HNY Policy and Pathway Repository - Humber

Children's Speech and Language Therapy service provides assessment and intervention for children with speech, language and communication needs, and with swallowing difficulties.

The speech and language therapy service accepts referrals for children who have a specific speech, language and communication need. 

Loss of speech or language skills
Please refer children whose language or aquisition of new words regresses. 

Children who stammer
Stammering can develop in children from an early age. Please refer any child who is repeating words/sounds (b-b-baby), prolonging words (looook) and/or getting stuck often at the beginning of words. We would also encourage referral of children who are showing signs of tension when talking or seeming reluctant to talk in front of other people.

Children with eating and drinking difficulties 
Babies and children where there are concerns about safety of swallow or chewing ability require a referral form or letter outlining the difficulty.  It is important that any relevant medical information is included with the referral.

Children with difficulties in understanding language and using sentences
If the child is below school age, it may be useful for the Health Visitor to go through the SLT pre-school referral checklist with the family to reassure/seek further information. However, if there is clear reason for concern signpost the parents to:

• speech and language therapy website http://www.humber.nhs.uk/services/paediatric-slt.htm for details on how to promote child’s speech and language development.
• local Children’s Centre groups (if available) which specifically target language development eg Talk time
• attendance at pre school/nursery if appropriate

For those children whose language skills are ‘on par’ with other areas of learning we offer a range of training courses for practitioners working in nurseries and schools.  

Children with social communication difficulties
Children who have difficulties initiating or responding to social communication, using communication for social purposes, developing social relationships, making their needs known, sharing information and participating in a two–way conversation may need to be referred for further assessment. 

Social communication difficulties may suggest an Autism Spectrum Condition. If the child has already been referred to an autism assessment and diagnosis service, the speech and language therapists who carry out assessments for the diagnostic teams may be involved in that process. In this instance referrals to the speech and language therapy service need not be made unless there are additional unmet social communication needs.

Children with eating and drinking difficulties
Babies and children who are struggling with weaning to lumpy food or are fussy eaters can generally be signposted to the Health Visiting team.

Exclude Red Flag Symptoms

Children with voice difficulties
Children who regularly have a hoarse voice, lose their voice or experience tightness when speaking require a referral to Ear, Nose and Throat (ENT) department.  The ENT consultant will then refer to speech and language therapy if appropriate. 

Do Not Refer

• Children whose first language is not English and have only recently started learning English. However, children who are having difficulty in acquiring home language, or having difficulty in both languages should be referred.
• Chidren under 4.5 years with speech sound difficulties. There may be exceptions if the child’s sound system is severely restricted or they have a structural abnormality e.g. cleft palate.
• Children may not produce all the sounds and sound combinations in words correctly until over the age of 7 therefore referrals are not accepted for the following difficulties unless the child themselves is significantly concerned:
  • a ‘lisp’ (‘s’ is said as ‘th’ eg ‘sock’ becomes ‘thock’)
  • ‘r’, ‘l’, ‘ch’ 

Referral Criteria

The service operates an open referral service for children aged 0-19 - referrals are accepted from parents/those with parental responsibility, and by any professional with parental consent. The only exception to this is for children with voice problems - this requires an ENT referral.

Referrals

For referrals to be accepted by the speech and language therapy service you need to complete a Referral form on ARDENS with a completed check list for the child  - either pre school or school aged.  Please note, referrals made without a completed checklist (appropriate referral support form) could be returned.

Information To Include

You need to indicate that there is parental consent to the referral, and a description of your concerns about the child's speech, language and communication.

GP Guidance

Referral form on ARDENS

Pre-school referral support form on ARDENS

School aged referral support form on ARDENS

Referral form link to http://www.humber.nhs.uk/services/paediatric-slt.htm The Humber website also contains resources and links to provide information and ideas to families and professionals who are concerned about a child's speech, language and communication.