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Children's speech and language therapy

How the service is provided

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.

Who is eligible for the service

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.

What will happen at your appointment

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.

Useful information

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.

Please click here for a full list of resources, links and information. 

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.

Making a referral

Eating, drinking and swallowing difficulties

If you are worried about a child or young person’s eating, drinking and/or swallowing skills, please speak to your child’s health visitor or GP in the first instance. Referrals for eating, drinking and/or swallowing difficulties will only be accepted from a health professional, for example GP, health visitor, paediatrician, dietician etc. Check our referral guidelines for more information. If you are a health professional and need to refer for eating, drinking and swallowing concerns complete this CYP SLT referral form.

Speech, language and communication difficulties

Before making a referral

We have updated how referrals to the Speech & Language Therapy Service are made. To make sure your referral is appropriate and can be accepted, you must:

  1. Check the SLT Service referral guidelines to confirm the child or young person meets our criteria. If you are unsure if they meet the criteria and would like to discuss:
    • Parents/ carers and early years or health professionals can contact our advice line on (01923) 470680 Option 3, Option 1 and leave a message for a member of our team to call you back
    • Schools can use their link email address to liaise with a therapist
  1. Complete all required pre‑referral actions listed in the guidelines (for example, using recommended strategies from our webinars or completing the speech screen). The referral form will ask for details of what you have completed and the impact of these.

Referrals will not be accepted if these steps have not been completed.

 

Who should make a referral 

  • If the concerns are related to the child or young person’s eating, drinking or swallowing, the referral needs to be made by a health professional. 
  • If the child is under 2 years 6 months, the referral needs to be made by a health professional.  
  • If the child is 2 years 6 months or over, and has not started school yet, parents/carers should make the referral (if parents/carers need help in making a referral they can access support from their child’s setting or a health professional).
  • For children or young people who are school aged, the school should make the referral (unless the child is being educated at home). 
  • For young people age 18-25 with a Hertfordshire EHCP, attending a Hertfordshire Further Education Setting/ College referrals should be made by the Local Authority (SEN).

 

Top tips for making a successful referral:  

  • Provide evidence of the impact of the child or young person’s speech, language and communication needs (SLCN) 
  • Give lots of detail about the child or young person’s SLCN   
  • Provide evidence of universal/targeted advice that has already been implemented   
  • Check our ‘Areas we cannot accept referrals for’ (in our referral guidelines) to make sure your referral is appropriate

Referral form

If you are a parent/carer or you are completing a self-referral please complete this referral form.

If you are an education or health professional, please complete this referral form.

 

Patient experience

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.

Additional useful information

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 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 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 service's 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’ proactive nature as one of the 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.

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