Why trauma-informed practice matters in Speech and Language Therapy

As Speech and Language Therapists (SLTs) we often work with children who present with more than just communication challenges. Some children may experience trauma through adverse childhood experiences (ACEs). Children and young people (CYP) who have experienced ACEs are at risk for a variety of developmental delays and disorders. A trauma informed approach in SLT isn’t about diagnosing trauma, it’s about recognising that past experiences shape how a child might engage, respond and feel in the therapy space.

Why trauma-informed practice matters in SLT

Trauma informed practice matters in SLT because children who have experienced trauma may present with heightened sensitivity to change, transitions or perceived demands. They might struggle with trust, regulation or expressive communication. Understanding all of this helps us to keep asking questions to know the ‘why’ behind the behaviour. Behaviour is communication and there is always a reason for it.

Principles of trauma-informed SLT

Being a trauma-informed SLT allows us to create a safe environment for the CYP. This can include predictable routines, transitions and attention to sensory needs. We also use consistent language and prepare children for what to expect next and limit unexpected changes. We empower the child and involve them in making choices e.g., letting them pick an activity or take breaks when needed. As trauma-informed therapists we interpret behaviour as communication and respond with curiosity, not correction.

What it looks like in practice

In practice it is important to take a mindful approach to assessments and therapy interventions. For example; if a CYP is not ready for formal assessment it is better to carry out more observations and informal assessments to build a picture of the CYP and for them to build a rapport with you as a therapist. It is also important to liaise with and support teaching staff to discuss the reasons why / if therapy is not a priority for the CYP at that time. However, it is important to continue supporting the child through implementing environmental support strategies and providing advice within the classroom on an individual basis. Remember every interaction is an intervention!

Final thoughts

Being trauma-informed doesn’t mean we need to know every detail of a CYPs story. It means we create spaces where the child feels seen, safe and respected and their behaviour is ‘heard’. We create a therapeutic relationship built on trust by making small changes in our language, routines and expectations.