Paediatric Speech & Language Therapy Checklist
N.B. Referrals will not be accepted for children whose language skills are in line with
their cognitive skills unless there is a specific need which should be stated on the
referral
Under 2 ½ years
 Child does not understand basic familiar words in context (e.g. ‘it’s bedtime’)
 Child is passive / non-communicative
 Child demonstrates unusual communicative behaviours (please give examples in referral
form)
 Child does not understand single words
 Does not attempt to communicate with familiar adults, even by gesture
 Child is in ‘a world of their own’
 Child has complex needs identified by a Paediatrician
2 ½ years
 Child uses fewer than 50 words (these do not have to be clear)
 Does not use two word phrases
 Has poor interaction skills i.e. poor eye contact
 Does not understand simple instructions and questions e.g. ‘where’s mummy’s nose?’
3 years
 Child not using 2 – 3 word phrases
 Consistently misses sounds from the beginning or ends of words e.g. ‘ay’ for /say/ and “ha”
for /hand/
 Parents struggle to understand child’s speech
 Child does not understand basic instructions or requests e.g. ‘put the spoon on the table’,
‘what are you doing?’
3 ½ - 4 years
 Child NOT readily using three – four word phrases
 Not using many different speech sounds which affects intelligibility
 Not understanding basic concepts e.g. big / little, on / under
 Not understanding question words e.g. who, what, where
 Speech not easily understood except by immediate family
Other
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Child has a significant hearing impairment
Child is stammering
Child has a tongue tie which affects feeding and swallowing – please send letter
Suspected Selective Mutism: consistent failure to speak in specific situations, duration more
than 1 month
Child has a persistent hoarse voice or voice loss
Child has a recently acquired disorder (e.g. acquired brain injury etc…)
Medical diagnosis / syndrome associated with communication delay
REFERRAL FOR THE FOLLOWING SPEECH DIFFICULTIES IS NOT APPROPRIATE PRE-SCHOOL:
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Difficulties with consonant blends e.g. sp, st, bl, pr, tr etc…
Difficulties with sh, ch, j, l, r and th
Lisps
SPEECH SOUND DEVELOPMENT
4 – 5 years
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Speech not easily understood except by immediate family
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Child consistently omits consonants from the starts of words
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Child consistently omits consonants from the ends of words
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Child does not use f or s sounds at all
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Child replaces speech sounds with k and g e.g. gaggy instead of daddy
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Child uses t and d instead of k or g e.g. tup instead of cup
5 – 6 Years
 Child has difficulty with consonant blends e.g. sp tr cl etc.
 Child has difficulty with sh ch j l sounds
7 + Years
 Child has difficulty with th and r
 Child has a lisp
LANGUAGE DEVELOPMENT 4 – 7+ YEARS
 Child is not using expected grammatical structures in comparison with other skills (e.g. –ing,
the, is etc.)
 Child is only using short simple sentences with little use of connectors (e.g. because, when,
and etc)
 Child does not appear to understand instructions in the classroom
 Unusual word order in sentences
 It is difficult to follow what the child is talking about because of confused content / muddled
word order in connected speech/narratives
 Child had difficulty with semantic skills e.g. limited vocabulary in the absence of any learning /
sensory difficulties and /or difficulties with sorting or grouping vocabulary
 Child has difficulty with pragmatic language skills e.g. using their language appropriately
 Child had difficulty following conversational rules e.g. turn taking, using appropriate eye
contact
 Child has difficulty with social interaction
SECONDARY SCHOOL Referrals will only be accepted for one of the following categories
 Child has transferred into the area with statement of SEN including Speech and Language
Therapy as an educational need in parts 2 & 3
 Child requires a speech and language assessment as part of Statutory Assessment Speech
sound difficulties / poor intelligibility
 Child has a recently acquired disorder (e.g. acquired brain injury etc…)
Other
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Child has a significant hearing impairment
Child is stammering
Child has a tongue tie which affects feeding and swallowing – please send letter
Suspected Selective Mutism: consistent failure to speak in specific situations, duration more
than 1 month
 Child has a persistent hoarse voice or voice loss (referral to ENT required prior to SLT)
 Child has a recently acquired disorder (e.g. acquired brain injury etc…)
Medical diagnosis / syndrome a