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Reply To: Progressive ataxia

Helen Clarke

1. Get permission from the lady to liaise with the NHS therapist – you then know that you would be working with the remit of what already has been provided and also be able to update the therapist on any deterioration. It may be that the NHS SLT had provided advice of intelligibility and also started the conversation about AAC and now is the time to reinforce both.
2. Encourage the lady to return to her GP to emphasise the urgency of the situation such as sudden and unexpected
3. The inclusion of a private therapist would not be contra-indicated in this situation at all but with so many potential cooks (NHS, you and private) there could be potential for confusion so i would recommend open and clear communication between all involved. As the volunteer you may need to consider your role and how you enable the space for everyone.
4. Good foundational advice on speech clarity such as slowing down and saying each part of the word with care and attention apply to all dysarthrias, as does breath control.
5. This lady does need a full assessment for an intervention plan to be put together and it doesn’t really matter whether this is carried out by NHS or private SLT, and in the meantime you can support through advocacy, liaison and advice on speech clarity. Forgive me if i’ve misunderstood your role as a volunteer therapist and your remit, and your skill set.