Adult speech and language therapy

Swallowing difficulties

We provide expert diagnosis and treatment of oro-pharyngeal dysphagia. This may include:

• safe swallow techniques 
• advice on changes to food and drink 
• exercises to improve swallowing 
• working with other professionals

Communication difficulties

Following expert diagnosis we can:

• explain the problem 
• listen to what you want to achieve 
• work together to plan treatment 
• offer a range of therapies 
• link with other professionals and support services 
• advise on communication aids

Inclusion criteria

Communication needs related to:

• neurological conditions:
  
  • rehabilitation and support for acquired and progressive neurological conditions (including but not limited to stroke, dementia, Parkinson's, MND)
  • functional neurological disorders (generalist advice and support; non-specialist service)
  • congenital or lifelong neurological conditions (such as cerebral palsy) including apraxia, dysarthria
• oncology:
  
  • incurable cancers not covered by services listed in the exclusion
  • cancers receiving treatment with curative intent, not covered by services listed in the exclusion
• stammer
• voice where there has been an ENT assessment within the last 12 months
  
  • organic, for example polyps, nodules, or VF palsy
  • functional, for example muscle tension dysphonia
• gender dysphoria

Dysphagia needs related to:

• assessment and treatment of identified oro-pharyngeal dysphagia indicated by 1 or more of:
  
  • indicators of aspiration such as coughing whilst eating or drinking
  • recurrent chest infections or aspiration pneumonia
• advice and support around disruption to normal eating and drinking or swallow processes due to age-related or cognitive changes
• differential assessment of suspected oro-pharyngeal dysphagia
• differential assessment of functional disorders, for example globus pharyngeus, fear of swallowing

Exclusions

• Those under 18

There are specialist services for primary presenting need related to (for each of these conditions, there may be an individual discussion around which service holds the most appropriate skill set to meet the presenting condition):

• respiratory diagnosis
• post-COVID diagnosis (symptoms of 12 weeks or greater)
• head and neck cancer
• ALD

Out of scope of this service, and without specialist provision, primary need related to:

• autism
• mental health
• congenital hearing loss
• laryngeal or upper airway disorders, for example intermittent laryngeal obstruction, chronic cough
• referrals for mental capacity assessment only, assessments to support legal processes
• long-term provision or maintenance of communication aids
• gastro-oesophageal difficulties or dysphagia (including nausea and vomiting) without presence of oropharyngeal dysphagia
• food refusal and/or weight loss unrelated to an oro-pharyngeal dysphagia and non-oral routes for nutrition or hydration
• difficulty with swallowing tablets in the absence of an oro-pharyngeal dysphagia

Due to the risks associated with dysphagia, referrals will be accepted for adults with an autism and/or mental health diagnosis for oro-pharyngeal dysphagia assessment as there is no other commissioned service.

Specialist speech and language therapy services

• Adult community learning disabilities.
• Community stroke services.
• Criminal justice liaison and diversion.
• Integrated community respiratory.
• Post COVID Syndrome Assessment Service.

We provide services from the following locations.

• Bodmin: Bodmin Health Centre and Bodmin Community Hospital.
• Callington Health Office.
• Camborne and Redruth Community Hospital.
• Helston Community Hospital
• Launceston Community Hospital
• Liskeard Community Hospital
• Newquay Community Hospital
• Penzance Bellair Health Office
• St Austell Community Hospital
• Stratton Community Hospital.
• Truro Health Park
• Torpoint Penntorr Health Centre
• Wadebridge Health Office

Communication resources

• Voice changes: Self-help from the Royal Cornwall Hospital NHS Trust Speech and Language Therapy Service.

Aphasia

• Aphasia information leaflet for family and friends (PDF, 249 KB).
• Stroke Association:
  • Communication problems after stroke.
  • Your communication after a stroke aphasia friendly information.
  • Communication picture book.
  • Activities that do not rely on speech.
• Aphasia Reconnect aphasia information pack. The charity who produced this leaflet no longer exists. Web addresses and contact details for them in this leaflet will not work.
• Tactus Therapy: 50 things you can do right now to help your loved one with aphasia. You will need to enter an email address to access this leaflet.

How stroke affects communication

An introduction to how strokes can affect communication. This video is 3 minutes long.

Communication tips after a stroke

This video demonstrates communication strategies being used between a person with aphasia and her daughter. This video is 4.5 minutes long.

When the words went away

A documentary from the Stroke Association created to increase public awareness of aphasia. This video is 51 minutes long.

Speechless

A BBC4 documentary telling the story of 2 stroke survivors living with aphasia. This video is 60 minutes long.

On the tip of my tongue

A documentary aiming to explore and raise awareness of aphasia. This video is 16 minutes long.

Swallowing resources

• International Dysphagia Diet Standardisation Initiative: Guidance, leaflets and ideas around how to modify food and fluid for safer swallowing.