Children's Speech and Language Therapy

The Speech and Language Therapy team work with CYP in the most appropriate setting to promote functional communication and/or eating and drinking skills. We work with families and education staff to empower them to be confident agents of change for the individual CYP. We routinely visit early years settings, mainstream schools and specialist schools. Some CYP may be seen at home or in a clinic according to clinical need. For those CYP with an identified need, an episode of care will be recommended. If required, the Speech and Language Therapist will work through an interpreter should a child or family have difficulty communicating in English.

We offer support in different ways:

Universal - something for all children, for example: raising awareness and increasing understanding of SLCN and eating or drinking difficulties

Targeted - something for some children, for example: working with families and settings to help identify and overcome barriers faced by CYP with SLCN or eating and drinking difficulties

Specialist - something for children with a defined clinical need, for example: where our input can make a significant contribution to a CYP’s health and wellbeing

Not all children will require specialist support from the service as advice and support can be accessed through our targeted and universal offer.

The Children’s Speech and Language Therapy Service supports children and young people from birth to 18 years old. Children and young people should be registered with a Hertfordshire GP or be resident in Hertfordshire, as well as attending a Hertfordshire school, college or early years setting. We also support young people up to the age of 25 years who have a Hertfordshire Education Health and Care Plan (EHCP) and are attending an educational setting in Hertfordshire.

Most pre-school children will attend a Speech and Language Therapy screening clinic. Most school-aged children will be seen in school for their first assessment. It is important that you respond promptly when invited to make an appointment and that you contact the Speech and Language Therapy Service if you are unable attend. Parents/carers are required to attend a child’s initial appointment.

The Speech and Language Therapist will talk to you about your concerns and ask about your child's speech and language development, or eating and drinking skills. The therapist will observe your child, and may carry out specific activities and assessments.

The therapist will talk to you about your child’s strengths and any difficulties they may have identified. At the end of the appointment the therapist may advise you that no further support from the service is required or they may provide you with some advice and strategies, and guide you to seek further support through your child’s educational setting. If your child does require direct support from the service, the therapist will inform you about what this episode of care will be.

If there is a particular activity you’re concerned about e.g. not being able to pronounce words, it would be helpful to have some toys and activities ready to show the therapist. Being in a room with fewer distractions can also help your child engage in the session.

We appreciate there can be technical difficulties when accessing virtual appointments, please check the link and internet connectivity before your appointment to ensure you can access the virtual clinic at the allocated time; if there is a delay in accessing the appointment it may not be possible to complete the appointment.

At the end of the appointment, the therapist will talk to you about how your child is progressing and provide you with advice and explain any next steps.

The Children’s Speech and Language Therapy service has provided some resources for parents and people who work with children. This is both general advice on common concerns, as well as specific advice sheets which a therapist may recommend for you.

Have you heard of the Local Offer? If you are a young person with, or have a child with special educational needs and disabilities(SEND), the Local Offer is Hertfordshire’s central source of information for SEND services and support. Visit www.hertfordshire.gov.uk/localoffer for an easily accessible one-stop shop.

Pre-School Children

Should you have concerns regarding your child’s speech and language development, please speak to your Health Visitor or local Family Centre in the first instance. They will often be able to provide you with advice on ways to support your child at home.

If you are still concerned after trying out their advice then please follow the guidance below.

Children under 2 years 6 months
Children under 2 years 6 months can be referred directly to the Children’s SLT service by a health professional if they have additional needs and there is a clearly identified language, communication, and/or eating/drinking need. Please refer using the online referral form.

Children aged 2 years 6 months and above (not in full time school)
If your child is aged over 2 years 6 months and you have ongoing concerns regarding their speech and language skills, then please refer to one of our screening clinics. These clinics offer an opportunity for you to talk with the therapist regarding your child’s development and for us to gather information to understand your child’s needs.

The criteria for attending a screening clinic is as follows:

• Screening clinics are for preschool children from aged 2 years 6 months and above, who are not yet in full time school
• We are unable to see children with Education, Health and Care plans, or those requiring associated assessment within these clinics. A referral should be made by your child’s Special Education Needs officer in this instance
• Children already known to the service, or children outside of the given age range for the screening clinics are not able to be seen
• We are unable to complete assessments of eating and drinking at screening clinics

If you have contacted our Advice Line and continue to require access to support and advice from the Speech and Language Therapy Team, please follow these steps:

• Complete the relevant case history form
  
• Send the form to hct.sltscreeningclinic@nhs.net to register your interest

Once your form is received, you will get an email message acknowledging receipt. You will then be contacted via email or text message regarding next steps.

If you have any difficulty completing the form and sending the information, please contact our administration team on 01923 470680 option 3 option 1.

If you would like advice on how to support your child at home whilst waiting for your screening clinic appointment, please follow the links in the Useful Information section above.

School-aged Children

If your child is in full-time school you should discuss any concerns you may have with your child’s teacher. Some children can be supported in their school without a referral to the service through advice from the school’s link therapist. SENCos and other educational professionals can refer a child to the service. If a referral to the service is needed, please complete the online referral form. Click here for referral guidelines and guidance on how to complete a referral.

Eating and drinking difficulties

If you are worried about your child’s eating and drinking skills, please speak to your child’s health visitor or GP in the first instance. Referrals for eating and drinking difficulties will only be accepted from a health professional, for example GP, Health Visitor, Paediatrician, Dietician. We would not carry out assessments of eating and drinking at our screening clinics.

Down Syndrome Advice Clinic

The Children’s Therapies service is now piloting a therapy advice clinic for preschool children with Down Syndrome living within the East Hertfordshire area. Parents or carers can book into these clinics to access advice and informal assessment from a physiotherapist, occupational therapist and speech and language therapist. They do not need a referral and do not have to be currently open to the service in order to access it. Booking details can be found HERE.

Patient Story

This is an example of a patient story in which a parent, client or carer is asked about their journey through an NHS Speech and Language Therapy Service in Hertfordshire. Such information has been collected on behalf of the Hertfordshire Community Trust in order to hear directly from patients about their interactions with a service and the ways in which it could be improved. A student Speech and Language Therapist, Charlotte Fraser, conducted an informal interview with a parent on 1 March 2017 under the supervision of Mhairi Mason, Speech and Language Therapist, to collect such data.

The journey

The parent outlined the child’s journey through the Hertfordshire NHS Speech and Language Service, specifically focusing on her current phase at Tier One provision of SLT at a local severe learning disability school. Though she emphasised that her child’s journey had been long and difficult, she praised the services continuing support and flexibility. She stated that she was extremely pleased with the current level of provision and felt that her child’s needs were being successfully being met and maintained.

Positive aspects of the service

The parent highlighted many positive aspects of the service, stating that though there was never a specific problem previously, the current SLT provision had been above and beyond what she expected.

Firstly, she highlighted that she always felt included in any decisions made concerning her child. She explained that there was always a clear path of communication and she was incredibly appreciative of the time dedicated by the SLT to ensuring she was kept up to date with her child’s progress. The parent expanded upon this, claiming that as a result she feels reassured and confident her child’s needs are sufficiently understood and being met at school.

Secondly, she commented upon the approachable nature of the professionals within the service, explaining that she felt able to contact them whenever she required reassurance or clarification. In addition, she was in no doubt as to their resounding dedication and care to improving the life of her child as well as their family.

Finally, she highlighted the professionals’ pro-active nature as one of best features of the service. She listed a variety of different activities that the SLT had specifically undertaken with her child as well as multiple activities devised and given to the agent of change (the school) to undertake. Furthermore, she was keen to highlight the inclusive nature of the SLT service as the professionals organised events such as Makaton Signing Workshops which provide relevant training for parents. Not only did she think these events were important for parents to attend in order to enhance their ability to communicate with their children, she said they had provided a sense of morale amongst those who attended. It was only during these sessions that she realised she was not alone as other parents were experiencing the same difficulties. Thus she explained that she was extremely grateful to the service for the opportunity to make friends with others in similar positions as it has recently been a great source of support. 

Negative aspects of the service

The parent struggled to find a negative aspect of the service, though she stated if she had to provide an answer it would be in the form of a suggestion rather than a criticism of the current provision. As highlighted previously, she thoroughly enjoys attending events provided by the service and would ask for these to increase in frequency. However, she recognised the difficulty of doing this given the time constraints on SLTs as well as the inconsistent and low attendance levels by other parents.  

Advice for future users of the service

The parent was pleased that the interviewer asked this question as she wished that she could have received advice from another parent in a similar situation at the start of her child’s journey. The first piece of advice she wished to share was the importance of patience – though she recognised each child’s journey through the service is different, she said that patience is vital to success as pressure on the child to achieve is minimised. Furthermore, she recognised that great change cannot occur overnight and thus it is a necessary, but difficult skill, to develop. She also said that she would encourage parents to be as pro-active as possible – whether this be through maintaining regular contact with the relevant professionals in the service thus feeling involved in the child’s journey or by attending parent meetings and training sessions. In doing so the parent claimed she had reduced her own anxiety and felt like a key part of her child’s progress. Finally, she wanted to encourage parents to develop or seek to find an effective support network as she stressed in order to cope, you must recognise that you are not alone in your struggle.

If you would like to share your story, please contact the Patient Experience team on 01707 388036 or email pals.hchs@nhs.net.

We would also love to hear about your experience on our service, please complete a survey by clicking here.

Useful information:

Your journey - speech, language and/or communication difficulties at school

Your journey - eating and drinking difficulty