Indicators For S&LT Referral (under 5s)

speech language communication skills

The pattern of speech and language development for most children is uneven. Children will present with a wide range of normal atypical speech language communication skills, as they move along the path of development.  Therefore, knowing when to refer a child to speech and language therapy can difficult and often not necessary.  However, there is a very small percentage of children who present with persistent atypical signs of speech, language and communication. Here are a few helpful observations parents and teachers can make, if they are concerned about their child speech and language skills.

Understanding Spoken Language Skills

8-12 months

  • Not interested in human voice
  • Does not join in turn-taking games such as peek-a-boo
  • Does not understand use of common objects e.g. cup, spoon etc…
  • Does not follow speech in context with gestures e.g. ‘no’, ‘bye-bye’

12-18 Months

  • Only understands a few single words
  • Does not follow simple, everyday instructions e.g. ‘get your coat

2.5 Years- 3 years

Does not understand two words joined together e.g. “give the cup to teddy

3 Years +

  • Does not understand short sentences e.g. “put teddy under the table
  • Does not understand concepts such as big and little

Spoken Language Skills

8-12 months

  • Does not vocalise apart from crying
  • Does not respond to carer by smiling or eye contact
  • Does not attend to carer’s voice

12 months -18th months

  • Does not babble or use sounds to represent objects e.g. ‘brrm-brrm’ for car
  • Does not locate source of sound
  • Relies on pointing to indicate need

18 months-30 months

  • Using jargon and few or no single words
  • Echoes whole phrases or the last word heard
  • Frustration or disinterest in communicating

2.5 years to 3 years

  • Limited vocabulary
  • Stereotyped language (receptive phrases not relevant to situation)

3 Years +

  • Immature grammar- sentences not developing
  • Words omitted or in wrong order
  • Increased frustration shown in challenging behaviours /reduced social interaction

Speech Sounds

8 months-30 months

  • Only uses vowel sounds (a,e,i,o,u)
  • Concerns about hearing
  • Excessive dribbling
  • Problem with chewing

2.5 years-3 years

  • Only uses a few consonant sounds
  • Consonant used only at the beginning/ends of words

3 Years +

  • Speech cannot be understood by strangers
  • Mainly uses sounds made at the front of the mouth e.g. b,p, d

Fluency/ stammering (For all under five’s)

  • Child repeat sounds or part words
  • Family history of stammering
  • Child prolongs or stretches sound
  • Parental concern
  • Child struggles to speak
  • Child aware, frustrated, upset or withdrawn
  • Additional behaviours (blinking, body movements etc..)
  • Inappropriate handling of difficulties/parent- child interaction
  • Teasing or bullying

For ideas around how to support early child language development and developing early language skills or to read more around speech language communication skills policy

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