ID #684 Speech and language therapy in a paediatric primary-treatment-centre: a carer-reported service evaluation of communication needs and timing of intervention following neuro-oncology treatment

Abstract

Speech, Language and Communication (SLC) skills, as well as swallow function are frequently impacted in paediatric neuro-oncology patients. Speech and Language Therapy (SaLT) is a core rehabilitation service. Assessment and management is recommended at diagnosis, during treatment and beyond, tailored to individual patients.

This Primary-Treatment-Centre service evaluation assessed carer-reported SLC needs and perceptions of when SaLT input would be helpful. Carers of patients <18 years, who had received treatment for a central nervous system tumour between 2020-2025 were invited to complete a questionnaire considering SaLT contact, SLC changes and perceived areas of SLC difficulties. Clinical-demographic information, including tumour location, was obtained from medical records.

To date, 95% (23/24) of invited-carers participated (nine Post-Fossa Tumours (PFT) and fourteen non-PFT). Six (26%) recalled SaLT input on- treatment (four PFT and two non-PFT), all reporting appropriate input. In addition to this, three (13%) with a PFT and one (4%) with a non-PFT would have valued SaLT input on-treatment but were not seen. Interestingly, ten (43%) requested contact at questionnaire completion and ten (43%) identified SaLT may be helpful in future.

Speech rate, confidence and word finding difficulties were rated as the most impacted areas of SLC. Five (21%) with PFT and 9 (39%) with non-PFT reported changes with SLC following surgery. Changes remain in 9 (39%) patients, with over half reporting “sometimes” or “usually” being bothered by these. Two patients (8%) had ongoing enteral feeding.

In summary, perspectives regarding SaLT differs according to tumour location, with input on-treatment more valued by the PFT group. Nine (39%) patients reported ongoing difficulties with SLC. As a direct result of this study, a PFT pathway is in development to increase access to SLT services. Furthermore, SaLT is now a core component of a recently established local Neuro-Oncology End-of-Treatment clinic, ensuring SaLT contact to educate and identify unmet needs.