Speech and language therapy referral guidelines - 5 years to 6 years 11 months

Refer to SLT if… 

• Setting have accessed and implemented the following targeted support for 3 months and there has been no/minimal progress: 
  • completion of an appropriate targeted language group or structured targeted language intervention such as NELI (Nuffield Early Language Intervention) or Wellcomm 
  • implementation of activities and strategies to support specific language needs through ‘Assess, Plan, Do, Review’ process.
• AND the child has difficulty with more than one of the following:
  • follows only part of instruction given 
  • learning and understanding new vocabulary and concepts in the classroom 
  • understanding ‘what’, ‘where’, who’, ‘when’, and concrete ‘how’ questions in conversation e.g. ‘when do we brush our teeth?’ or ‘how do you brush your teeth?’
  • understanding conversations about things in the past or future
  • understanding spoken language that has an impact at home or in school.

Refer to SLT if… 

• Setting have accessed and implemented the following targeted support for 3 months and there has been no/minimal progress: 
  • completion of an appropriate targeted language group or other structured language intervention such as NELI (Nuffield Early Language Intervention) or Wellcomm 
  • implementation of activities and strategies to support specific language needs through ‘Assess, Plan, Do, Review’ process.
• AND the child has difficulty with more than one of the following:
  • telling you about something that has happened to them or difficulty re-telling a simple story 
  • using longer, complete sentences and misses words out or uses words in the wrong order 
  • using a range of verbs and uses empty verbs such as ‘do’, ‘get’, e.g. ‘girl do football,’ (instead of girl kicking football) ‘Daddy get flowers’ (instead of Daddy buying flowers)
  • not being able to make themselves understood due to difficulties with selecting words and forming sentences to express their needs and ideas leading to frustration
  • finding the correct word to use or naming items correctly.

Refer to SLT, if the child does not meet exclusion criteria* below, plus : 

• Setting have accessed and implemented the following targeted support for 3 months and there has been no/minimal progress: 
  • attended 'Supporting social communication in school aged children' training 
  • implementation of activities and strategies to support specific communication and interaction needs through ‘Assess, Plan, Do, Review’ process.
• AND the child has any of the following:
  • Minimal interactions with familiar adults e.g. not seeking them out, not initiating or responding to them during an interactive game such as peek a boo
  • is not using a communication system (for example spoken words/phrases, sign, pictures or symbols) with a key adult 
  • is not communicating for a variety of reasons (for example rejecting, requesting, responding, commenting, self advocate)
  • is not having conversations about topics of interest to them.

*Exclusion criteria:   

• Child who presents with differences in their communication skills linked to a possible or diagnosed neurodivergence such as Autism. Neurodivergent communication (for example, taking longer turns in conversation, speaking about a small range of topics, talking in detail about a topic, eye contact differences) does not need to be changed, but accepted within an inclusive environment. For more information on neurodivergent communication watch our Celebrating Autistic Neurodivergence webinar.
• Child has differences in their social skills that appear to relate to the child’s general developmental level. 

 

Refer to SLT if... 

• Setting has accessed and implemented a phonological awareness assessment and intervention for 3 months, such as Fun with Sounds for reception age (see training page) or Newcastle Assessment & Intervention for Phonological Awareness (NAPA/NIPA) for year 1 and above.
• Setting has completed the speech screen (either the word document or PDF version).
• Adults find it difficult to understand what the child/young person is saying. 
• AND the child is having any of the difficulties below:
  • misses out or swaps sounds with other sounds, for example, on the speech screen they may say “tea” for “key”
  • literacy/behaviour/confidence/participation due to impact of speech sound difficulties
  • says the same word in a different way every time, for example fish may be said as “fis” “pish”, “bi”; "Bobby" may be said as “goggy”, “bo-ee”, “boddy”
  • only using one or two consonants, for example, if trying to say “Grandad fell over” they say “Danda dell oder”
  • vowel errors, for example, says “raddy for ready” or “mer” for “more” (not due to any accent differences)
  • only using vowels, for example, “ar” for “car” “eh” for “bed”, “uh-ee” for “mummy”, “uh-er” for “jumper.”
• OR the child has cleft related speech concerns and referral is from a specialist cleft centre or other relevant professionals or the child has cleft related speech errors or nasal speech in the absence of identified cleft palate (phonological awareness assessment and intervention/speech screen do not apply for cleft‑related referrals).