Is speech and language therapy meeting the needs of language minorities? The case of deaf people with neurological impairments.

The cultural diversity of the UK poses a challenge for speech and language therapists. Work with children from language minorities has been documented, but less so with adults. This raises the question of whether adults from minority communities are gaining access to services. Deaf people who use British Sign Language (BSL) are one language minority. It is known that sign language is vulnerable to neurological damage. Of interest is whether Deaf people with such damage are referred to speech and language therapy (SLT). The aim was to find out how many deaf people were referred to SLT services in the UK over the last 5 years, and reasons for the referrals. We also explored the service offered to Deaf referrals, and whether SLT teams had access to BSL skills, either internally or via interpreters. A brief questionnaire was sent to the managers of all SLT services in the UK (n=264). There was as 60% response rate. Only 34 services received referrals of Deaf patients, with a total of 39 Deaf people seen. This is substantially below the predicted rates. Most referrals were for dysphagia, or dysphagia with communication impairments. In line with this, dysphagia management was the dominant service, although most referrals also received language assessment. Most teams did not have signing staff members and access to interpreters was variable. The results suggest that many Deaf people are not gaining access to SLT after neurological impairment. Those who are referred are unlikely to receive language therapy. The instigation of a national team specializing in BSL impairments is recommended.