My working life ... Speech and language therapist

Kate Freeman tells Gabriella Jozwiak about her vital role.

Kate Freeman is a speech and language therapist (SLT) with more than 20 years experience working with children. SLTs support children and adults with disorders in speech, language, communication and swallowing.

Ms Freeman specialises in early years speech and language development and has two roles: she is a lead advisor for UK communications charity I CAN and also an independent SLT.

She says, 'I CAN supports children's communication development from birth to 19. We work with people supporting children's needs, such as health visitors, early years practitioners, family support workers, special educational needs co-ordinators, teachers or youth justice practitioners.

'I deliver and write training courses and materials for I CAN. I don't deliver direct therapy for I CAN, but I do as an independent therapist.

'Often, parents come to me after their child has been identified as needing extra support, or because they've noticed a difficulty. Some have already seen an NHS therapist, but are concerned about waiting list times.

'All therapy begins with an assessment. I meet the child and ask the parents or guardians what they have noticed. It might be the child is not developing language how they ought to. Or they might be using words, but can't be understood.

'I try to identify what's going on behind that. Can the child hear? Are they able to distinguish between different sounds? Do they understand what's being said? Often, children have difficulties with understanding, but it's masked because they follow other clues like context, gestures and facial expressions.

'It's important to reassure parents their child may be bright despite having problems. Communication difficulties are not an overall learning difficulty.

'You can usually work out what's going on in one session. After that, we arrange to meet weekly or fortnightly, perhaps for an hour, to keep addressing difficulties. It's important to provide information to parents and nursery staff or teachers about how to support them. You can't impact on overall communication in just an hour a week.

'Some children's language will never be okay. For them, we develop strategies to help them cope. You also have to be aware how that impacts their emotions.

'Sometimes I refer cases to specialist SLTs, and it's common for SLTs to specialise. When I worked for the NHS, cleft palate was my specialism. Although we're called SLTs, we also help with feeding and swallowing, because we're experts in the mouth area. We also work closely with other health professionals, such as physiotherapists, paediatricians and psychologists.

'An SLT's caseload depends where they practice. In a community clinic, you could have 50 or more on your books. It depends on the way local authority funding works in your area.'



Degree in SLT with pathology and therapeutics, Birmingham City University - 1988

Diploma in managing health services, Open University - 1998

Hundreds of additional training courses such as Makaton signing and parent-child interaction therapy.

Employment history

1988-1993 - Speech and language therapist at North Warwickshire Health Authority.

1991-1993 - Part-time project co-ordinator /researcher with the Social Care Association

1993-1997 - Project manager, Coventry and Warwickshire Out-of-School Childcare Initiative

1996-1997 - Sessional tutor for play work at Mid Warwickshire College and North Warwickshire College

1997-1999 - Specialist speech and language therapist at Rugby NHS Trust

1999-2004 - I CAN service development officer

2004-2008 - I CAN professional advisor

2008 - present - I CAN lead advisor and independent SLT


All SLTs must complete a three- or four-year degree course in the subject. Mature students with a related degree, such as linguistics or psychology, may be able to enter a two-year postgraduate qualifying course. The courses include practical elements that could be carried out in schools, NHS hospitals or community health clinics.

Upon qualification, SLTs must register with the Health and Care Professions Council (HCPC). Therapists must demonstrate continued professional development and update a training log online. The HCPC checks these at random to ensure therapists are keeping up to date with best practice.


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