Guidelines for referral of children with Developmental Disorders of Speech and Language

Nature of Service
The Nuffield Hearing and Speech Centre specialises in the Developmental Disorders of Speech and Language with a particular expertise in verbal dyspraxia/childhood apraxia of speech. The children referred, therefore:

• will have difficulties primarily with the production of accurate speech, but may also have a significant language problem.
  
  
• will be aged 3 years or more
  
  
• will 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 a speech disorder complicates the primary diagnosis.

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 1.5 hours. Exceptionally, some older children may be seen by these professionals in separate appointments on the same day.

Making a referral
We welcome referrals from GPs, Paediatricians and Speech and Language Therapists.

Essential Information

• Medical information from a doctor detailing any underlying medical conditions 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
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 Lucas - Consultant in Audiovestibular Medicine

Dr D Lim - 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

Hilary Stephens

Shula Burrows

Frances Ridgway

Jenny Gorle

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 may 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
Speech and Language Therapy at the Nuffield Hearing and Speech Centre is offered to some children with particular needs.

Please note:

• Therapy is offered only for speech, not language.
  
  
• Therapy is offered as a supplement to 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 either a 10 week course of one hour’s therapy a week or a one week  intensive course of one hour’s therapy daily for 5 days in the school holidays.
  
  
• Therapy may include electropalatography (EPG) for children over 8 years old.

Additional Information
A booklet, 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.