Speech and language therapy in Latviatwo different professions, and when to go

This is the distinction most often confused in Latvia.

• TrainingAudiologopēds: MedicalLogopēds: Educational
• StatusAudiologopēds: Registered healthcare professionalLogopēds: Teacher
• Age groupsAudiologopēds: From birth to old ageLogopēds: Mainly preschool and school-age children
• ScopeAudiologopēds: Communication, speech and language, phonation, swallowing, hearingLogopēds: Assessment and correction of speech and language disorders
• Where they workAudiologopēds: Healthcare providers, rehabilitation teamsLogopēds: Educational settings and private practice

A clinical speech therapist at the POGA rehabilitation centre explains that a logopēds has pedagogical training and deals more with educational questions, while an audiologopēds has medical training and is a registered healthcare professional.

Rīgas 1. slimnīca states that the audiologopēds handles swallowing disorders, aphasia, dysarthria, vocal cord damage and hearing loss, and works within a multidisciplinary rehabilitation team after neurological, oncological or traumatic illness. In hospitals the two professions often work in parallel: a child with hearing loss may need both clinical therapy and educational language support.

Veselības centrs 4 lists these signs as reasons to see a clinical speech therapist:

• Poor oral motor skills early on: weak sucking and heavy drooling in the first year of life.
• Limited biting, chewing and swallowing during meals in the second year.
• Prolonged non-verbal communication by gesture in toddlers in the second year.
• Using distorted versions of individual words in speech.

Rīgas 1. slimnīca adds hearing problems affecting speech perception, and stagnation or regression of previously acquired language, for example after a virus or injury.

• An audiologopēds is a registered healthcare professional specialising in medical speech therapy, listed in the practitioners register.

• A logopēds has pedagogical training and is not a registered healthcare professional.
• Some specialists train further in specific methods, such as oro-facial therapy or alternative communication.
• Register entries must be renewed every 5 years.

• Age. The audiologopēds works with all age groups, including adults after stroke. The logopēds works mainly with children.
• State quotas. At some providers the service is available within state quotas with a co-payment; elsewhere it is private only.
• Swallowing problems. If swallowing is the main problem, the audiologopēds is the right professional, not the logopēds.
• Languages. Some specialists deliver sessions in Latvian, Russian and English.
• Team. For children with complex needs, a provider where the therapist works alongside a physiotherapist and others is worth seeking.

• Children under three are allowed to play at the start while the history is taken from the parents.
• Parents are advised to review the mother's passport beforehand and recall when the child said their first words.
• An audio or video recording of the child speaking helps a great deal, since children often do not cooperate during the appointment as much as the specialist needs.
• Veselības centrs 4 states that it assesses sound production using a phoneme album, screens speech comprehension, assesses auditory attention using whispered words and word chains, and from age five also runs a hand dexterity test.
• Therapy uses a range of methods, including oro-facial massage, myofunctional exercises, voice exercises and graphomotor exercises.

Rīgas veselības centrs states that clinical speech therapy is available within state quotas and publishes a price list showing both the co-payment for the state service and the total payment.

• Therapy session within state quotasPrice EUR: co-payment per price listSource: Rīgas veselības centrs
• Private therapy sessionPrice EUR: per provider price listSource: Rīgas veselības centrs
• Patient co-payment for a child under 18Price EUR: 0.00Source: NVD
• Consultation assessing the need for assistive devicesPrice EUR: per price listSource: Rīgas veselības centrs

The audiologopēds is a registered healthcare professional and therefore subject to practitioners register requirements and Health Inspectorate oversight. The logopēds, with pedagogical training, works within the education system.

If you have doubts about the quality of a service received at a healthcare provider, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.