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Who else may be working with children with speech, language and communication needs?

An adult and toddler holding hands

There are a number of different agencies and services, which may be working with a child with speech, language and communication needs, depending upon the level of support required.  Therefore, it is important that the child’s key worker within their early years setting, is aware of who else is involved and what they are working on, in order to provide a holistic approach to further support the child’s individual needs.

Wye Valley NHS Trust

Speech and Language Therapy Services

In Herefordshire, the Speech and Language Therapy Service supports children who have speech, language and communication needs from birth to 11 years old and covers difficulties in areas of:

  • Speech
  • Talking
  • Attention and listening
  • Understanding
  • Interacting
  • Swallowing, eating and drinking

The service also has Speech and Language Therapists who work to support children with more specific and complex needs, including:

  • Autism Spectrum Disorder
  • Cleft lip and palate
  • Eating and drinking difficulties
  • Hearing impairments
  • Learning difficulties / complex needs
  • Developmental Language Disorder
  • Selective mutism
  • Stammering / dysfluency

If a Speech and Language Therapist is working with a child in your setting, ask the child’s parents to let you know when they are having therapy and what suggestions and activities have been provided.  

This will help you to focus on similar areas of development for the child, within your setting.  Children are usually seen for blocks of therapy (4 to 6 weeks) and are then given time to practise at home and in the setting, before being seen again and either offered another block of therapy or if they’re making progress, being monitored or discharged.  Some children may be offered group sessions with a Speech and Language Therapy Assistant, before having individual therapy, particularly if they are having difficulty with listening and paying attention.

Children's Occupational Therapy

There is a children and young people’s community occupational therapy service in Herefordshire, where Occupational Therapists can assess any functional difficulties a child or young person may be having with elements such as fine and gross motor skills, perceptual skills, living within the home, specialist equipment, self-care skills or discharge from hospital. 

The team will work with children and young people in both group settings and on an individual basis and, if appropriate following assessment, a programme of treatment will be offered to help provide or improve compensatory support through specially selected activities.  This approach can enable a child or young person to reach their maximum level of functioning within their daily life.

Paediatric Physiotherapy

This is a specialist community physiotherapy service for babies, children and young people living in Herefordshire.  Children’s Physiotherapists, who have additional knowledge and experience of child development and childhood disabilities, are responsible for the assessment and physical rehabilitation of children and young people, identified as having difficulties with the development of gross motor skills and mobility, as a result of accident, injury, disease or disability. 

They also see children with specific conditions, such as cystic fibrosis, juvenile arthritis, chronic fatigue syndrome, gait anomalies and life limiting conditions. 

The physiotherapists will use a number of tools to fully assess and understand a child’s physical needs and their level of functioning, which includes visiting them in a variety of settings, such as clinics, home, nursery or school.  The physiotherapy programmes devised will work towards set treatment goals, which have been agreed with the child and their parents / carers, to help maximise the child’s independence and physical functioning.

Community Paediatricians

The county’s Community Paediatric Service is based at the Child Development Centre on Ross Road, Hereford and comprises a small specialised team.  They provide a consultant-led service, which is dedicated to improving the health and wellbeing of children and young people with developmental disorders, disabilities or life limiting conditions, along with those in care or in need of protection. 

Parents can request to use the service via referral from their GP, Health Visitor, Speech and Language Therapist or School Nursing Service.

Child Development Centre COSI Group

Children diagnosed with autism can access the Communication and Social Interaction Group (COSI), in their pre-school year.  The group provides learning through play, using visual support materials, to help encourage understanding and to support development of communication and interaction, whilst expanding a child’s enjoyment and acceptance of a range of activities and experiences. 

The group has a maximum of five children in each session and helps to provide children with a routine, so they are more able to anticipate changes and feel secure.  The children are reviewed termly and support and advice is provided to parents and early years settings, including when a child is ready to transition into school.

Child Development Centre Talk Talk Group

Children in their pre-school year, whose language is severely delayed or disordered, can access this specialist group provided within a communication friendly environment.  The group provides intensive intervention to meet a child’s individual needs, which are assessed and reviewed termly by the Speech and Language Therapist and class teacher, in conjunction with parents.  

The child's transition into school is fully supported through the group, in liaison with pre-schools, schools and parents.

Health Visiting Service

The county’s Health Visitors work with parents from before a child is born, until when they start school at five years old, incorporating the following five key stages:

  • Antenatal
  • New birth visit
  • 6 to 8 weeks postnatal
  • 9 to 12 months developmental review
  • 2 to 2.5 years developmental review

They can offer evidence-based support and informed advice to help families, whilst also providing signposting to relevant groups for further networking and support.

Additional local services


Portage is a home teaching scheme for families with a pre-school aged child, between 0 and 4 years old, who may have a special educational need or disability.  A Portage Worker will liaise with parents to identify long term goals, before starting to take small steps to support the child with their development.

The aim of each home visit is to decide on a play based activity, which is grounded in everyday situations, which the whole family can enjoy and practice together, to provide fun and success for the child.

If a child in your setting is having portage at home, the Portage Worker may arrange a visit with you, in order to share information, activities and plan any next steps.

Physical and Sensory Support (PASS)

PASS is a Herefordshire Council service that provides specialist teaching and support for children and young people with hearing and / or visual impairments and physical disabilities.

The team also offers free assessments, advice and specialist equipment to further help support children within early years settings and welcome referrals from professionals.

Private Speech and Language Therapy

Some parents decide to pay for a private / independent Speech and Language Therapist for their child, however they should also be encouraged to refer their child to local NHS services.  If a child is receiving private therapy, you should still ask to be kept informed of their progress and ask the parents to share any suggestions or activities that can also be used within the setting.

If a parent asks for a recommendation for a private therapist, you can direct them to the Association of Speech and Language Therapists in Independent Practice, which provides a database of over 1,300 qualified private / independent Speech and Language Therapists.

Number 8: Good practice

A nursery manager noticed that several children in her setting had frequent colds and ear infections / glue ear.  She spoke to her staff and to the locality Health Visitor and realised that this could mean that children, from time to time, were experiencing intermittent hearing loss.  This would be impacting on their language development, as they would find it harder to ‘tune in’ to people using language around them and may not be able to focus on the sounds in words.

The setting decided to take some steps to improve adult / child interaction, specifically for those with glue ear, but ultimately for all children as good practice.  Staff would help make listening and learning language easier by:

  • Getting the child’s attention before starting to talk
  • Making sure the adult faced the child as much as possible and at group times, making sure each child was seated so they could see the adult’s face
  • Checking background noises were kept to a minimum
  • Speaking clearly, without shouting, and maintaining a normal rhythm of speech
  • Keeping language simple
  • Using gestures and other visual cues

Staff would also carefully monitor these children, as there may be other reasons for their speech and language delay.