When to Instruct a Speech and Language Therapist

You may want to refer to Speech and Language Therapy if someone has noticed changes in a persons communication.

This could involve language (finding words, understanding conversation, reading or writing), motor speech (speech that has become slurred, slow, quiet or harder for others to understand), or changes related to cognition, such as difficulty following conversations, staying on topic or organising thoughts.

A referral is appropriate when these changes mean the person can no longer take part as fully as they did before. For example, communication may have become less effective in relationships and friendships, at work or in education.

They may find it harder to speak up for themselves and make their wishes known, or the changes may have affected their confidence and quality of life.

You may want to refer to Speech and Language Therapy if someone is having difficulties with eating, drinking or swallowing (also known as dysphagia).

Signs include coughing or choking when eating or drinking, unexplained weight loss, or repeated chest infections. A person may begin avoiding certain foods or drinks, change their usual mealtime habits, or find they no longer enjoy mealtimes as they once did.

If these changes are affecting their health, wellbeing or ability to take part in mealtimes and social occasions as fully as before, our team can assess the difficulties and offer support.

Solicitors should instruct an SLT when a client’s ability to understand, retain, weigh information or communicate a decision may be impaired due to:

• Acquired brain injury
• Stroke or neurological conditions
• Learning disability
• Dementia or cognitive decline
• Mental health conditions affecting communication
• Developmental communication disorders
• Progressive conditions (e.g., MND, Parkinson’s)

SLTs provide specialist assessment to determine whether the client cannot make a decision, or whether they can, but require communication support. This distinction is critical in MCA compliance and litigation.

SLTs protect clients from being incorrectly deemed to lack capacity due to communication barriers. An SLT should be instructed when:

• An assessor reports “non‑engagement”, “limited insight”, or “inability to weigh information”.
• The client appears inconsistent, confused, or overly compliant
• The client struggles with verbal reasoning or complex language.
• There is concern about undue influence or suggestibility.
• The assessment environment may not have been communication‑accessible.

SLTs ensure the client is given every lawful opportunity to demonstrate capacity.

If a client lacks capacity, an SLT can help elicit and interpret their preferences using accessible communication methods. An SLT should be instructed when:

• The client’s wishes are unclear or difficult to interpret.
• Family members disagree about what the client wants.
• Behaviour is being misinterpreted as preference or refusal.
• The MDT needs structured communication support to represent the client’s voice.
• A best‑interests meeting requires defensible, person‑centred evidence.

SLTs ensure the client’s values and preferences are accurately represented.

SLTs provide expert evidence on how communication difficulties influence:

• Reliability of testimony.
• Susceptibility to coercion or undue influence.
• Ability to participate in legal interviews or meetings.
• Understanding of legal concepts (e.g., risk, consent, consequences).
• Capacity to instruct a solicitor.

Solicitors should instruct an SLT when communication vulnerability may compromise procedural fairness or the integrity of evidence.

SLTs produce medico‑legal reports that address:

• Cognitive‑communication skills.
• Executive functioning as it relates to decision‑making.
• Language comprehension and expression.
• Ability to weigh information.
• Environmental and interpersonal communication barriers.
• Recommendations for lawful, communication‑inclusive assessment.

These reports are frequently used in:

• Court of Protection proceedings.
• Personal injury litigation.
• Clinical negligence cases.
• Safeguarding enquiries.
• Mental capacity disputes.

An SLT should be instructed when:

• Assessors require training or support to phrase questions appropriately.
• The MDT needs advice on communication‑inclusive practice.
• There is disagreement about whether the client can participate.
• The assessment process itself is under scrutiny.

SLTs provide expert guidance that strengthens the defensibility of MCA outcomes.

Communication disorders can present as:

• Apparent non‑compliance.
• Reduced engagement.
• Emotional dysregulation.
• Difficulty weighing options.
• Inconsistent responses.

SLTs help determine whether behaviour reflects communication impairment rather than incapacity, a distinction that can materially affect legal outcomes.