How do I get a referral to a Speech Therapist?

The Health Visitor has told you not to worry, that she might be a little bit behind but she will catch up in a few months.  So you wait…and wait but you still feel like her language is not developing as quickly as other children. Her speech is not as clear as others at nursery and she is not progressing as fast as her older sister.

Sound at all familiar? If the answer is yes, there are a couple of things I would recommend you try to fast track a referral to a Speech Therapist

Get a hearing test.

If your child cannot hear it – then they won’t be able to say it. Nearly 80% of children under the age of 8 will suffer with glue ear which can affect their hearing and access to speech sounds. It is always worth getting this checked out before doing anything else.

Get your facts straight.

The more you know about child development, the more you will understand about your child’s difficulties. Often, the more you find out about your child’s delay, the less concerns you will have.

But don’t take my word for it, take a look at the Talking Point website and the Cochlear’s Integrated Scales of Development to get an idea of where your child is up to. It may surprise you, what is ‘typical’ for a child at 2 years.

Be specific.

Let me explain, if you go to your GP and say, her speech doesn’t sound like the others at nursery this doesn’t give the doctor enough information about what’s going on and whether to refer to a Speech therapist or not.

if you say:

She isn’t using any functional words to request and she is playing on her own agenda or

She seems to be replacing all of her initial consonants with a ‘t’ or a ‘d’

This gives the Doctor much more information to go on. And a more specific reason to give you a referral to a Speech therapist.

Think about it, if you are vague about what the problem actually is, it’s difficult for the health visitor or doctor to know what you are concerned about.

Vitally important, last and final point:

Be the expert.

You may have a ‘gut feeling’ but you will get a lot further into the referral process if you have facts and examples to show to your Health visitor, GP and paediatrician to back-up your concerns.

Demonstrate your child’s knowledge and skills and track their progress on this ‘talking point chart’

Have videos demonstrating behaviour in situations other than the GPs office.  Show the Doctor what they are like at home; in a crowd or at nursery.

Gather as much information as you can from nursery staff or their childminder.  Ask them to write a note or short letter to support your concerns.

It is a shame we have to go to such lengths as parents to get an NHS referral to Speech and Language Therapy. But,  honestly, it is worth doing if you are concerned.

If you don’t want to wait, you can call me at Mable or sign up for a free consultation when we Launch in October – I will be happy to talk things through and advise on assessment and therapy options.

For all of you trying to get a referral to a Speech Therapist I hope this is useful! – Let me know how it goes


Using language strategies to help kids talk about emotions

We’ve seen it all! crying, laughing, whinging, hitting, pinching, squealing – Children can make it quite clear how they are feeling by their actions…. and noises!

The good news is, as children begin to pick up new words they can communicate about things that upset or fascinate them and so learn new ways of regulating their behaviour.

Too often,  the vocabulary we teach our children to describe feelings is often restricted by what we think will be easier for them to learn.

So what does this mean? – It means we limit their vocabulary to usually happy and sad – these two words are very powerful, but simply not diverse enough to cover all the emotions and feelings our children are experiencing.

More importantly, if we limit what words our children are learning, we limit their ability to describe their life and environments. Wouldn’t it be nice if our children had a couple more words to describe how they’re feeling?

So how do I get started?

Help her to understand her emotions by giving her the feeling names

Encourage her to talk about how her mood – for example, ‘we are going to pizza express with Amy later, you look like you are excited!’

By giving her a label for how she is feeling  she makes a connection between the word she hears and the emotion.

This  starts to build up her vocabulary which will allow her to talk about feelings in the future.

Give her lots of opportunities to identify feelings in herself and others

You might say ‘you hurt your knee but you didn’t cry, because you are very brave!’

Or you might point out a situation they would remember ‘ Do you think mummy was brave when she hurt her toe this morning?’

The best way to teach  appropriate ways to react to things is be modelling good behaviour ourselves.

Your child learns from your behaviour. They see your facial expressions and body language when you get angry, or  frustrated.

‘When daddy gets angry he will sometimes leave the room, take a deep breath and come back when he feels calm’ This provides them with a strategy to use when they feel the same way. It also supports their understanding of recognising emotions in others.

Don’t restrict her vocabulary – the early years are the best time to teach new words. Here’s some inspiration:

  • Words: confused, brave, curious, disappointed, generous, friendly, jealous, bored, surprised, proud, calm, shy,
  • Phrases: I think, I feel, I wonder, I want

Resources to help

This website has a huge amount of resources including an excellent book list covering lots of different emotion words and feelings

Centre on the Social and Emotional Foundations for Early Learning (CSEFEL)

Special Time

So how do I play with my child to help their development?

Create special time. For ten minutes each day -Call it by the most special name there is — your child’s name. So in your house it might be Liam time


  • Choose a time when any other children are being looked after by someone else (unless they are old enough to stay occupied with something.) If you have more than one child, you’ll want to set up a schedule so all siblings know their special time is coming soon.
  • Set a timer for ten minutes. Turn off all phones so you can’t hear incoming calls. I suggest starting with ten minutes because it will seem like an eternity if you aren’t used to being fully present in the moment with another person. Don’t worry, it gets easier, and you do start to enjoy it!
  • Say “Today you get to decide what we will do with our ‘Special Time.’  What would you like to do?”

    Don’t structure Special Time.  This is about following your child’s lead!

  • Just connect to your child and be present!! If he wants to play with his blocks, don’t rush in to tell him how to build the tower.  Instead, watch with every bit of your attention what he is doing. Occasionally, say what you see without interfering:  “You are making that tower even taller….you are standing on your tiptoes to get that block up there. Don’t take control or suggest your own ideas unless he asks.

    Take the pressure off your child to talk –  avoid asking questions or asking your child to ‘say’ certain things  ‘ just play and establish a connection’

  • If he wants to do something that he isn’t usually allowed to do, consider whether there’s a way to do it safely since you are there to help him.  Maybe you always tell him that it’s too dangerous to jump off the chest-of-drawers onto the bed, but for special time you can push the bed next to the chest-of-drawers and stay with him as he jumps to be sure he’s safe.  Maybe he has always wanted to play with his dad’s shaving cream but you weren’t about to let him waste a can of it, or to clean it up.  For special time, you might decide to gift him with his own can of cheap shaving cream and let him play with it in the tub, and then the two of you can clean it up together
  • End Special Time when the timer buzzes.  If your child has a meltdown, handle it with the same compassionate empathy with which you would greet any other meltdown and give him your full attention in his meltdown.  But don’t think of that as extending special time, just as you would not give your child anything else he has a tantrum about, like an extra biscuit. Special time needs boundaries around it to signal that the rules aren’t the same as in regular life.

Remember if its not fun – its not working!

Play and Development in the Early Years

Why are the Early Years important? 

Between the ages of 2 and 6 children’s brains are going through a period of rapid growth.These Early Years are the single most important time to for children to develop and learn about the world.

The Science

Neuroplasticity refers to functional and structural changes in the brain that are brought about by training and experience. (Johnstan et al 2009). At birth each neuron has 7500 connections. these  increase rapidly in the first two years of life until the synaptic connections are double that of an adult brain. During the early years Neuroplasticity allows children to  maintain the skills that are most important and relevant to them and prune other ones away (apotosis)  (Mundkhur 2005).

Research demonstrates that intensive early intervention can alter positively the cognitive and developmental outcomes of young infants (Yoshinaga-Itano, 2001). Learning Language is a skill innate and unique to human beings. The critical period for language learning is between the ages of 2-6. This is why early intervention is so important.

What can I do in the Early Years to support my child?

We know children are dynamic learners. They develop their ability to listen, understand and talk from the events and experiences that are going on around them . The best way to teach our young ones new ideas, concepts and words is through experience and more specifically Play!

Who says?

Many studies have demonstrated the superior learning and motivation arising from playful, as opposed to instructional, approaches to learning in children. Pretend play supports children’s early development of symbolic representational skills, including those of literacy, more powerfully than direct instruction. (Cambridge researcher David Whitebread 2013)

Positive, nurturing and creative relationships are essential for healthy child development. Children need the company of knowledgeable, mature and emotionally balanced adults who fully understand their developmental need. Thats where you come in!

see our post on play – Special Time


  • Johnston MV, Ishida A, Ishida WN, Matsushita HB, Nishimura A, Tsuji M. (2009) Plasticity and injury in the developing brain. Brain Development 31:1–10.
  • Mundkur, N. (2005) Neuroplasticity in children The Indian Journal of Pediatrics Volume 72, Issue 10, pp 855-85
  • Yoshinaga-Itano, C. Coulter, D. Thomson, V. (2001) Developmental outcomes of children with hearing loss born in Colorado hospitals with and without universal newborn hearing screening programs. Semin Neonatol. Dec;6(6):521-9.

Why is play important?

Play is an essential part of every child’s life and is vital for the enjoyment of childhood as well as social, emotional, intellectual and physical development. When children are asked about what they think is important in their lives,playing and friends is usually at the top of the list.


Play helps children develop confidence, as well as concentration and inventiveness:

• Helps build relationships – when your child is engaged with you they learn to read non-verbal cues. things like sharing enjoyment, making eye contact and understanding body language and gesture

• Promotes feelings of self-worth and competence – Play promotes independence. Its ok for things to go wrong when your little ones are playing. Try not to intervene and let them problem solve for themselves

• Helps children to think independently – Play should be child led. Its the perfect time to develop their imagination, their problem solving and independent thinking

• Expands attention span – children love nothing more than playing with an engaging adult. with practice children will attend for longer periods and improve attention skills

• Encourages language development and communication – Play is the perfect opportunity to develop new vocabulary and support understanding of new concepts. Think about playing with dolly – you can reinforce vocabualry for body parts, clothing, food and drink, as well as teaching concept words around familiar routines like bathtime (wet/dry) and shopping.

• Helps children with imagination – Play is limitless and fun! it teaches us to be adaptable from a very early age, for example when we use a banana as a telephone we use our imagination to make it real. AS children get older imaginatin helps develop story telling skills and thinking creatively about how to solve problems.

• Helps with developing patience – Playing with others means  developing social skills, like taking turns, sharing and winning and losing games. this helps children deal with the emotions surrounding these experiences which will support their social interaction when they get to school.