11/02/2026
We as therapists cannot work effectively in a silo, it’s a team approach.
Communication isn’t for 60 minutes once a week, term time only. It’s all day, everyday, from the waking moment to the last before sleep.
The environment and support within it matters so much, and therapy often becomes ineffective if the other parts of the jigsaw don’t help the whole picture fall into place.
I want to explain something that often gets completely misunderstood.
Speech and Language Therapy does not work without the right staff in place.
Especially not for children with complex autism and high support needs.
For minimally speaking autistic children, communication is not something that happens for an hour a week in a “session”.
It happens or fails to happen, across the entire waking day.
As an SLT, I can assess, plan, model and guide.
But I cannot make progress unless there are trained, consistent adults implementing that support moment by moment.
For children like this:
* communication is often non-typical (movement, behaviour, music, sensory actions, regulation)
* frustration escalates quickly if communication is misunderstood
* learning depends on trust, safety and predictability
* skills must be **generalised across people, places and routines**
This means staff must understand:
* how to recognise all forms of communication as valid
* how to model AAC and alternative communication consistently
* how sensory regulation and communication are inseparable
* how to work within low-arousal, relational approaches
* how to support personal care, eating, risk and regulation safely
Untrained or generic staff cannot do this.
Good intentions are not enough.
Without specialist staff:
* therapy plans sit in files
* AAC devices go unused
* communication attempts are missed or misinterpreted
* frustration increases
* progress stalls or reverses
This is why waking-day provision matters.
This is why 24-hour consistency matters.
This is why you cannot simply “send in an agency”.
When Local Authorities approve therapy but fail to approve or provide suitable staffing, they are setting the child and the therapy up to fail.
And then families are blamed for lack of “progress”.
That is not how communication development works.
And it is not how evidence-based practice works.
If we want real outcomes, we have to stop pretending therapy can exist without the people who make it real.
Children deserve better than that.