Guidelines for referral to the Nuffield Speech Clinic for children with developmental speech disorders

Nature of Service
The Speech Clinic at the Nuffield Hearing and Speech Centre specialises in developmental speech disorders, with a particular expertise in verbal dyspraxia/childhood apraxia of speech. The children referred should meet the following criteria:

• make frequent production errors, so their speech is difficult to understand
  
• have some spoken output (at least 20-30 spoken labels or attempts at words used regularly
  
  
• be aged 3 years or more
  
  
• have received at least one course of speech and language therapy locally, targeting speech

We are not a specialist centre for second opinions on autism, social communication disorders, dysfluency (stammering), cleft palate or developmental delay unless there is a specific concern that an additional speech disorder exists.

Assessments are undertaken in a joint clinic by the specialist speech and language therapist and consultant in audiovestibular medicine or neurodevelopmental paediatrics. Appointments usually last for 1½ hours.

Making a referral
We welcome referrals from GPs, paediatricians, speech and language therapists, audiovestibular physicians and/or ENT consultants, stating clearly the clinical question to be considered such as diagnosis and/or management advice.

Essential Information

• Medical information from a doctor detailing any underlying medical conditions, developmental delay or past history and current hearing status.
  
  
• A recent speech and language therapy report with details of assessment and current therapy. In addition to details of the child’s speech, we require information from formal/informal recognised tests about the child’s current receptive and expressive language skills.
  
  
• Address and telephone number of family.
  
  
• Address and telephone number of speech and language therapist.

Please note: No appointment will be allocated until this essential information is received.

Desirable Information
We welcome additional reports from other relevant professionals, such as educational psychologists and occupational therapists. Copies of statement of special educational need/individual educational plan and school attainment levels in literacy and numeracy are also helpful.

Referrals should be addressed to:
Nuffield Speech Clinic
Nuffield Hearing and Speech Centre
Royal National Throat, Nose and Ear
__Hospital
Gray’s Inn Road
London  WC1X 8DA

Please note: All referrals will be discussed jointly by a medical consultant and the consultant speech and language therapist.

Team members

Medical Consultants
Dr D Lim - Consultant in Audiovestibular Medicine

Dr D Lucas - Consultant in Audiovestibular Medicine

Dr B Mac Ardle - Consultant in Audiovestibular Medicine

Dr M Bellman - Consultant Neurodevelopmental Paediatrician

Specialist Speech and Language Therapists
Pam Williams - Consultant/Team Manager

Shula Burrows

Jenny Gorle

Frances Ridgway

Hilary Stephens

After assessment
Some children may be referred to other members of the multidisciplinary team in the Centre, including the clinical psychologist, occupational therapist and developmental paediatrician or to other specialists if this is indicated. Most children are only seen once in the clinic but some will need review.

Reports
These are sent to the referring doctor, local speech and language therapist, community paediatrician, parents and any other professionals agreed with the parents in the clinic. Reports can take about 6 weeks to arrive.

Our reports are health service reports. We do not write reports for statements of special educational needs, although parents are welcome to use our reports as part of their evidence if they so wish.

Therapy
We aim to support local services in meeting children's speech needs. This may include some speech and language therapy sessions at the Nuffield Hearing and Speech Centre.

Please note:

• Therapy is offered only for speech, not language.
  
  
• Therapy is offered to complement local provision, not instead of it.
  
  
• A child’s name will be put on the therapy list only after the clinic assessment.
  
  
• In most instances, we can only offer one course of therapy.
  
  
• Children may be offered a course of weekly/fortnightly sessions in term time or an intensive course of therapy one hour daily for 5 days in the school holidays.
  
  
• Therapy may include electropalatography (EPG) for children over 8 years old.

Additional Information
A leaflet, entitled “Your child’s visit to the Nuffield Hearing and Speech Centre” is sent to all families with
their appointment letter. It describes what will happen during the assessment and contains other helpful information. You can obtain a copy by telephoning the speech and language therapy clerical officer on 020 7915 1415.