Children’s Speech and Language Therapy: Community Services Referral Criteria This service comprises two teams: the Community Clinic Team and the Children’s Centre Team. Children’s Centre Team Accepts referrals for children under 3 years with a delay in language or communication. The emphasis is on early intervention and preventative work so most children will be seen at home for their initial assessment. Community Clinic Team Referrals are accepted for children aged between 3 years and 4 years 11 months with the following:‐  Inability to communicate his/her basic needs at the level of their peers  Speech, language and communication difficulties are severely restricting social interaction  Speech, language and communication difficulties are significantly affecting ability to access the curriculum or communicate with family and peers  Significant and persisting language delay or disorder  A stammer We do not see children with tongue tie unless this is affecting speech sounds or feeding (*see below). We do not treat children under 5 years old if the only concern is a lisp. Referrals are accepted for children aged between 3 years and 10 years and 11 months with the following:‐  Significant and persisting speech sound difficulties or pronunciation difficulties All referrals accepted by this service will indicate the presence/likelihood of significant and persisting needs in the areas of speech, language and/or communication. For clarification delays of 12 months or more are seen as significant. Referrals are accepted when the child requires specific input from this specialist service, where needs cannot be effectively met by another service e.g. ISCAN or CLASS. If you are concerned about a child who is 5 years of age or older (apart from children with a significant and persisting speech delay or disorder), please refer to the Mainstream Schools Service. *If you are concerned about feeding difficulties, please refer to the ISCAN SALT Team. 1
Age 9 months 12 months Refer If Little or no interest in sound. Not babbling (bababa, mamama) or vocalising. No eye contact/very reduced eye contact. Not smiling, pointing or babbling. No interest in other people 18 As above plus: months Little or no pretend play Very poor attention Not saying any words Doesn't respond to simple spoken language 2 years As above plus: Fewer than 20 words Child is stammering Always has a hoarse voice 2 ½ As above plus: years 0‐50 words but not putting words together. Close family can't understand what child says 3y0m ‐ As above plus: 3y11m Only using 2 word phrases ‘Parrots’ set phrases. Uses words in the wrong order in a sentence. Poor understanding. Hardly ever interacts with others. 4y0m ‐ As above plus: 4y11m Uses phrases of less than 5‐6 words. Is unable to describe a sequence of events using words such as ‘and’. Is unable to have a conversation with an adult. Uses words in the wrong order in a sentence. Often does not seem to understand questions and instructions. People find it difficult to understand what he says. 5y0m + Refer to MSS service Refer If Not Using These Sounds In Words Referral for speech sound difficulties not necessary w, p, b, m, t, d, k, g, n, ng, h Above plus: f, s, z, y Above plus: sh, j, ch, and some 2 consonant blends (e.g. sp, tr, bl) *Please use some of these phrases on your referral form if they are relevant
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Speech and Language Therapy Referral Form : COMMUNITY SERVICES PLEASE COMPLETE ALL FIELDS TO ENABLE US TO PROCESS REFERRALS EFFICIENTLY Child’s details First Name: Surname: Address: Post Code: Date of birth: Gender : M / F NHS Number (if known): Nursery/School: Tel: Health Visitor: GP Name: Would you like an interpreter? Y / N Home Language/s: Parent/carer 1 Name: Parent/carer 2 Name: Relationship to child: Relationship to child: Parental responsibility? Y / N (required for referral): Parental responsibility? Y / N (required for referral): Address (if different from above): Tel: Address (if different from above): Tel: Other Information Other agencies involved: Referred by: Name: Work Address: Email address: Work role: Tel: Date: I would like a copy of this child’s first appointment letter so I can remind them to attend. Y / N 3
*REFER TO OUR REFERRAL CRITERIA TO HELP YOU FILL IN THIS PAGE* Reason for referral (please tick one or more boxes as appropriate)  Late Talker  Unclear speech sounds  Difficulty putting phrases and sentences  Difficulties with social use of language  Stammering together  Difficulty understanding language  Other (Please specify) (If the child has tongue‐tie but it is not affecting speech sounds, referral not necessary unless they are experiencing feeding difficulties, in which case, refer to ISCAN SALT Team) Please give details of the difficulty and give examples of what the child is saying or which sounds the child finds difficult. (Use phrases from our referral criteria here) How is this affecting the child? Parental Consent I consent to my child being referred to Speech and Language Therapy   I have discussed the Information for Families Leaflet I understand that a copy of my child’s first appointment letter maybe sent to the referrer  Signed: ________________________________ Date: __________________ Print Name: ______________________________________________ *Please send this completed referral form to: Speech and Language Therapy Department, Tameside General Hospital, Fountain Street, Ashton‐under‐Lyne, OL6 9RW / TEL: 0161 331 5156 4