Collaborative working between pediatric speech and language therapy and ENT colleagues: what is good practice?

PURPOSE OF REVIEW: This article considers current evidence pertaining to good practice in joint paediatric speech and language therapy (SLT) and ear, nose and throat (ENT) assessment and management in the general hospital clinic. Because of space limitations, this review excludes those cases that are typically referred into highly specialist clinics dealing with cleft palate or profound hearing loss and cochlear implant. It will instead focus on children with the types of communication difficulties that are related to physical anomalies and conditions impacting on speech, nasal resonance, voice and those cases with a history of fluctuating or mild hearing loss. The value of the multidisciplinary team in appropriate decision making has to be considered in terms of outcomes and related cost-effectiveness.

RECENT FINDINGS: Research into the dynamic between paediatric ENT and SLT outcomes remains relatively sparse. Evidence continues to show that multiple factors impact on any decision regarding surgical or SLT interventions. SLT opinion across a range of perceptual, physical and social parameters aids the medical consultation on a case-by-case basis. Current evidence for speech therapy interventions shows that environmental management and family involvement are crucial, and any direct intervention should be well timed and regular to be effective.

SUMMARY: The development of communication and listening is easily disrupted because of ENT disease or abnormality. The child's relationship with the ENT consultant and SLT may span several years, and communication difficulties may persist after any apparent physical problem has resolved. It is essential to jointly consider the optimum timing for any surgical and speech interventions so that services are better targeted and cost-effective.