Speech–Language Pathology in Paediatric Palliative Care: Key Roles and Future Directions
Dr Lauren Crumlish PhD, Certified Practising Speech Pathologist 4 min read
How Can We Ease Communication Challenges in Paediatric Palliative Care?
Supporting children in palliative care involves more than simply managing their physical symptoms—it is about enabling them to express their hopes, fears, and needs. For many professionals, the emotional aspect of helping families and children communicate effectively, even in end-of-life contexts, is both challenging and humbling. This review by Krikheli, Mathisen, and Carey (2018) underscores the importance of SLPs taking a central role in fostering better communication experiences for children with life-limiting conditions. By doing so, SLPs empower caregivers to understand and respond to each child’s changing communication demands. This collaborative pathway can lessen frustration, promote emotional well-being, and support the development of meaningful connections between the child, family, and healthcare team.
What Did the 2018 Scoping Review Investigate?
In this systematic scoping review, the authors used Arksey and O’Malley’s (2005) method to identify and analyse literature related to the role and scope of speech–language pathology services within paediatric palliative care. They drew attention to key areas where SLP input seems especially crucial: communication, feeding and swallowing, upper-airway management, and oral health. Yet, evidence on children’s needs and age-specific strategies remained sparse. A large portion of the existing literature appears to rely on data from adult or geriatric palliative care research, which may not fully address the unique developmental stages and conditions faced by children.
Which Areas of SLP Practice Are Highlighted in Paediatric Palliative Care?
To illustrate the main findings, below is a simplified table outlining core themes identified in the review:
| Theme | Key Points |
|---|---|
| Communication Management | Facilitating expressive and receptive communication to maintain emotional connection. |
| Feeding & Swallowing Support | Assessing and managing safe feeding options that adapt as the child’s condition changes. |
| Upper-Airway and Oral Health | Monitoring airway-related risks and integrating oral care strategies within palliative care. |
| Multidisciplinary Team Collaboration | Working collaboratively with doctors, nurses, counsellors, and family members. |
These themes remind us that a child is not just a patient with symptoms—they are a person with complex needs, strengths, and aspirations. By offering nuanced solutions for communication, feeding, airway support, and more, SLPs ensure that children in palliative care retain as much autonomy and comfort as possible.
Why Do We Need More Paediatric-Specific Guidelines?
Although the review underlines the promising contributions of SLPs, it also exposes a critical gap: the scarcity of paediatric-specific research and clearly defined clinical guidelines. Children differ from adults on developmental, emotional, and physiological levels, so applying adult palliative care frameworks in a paediatric setting may not always be appropriate. Going forward, researchers and clinicians are encouraged to develop and refine guidelines that reflect children’s evolving medical, emotional, and communication requirements. Such guidelines could help standardise best practices across different healthcare settings, including hospitals, hospices, and home-based care.
How Might This Shape Practice for Families and Professionals?
• Parents and Carers: Understanding that SLP support extends beyond “speech” alone helps families recognise potential feeding, swallowing, and comfort benefits. This realisation can ease concerns, enhance quality of life, and encourage early referral.
• Speech Pathologists: As SLPs, expanding our expertise to paediatric palliative care settings reinforces holistic care. This may involve refining skills in end-of-life counselling, ethical decision-making, and working with sensitive family needs.
• Health Professionals: Recognising the active role SLPs play encourages a team approach, blending medical perspectives with tailored communication and swallowing interventions that honour the child’s individuality.
Because the field of Paediatric Speech Pathology in palliative care is evolving, interdisciplinary collaboration remains vital. Elucidating the SLP’s role can strengthen referral patterns, improve training, and ultimately build a more compassionate and comprehensive care model for young patients and their loved ones.
Where Do We Go From Here?
The scoping review offers a clear message: SLPs are well positioned to meet the unique communication, feeding, and other clinical needs that arise in paediatric palliative care. However, the research base still has gaps, particularly when it comes to age-specific guidelines and consensus on best practices. By addressing these gaps, professionals can ensure children experience more dignified, comfortable, and enriched care journeys. If you or your child need support or have questions, you can apply for consideration.
Why is communication support crucial for children in palliative care?
Children facing life-limiting conditions benefit from clear, comfortable, and emotionally validating ways to express themselves. Effective communication can reduce stress, foster connection, and help children continue to engage with the world around them.
What does feeding and swallowing management entail?
Feeding and swallowing management can involve adjusting food textures, monitoring oral intake, and ensuring safety while eating or drinking. This approach adapts with the child’s progression, offering relief and comfort in line with their changing needs.
How do SLPs collaborate with other healthcare professionals?
SLPs often work within multidisciplinary teams, contributing their expertise to guide communication methods, assess feeding support, and inform overall palliative care plans. This collaboration ensures a holistic, child-centred approach.
Are there established clinical guidelines for SLP services in paediatric palliative care?
Current literature draws mostly upon adult palliative care research, and paediatric-specific guidelines remain in development. Future research will help define age-targeted best practices for children with complex medical needs.
How can parents and carers access speech–language pathology services in a palliative setting?
Often, a referral from a paediatrician, nurse, or social worker initiates the process. Families can also directly contact private clinics or hospital-based services to inquire about available SLP support.
