Speech and language therapy referral guidelines - 3 years, 6 months to 3 years, 11 months

Refer to SLT if…

• Parents/carers have accessed and implemented the following support for 3 months and there has been no/minimal progress: 
  • FOLLOW - Top Tips for Talking Webinar and FOLLOW postcard
• AND the child has difficulty with any of the following:
  • understanding instructions containing 2 key words, for example, not following instructions such as ‘point to the sun and the cow’, ‘point to the cat’s tail’ / point to the dog’s nose (when you are not looking at or pointing at the item)   
  • understanding what simple words mean, for example, body parts, animals, food. 
  • understanding simple ‘what’, ‘where’ and ‘who’ questions, for example, ‘what’s that?’ ‘where’s Daddy?’ or ‘who’s that?’
  • understanding a range of simple concepts despite multiple exposure to these, for example, size (big/little) and position (in/on/under). 

Refer to SLT if… 

• Parents/carers have accessed and implemented the following support for 3 months and there has been no/minimal progress: 
  • FOLLOW - Top Tips for Talking Webinar and FOLLOW postcard
• AND the child has difficulty with any of the following:
  • not creating their own 3-word phrases
  • wants to tell you things, comment and ask questions but has difficulty getting their messages across   
  • not learning or copying new words easily when they are exposed to them, for example, in nursery or through looking at books.

Refer to Speech and Language Therapy, if: 

• Parents/carers have accessed and implemented the following support for 3 months and there has been no/minimal progress: 
  • JOIN Webinar and JOIN postcard    
  • Say, Show, Wait Webinar
• AND the child has any of the following:
  • Minimal interactions with familiar adults, for example, not seeking them out, not initiating or responding to them during an interactive game such as peek a boo. 
  • does not use language or non-speaking skills (e.g. body language/facial expression) to communicate with key adults
  • does not communicate for a variety of reasons (for example, rejecting, requesting, responding, showing and sharing interest, commenting).

Refer to SLT if… 

• Parents/carers have accessed and implemented advice from the Speech Sound webinar and postcard for 3 months and there has been no/minimal progress.   
• Parents/carers have completed the speech screen (either the word document or PDF version).
• Adults find it difficult to understand what the child is saying.
• AND the child is having any of the difficulties below:
  • misses out or swaps sounds with other sounds, for example, on speech screen they may say “ta” for “tap” / “dough” for “toe” 
  • speech errors are impacting on behaviour/ confidence/ participation 
  • says the same word in a different way every time, for example, fish may be said as “fis”, “pish”, “bi”, for example, baby may be said as “gaygee”, “bay-ee”, “baydee”.
  • only using one or two consonants, for example, if trying to say “teddy fall over” they say “deddy dall oder”
  • vowel errors, for example, says “taddy" for "teddy” 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 professional or the child has cleft related speech errors or nasal speech in the absence of identified cleft palate (speech sound webinar/postcard and speech screen do not apply for cleft‑related referrals).