Children develop at different rates and their speech, language and communication development should be in line with cognitive skills.

If there is concern about the impact of a child’s speech and language difficulties on their daily living skills and efforts support the child have been implemented without success, request for SLT involvement should be made with reference to the following guidelines.

Children whose communication skills have previously been assessed as being in line with their cognitive ability should only be referred if a new or specific difficulty arises.

For more information on speech and language development visit www.talkingpoint.org.uk

Requests should be made at any age where:

  • Child is stammering
  • Child shows suspected Selective Mutism          
  • Child has a recently acquired disorder (acquired brain injury and similar)
  • Child has an identified severe/profound hearing loss
  • Child has a mild or moderate hearing loss and the child is not making expected progress despite appropriate strategies being in place
  • Child has cleft lip or palate and a current identified need.

Under 2 years

  • Child does not understand basic familiar words in context for example, "it’s bedtime."
  • Child does not attempt to communicate or share attention with others
  • Child demonstrates unusual communicative behaviours.

2 years

  • Child is communicative (gestures, noises, pointing) but no recognisable words
  • Child does not understand single words or simple commands without cues
  • Child does not attempt to communicate with familiar adults, even by gesture
  • Child is in a world of their own

2 and a half years

  • Child uses fewer than 50 words (these do not have to be clear)
  • Child does not use two word phrases
  • Child has poor interaction skills such as poor eye contact
  • Child does not understand two part instructions and questions for example, “Where’s mummy’s nose?”

3 years

  • Child not using two to three word phrases
  • Parents struggle to understand child’s speech
  • Child does not understand basic instructions or questions such as, “Put the spoon on the table.” or “What are you doing?”

3 and a half to 4 years

  • Child not readily using three to four word phrases
  • Child not using many different speech sounds which is affecting intelligibility
  • Child consistently misses sounds beginning or end sounds such as ‘ea’ for tea, ‘ma’ for man
  • Child not understanding basic concepts such as big or little, on or under
  • Child not understanding question words such as who, where, what.

5 to 7+ years

Language development

  • Child does not appear to understand instructions in the classroom
  • Child uses short, simple sentences without connectors (example because, when, and)
  • Child uses unusual word order in sentences
  • Child struggles to learn and remember new words
  • Child has difficulty using language to make needs known or retell events
  • Child has difficulty using language to problem solve.

 

Speech sound development

Referral for the following speech difficulties is not appropriate pre-school:

  • Difficulties with consonant blends e.g. sp, st, bl, pr, tr
  • Difficulties with sh, ch, j, l, r, and th
  • Lisps

4 to 5 years

  • Speech not easily understood except by immediate family
  • Child consistently omits consonants from the start or end of words
  • Child does not use f or s sounds at all
  • Child confuses t/k sounds and d/g sounds, for example, ‘tar’ for car.

5 to 6 years

  • Child has difficulty with consonant blends, sp, tr, cl. 
  • Child has difficulty with sh, ch, j, l sounds.

7+ years

  • Child has difficulty with th and r
  • Child has a lisp.

 

Eating, drinking and swallowing (EDS) difficulties where commissioned

(Currently only in Pennine and West Lancashire).

An initial assessment is appropriate for children who have:

  • Obvious signs of difficulty in chewing or swallowing such as choking, coughing, eyes watering, colour change, respiratory distress, gurgly voice quality
  • History of prematurity or difficulty in establishing oral feeding
  • Medical conditions or syndromes which are impacting on chewing and swallowing
  • History of frequent chest infections in association with any of the above
  • Enduring difficulties with eating drinking and swallowing where advice from other professionals has not improved presentation.

Assessment by speech and language therapy cannot be offered to children with:

  • Difficulties associated with weaning such as refusing solids, spitting out or refusing lumps, where there is no associated medical or neurological  condition
  • Difficulties which are behavioural such as food refusal, fussy eaters, restricted diet
  • Poor appetite.

We do not referrals for any of the following circumstances:

  • Children whose primary area of difficulty relates to emotional or behavioural problems only.

 

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