2 years 6 months to 2 years 11 months

These 4 key areas of speech and language development are described below:

  • Understanding of language, also referred to as receptive language, is what a child is able to understand when others are talking to them.
  • Spoken language, also referred to as expressive language, refers to the words and sentences that a child is able to use.
  • Social communication is the exchange of ideas or information between individuals.
  • Speech is not the words we use (language), but the way in which we produce the sounds and pronounce words.

For the child you are referring, select the drop down options linked to your areas of concern to find out when to refer to Speech and Language Therapy.

Understanding of language

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: 
  • AND the child has difficulty with any of the following:
    • does not understand instructions containing 2 key words, for example, not following instructions such as ‘give the apple to Mummy’ or ‘point to the dog’s nose’ when looking at book (when you are not looking at or pointing at the item) 
    • understanding simple body parts, animals, food
    • understanding simple ‘what’ and ‘where’ questions, for example, ‘what’s that?’ or ‘where’s Daddy?’

Spoken Language

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: 
  • AND the child has difficulty with any of the following:
    • using fewer than 10 words
    • no progress in number of words since attending Early Talk and using fewer than 50 words.

Social communication

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: 
  • 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
    • 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).

Speech sounds

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).
  • close relatives find it difficult to understand what the child is saying 
  • AND the child is having any of the difficulties below:
    • Only using one or two consonants, for example, if trying to say “teddy fall over” they say “deddy dall oder”
    • Making 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 professionals 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).

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