Referring to speech and language therapy

Also called SLT referral, SALT referral, Speech therapy referral, Self-referral to speech and language therapy

How to get a child or an adult seen by an NHS speech and language therapist, who can refer, and how long the wait really is.

What it is

A referral is the request that gets a person onto a speech and language therapy caseload. In the NHS across the UK, most services accept referrals from a GP, health visitor, school, nursery, consultant, nurse or social worker, and a growing number accept self-referral by a parent or by the adult themselves. Private therapists take direct bookings.

The route differs by age. Children's services are usually community-based and organised by area, often reached through the health visitor or the school. Adult services are usually split into acute (hospital, for stroke, head injury and swallowing) and community (long-term conditions, voice, stammering, AAC).

Who it can help

Any child whose speech, language or communication is behind or different, whether or not there is a diagnosis. Any adult whose communication has changed because of a stroke, injury, a progressive condition, surgery, a voice problem or a stammer, and any adult with a lifelong disability whose communication has never been assessed properly. Swallowing difficulties are also SLT territory and are usually seen faster.

It is not a route to a device by itself. AAC often needs a further step: see AAC assessment.

How it works

The referral is triaged, and the person is placed on a waiting list for an initial assessment. Waits vary enormously by area and by service, from weeks to well over a year for some children's services, and the honest answer is to ask the service directly for its current wait and to ask again if you have heard nothing after the time quoted. After assessment the therapist decides on a plan: direct therapy, a programme for parents or school staff to deliver, a review in a few months, or discharge with advice.

A referral can be declined if it does not meet the service's criteria. If that happens you are entitled to know the criteria and the reason, in writing.

Getting started

For a child in England, Scotland or Wales: ask the nursery or school SENCO (ALNCo in Wales) whether they can refer, and ask the health visitor or GP at the same time. Two referrals do no harm. Check the local NHS children's therapy service website for a self-referral form; many now have one. Write down three concrete examples of what you are worried about, with the child's age, because vague referrals are triaged low.

For an adult: the GP is the usual route, and a hospital team should refer on discharge. Ask which service you were referred to and get its phone number. While you wait, nothing stops you starting: the Speech and Language UK resources for children and the Stroke Association resources for aphasia are free, and a talking board costs nothing to try. Do not let anyone tell you to wait for the therapist before giving a person a way to communicate.

Where to get help

Your GP, health visitor or school can refer you, and many services also take referrals from families directly. RCSLT is the professional body and lists what to expect. Speech and Language UK runs a free helpline for families of children. Afasic supports families of children with speech and language difficulties. To find an independent therapist, RCSLT's guidance on choosing one is the place to start.