Children’s Speech and Language Therapy Service –

Communication checklist

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required?

This guide is designed to help parents / carers and professionals decide whether a request for the involvement of the Children’s Speech and Language Therapy Service is recommended.

Please look at the table appropriate for the child’s age and tick the relevant descriptors that best describes their speech, language and communication skill. If the majority of the ticks are in the ‘request involvement’ column please complete a referral form and send to Children’s Speech and Language Therapy Referrals, Child Development Centre, Doncaster Royal Infirmary, Armthorpe Road, Doncaster, DN2 5LT

At ANY AGE, please make an immediate referral if a child:

o Is stammering (dysfluent) or if parent reports hearing stammering

o Has difficulty with eating or drinking in terms of chewing and swallowing

o Has a hoarse voice or abnormal voice quality

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 2

Age 12-18 MonthsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Cooperates in routines. Beginning to follow simple one word instructions but not yet consistently

Limited understanding of any language shown

Briefly imitates simple everyday activities such as feeding dolly, reading a book.

Beginning to show interest in imitating simple actions

Not showing interest in playing with any toys/ activities

Plays alone, enjoys putting objects in and out of containers Beginning to make some sounds Shows little interest in rhymes or actions

Single channelled attention, can attend to an activity of his own choosing for a short while.

Difficulty shown in finding common object or people

Enjoys actions and rhymes. Is not making any sounds or noises

Understands simple commands in context e.g. “pick it up” “get your coat”.

Points to familiar people and common objects when asked.

Vocabulary of 10-20 words used meaningfully.

Attempt to imitate new words.

Chatters nonsense to self-using a range of different sounds and intonation.

SPEECH SOUNDS TO EXPECT: p, b, t, d, n, m

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 3

Age 2-2 ½ YearsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Plays with a range of activities/ toys Pretend play emerging Little or no pretend play

Good pretend play Only able to concentrate for short spells Shows no interest in other people

Enjoys playing with other people Responds to their name Does not respond to their own name

Able to concentrate for short spells Uses jargon/babble and few words (less than 10) Poor attention

Uses a small number of words i.e. 10-50Appears to understand some names of familiar objects, instructions and actions.

Uses very few or no words

Speech can be understood by close familyResponds to simple instructions, cannot respond to longer instructions

Few words that can be understood by close family members

Understands words and simple phrases without clues

Little understanding of the names of familiar objects, actions and instructions.

Unusually distressed with changes to their routine

SPEECH SOUNDS TO EXPECT: p, b, t, d, n, m

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 4

Age 2 ½ - 3 YearsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Concentrates on activities of own choice for several minutes Uses 10-30 plus single words Does not respond to own name

Enjoys playing with other people No concerns around understanding of language Flits attention from activity to activity

Likes routine but is flexible if changes occur Little or no pretend play

Understands a range of simple instructions and words Reluctant to let others join in their play

Large single word vocabulary (50 plus words Becomes unusually distressed about changes

Starting to put 2 words together Difficulties understanding simple instructions

Understood by close family in a known context

Few or no words used although other skills are good (e.g. attention/play)

Not joining words together

Close family find the child difficult to understand even in context

SPEECH SOUNDS TO EXPECT: p, b, t, d, n, m, w, The final sound of words may be missed off

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 5

Age 3-3 ½ YearsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Focuses on activities and responds to adult prompts

Uses sentences containing only 2 words

Cannot focus on an activity for longer than a few minutes

Likes to play with others, welcoming adults to join in their play

Appropriate play, attention skills shown Poor eye contact

Plays with a wide range of toys/ activities No concerns about comprehension Does not respond to their name

Uses sentences of 3 or more words Frequently difficult to understand by less familiar people Does not show an interest in people

Some words can still be hard to understand particularly to unfamiliar people Limited pretend play

Doesn’t respond when adults join in their play. Prefers to play aloneOnly saying single words (or learnt sentences)

Close family find them difficult to understand most of the time

Not understanding simple instructions

No spontaneous consistent words used

Becomes unusually distressed about changes

SPEECH SOUNDS TO EXPECT: p, b, t, d, n, m, w, s, z, f

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 6

Age 3½ - 4 YearsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Joins in with the play of others Uses some immature speech sound patterns

Often has difficulty in joining in play with others

Understands the majority of what is said Can sometimes be difficult to understand, even in context.

Becomes unusually distressed about changes

Plays with a wide range of toys/ activities Repeats what is said, even questions, without understanding the meaning

Uses sentences that are at least 5-6 words long and used appropriately Does not respond to name

Can mainly be understood by you Shows limited interest in other people

f, v, s, sh sounds are used but not always in every place within words

Poor eye contact

Has difficulty with consonant blends (e.g. boo for blue, ack for black, ky for sky)

Difficulties understanding spoken language

Not using 2 words together in a sentence

Cannot be understood by family most of the time.

Shows unusual patterns of speech sounds (e.g. using one sound for all constants, not using f, v, s, sh or using k, g in place of other sounds).

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 7

Age 4 – 5 YearsA Request for Involvement is NOT Required Continue to Monitor A Request for Involvement IS Required

Typically able to join in with the play of peersUsually can be understood by the family but makes some speech sound errors

Has difficulty joining in play with others or lacks interest in playing with others

Listens and understands simple stories Does not consistently understand who? What? Where? type of questions

Understands ‘why’ ‘how’ questions Finds it difficult to respond to instructions with 2-3 parts and questions

Can follow 2-3 part spoken instructions (e.g. get your coat then line up)

Difficulty in understanding stories and in sequencing events

Using long sentences although may make some grammatical errors (e.g. breaked) Cannot hold a meaningful conversation

Able to describe the sequence of a simple event including past events Difficulty recalling familiar words

Can sometimes be difficult to understand when speaking in long sentences or when upset/ excited

Forms sentences with unusual word order

May still make occasional errors with double consonants (e.g. sp, fl, tr)

Speech is difficult to understand even in context

Not consistently using sounds – sh, ch, j, y, r, th

Not using early speech sounds – t, k, g, f,s

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 8

Age 5 – 7 YearsA Request for Involvement is NOT Required A Request for Involvement IS Required

Engages in two – way conversations Unable to sustain their attention to a set task for any length of time

Uses letter and sound links to spell unfamiliar words Does not engage in two way conversations and does not show interest in communicating with other people

Uses questions – ‘why?’ ‘how?’ Speech is very difficult to understand

Can tell and retell a simple story Understands / uses limited range of vocabulary

Understands complex multi part instructions. Has difficulties understanding why? questions

Uses lengthy sentences but makes some grammatical errors (e.g. felled, buyed) Overuses general words such as ‘thingy’ ‘that’

Speech is easily understood Cannot use full sentences to express thoughts, needs and wants

Evidence of a lisp (e.g. uses th for s) Has difficulties retelling stories or talking about evets un order

A few double consonants (e.g bl, gr) are still not used correctly

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 9

Age 7 – 11 YearsA Request for Involvement is NOT Required A Request for Involvement IS Required

Shows a good understanding of the sounds in words (e.g. can identify beginning/ end sounds in words) Understands/ Uses a limited range of vocabulary

Follows a 2-3 part instruction, ignoring less important parts and makes related comments

Uses the wrong words for things, e.g. ‘shark’ instead of ‘whale’ or makes up their own words for things, e.g. cuttergrasser

Speech is easily understood Has difficulties understanding 2-3 part instructions: may follow peers or only complete part of an instruction

Can count syllables within words Has difficulties understanding why? and how? questions

Uses a range of grammatical words and endings to show different tenses within their spoken language

Has difficulty understanding stories, e.g. answering questions about what they have read, understanding how events are connected to the overall plot

Uses a range of sentences to ask questions, describe events, explain information and engage others in conversation.

Has difficulty using spoken language to explain, share ideas and opinions

Use more complicated grammatical structures to join phrases together

Has difficulty retelling events and stories, e.g. lacks organisation, omits important information

Can tell and retell stories Makes frequent grammatical errors

Can sequence events from their own lives as well as stories. Speech continues to be very difficult to understand and the child is upset by it

Takes turns, responds and maintains two way conversations. Does not engage in reciprocal conversations and does not show interest in communicating with other people

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 10

Age 11 – 16 YearsA Request for Involvement is NOT Required A Request for Involvement IS Required

Shows an understanding of sarcasm and less commonly used phrases

Has difficulties understanding complex instructions, stories and /or more abstract language

Can explain the meaning of words with multiple meanings Has difficulty using spoken language to explain, share ideas, persuade others, negotiate and / or retell events/stories

Formulates complex sentences (7-12+ words) that include complex connectives (e.g. even though, however). Uses sentences which lack detail or grammatical structures

Engages in reciprocal conversations with a range of people, fully recognising the difference between conversations with peers to adults.

Understands/ uses a limited range of vocabulary or has difficulties explaining what words mean

Generates complex stories that contain lots of detail Does not engage in appropriate reciprocal conversations

Can follow instructions that do not follow the word order (e.g. Before filling in your worksheet, collect a book and write your name on it).

Unaware when people have not understood them

Can build an argument to be able to persuade, negotiate or explain a situation. Cannot follow complex instructions

Is a Request for the Involvement of the Children’s Speech and Language Therapy Team Required? 11