Support Pathways for Preschool Children with Language Needs

Care Pathways for Preschool Children with Speech, Language and Communication Needs

Health Visitor referral care pathway for children under 3 years Most children to receive EYCP package or CC support first devised in close partnership with SLT s Strategies that promote language and communication. Lots of evidence and research provides evidence that these are the most effective way to promote language and communication development. ALL parents benefit if their child has delayed language. When a child has SLCN interaction between caregiver and child is affected at every level. Children with complex./additional needs and would meet criteria for PCN caseload to be referred directly to SLT if in doubt call Vicky Millgate 01225 831708 or advice line 01225 831752 we will talk about PCN pathway later. Consider Therapy BOOST at RUH discuss with OT/ physio / SLT first at RUH 01225 824220.

Service Pathways Initial referral via Single Point of Entry form. Attach Communication profile if possible/appropriate. Complete with parents This will then be triaged If the referral meets the criteria for clinic service: Parents sent questionnaire and pack of screening assessments BUT have option to call and talk to a therapist instead. They are then referred directly to appropriate part of service OR offered telephone initial consultation or face to face initial consultation if further information is needed If meets criteria for PCN Service a different pathway will be offered. Children under 2 and/or babies with feeding difficulties please refer directly to Jo Williams at RUH.

What happens next: Clinic Service Community Clinic St Martin s Hospital, Keynsham HC, Paulton Hospital Offer a mixture of face to face appointments, telephone consultations and video consultations. Mixture of group and one to one support Missed appointments. A letter is sent to parent asking them to make contact and arrange a new appointment. 4 weeks to respond. Social Inclusion service ( v. limited capacity, children need to meet criteria. No direct referrals to this service can be accepted)

Language Groups Two Can Talk For children between 2 and 3+ years with diagnosis of language delay who have received Early Years Care Package and/or Children s Centre package Now more targeted and specialist support. 4 week small group max 4 children At the end of the group the family are offered a 1:1 appointment for further assessment .

Pre-school language Service (PSLS) For children over 3 years with language difficulties . More direct therapy (although parents continue to be very actively involved) Children seen 1:1 or in small groups as appropriate Key workers from settings are invited to attend. All settings sent TOPs Targets

Phonology (Speech sounds group) Children over 3 years whose understanding of language broadly within normal limits and using simple sentences. Initially parents are invited to attend on line parent information group If appropriate, children then seen for blocks of 1:1 therapy. Emphasis is on devising and modelling home programme

Fluency (stammering) Often telephone initial consultation. Initially work with parents to support them to support their child ( indirect therapy) Specialist programme ( Lidcome) offered if appropriate Older children one block of therapy and then annual invite to group

What happens next -PCN ( Pre-school Complex Needs) Service This service is for children with complex needs: - usually 1st percentile , multiagency involvement and/or has possible additional diagnosis e.g. ASD, Down Syndrome, Cerebral Palsy (if severe), neurological conditions etc. Selective Mutism (not seen by PCN but specialist therapist available)

PCN offer If the child is a new referral to SLT they will be offered: Initial phone call with an SLT within 6 weeks case history will be taken. Strategies will be discussed with the parents and advice will be sent via e mail. This includes written advice as well as links to videos. The family will be offered a face to face clinic appointment 6 weeks after their initial phone call. This will enable the parents to meet their therapist and discuss how they have got on with the strategies suggested. The child will be assessed and a report and targets will be written. This will be shared with parents and early years settings. The child will be reviewed/monitored termly (6 weeks) in their early years setting. Feedback to parents will be sent in the post. We also offer Communication in Autism Training (CAT) and Makaton training.

Preschool Education Health Care Plan Pilot Project There are an increasing number of preschool children with completed EHCPs. A pilot project has been funded by the local authority for HCRG Care group to provide the provision for children stated on their EHCP. This will start at the beginning of February 2023 and will last for 12 months. This is already a very busy caseload and likely to reach capacity before the end of the academic year 2023.

Concerns re: ASD With severe lang difficulties PCN service Some lang diff but not severe clinic service No lang diff refer to community paediatrician only ASD pathway (diagnostic only) training available to EY settings on ASD through local authority. You can refer to community paediatrician at the beginning when you also refer to speech and language therapy if the child has significant language needs. All children would need to be seen by a paediatrician to get a diagnosis of ASD. Children are assessed with an ADOS but this might not be needed with a robust SLT report. ADOS has long waiting times currently about 12 months.

Contact details for the SLT team Serena Withers office manager , 01225 831708 (you can contact any of the SLTs through Serena) Speech and language therapy advice line (open Wednesdays 1-4pm during term time) 01225 831752 Clinic service: sally.Oakley@hcrgcaregroup.com Preschool Complex Needs service: Vicky.Millgate@hcrgcaregroup.com Professional Lead: Claire.Galloway@hcrgcaregroup.com