Speech and Language Therapy Referrals and Challenges in Educational Settings

 
Speech and Language
Therapy – language referrals
into service, 3-11 years
 
 
Sylvia Davie & Fiona Davies– Wirral Community Health and Care NHS Foundation
trust
 
Issues and challenges
Universal, targeted, specialist level input
Referring to SALT
 
Referral booklet – how to use it
 
Referral guide and criteria
 
Referral form
What happens next
 
Episodic working in SLT
 
Training
 
Parent drop-ins
Language base criteria and referrals
 
Topics to be covered today
 
    The impact ….
Lower academic
achievement
More likely to be socially
isolated and be bullied
More likely to develop
behavioural difficulties
High incidence of
language difficulties in
young offenders
Stronger likelihood of
mental health problems
in adulthood
 
Challenges for schools and
speech and language therapy
 
Staff numbers
Class size
Numbers of children needing support
Funding
Limited availability of SLT
 
“Language opens doors! It unlocks the world of reading and the imagination,
the excitement of writing, the capacity to explore new subjects, and releases
our potential to learn and grow as an individual. In schools it underpins
progress, impacts on attainment through primary and secondary years,
affects self esteem and behaviour and plays a huge role in a child’s future life
chances ……….. Language is at the heart of education and we believe that
more needs to be done to address the issue throughout school and give
teachers support to make a difference to those children’s lives.”
Jane Harley, Strategy Director for UK Education at Oxford University Press
 
High quality classroom talk is a key factor in improving pupil engagement and
outcomes
Ofsted annual report 2009/2010
 
 
Who needs support from SLT?
 
Universal / Targeted / Specialist input
 
         What does this mean?
 
 
 
SLCN includes a wide range of needs that require
different levels and types of provision
 
Universal input 
is for all, i.e. a whole class / school
approach, ensuring all children have appropriate
language and communication opportunities.
Staff training and development
Creating communication friendly environments
Whole class / school intervention approaches
 
 
 
Targeted input
 provides specific support for
children with delayed language and
communication skills.
Language groups
Narrative groups
Social skills groups
Speech sound programmes
 
Specialist input 
is in addition to the universal
and targeted input for children who require a
highly individualised programme of work.
Children with complex learning and
communication needs
Children with developmental language
disorder.
 
Making a referral
 
Referral Guide for children in school aged 3-11 years with Speech, Language and
Communication difficulties
Starting point
: 
Look at referral booklet below for the child’s
chronological age and see if the child is at 
green
, 
amber
 or 
red
 for
the area you are concerned with.
 
If they are 
green
 on the table this is age appropriate so do not worry!
 
 If they are 
amber
 look at the white column where you will find interventions
to carry out in school to support the child’s development. Provide input then
review their progress after at least a term. Then check with the referral
booklet again. If there has been no progress then refer to SLT.
 
If the child comes out on 
red 
then refer to SLT but carry out interventions from
the white column while waiting for child to be seen.
 
 
 
Speech and Language Therapy referral form to be completed
with evidence of interventions attached.
 
For children aged 7 years and under, all referrals for language
and/or social communication concerns must include a full
Wellcomm screen. Referrals will be rejected if Wellcomm
screens are not completed and attached.
 
 For all children for social communication concerns a social
communication questionnaire must be completed by setting
and parent/carer.
 
Making a SALT referral
 
 
Selective Mutism
 A specific predictable pattern of not talking which has persisted for at least one
month (two months in a new environment)
 A marked contrast between a) talking and interacting freely with people in the
child’s ‘comfort zone’ and b) avoidance, non-verbal communication, minimal verbal
response or total lack of vocalisation with other people.
 A visible ‘freeze’ (increased body-tension and fixed facial expression) when the
child becomes aware of a person outside their comfort zone.
 
Stammer
 Frequent stammers/stutters e.g. repetitions, getting stuck, lengthening of sounds
Child is aware/anxious.
 Parent is concerned about it or there is a family history of stammering
 
Voice disorder
 Child presents with a hoarse voice, periods of no voice
 
Refer straightaway if concerns about:-
 
What happens next?
 
If accepted child will be seen within 13 weeks of
receipt of referral
Episodic working, empowering parents and staff to
support children’s language
Most children with targeted needs identified will be
discharged with advice and strategies provided.
New training offered for school staff
Parent drop ins following discharge to support future
concerns
 
Training
 
 
What are speech, 
language
 and
communication?
How can we support children’s speech,
language and communication needs in their
setting?
Comprehension monitoring
Verbal reasoning and Blank levels
Vocabulary development
Supporting expressive language difficulties
Communication friendly schools
 
Language Bases
 
3 Language Resource Bases on Wirral
 
F2 to Year 2
 
For children with primarily a significant expressive speech and language
disorder
 
Cognitive ability within the average range
 
Don’t have a diagnosis of ASC
 
Main intake September; occasionally places become available during the
school year
Please flag up concerns as early in the school year as possible - even if child is
already known to SLT
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Explore the importance of speech and language therapy referrals for children aged 3-11, addressing issues, challenges, and the impact of language difficulties on academic achievement and social development. Discover the role of schools and speech therapy in supporting language development, and how language skills underpin educational progress and future life chances.

  • Speech therapy
  • Language development
  • Education
  • Challenges
  • Referrals

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  1. Speech and Language Therapy language referrals into service, 3-11 years Sylvia Davie & Fiona Davies Wirral Community Health and Care NHS Foundation trust

  2. Topics to be covered today Issues and challenges Universal, targeted, specialist level input Referring to SALT Referral booklet how to use it Referral guide and criteria Referral form What happens next Episodic working in SLT Training Parent drop-ins Language base criteria and referrals

  3. The impact . Lower academic achievement More likely to be socially isolated and be bullied More likely to develop behavioural difficulties High incidence of language difficulties in young offenders Stronger likelihood of mental health problems in adulthood

  4. Challenges for schools and speech and language therapy Staff numbers Class size Numbers of children needing support Funding Limited availability of SLT

  5. Language opens doors! It unlocks the world of reading and the imagination, the excitement of writing, the capacity to explore new subjects, and releases our potential to learn and grow as an individual. In schools it underpins progress, impacts on attainment through primary and secondary years, affects self esteem and behaviour and plays a huge role in a child s future life chances .. Language is at the heart of education and we believe that more needs to be done to address the issue throughout school and give teachers support to make a difference to those children s lives. Jane Harley, Strategy Director for UK Education at Oxford University Press High quality classroom talk is a key factor in improving pupil engagement and outcomes Ofsted annual report 2009/2010

  6. Who needs support from SLT? Universal / Targeted / Specialist input What does this mean?

  7. SLCN includes a wide range of needs that require different levels and types of provision Universal input is for all, i.e. a whole class / school approach, ensuring all children have appropriate language and communication opportunities. Staff training and development Creating communication friendly environments Whole class / school intervention approaches

  8. Targeted input provides specific support for children with delayed language and communication skills. Language groups Narrative groups Social skills groups Speech sound programmes

  9. Specialist input is in addition to the universal and targeted input for children who require a highly individualised programme of work. Children with complex learning and communication needs Children with developmental language disorder.

  10. Making a referral

  11. Referral Guide for children in school aged 3-11 years with Speech, Language and Communication difficulties Starting point: Look at referral booklet below for the child s chronological age and see if the child is at green, amber or red for the area you are concerned with. If they are green on the table this is age appropriate so do not worry! If they are amber look at the white column where you will find interventions to carry out in school to support the child s development. Provide input then review their progress after at least a term. Then check with the referral booklet again. If there has been no progress then refer to SLT. If the child comes out on red then refer to SLT but carry out interventions from the white column while waiting for child to be seen.

  12. Making a SALT referral Speech and Language Therapy referral form to be completed with evidence of interventions attached. For children aged 7 years and under, all referrals for language and/or social communication concerns must include a full Wellcomm screen. Referrals will be rejected if Wellcomm screens are not completed and attached. For all children for social communication concerns a social communication questionnaire must be completed by setting and parent/carer.

  13. Refer straightaway if concerns about:- Selective Mutism A specific predictable pattern of not talking which has persisted for at least one month (two months in a new environment) A marked contrast between a) talking and interacting freely with people in the child s comfort zone and b) avoidance, non-verbal communication, minimal verbal response or total lack of vocalisation with other people. A visible freeze (increased body-tension and fixed facial expression) when the child becomes aware of a person outside their comfort zone. Stammer Frequent stammers/stutters e.g. repetitions, getting stuck, lengthening of sounds Child is aware/anxious. Parent is concerned about it or there is a family history of stammering Voice disorder Child presents with a hoarse voice, periods of no voice

  14. What happens next? If accepted child will be seen within 13 weeks of receipt of referral Episodic working, empowering parents and staff to support children s language Most children with targeted needs identified will be discharged with advice and strategies provided. New training offered for school staff Parent drop ins following discharge to support future concerns

  15. Training What are speech, language and communication? How can we support children s speech, language and communication needs in their setting? Comprehension monitoring Verbal reasoning and Blank levels Vocabulary development Supporting expressive language difficulties Communication friendly schools

  16. Language Bases 3 Language Resource Bases on Wirral F2 to Year 2 For children with primarily a significant expressive speech and language disorder Cognitive ability within the average range Don t have a diagnosis of ASC Main intake September; occasionally places become available during the school year Please flag up concerns as early in the school year as possible - even if child is already known to SLT

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