communications, written or spoken language, mathematical cognition, speech and voice, and orofacial myofunctional disorders, without the involvement of a doctor. Speech therapists require a medical prescription to provide treatment.“ Article 16 of Ministerial Decree No. 2011-73, dated 16/02/2011, setting out the procedures which may be performed by nurses and allied health professionals (replaced by Ministerial Decree No. 2017-803, dated 10 November 2017).

What skills do speech therapists have and in what areas do they intervene?

Speech therapists thus specialise in communication, language, learning and swallowing. They support patients of all ages (from birth to the end of life) who have congenital disorders (genetic conditions, etc.), developmental disorders (specific learning disorders, etc.) or acquired disorders (dysphonia, neurological disorders, etc.). Speech therapists generally work as part of the regulated fees system (based on an agreement signed between the healthcare professional and health insurance funds) and their practice is governed by the NGAP general nomenclature of medical procedures. The most commonly encountered requests in private practice relate to pre-school and school-age children.

Prescription for speech therapy from your doctor

Many professionals working with children and infants have access to the tools required to screen for disorders, however referrals to a speech therapist for an assessment must come from a doctor (paediatrician, general practitioner, etc.). Whenever speech therapy is prescribed, the first appointment will involve a speech therapy assessment, comprising:

• An anamnesis (medical history questionnaire): language development, psychomotor development, any previous medical history, onset of symptoms, functional impact on daily life;
• Tests which are targeted (depending on the complaint and the symptoms observed) and standardised (the results are compared to a norm – an average obtained from a sample of the general population and categorised by age/level, following scientific validation). These help to determine the follow-up to the assessment;
• Clinical observation and qualitative analysis of communication and behaviour in relation to language and/or learning.

The importance of a speech therapy assessment in patient follow-up

The speech therapist is required to produce a written report of the assessment, which will become part of the medical records and will be sent to the patient (or to the patient’s legal guardians) and to the prescribing doctor. Depending on the results, a speech therapy diagnosis will be made, which will determine further action to be taken (whether regular treatment is required, therapeutic guidance).

If treatment is required, the frequency of sessions is agreed between the speech therapist and the patient depending on the severity of symptoms and the functional impact. Length of treatment varies on the basis of a number of factors, including the consistency and commitment of the patient and their families.

In conclusion, the scope of speech therapy is very broad insofar as it covers the entire population (all age groups) and treats a range of diseases. If you have any doubts, please see your general practitioner, who will be able to refer you to an appropriate professional.

 https://www.legimonaco.mc/305/legismclois.nsf/TNC/19D263E7B2D9C8F9C125773F003B22DB!OpenDocument