Reference number: Title: Working Together Guidelines For Supporting Children and Young People with Speech, Language and Communication Needs Version number: 2 Policy Approved by: Date of Approval: Date Issued: March 2016 Review Date: March 2019 Document Author: Speech & Language Therapy Service Director: Version Control and Summary of Changes Version number Date Comments (description change and amendments)
The guidelines have been developed through professional consensus, using available evidence and in line with the standards set out by the Royal College of Speech & Language Therapists (RCSLT, 2006). Scope of the Guidelines These guidelines and the accompanying screening tools are divided into 3 sections: Early Years (up to the start of the reception year- F2 ) Primary School Age Secondary School Age (up to 19 years if in statutory education) Eating, drinking and swallowing in children 0-19yrs National Policy and Statutory Requirements These guidelines comply with the requirements if the NHS Litigation Authority and Risk Management Standards. This includes a requirement to conduct an Equality Impact Assessment on all new and reviewed policies which is a requirement of the Race Relations (Amendment) Act 2000, the Disability and Discrimination Act 2005 and the Equality Act 2010. The service contributes to all elements of the 0-19 Healthy Child Programme agenda, specifically in relation to:- Be Healthy – promoting positive emotional well-being and mental health for children and young people with significant communication and eating/drinking needs. Enjoy and Achieve – enabling children with significant communication needs to fulfil their learning and social potential. These guidelines reflect a number of key national drivers for Speech & Language Therapy Services. Healthy Brighter Futures – the Strategy for Children and Young People’s Health (DoH 2009) Framing the Contribution of Allied Health Professionals: delivering high-quality healthcare (DoH Oct 2008) Better Communication: an action plan to improve services for children and young people with speech, language and communication needs (DCSF/DoH 2008) A Call to Action – Health Visitor Implementation Plan (DoH 2011) Supporting Families in the Foundation Years (DoH/DfE, 2011)
Expected Development Tick Monitor Tick Request for SALT Involvement Tick Understands lots of words and simple instructions e.g.: where’s your shoes? Show me your nose. Uses a range of single words and puts 2 words together e.g.: ‘more juice’ ‘ben jump’ little understanding of the name of familiar objects, actions and instructions e.g.: Where’s the car? Using no words or a small number of single words Not copying words or phrases CHILD SHOULD ACCESS ‘Let’s Get Talking’ Group Use the Pathway for Late talking 2 year olds to identify whether a child meets criteria for SALT referral (concerns with stammer, voice, eating drinking and swallowing, complex needs, deterioration in skills or significant difficulty engaging with parents/carers). Also consider referral to GP has attended Let’s Get Talking group and made little progress (after period of 2-3 months post group) Child is understood by family members around 50% of the time. Children miss ends off words at this stage Sounds to expect at this stage: p,b,m,n,t,d, Sounds emerging by 3 years: w,s,f,k,g Is understood by main carer around 50% of the time but other family members often cannot understand. Alongside good developing language: Very few of the early consonant sounds developing only using vowel sounds Reduced number of speech sounds used If Monitoring language: CHILD SHOULD ACCESS ‘Let’s Get Talking’ Group If Monitoring how clear the child’s speech is: Strategies / Activities to use: Review Date: Progress made: Action needed: 3 years
Expected Development Tick Monitor Tick Request for SALT Involvement Tick Understands and uses simple ‘who’, ‘what’, ‘where’ questions Understands longer instructions such as ‘make teddy jump on the chair’ Starting to understand simple concepts such as big, little, in. Understands only simple instructions such as ‘put the cup on the without adult support. E.g. pointing or showing use: Difficulty understanding simple instructions. Need support e.g. pointing and showing Puts 3 or more words together in a sentence Uses action words as well as nouns Beginning to use word endings e.g. ‘cats’ Can retell a simple past event Using sentences containing only 2/3 words e.g. ‘more juice’ ‘mummy wash hands’ and has made progress over the last 3 months Not using 3 or more words together in sentences (and has not made progress in the last 3 months) Unusual word order Child understood by familiar people most of the time. Most sounds are now heard It is very common for children to have difficulty with k. g, ch, j, sh, th, r, y at this age. is not yet using some consonant sounds e.g. ‘s’, ‘f’, ‘g’, Childs speech is understood by strangers less than 75% of the time not understood by familiar people most of the time. Speech patterns show: Missed initial consonants Unclear Vowels Only one or two consonants All final sounds missed Not using sounds such as p,b,t,d,n,m ‘f’, ‘v’, ‘s’, ‘z’ –none of these present If Monitoring Strategies / Activities to use: Review Date: Progress made: Action needed: 4 years
Appendix 2 Developmental Guidelines Development of Speech Sounds There is great variation in the rate of children’s development of speech and language so the ages below should be used as a guide only. Knowledge of normal stages of development may aid identification of SLCN. The table shows at what age 50% and 90% of children usually use the sounds listed. 50% of children use sounds by 90% of children use these sounds by most vowels 1 ½ to 2 years 3 years p, b, m, n, t. d.w 1 ½ to 2 years 3 k, g, f, h,y 1 ½ to 3 years 4 years ng, s 1 ½ to 3 years 5 years L 3 to 3 ½ years 6 years sh, ch, j, z, v 3 ½ to 4 ½ 6 years r, th 4 ½ to 5 ½ years 7 NB The common errors of ‘f’ for ‘th’ e.g. ‘fumb’ for ‘thumb’ and ‘w’ for ‘r’ e.g. ‘wed’ for ‘red’ are immaturities not to be worried about and may not need therapy. Sound Clusters Two or more consonants together are known as ‘clusters’ or ‘blends’ and take longer to develop e.g. sp, st, pl, cr. Beginning of pl/bl, cl/gl, fl e.g. play, blue Usually by 4 – 4½ years Beginning of Words pr/br, tr/dr, fr e.g. present, bridge. qu (‘kw’) e.g. queen has the cluster ‘kw’. Usually by 4 – 4½ years Beginning and/or End of Words sm, sn, sp, st, sk, sw, sl e.g. smile, spider, ask. Usually by 5 Ends of ms, -ls, -ps, -ts, -ks e.g. drums, balls, lips Usually by 4 - 4½ years Beginning or Middle of Words spr, str, scr, spl, thr, shr e.g. spring, instruction Usually by 7 years Development of Speech and Language 5 Years and Upwards AGE UNDERSTANDING EXPRESSION 5 years Understands more complex stories Understands ‘how’/ ‘why’ questions Can name categories and give examples from theme e.g. food, animals. Generally well formed sentences but still errors e.g. “the boys fighted in the playground?”
Leicestershire Partnership NHS Trust Checklist for the Review of Procedural document by appropriate Leicestershire Partnership NHS Trust Committee To be completed by policy lead and attached to any procedural document when submitted to the appropriate committee for consideration and approval. Name of document Yes/No/ Unsure Comments 1. Is the clear and unambiguous? Yes Is it clear whether the document is a guideline, policy, protocol or standard? Yes 2. Rationale Are reasons for development of the document stated? Yes 3. Development Process Is the method described in Yes Are people involved in the development identified? Yes Do you feel a reasonable attempt has been made to ensure relevant expertise has been used? Yes Is there evidence of consultation with stakeholders and users? Yes 4. Content Is the objective of the document clear? Yes Is the target population clear and unambiguous? Yes Are the intended outcomes described? Yes Are the statements clear and unambiguous? Yes 5. Evidence Base Is the type of evidence to support the document identified explicitly? Yes Are key references cited? Yes Are the references in full? Yes Are supporting documents referenced? Yes 6. Approval If appropriate have the joint Human Resources/staff side committee (or equivalent) approved the document? N/A 7. Dissemination and Implementation