The disabled student experience during training 

Being a disabled SLT student

The first decision a disabled SLT student often makes is whether to share information regarding their disability to a HEI. This could be upon application, admission or during the course. Further information on this can be found in the disclosure/sharing information section of this guidance.  

If a student shares this information, HEIs will have a system for students to access e.g. via student support/disability services and occupational health. A disabled SLT student may consent to an assessment to determine what needs they have and what support is required. This can be shared with the HEI and may lead to receipt of Disabled Student’s Allowance (DSA) (UK Government, n.d). 

DSA is independent from specific HEIs but can inform the support and reasonable adjustments available, however it is not essential or mandatory to have DSA to receive support. Students will still be able to explore other support options listed in this guidance, regardless of whether they are in receipt of DSA or not. Students can be directed to either DSA assessors with a specialist knowledge of their specific need, or who have an established working relationship with the HEI to find the best possible outcome. 

In terms of documenting needs and support, a student in England may already have an Education Health and Care Plan (EHCP) that HEIs can access. In Wales, this may be an Individual Development Plan (IDP), in Northern Ireland a Statement of Special Educational Needs, and in Scotland a Co-Ordinated Support Plan. Students are able to seek support regardless of whether they have ever had one of these documents. HEIs also put together separate documents detailing needs and support often called a Learning Support Plan or Disability Support Summary that can be shared with teaching staff and placement educators. 

Disabled students are strongly recommended to familiarise themselves with the available support within their HEI and to also take advantage of all the support on offer both by their course team and through the central HEI services. HEIs should make it clear from the start of the course where and how students can access this information. It is advised that disabled students become familiar with this support system at the earliest available opportunity. 

However, students do not have to have everything in place at the start of their course and some students may only need support from partway through. These support systems can be initiated at any point during the degree and students should always feel able to seek support, even if they haven’t needed it before. 

Getting started as a disabled SLT student (including those diagnosed on the course)

1. Decide whether to share information regarding your disability. You may wish to talk it through with your family, friends or other networks to help you decide, as well as to weigh up the pros and cons.
   
2. Arrange a meeting with your personal tutor/disability lead tutor. Topics you may wish to cover (if you feel comfortable to) include:
   
   • a description of your access needs 
   • your strengths and things you are good at 
   • what you think will help (if you know) 
   • the reasonable adjustments the HEI can offer 
   • what services are available at the HEI 
   • how you can check in with a member of staff if your needs change or aren’t being met. 

    It is useful to get the content of this meeting confirmed in writing afterwards e.g. an email. 

3. Contact disability support services to receive an assessment. This may lead to you getting Disabled Student’s Allowance, a Learning Support Plan (or similar – a document detailing what you need to access the course including placement), specific equipment (e.g. software for notetaking) and/or access arrangements for assessments. You may also wish to find out what further support they offer within their department e.g. diagnostic services and/or counselling services.
   
4. Outside of the HEI, you may need to register with a new GP/local health providers if you have moved locations. This could include transferring to a new pharmacy to get your repeat prescriptions and/or specialist medical teams to a local provider.
5. You may wish to explore if your HEI has a Disabled Students peer support network or society either within your department (i.e. specifically for SLT students) or generally in the University. Although not every University has access to this.
6. Student membership of the RCSLT is free for all Speech and Language therapy students in the UK to join and to access the disabled SLT and SLT students working group which meets online. To access the working group, email berenice.napier@rcslt.org.

Being diagnosed during the course

Some students who enter a programme do not have a diagnoses of disabilities, but find out during their time on the programme that they may be considered disabled.  

For example, Jaspreet was halfway through her first year of SLT and attended lectures on autism spectrum condition. She identified with what was being said, and wondered if she should pursue an autism diagnosis for herself. She felt apprehension as she was worried about being perceived as having a condition she was supposed to be working with clinically as a future SLT. However, after discussion with her personal tutor, Jaspreet felt more confident to go forward with this. 

On another course, Ashley found it difficult to write assignments and learn phonetic transcription. They were referred to disability support services where they received a diagnosis of dyslexia and were able to access resources to make these aspects of the course more accessible. 

If a student starts to suspect that they may have a disability during the course, they can seek support either via their HEI’s disability support services (which are usually separate to the SLT department) to access diagnostic screening services, and/or via their GP, who can make referrals to specialist agencies. 

Some people may recognise that they are struggling but do not wish to pursue a specific diagnosis. These students can still arrange to have conversations with personal tutors to find out what support is available to them on the course, e.g. extra support on revision strategies or academic skills. 

As with students who already have a declared disability on entry to a course, once a disability is declared, the HEI has a duty to the student (under the Equality Act 2010) to ensure that support and reasonable adjustments are put in place to enable the student to pursue their studies. Some HEIs have a separate policy for students diagnosed in the duration of their course meaning marks can be re-analysed retrospectively in light of the new identification of needs. Students can speak to their tutor about this at their HEI. 

A newly diagnosed disabled student is still required to meet the learning outcomes in order to progress through their course. See Fitness to Practise section for further details. 

Disclosure/sharing information about disability 

Disabled students in Higher Education have the right to choose whether or not to share information about their disability. 42% of students share during application and 37% at induction or during first year (Equality Challenge Unit, 2012).  When making the decision regarding sharing, individuals weigh up the pros and cons of this and therefore a supportive environment is key.  

Disabled SLT students are encouraged to share information about their disability at the earliest possible opportunity to HEIs and PEs to enable support to be put in place in a timely manner. However, it is important to bear in mind that not all disabled students feel comfortable sharing this information. Groups less likely to share are those with less-visible disabilities, international students and postgraduate students (Equality Challenge Unit, 2012). Students with conditions common in the populations that SLTs work with (e.g. those with a stammer) may also find it difficult to share information due to fear of how it will be perceived. 

It is important that during this process, professionals make it clear to the student what they will do with the information given, how they can share this information further and with whom. This helps students avoid the assumption that the information they have shared with one person will be automatically circulated to all HEI staff.  

Deciding to share

Some positive reasons to share information on disability may be to: 

• enable timely reasonable adjustments to be put in place on the course and on placement 
• not have to manage everything on their own  
• gain support and advice from tutors  
• understand more about their own disability. 

However, some students may not wish to share because they: 

• fear being discriminated against, stigmatised and/or prejudiced 
• feel worried about being seen as unsuitable for the course or placement 
• are concerned about the confidentiality of what they share 
• have had previous negative experiences of disclosure 
• do not regard themselves as disabled or ‘disabled enough’ (Equality Challenge Unit, 2012). 

Whilst it is not mandatory in law for the student to share information regarding their disability with their HEI, it is important that the student is able to make an informed decision and is aware of potential consequences associated with not doing so. For example, the student needs to be aware that anything not declared that then poses a potential risk will result in them being assessed in terms of ‘fitness to study’.  

Standard 6.3 of HCPC’s standard of conduct, performance and ethics (2016) states that “you must make changes to how you practise, or stop practising, if your physical or mental health may affect your performance and judgement or put others at risk for any other reason”. HCPC has further information and a flowchart to support decision-making in this area. More information can also be found in the Fitness to Practise section of this guidance. 

A further consequence of not sharing information could be poorer performance on the course itself due to a lack of support via reasonable adjustments. An example of this comes from Aisha’s story. Aisha has chronic fatigue and did not share any information with her HEI about this as she thought she could manage the course and placement. Aisha achieved well on the course but when it came to placement, she was allocated a setting that required a 45 minute wait for the bus and by the end of her first week, was beyond exhausted. Her thoughts began to escalate and she was anxious she might fail and wondered whether SLT was really the career for her. She reached out to her placement tutor and a reasonable adjustment was implemented in placement where she was able to finish 10 minutes early each day so that she didn’t have a long wait for the bus. This was easily implemented and meant that Aisha was able to finish and pass her placement. 

Moreover, it is not compulsory for an SLT student to declare their disability specifically by its diagnosis/label and adjustments can be put in place without this. It is particularly important for HEIs and PEs to understand the impact of that disability (rather than just the label) in order to consider reasonable adjustments and understand potential variable performance during the course or placement.  

It is also important in terms of Fitness to Practise (as stated above) and when considering Health and Safety when a student is on placement. Sharing information with PEs enables them to maintain a safe working environment (e.g. if working in a setting with service users who may cause injury).  

In terms of what educators can do on this topic, creating a disability-inclusive culture helps increase people’s confidence to share. Tips to develop this culture can be found throughout this guidance. 

Communication and Confidentiality when sharing

Confidentiality is a right, unless the safety of self and others is compromised (Data Protection Act, 2018; Equality Act, 2010; Disability Discrimination Act, 2005). Any discussions should be formalised and duly recorded in the appropriate way. See placements section for specifics around sharing to a placement provider. 

All forms of communication should be frequent, clear, ongoing and a two-way process, with the student involved at every stage. It can be helpful, especially during the initial stages of sharing, for staff and students to jointly determine the frequency and format of ongoing communications to set expectations. Clear and concise communication can also help build the confidence of a disabled student, by enabling them to easily talk about their specific requirements to potential employers. HEIs should encourage an open door policy for all students. 

The disabled student should be aware of who the right person is to approach if there is any dispute or concerns regarding any aspect of the course.  

Legal responsibilities 

HEIs have a legal duty to disabled students with the legislation differing depending on the territory within the United Kingdom. 

Equality Act (2010)  

In England, Wales and Scotland, disability is listed as a protected characteristic and is defined in the Equality Act (2010) as: 

‘a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your abilities to do normal daily activities’. 

Substantial is defined as ‘more than minor or trivial’ and long-term as ‘12 months or more’. 

This can mean (for example): 

• physical and/or sensory disabilities 
• chronic illnesses/health conditions 
• communication differences 
• learning difficulties 
• neurodivergences (including autism)  
• mental health conditions such as anxiety or depression. 

There is further detailed guidance on how this definition is interpreted on gov.uk. 

The Equality Act (2010) states that disability is a protected characteristic making it against the law to discriminate against a person due to their disability. It is against the law for education providers to treat disabled students unfavourably/at a substantial disadvantage compared to non-disabled students. This includes: 

1. Direct Discrimination – Being treated badly due to something that happens because of a disability. EG: Being refused access to a lecture because of a disability.
2. Indirect discrimination – A rule or arrangement that is in place that applies to everyone but puts the person with the protected characteristic at a disadvantage. EG: Providing lecture content in a standardised format that is not accessible to a student with a specific disability requiring adjusted formats.
3. Discrimination arising from a disability – Treating someone unfairly because of their disability. EG: Lectures taking place in rooms without lift access when a student in a wheelchair is required to be present.
4. Harassment– Unwanted behaviour linked to a protected characteristic that violates someone’s dignity or creates an offensive environment for them. EG:A lecturer telling off a student who has ADHD in front of the class for not concentrating.
5. Victimisation – Treating someone unfairly because they’ve complained about discrimination or harassment. EG: Telling a student they can’t go to class because they’ve complained about how their reasonable adjustments are not accommodated. 

Under the Equality Act (2010), HEIs have a duty to ensure equality of opportunity for disabled students by: 

• changing rules or practices e.g. extensions to written submissions 
• altering or removing physical barriers e.g. ramps into buildings where lectures are taught 
• providing support services or devices e.g. note-taking software.  

View an animated summary of the Equality Act. 

HEIs are also listed as public authorities in the Act and therefore need to fulfil the requirements of the Public Sector Equality Duty (PSED, 2011). More information can be found in Disabled students at university: discussion paper. 

Disability Discrimination Act (1995) 

In Northern Ireland, disability is defined in the Disability Discrimination Act (1995) as a ‘physical or mental impairment that has a large and long-term adverse effect on the person’s ability to carry out normal day-to-day activities’. ‘Long-term’ is classified as likely to last for or have lasted for at least 12 months. ‘Normal day-to-day activities’ are defined as the things people generally do on a daily basis. 

United Nations Convention on the Rights of Persons with Disabilities 

Disabled people are also protected under the United Nations International Agreement on the Rights of Disabled People (2011). Article 24 Education states that disabled people have a right to education without discrimination and on the basis of equal opportunity. It states that disabled people have the right not to be excluded from education systems on the basis of disability. 

Key principles for pre-registration speech and language therapy programmes 

Regarding disability, it is recommended that SLT pre-registration programmes:  

a) Maintain high professional standards for all students alike and not pre-judge the professional competencies of disabled students. 

 b) Ensure that disabled students are not expected to meet competence standards at application, or at the beginning of courses, that other students are only expected to meet during, or at the end of their courses. 

c) Carry out impact assessments of: 

• admissions procedures
• the provision of occupational health services
• processes for allocating and arranging work placements

d) Ensure its staff are informed about ableism, reflect upon their own unconscious biases and act as anti-ableist allies for their disabled students.

e) Acknowledge the intersectionalities that disabled SLT students from marginalised/racialised backgrounds and/or identifying as LGBTQIA+ may experience and stand in solidarity with them.

 f) Observe best practice in enabling students to achieve their academic and professional potential within a HEI.

HEI staff and supporting disabled students 

The RCSLT wishes to encourage disabled individuals to join the profession, and to advise HEI staff to be inclusive and anti-ableist (i.e. anti-discriminatory) in their approach to disabled students. Staff should ensure that they do not discriminate against particular students through their actions or omission. This requires staff to have opportunities to reflect on and develop their anti-ableist allyship toward disabled people and challenge the basis of ableist attitudes and practices. See the glossary of terms for an explanation of the terms ableism and anti-ableism. 

Academic staff should undertake disability awareness and anti-ableist allyship training. This culture should be embedded and demonstrated within each department/faculty as in the section Creating a disability-inclusive culture.  

Treating disabled students fairly may not equate to treating them the same as non-disabled students- in other words, treating people equitably is not the same as treating people equally (read this blog from Social Change on the difference between equity and equality for more information).

Staff should also adhere to any Disability Support Summary (DSS – or similarly named document containing disabled students’ needs and reasonable adjustments) and work with disability support and occupational health services within the HEI to ensure the written documents accurately represent the specific demands of the SLT course. For example, a placement may require travelling from home to home during a community placement. This could mean that whilst a health centre may have adequate access, the writers of a DSS need to be made aware of how to put in access support for visits to homes to ensure the student has equitable access to the placement. Staff are governed by the legislation and also their HEI policies and procedures. Staff should be familiar with these in regard to disabled students.  

It is important that HEI staff are aware that some students may not be aware of the help available to them until situations deteriorate significantly. For example, not being diagnosed with a condition until mid-course or a change in their disability during the course of their studies. HEIs should ensure disabled students are familiar from day one of the course of the possible support and resources available to them.  

Academic staff should be open and available to students regardless of any disabilities and should observe the same approach to students as to clients in terms of accepting, respecting and advocating for them. This is also stated in the RCSLT’s Curriculum Guidance, Code of Ethics and Professional Conduct, as well as HCPC disability guidance.  

Naomi’s story: 

“I’ve been accommodated from the start at my university. I was given reasonable adjustments in the interview before being accepted into the course by being given extra time and having the questions in a written format allowing me to process and answer them effectively. I was then allowed to have a tour around part of the university including the speech and language therapy clinic before university started to allow me to familiarise myself with the building and meet the disability lead for the course, so that I had a familiar face to look for when I started. My disability support plan was shared with my lecturers for me and I was then able to meet with them to discuss this further if I needed. I’m able to record my lectures, wear noise reduction earplugs, take rest breaks during lectures if needed and also get extra time for exams”. 

Creating a disability-inclusive culture 

Creating a disability-inclusive culture should be seen as a progressive partnership between the HEI and its staff, PEs, students and other stakeholders. This can be established via the following: 

• speaking about disability as a part of the SLT workforce and not just as a service user experience  
• celebrating the visibility of disabled SLT staff and students within HEIs and placement settings 
• making it clear that disability and difference are welcomed in the SLT profession, right from the start of the admissions processes, including though promotional materials  
• acknowledging intersectionality for students from marginalised/racialised backgrounds and/or LGBTQIA+ students, who may experience further oppression or discrimination, acting as an ally for them. 
• taking a whole department approach to inclusion, including a commitment from senior SLT management with the ethos that people are able to bring their whole selves to work/study 
• using disability-inclusive language with staff and students (see Gov.Uk’s Guidance: Inclusive language: words to use and avoid when writing about disability) 
• ensuring reasonable adjustments are not seen as additional ‘effort’ for teaching staff and placement educators but a natural variation in access needs.  
• having clearly disseminated and comprehensive policies on support for disabled SLT students 
• sharing information on disability to all students not just those who are disabled, particularly around allyship capturing the student voice about disability issues and centre this in policy and process decision-making 
• including representation from disabled students on all projects affecting students, not just those specific to disability 
• creating opportunities for peer-to-peer support for disabled students 
• using a positive inclusion statement at the start of modules which indicates that varied communication styles are appreciated and that students must treat each other with respect 
• providing students with options for ways to contribute to lectures e.g. via technology such as Padlet and Mentimeter 
• frequently reminding students of ground rules in lectures e.g. ‘Give everyone the opportunity to contribute in ways that are accessible to them’. 
• allowing time for discussion to ease the demand for ‘instant’ participation and model patience, allowing more time for people to think before responding. 

The North West Practice Education Group’s ‘Inclusive approaches to supporting learners in practice’ also contains information on this topic. 

Reasonable adjustments

What are they?

HEIs have a legal responsibility to try and remove barriers disabled students face in their education. The aim of making these ‘reasonable adjustments’ is to create an equitable level of access for all students, disabled and non-disabled alike. The legal duty for education providers is an anticipatory one meaning there should be forward strategic planning to address systemic barriers faced by disabled students that can be activated as appropriate, as well as individual reasonable adjustments for specific needs. 

Inclusive system-wide practice can look like: 

• using e-learning platforms to support teaching and learning and ensuring all staff are trained in digital accessibility 
• having academic disability champions within departments for both staff and students and enabling opportunities for peer-to-peer support (where students feel comfortable to do this) 
• building inclusivity and accessibility considerations into curriculum design and programme review 
• utilising flexible study methods, such as alternative or editable formats of content as standard practice 
• providing all materials for sessions in advance 
• creating alternative assessment options for all students. 

More information on this can be found in ‘Managing reasonable adjustments in higher education’ (Equality Challenge Unit, 2010).

Examples of individual reasonable adjustments to access teaching can include:   

• specific alternative formats for information presented, for example in large font 
• permission to audio record lectures (with pauses to avoid recording any confidential information shared) 
• accessible rooms and venues. 
• adaptations to assessments and examinations (see ‘Access arrangements’ section). 

An example of what reasonable adjustments can look like in practise can be found in Bethany’s story. Bethany is autistic and before her reasonable adjustments were implemented, she was struggling to retain key content and stay on task due to the exhaustion of managing sensory challenges (background noise and lighting) as well as the anxiety of encountering new information which she struggled to plan how to work through. Bethany’s reasonable adjustment was access to all content a week in advance. This allowed her to go over the content before the actual session so that she was familiar with key concepts and had less anxiety about unexpected material. She also started to wear ear plugs and ensure she sat in a suitable position in class to manage the sensory environment. 

This guidance deliberately does not provide an exhaustive list of what reasonable adjustments can be implemented. This should be tailored to each student’s individual needs through collaboration with teaching staff, the disability support services within the HEIs, and PEs when considering access to placement. Information on the possibilities for reasonable adjustments in relation to specific conditions can be found in the Disability Rights guidance Adjustments for disabled students and apprentices (2003)

It is important to acknowledge how students are to give feedback on their support and how this can be dynamically developed over their course. Staff can provide opportunities for the student to express their perception of how the support is working, either via regular meetings or written communication. This investment of time at defined intervals can help to improve student outcomes. 

Who to ask? 

Students can get in touch with the disability support or student support services at their HEI. They can also ask the disability lead tutor (or equivalent) or ask their personal tutor or course lead. 

It is important that the student takes the lead on what they share and with whom it may be shared (see sharing section of this guidance) but is able to be fully supported by staff who know the policies and procedures of their HEI and where to signpost the student to. The onus is not just on the student to advocate for themselves, but should be incorporated into part of a wider support network and be regularly reviewed. 

What is ‘reasonable’?

The Equality and Human Rights Commission (EHRC, 2019) measures ‘reasonable’ as dependent on the setting’s circumstances in relation to practicality, cost, the organisation’s resources and size, how effective the change will be in avoiding the disadvantage the person would otherwise experience and the availability of financial support.  

It is important to remember that not all reasonable adjustments can be met. This can be due to a number of reasons including lack of resources or logistics. An open and honest discussion needs to take place between the disabled student and the HEI, to determine what can be done in order for the disabled student to meet the course competencies, without lowering the academic standard of the course. Further information on this can be found in Health, disability and becoming a health and care professional (HCPC, 2015). 

If what is reasonable cannot be agreed between the HEI and the student, a further route can be for the student to take legal action to ask a court to decide what is ‘reasonable’ (see Raising concerns – for students).  

Pre-registration eating, drinking and swallowing (EDS) competencies

Students graduating from 2026 onwards will need to have achieved RCSLT’s pre-registration EDS competencies to be able to graduate. For some disabled students, this may present challenges. It is recommended that if a student chooses to disclose their disability and have reasonable adjustments put in place, they discuss how their disability may be impacted within this clinical area.  For students with a disability where their disability specifically prevents them from achieving these competencies, the timeframe has been altered to 2028 onwards. This extended timeframe has been introduced to ensure that any course information for prospective students includes the pre-registration EDS requirement. It is also to allow RCSLT to further explore how disabled students are impacted by this requirement. The RCSLT advises that when a student or HEI is concerned a disabled student will not be able to achieve the competencies because of their disability, to contact them early in the course to establish what additional support can be put in place. It is anticipated that by 2028, RCSLT will have worked with relevant stakeholders to have a clear understanding of how disabled students are impacted by this requirement and what changes need to be considered. 

Access arrangements

A Disability Support Summary (or similarly named document detailing needs/support e.g. Reasonable Adjustment Plan) often includes a section for reasonable adjustments required for assessment procedures. 

The HEI has a duty to take an anticipatory approach and adjustments should be proactive, not reactive.  

It is advised that arrangements are accommodated for (via a joint effort between the HEI and the student) as soon as possible, e.g. at the start of the academic year. This is because the arrangements can take some time to be put in place. They are usually arranged via the disability support services within the university, as well as via the disability lead lecturer in the SLT department. Students can also ask their personal tutor about the process for these arrangements. 

Examples of access arrangements are: 

• extended deadlines for assignments 
• allowing the use use a word processor/laptop rather than hand write exam scripts 
• taking an exam in a smaller room with less students present 
• allowing alternative forms of assessment so long as these are equitable for all students and meet the learning outcomes of the programme.  

Most HEIs require access arrangements to be formalised in writing by disability support services within the HEI in order to implement them. 

More detailed information on reasonable adjustments and access arrangements: 

• Reasonable adjustments in college and university education (Scope, 2023)
• Adjustments for disabled students and apprentices (Disability Rights UK, 2023)

Practice-based learning/placements  

Placements are a core part of an SLT degree to prepare a student to join the SLT workforce.  

While SLT students need to meet the professional standards as set out by the RCSLT Practice based learning guidance (2021) and HCPC Standards of Proficiency (2023), disabled students must not be disadvantaged as result of this it also must be recognised by HEIs and Placement Educators (PEs) that being an SLT encompasses many different ways of working. 

Just as for access to teaching and assessment in the HEI, PEs are also legally required under the guidance listed above and the Equality Act (2010) to implement reasonable adjustments in the workplace to ensure disabled SLT students are not disadvantaged compared to non-disabled students. See reasonable adjustments section.

Phoebe shared why reasonable adjustments are essential for disabled students: 

“On my placement, when writing up the medical notes the PE would dictate and I would have to type as she spoke. This was near impossible as trying to keep up and listen to what I had to type as well as trying to remember how to spell words was too much and so my spelling became much worse. While this may be how she is with all students for those with learning difficulties/disabilities, having your weakness exaggerated is hard to see/experience especially when you are trying to show your strengths in the subject. I also feel it may create an environment where the learning difficulty becomes the main point and not the knowledge you are writing. For example, the notes are now focused on correcting the spelling with the knowledge written in them is missed.  I would like to note that this PE did also try to help, for example finding a way to get spell check on the note taking system. This was a useful tool for me, however she did then go on to comment on how long it takes for me to have to use it check the notes. This method of teaching led to me becoming much more tired and frustrated then if I could be given time to write my own notes and go through them together. To me the main frustration was that I felt she saw a heightened version of the worst aspects of my dyslexia and so I felt that I couldn’t/wasn’t showing her my true abilities.” 

Sensitivity and anti-ableist advocacy are required to meet the needs of disabled students on practice placement, and the possibilities for flexible adjustment within the practice placement setting. Just as for employers with disabled employees, PEs are expected to implement reasonable adjustments. It is important for HEIs and PEs to bear in mind that students may not realise they have disabilities/they may still be coming to terms with their disabilities and may not know what access requests they need in advance.  

The needs of disabled SLT students must be recognised and supported via effective pre-placement planning, monitoring, reviewing and debriefing to enable them to demonstrate the required professional standards as above. Effective communication and partnership working between the student, HEI and PE is also needed. 

Practice experiences for disabled students should be organised as far in advance as possible. Practice experience should not be changed at the last minute as this does not leave students or PEs time to prepare. In practice, this may be unavoidable, however, it is essential that the HEI has robust communication channels to ensure minimum disruption to the student.  

Preparing and planning for placement

There are 3 separate meeting points that may be useful for disabled SLT students in regards to placement: 

1) At the earliest possible point upon starting the course or receiving a diagnosis– it is useful to discuss with the HEI what access needs the student anticipates they may need on future placements. This allows for HEIs to incorporate this into their placement planning and allocation processes. A student may also need to be cleared by occupational health which can take time and submission of evidence regarding fitness for placement. 

2) Once a disabled SLT student has a placement allocated – it is useful to arrange a pre-placement meeting with the PE (and HEI as appropriate) to discuss the student’s access needs on that specific placement. There may be the option for a pre-placement visit, if time and resources allow. 

3) Midway point: halfway through placement, it is useful for the HEI and/or PE to check in with the student to ensure access needs are being met or whether any new adjustments need to be explored. Discussion at these meetings enables exploration of what might be done to manage issues and by whom (HEI, student and PE). For example, students can talk through their learner passport/Disability Support Summary. 

Some HEIs require students to sign a summary of these pre-placement meetings with consent for what information shall be passed on to the PE and what information is left out.  

Tips from a current SLT on what works well: 

• having a PE coordinator  
• having regular link meetings between educators and universities  
• clear communication and appropriate pre-placement meetings for students who which to disclose and have reasonable adjustments whilst on placement 
• extra training for staff on supporting students with disabilities – both within employers and from the HEI.  

Sharing information

Detailed and student-specific practice-based learning plans for disabled students (sometimes called ‘Placement Action Plans’ – PAPs) should be available to PEs prior to placement starting, with the permission of the student. Students are strongly encouraged to share relevant information about their disability/PAP with PEs to enable them to have the optimal placement experience. 

If agreed with the student, this should be discussed with the PEs in advance of placement with sufficient time given to PEs to make the necessary adjustments. Students may also have an AHP Learner Passport that they can share that describes how they best learn and any particular health/learning needs. 

The student has control over what information is passed on to the PE and has a copy themselves. This copy allows the student to feel confident with the information the PE has been given and can use this to draw on if difficulties arise during the placement.  

It is important for PEs to bear in mind that students may not have the workplace knowledge to anticipate how their disability might impact them during this specific placement. It can be helpful in advance of this meeting for the PE to share with the student that they will be working with details of: 

• clinical areas/patient groups 
• environments/physical spaces 
• travel and method/amount of travel 
• timings  
• pacing/amount of change expected 
• systems 
• multi-disciplinary staff  
• communication scenarios 
• expectations e.g. how to say if they are ill or late 

so that the student and PE together can plan what reasonable adjustments are required. It is helpful to share what each day is likely to be like. 

Discussions would also normally include consideration of the impact of a student’s disability in general and specific areas. These might include access needs related to: 

• mobility 
• communication and interaction 
• physical and/or mental fatigue 
• effects of medication 
• software/writing/dexterity 
• organisation/planning 
• health and safety 
• environmental factors  
• whether or not the placement should be deferred, in some cases.  

Top tips for disabled students preparing for placement

Ellie is currently an SLT student and has these top tips for disabled students preparing for placement: 

• Get a plan as soon as possible – I applied in my first year, giving me a 10 month buffer before a placement. 
• Even if you’re not sure you’ll need support it is better to have a plan – you can distribute them with whoever, whenever you feel appropriate. 
• Make sure a member of course staff knows you’re waiting on one so they can support you in chasing. 
• Update it after every placement to include new things you have found out about how your needs impact your work. 
• Have open dialogue with placement educators to fill in the gaps on the plans. 

Keira’s story 

“At my university, there was a lengthy process of being cleared by both occupational health (who required lots of evidence that I was fit for placement) as well as meeting with the disability team to create a separate ‘placement action plan’ which outlined my disability and reasonable adjustments that placement educators could put in place. The idea of the plan is that the onus is on the student to share with placement educators if they wish, which usually requires meetings preplacement (if the placement educators have time).  

I had a range of experiences on placement in response to this action plan, including one placement signing me off as I was on crutches, and it was against health and safety policy to be allowed on crutches in that setting. Another placement didn’t have lifts, so I was expected to climb three flights of stairs to the office, and on the first day my placement educator said, “you’ll be ok with stairs as you said you’re doing well at the moment, didn’t you?” I felt like I couldn’t explain that three flights of stairs were too much regardless of having a good day, so I endured the stairs and felt embarrassed when it took 10 minutes to compose myself once in the office. 

I also had fantastic placement educators who met me remotely pre-placement and talked through my dynamic disability and understood that some days I may be “less able” than others. One placement educator pre-checked with a custody suite that I could use my crutches on placement if required which made me feel at ease and took the shame away from needing to use them.  

I found it alarming how many of the NHS clinics on placements were not wheelchair accessible, not only does this stop people with physical disabilities being able to become therapists, but it also furthers the inequity of access to healthcare for disabled people”.  

Being an anti-ableist ally for disabled students on placement

It is not the place of PEs to judge whether disabled students should be training to be SLTs. An example of this situation is from Leanne who was told on placement that she was not able to support people with communication differences as she herself had ‘a speech problem’. 

Phoebe also shared her story on this topic: “I was asked on placement what area I want to work in, and I stated wanting to work with adults. My PE told me it would be harder for me due to my dyslexia as I would struggle to help them with writing and spelling and so I should think about it. At the time this made me quite uncomfortable and ended with me joking and agreeing with her, even though before this I felt that my learning difficulty could be used in a positive way as I would have my own strategies to share. This comment then continued to weigh on my mind as I began to think maybe I shouldn’t work with adults if I couldn’t help them in all areas. If your PE suggests an area is not for you due to a learning difficulty/disability, then it is hard to go against them and say no.” 

HEIs should support educators to make reasonable adjustments, with student support services bolstering this effort. They are required to adhered to the HCPC guidance on becoming a health and care professional. 

It is important that discussions and preparation for placement are a joint endeavour between all parties and the student does not have to take full responsibility for gaining equal access to placement. Being disabled often means energy is already additionally expended on the maintenance and admin of having a disability.  

It is also important that PEs and HEIs advocate for disabled students when navigating placement (e.g. ensuring there is an accessible place for the student to sit) as part of taking away this burden. PEs can also support disabled students to practice advocating for themselves on placement to support transition to work, if this is something the student wants to work on.  

PEs can further demonstrate allyship to disabled students by being aware of microaggressions and their impact. For example, if a student has a stammer and in a therapy session hears a PE praise a service user for not stammering, the student could internalise that their stammering voice is not valued and this could impact on how they see their success as a future SLT.

Students may require support from educators and HEIs where staff and/or service users display prejudicial and offensive behaviours due to conditions such as a brain injury, and additional preparation and support may be required for this. This may consist of PE’s creating an environment of emotional safety for a student to raise the issue with them, advocating for the student and also gaining consent to report to their HEI under safeguarding processes as required. Students should be aware of the system of support within the HEI and feel comfortable to access this. 

When marking a disabled student on placement, PEs should consider how to take an anti-ableist stance to providing grading and feedback on their progress. A student should not be discriminated against through their marks or feedback in relation to their disability. This includes those students with communication differences who still face stigma/prejudice in the workplace due to assumptions that there is only one acceptable way of communicating with service users. 

For example, if a student is neurodivergent and communicates in a way that is different from the neurotypical method (e.g. in terms of eye contact and body language), it is important for placement educators to respect this as an equally valid way of communicating and not deduct marks on any learning outcomes that relate to communication expectations as long as the student continues to meet the criteria provided relating to the SLT curriculum and HCPC Standards of Proficiency. 

Similarly, PEs should not discriminate against a disabled student in relation to external forces outside of their control. For example, if a disabled student requires a taxi to get to placement and the taxi is late, or if a disabled student needs to spend lunch time alone or if they are fatigued in parts of the day. 

Specific guidance on supporting neurodivergent students on practice-based learning has been developed by Health Education England in Guide to Practice-Based Learning (2022).

Charlie’s story: 

“I was on placement in an autism assessment service in my first year of training. I quickly realised that I am autistic as I identified very strongly with lots of the children we were seeing for assessments and with lots of the research I was reading. I struggled a lot for a few weeks as I felt like an imposter and that somebody in the team would figure out that I’m autistic. This made me feel really unsafe. I eventually spoke to my PE who immediately did exactly what I needed: she believed me from the get-go and didn’t question how I felt. She worked very closely with me to figure out what I was finding hard on placement and what we could change about the rest of the placement. For the activities I was finding hard (such as observing ADOS assessments which was often very upsetting for me), she found alternatives for me to take part in and also sensitively informed other staff that I wouldn’t be taking part in these activities without explicitly stating why. She also asked me whether I would like to be more involved in the team’s work on neuro-diversity affirming practice. She valued my contributions and made it clear that my voice is important and that the team want to hear from people like me. This was incredibly empowering. It has made a lasting impression on me and made me feel that I will be valuable and important as a neurodivergent SLT. We also decided to have a check in everyday on placement (even if I wasn’t working with her that day specifically) which made me feel really supported and safe. Her actions meant that while I was going through a very significant life event, I was still able to achieve my goals on placement. I felt seen and understood from the first conversation about being autistic, and that has impacted my life far beyond that placement”. 

Phoebe has some final thoughts on this: “Overall, I feel my experience in the placement would be different to how other (neurotypical) students on my course would have experienced it, and this difference is due to my learning difficulty. While I feel the comments made may have been her way of trying to help, they not only knocked my confidence with working with adults but also in my abilities as an SLT.   

To me, the biggest effect that it had was that I began to think I should not disclose my dyslexia when it comes to looking for jobs in case others share her views and don’t want to hire me. This is a huge impact for me as before this experience I was always very proud of having dyslexia and believed that I could use it as a way to help others through giving different perspectives and through relating to frustrations. Feeling that I should have to hide a big part of me felt like I had been knocked back years in confidence. Through talking to other SLT students and lecturers I have come back to thinking that it could be used as a strength. But I believe this is now going to be a doubt I carry forward, whether to disclose my dyslexia to future employers and in helping others with areas affected by my dyslexia”. 

Raising concerns – for students 

As above, HEIs and PEs have a legal duty to consider all requests to reasonable adjustments and be able to explain why they are not able to be implemented.  

If a student is experiencing discrimination or difficulty with the implementation of reasonable adjustments either at the HEI or on placement, they can raise these concerns via informal and formal channels such as:  

1. Sharing concerns with their personal placement tutor or other member of staff within the SLT department 
2. Starting the internal formal complaints procedure at the HEI 
3. Making a complaint to the office of the Independent Adjudicator, if the internal complaints procedure has been exhausted 
4. Ultimately, they can consider taking legal action regarding disability discrimination 

(Office for Students, 2019) 

Students may find it difficult to raise concerns and/or face barriers in doing so (e.g. discrimination/stigma). Staff should implement the tips in the ‘creating an inclusive culture’ section also to support an environment where students feel able to advocate for themselves in terms of raising concerns if their needs aren’t reasonably being met. 

Fitness to practise

Disabled SLT students are still required to meet the learning outcomes to progress through a course, as the Health and Care Professions Council (HCPC) requires all graduates who apply for entry to the register to be able to adhere to its Standards of Proficiency (2023).  

The reasonable adjustments outlined in any Disability Support Summary (DSS), or equivalent, shouldn’t affect the standards required to meet the learning outcomes of any given programme of study but are there to provide alternative methods of meeting these fitness-to-practise standards. 

The HCPC Standards of Proficiency (2023) cannot override the legal requirements under the Equality Act (2010) and if the threshold for reasonable has been met, the focus should be on whether the student can meet the HCPC Standards with the reasonable adjustments or not. The baseline position is always that any student training to be an SLT must be able to meet these competency Standards. 

The HCPC Standards of Education and Training (2017) state that admissions for programmes leading to eligibility to apply for registration must apply selection and entry criteria that includes: 

“b) health and disability: applicants should be in sufficiently good health to be able to comply with the programme requirements, with reasonable adjustments and support where necessary.”

This is also reflected in Standard 6.3 of HCPC’s standard of conduct, performance and ethics states that ‘you must make changes to how you practise, or stop practising, if your physical or mental health may affect your performance and judgement, or put others at risk for any other reason’. All students are expected to adhere to this. 

Health and safety 

Health and safety legislation must not be used inappropriately to avoid making a reasonable adjustment.  

The Equality Act (2010) does not override health and safety legislation and therefore HEIs and placement settings are not required to make adjustments that would endanger the health and safety of the disabled person or of other people e.g. other staff and/or service users. 

There is a duty to protect the public as well as the student. HEIs will carry out a risk assessment if deemed necessary. If occupational health screening and discussion with the student reveal they may be a danger to themselves or others (either on the taught element or on practice placements) then they may, exceptionally, be refused admittance or withdrawn from a setting. 

Useful organisations

• Advance HE 
• Disability Information Scotland 
• Disability Rights UK 
• HCPC 
• Office for Students 
• Scope 
• UCAS 
• UK Neurodivergent SLT Professionals Facebook Peer Support Group 

Users of this guidance may also wish to visit the websites relevant to particular conditions and/or organisations for condition-specific support. A non-exhaustive list includes RADLD, NAPLIC, AFASIC and STAMMA. 

Related RCSLT guidance

• Diversity, inclusion and anti-racism resources 
• RCSLT Practice-based learning guidance 
• Students 
• Link on SLT as a career webpage 
• LGBTQIA+ resources 
• Supporting SLTs with disabilities in the workplace > students on placement 
• Meeting the HCPC standards 
• Settings where SLTs work 

Frequently asked questions (FAQs) for students

Am I classed as disabled? 

Disability is a very personal topic and self-identification as disabled can be complicated for many reasons. The definition that HEIs are legally bound to is in the Equality Act (2010). You can find this information in the Legal Responsibilities section.

How do I ask for support? 

You can do this in various ways. You could have a discussion with your personal tutor who can signpost you to the HEI’s disability support services etc. You can often email the disability support services directly too. You might find this email address on their intranet page, your HEI’s webpages or on promotional materials for the HEI. 

What support can I ask for? 

Disabled HEI students can ask for assessment and support in regards to accessing: 

• Teaching and learning (e.g. recording lectures or accessible buildings) 
• Assessments (e.g. extra time on exams) 
• Practice-based learning/placement (such as getting to the setting) 
• Funding (through Disabled Student’s Allowance) 

Students may also be able to seek diagnostic screening for learning differences such as dyslexia and neurodivergence through their local disability support service at their HEI, as well as access to counselling services. 

What do I do if I think I have an undiagnosed condition/disability? 

For learning and neurodivergent differences (e.g. dyslexia and ADHD), some HEIs offer screening via their disability support services.  

For other health concerns, you can still contact your GP or other healthcare professionals to discuss your situation. 

What is a Reasonable Adjustment? 

Changes that organisations must make under disability law to prevent disabled people being disadvantaged in comparison to non-disabled people. 

My teacher/placement provider won’t implement the reasonable adjustments I’ve asked for. What do I do? 

HEIs and PEs have a legal duty to try and remove barriers to learning for disabled students. If you are having difficulty with this you can find out more about your options in the raising concerns section.

My placement feedback is ableist. What do I do? 

If you think that you have been discriminated against due to your disability when on placement, speak to your placement and/or personal tutor at the HEI in the first instance (if you feel comfortable to). You can also raise the issue with the disability support services at the HEI. If you still feel you need further assistance, you can find your options in the raising concerns section.  Information on how placement educator can be anti-ableist allies can be found in being an anti-ableist ally for disabled students on placement section.

You may also wish to seek peer support either from your local disabled students network, SLT society or the RCSLT disabled SLTs and student SLTs working group. 

Can I be an SLT if I’m disabled? Does my disability need to be ‘fixed’ to be an SLT? 

14% of SLTs report having a disability/difference (RCSLT, 2023). There are many SLTs with varying disabilities/differences who bring a wealth of knowledge and lived experience to the profession. Disabilities do not need to be ‘fixed’ for a person to become an SLT. The main point is that a student must be able to meet the points described in the Fitness to Practise section. 

Glossary of terms

• Ableism/Anti-ableism – Ableism is discrimination or prejudice towards disabled people. Anti-ableism is therefore views, actions and practices that challenge this prejudice and discrimination. 
• Allyship – Allyship means active support for those from marginalised communities from those not belonging to that group. 
• Competence – Competence is the ongoing ability to meet the standards for professional knowledge, understanding and skills, so that a person can, practice safely and effectively.  
• Disability – Under the Equality Act (2010), disability is defined as ‘having a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. A full definition of this and the terms within it can be found in definition of disability under the Equality Act 2010. 
• Disabled Students Allowance (DSA) – The Disabled Students’ Allowance cover any extra costs that you have to pay during your course that are directly associated with your disability, e.g. specialist equipment.  
• Disability Support Summary – A Disability Support Summary (can also be called a Reasonable Adjustment Plan or similar) forms part of a learning agreement. It identifies the learning outcomes / objectives you wish to achieve, a strategy to meet these objectives, and the means by which you will provide evidence of this achievement.  
• Disclosure – The term used within disability literature to refer to the process by which the disabled person lets others know about their disability and/or access needs. Most commonly referred to in this guidance as ‘sharing of information’. 
• Equality Act 2010 – The main piece of legislation used in the UK to protect disabled people from discrimination. 
• Fitness to Practise – A person’s fitness to practise is their ability to practise their profession in a way which meets the HCPC and professional body requirements. They must have the skills, knowledge, character and health to do their job safely and effectively.  
• Health and Care Professions Council (HCPC) – They regulate the SLT profession and were set up to protect the public. To do this, they keep a register of health and care professionals who meet their standards for their training, professional skills, behaviour and health. 
• Higher Education Institution (HEI) – Usually, a University where undergraduate and postgraduate study takes place.
• Practice-Based Learning/Practice Placement – Placement learning is the learning achieved during an agreed and negotiated period of learning that takes place outside the institution at which the full or part-time student is enrolled at. These are an opportunity to gain workplace experience in a SLT setting.  
• Reasonable Adjustment – Changes that organisations must make under disability law to prevent disabled people being disadvantaged in comparison to non-disabled people. 
• Social model of disability – Coined by Mike Oliver in 1983, it is the idea that that barriers that disabled people face are caused by society and not by their condition or disability itself.
• Standards of Proficiency (SOPs) – These are the professional standards that the HCPC set, which SLTs must meet before they can be registered with the HCPC.  

Contributors

Lead Author 

Claire Westwood – Lecturer in Speech and Language Therapy, Birmingham City University   

Supporting Authors 

• Catherine Fisher – Consultant Speech and Language Therapist (The Cambian Group) 
• Ellie Freeman – Student Speech and Language Therapist 
• Felicity Emmerson – Specialist Speech and Language , Central North West London (Ealing Community partners)   
• Sian Tooke – Highly Specialist Speech and Language Therapist, Cornwall Partnership NHS Foundation Trust 

References

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