Step 1

If your child needs to be seen by a speech and language therapist, they can be referred by their:

Health professional, for example:

• 0-19 Public Health Nursing Team
• Paediatrician (Children’s Doctor)
• GP
• Learning Disability Nurse

Education provider, for example:

• Childminder
• Nursery
• School
• College
• Educational Psychologist
• Social worker

Step 2

If the referral is appropriate, the speech and language therapist will assess the child/young person to decide on their strengths and needs.

The therapist will sometimes use a formal standardised assessment but may also use informal assessments, for example observation, to help decide the best way to support and develop the child/young person’s communications skills.

Step 3

They may then provide advice, intervention and/or training if this is seen to be appropriate.

The speech and language therapist may work closely with parents/ carers/ teaching staff, discussing the child’s needs and provide coaching on ways to practise activities at home/school.

The speech and language therapist will work collaboratively with other professions including teachers, support assistants, nursery staff or others who the child has regular contact or support from.

The therapist will discuss the child/ young person’s needs to help others understand the nature of the difficulties and provide them with ideas and strategies to help promote and maximise his/ her communication skills.

If you feel you need more specific advice, it is important to contact your child’s named Speech and Language Therapist on 01204 462670 or discuss a referral into the service with the health or education professional who knows your child best.

Explore our Speech and Language Tool Kit

There is open access to the service, anyone with the consent of the child’s parent or carer can refer to the service.

Making a referral

Referrals can be made into the service by a health, social or education professional, with the consent of the child’s parent or carer. If speech, language and communication is the only concern, referrals can be made using the single agency referral form.

Where there are additional concerns regarding a child’s development, referrals should be made using the holistic Early Help Assessment (EHA) – including copies of the original EHA and any subsequent reviews.

Completed referrals should be emailed to: paedcommtherapyreferrals@boltonft.nhs.uk and clearly titled ‘Speech and Language Therapy referral’.

What should I include in the referral?

It is advised that the person or service who knows the child best completes the referral.  This will not affect waiting times but will ensure that the information we receive is comprehensive and detailed.

Please ensure that all sections are completed and include information on the functional impact of the child’s speech, language and communication concerns.

For dysphagia (feeding/swallowing) referrals, please use the specific referral form, and include as much detail as possible re: medical history, early feeding history, current diet and reason for concern.

These should be marked as urgent when emailed to paedcommtherapyreferrals@boltonft.nhs.uk

Why might a referral be rejected?

There are a number of reasons a referral may be rejected, for example:

• If the incorrect paperwork is used – i.e. single agency form instead of an EHA
• There is not enough information regarding the child’s speech and language needs.
• Incomplete information or pre-requisite assessments e.g. Wellcomm.

It is essential that the referrals received are high quality to enable us to triage to the right team.  If a referral is rejected; the reason will be shared within the rejection letter to enable this to be resubmitted with the right level of information.

Waiting Well

Whilst your child is waiting for a face-to-face appointment, you as their parent/ carer, will receive a phone consultation to carry out a case history, and provide initial advice and strategies to support you and your child, whilst waiting for their assessment.

We would also recommend that you explore the Speech and Language Therapy toolkit and the useful links sections depending on your child’s needs.

Please email paedcommtherapyreferrals@boltonft.nhs.uk for more information.

Royal College of Speech and Language Therapy guidance on bilingualism (2018)

• Any individual with knowledge of more than one language should be considered bilingual, regardless of the relative proficiency of the languages understood or used
• The main aim of intervention with any bilingual client is to maintain, restore or achieve bilingualism
• Assessment and intervention must always be carried out in both/all languages, and bilingual children should not be compared to their monolingual peers – bilinguals are not two speakers in one
• Normative data based on monolingual children should never be applied to bilingual speakers

HCPC Standards of Proficiency (2023)

Professional Standard 13: Draw on appropriate knowledge and skills to inform practice

Assess and plan interventions in the service user’s home language with the assistance of professional interpreters, and with reference to professional clinical guidelines and evidence-based practice.

All registered Speech and Language Therapists are required to work within the guidelines and professional standards detailed above. Therefore, assessment in both/all languages a child is exposed to is therefore an essential part of the assessment process.

We work with Bilingual Speech and Language Therapy Assistants and Professional Interpreters to ensure we follow RCSLT guidelines and meet the HCPC standards of proficiency.

After triaging the referral, the patient will be added to our caseload and seen for an initial assessment and subsequent reviews as appropriate. Our input will vary for patients in hospital and the community, however will include:

• Reviews – face to face/via telephone
• home visits
• nursing and residential home visits
• clinic appointments with our community team