Your Appointment

Pre-appointment discussion

Prior to arranging any appointment, we will briefly discuss the nature of your difficulties and decide whether we can help you. We will provide you with copies of two documents giving information about our service, terms and conditions and fees to ensure that you are fully informed about the service offered and the costs involved. We will also agree where you would prefer to be seen. There is no charge for the time spent arranging your initial appointment. We aim to offer you an appointment within 2 weeks of you requesting one.


Initial sessions normally take place at The Orchard Therapy Centre, but we are able to offer you therapy sessions in your home, while you are still in hospital (with agreement from your Consultant) or at your residential or nursing home. We can also offer therapy sessions via Skype for people living further afield or abroad.

Initial appointment

Your initial consultation will be up to 1 hour in length and will include:

  • taking a detailed case history
  • exploring how your communication difficulties affect your daily life
  • discussing any previous or current Speech and Language Therapy you may be receiving
  • making a preliminary diagnosis following initial observations and assessment
  • informing you about any referrals to other services which may be required / be of benefit

Following your initial appointment, you will receive a short report. This will outline the nature of your difficulties and any advice given during the session, along with the recommendations for further assessment/therapy as appropriate. An estimate of the costs involved in any further treatment will also be provided.


Careful, detailed assessment is essential in order to reach a diagnosis and plan appropriate therapy for your communication or swallowing difficulties. This will be done through formal standardised tests and clinical observations. Assessment is an ongoing and integral part of your treatment; to ensure that the therapy is effective, to review your progress following a block of therapy, to inform the decision about further treatment, or to provide a second opinion.


Therapy sessions are normally between 45 minutes 1 hour in length.

The number of sessions offered will depend on many factors such as:

  • The nature of the problem
  • What therapy is aiming to achieve
  • What the evidence from research into your communication problem suggests will be of most beneficial way to receive therapy (eg. weekly vs. more intensive)
  • What is practical in terms of travel, your other commitments and the finance you have available

All of these factors will be discussed with you to ensure that the treatment you receive is provided at the best time for you and in a way which will deliver the best possible outcome for you.

Therapy involves working with both you and your family/friends/carers in order to maximise the success of communication in everyday life. Communication problems are complex and improvements are only possible if the programme of therapy given by your therapist (e.g. exercises, conversation strategies) is carried out regularly between sessions. In the same way, advice given about managing swallowing problems needs to be followed in order to benefit from the recommendations.

Where communication difficulties are caused by a medical condition in which there will be progressive deterioration, the aim of therapy will be maintenance rather than improvement of function. We would aim to help you to maintain your ability to communicate for as long as possible. This includes planning ahead to ensure that strategies are in place to help communication to continue via other means if speech becomes too difficult. We can advise on, and help source, communication aids and adaptations as necessary.

When working with you to manage your eating, drinking and swallowing problems, we would aim to maintain safe eating and drinking for as long as possible.

Other types of therapy


Some types of therapy are best provided within a small group and this will be discussed with you if it is felt to be the best treatment option for you. Group therapy is often the 'next step' for you after some blocks of individual therapy sessions. Many people are unsure about group therapy to begin with, but there is good evidence of the success of this type of therapy for people with a variety of communication problems. We would encourage you to take up the opportunity to have structured conversation practice in a small, supportive group.

Computer therapy

There are an increasing number of apps and computer therapy programmes available, and we are able to make recommendations about the type of software which may be appropriate to incorporate into your treatment plan. Computer therapy is particularly useful for carryover exercises between sessions, but the type of exercises and level of difficulty require specialist knowledge of the underlying communication difficulties if they are to be effective.