Service Information

Our service is made up of qualified speech and language therapists and experienced speech and language therapist assistants. We also have a very small team of administration staff who will answer the phone and pass on messages to the team. 

The phone lines often get very busy, so it can be easier to send an e-mail to the service cits.admin@cnwl@nhs.net

We offer speech and language therapy for children and young people in Hillingdon to help them communicate. We offer support to children, young people and their families who have difficulties with their speech, language and communication skills or difficulties with eating and drinking.

These difficulties might include:

• Saying sounds clearly
• Understanding what has been said to them
• Using words and sentences
• Saying words and sentences fluently
• Their voice sounding croaky, strained or unusual
• Being unable to talk when not at home
• Understanding social situations, making friends or changes in routine
• Eating and drinking safely.

Speech and language therapists can:

• Assess the child or young person’s communication skills to identify areas of difficulty or difference, and provide advice as needed
• Work with families, carers, schools and nurseries to jointly identify how best they can help the child or young person to communicate to their full potential. This might be through training, workshops, talking through issues at meetings or showing others how they can continue supporting the child or young person
• Advise and support education staff on how they can run interventions to support children and young people in their setting
• Work directly with children or young people if needed – this might be individually or in groups and will usually involve parents, carers, school or nursery staff watching the sessions so that they know how to help the child or young person. This helps maximise the progress that the child or young person will make with their communication skills as they are being supported throughout the day
• Assess the child or young persons’ eating, drinking and swallowing skills to identify areas of difficulty, and provide methods for all those involved to maintain the safety of the child or young persons’ eating, drinking and swallowing and support improvements in these skills, where possible.

This team provides a service to children before they start school (pre-school) who live in Hillingdon or who are registered with a GP in Hillingdon.

We also provide a service to:

• Children in a mainstream school reception class with speech sound difficulties
• Mainstream school infant-age children with a stammer
• Mainstream school infant-age children who have voice problems
• Older children and young people who have difficulty eating and drinking safely
• Children and young people who have had an acquired brain injury. For example tumour, stroke and head injury.

This service isn’t for children with a permanent sensori neural severe to profound hearing loss who are being assessed for cochlear implant, wear a cochlear implant or radio aids and have speech, language and communication needs. Read more about our Hearing Impairment Speech and Language Team who provide speech and language therapy to these children.

Who do we work with?

Our Early Years Team sees mainly pre-school-age children with speech, language and communication needs working closely with parents and carers. We also see some older children in full time education whose needs are best met within a clinic setting.

The team also provides advice and support for children and young people in full time education with motor eating, drinking and swallowing difficulties and children and young people with acquired brain injury. We work in partnership with all professionals that might be involved in the child’s care.

 This could include:

• Occupational therapists
• Physiotherapists
• Paediatricians
• Portage
• Nursery 
• Education staff. 

If you are unsure whether to refer to this team you can contact us at our CITS advice line on 01895 488200 or email citsadmin.cnwl@nhs.net and we can advise you.

Where do we work?

We work in a range of settings including local health clinics and children’s centres, as well as the Child Development Centre (CDC) located ay Hillingdon Hospital. Children may also occasionally be seen in other places if required such as nursery or in hospital

We provide speech and language therapy in mainstream primary and secondary schools in Hillingdon to support children and young people with identified moderate or severe speech and language difficulties. 

Please note that we do not provide a service for children and young people who are presenting with social communication differences and who have good language skills. This ensures we are delivering neuro-diverse affirming practises. For more information on neurodiversity, please see the National Autistic Society website.  

Schools are encouraged to use the following resources available relating to neurodiversity:

• Partnerships for Inclusion of Neurodiversity in Schools (PINS) project
• Learning About Neurodiversity at School (LEANS) project

Who is this service for?

Children and young people who might experience difficulties or differences in the following areas:

• Understanding what the teacher is saying in lessons
• Understanding what friends are saying at school
• Only being able to use single words or short phrases or sentences when talking
• Not having any words
• Getting words in the wrong order when they talk
• Explaining more complicated ideas and thoughts
• Saying sounds clearly
• Speaking fluently - known as stammering 
• Speaking in school, even if they speak at home – known as selective mutism. Note: sometimes a referral to other services is needed e.g. child and adolescent mental health services (CAMHS)
• How their voice sounds e.g. sounding hoarse or croaking. Note: sometimes a referral to other services is needed e.g. ENT or a specialist voice service

Before referring to the speech and language therapy service, we ask schools to run language interventions for a minimum of one school term, as part of the graduated response model.

Schools can document the support they have offered your child using a My Support Plan or the school’s own equivalent of this document.

• Hillingdon Ordinarily Available Provision (OAP)

Language interventions that schools might run include:

• Language Link interventions
• Interventions which have previously been modelled by the speech and language therapy service in school with other children or young people
• Attention Hillingdon! groups

Referrals need to be discussed and agreed with the school’s link speech and language therapist at the termly link planning meeting to ensure that those children and young people with the most severe needs are prioritised. Please refer to the 'transferring to the mainstream schools service - primary and secodnary' tab below. 

Transitioning to mainstream primary school 

Download this document for useful information for parents/carers of children who are known to the early years speech and language therapy service and who will be starting in reception.

Transitioning to mainstream secondary school 

• Friendship problem solving
• Transition advice for parents
• Asking for help flowchart
• Example map of a school
• Example timetable
• Moving up by Kidscape
• Kidscape help with bullying: Top tips for children
• Kidscape help with bullying: Top tips for parents / carers
• Problem solving prompt sheet

How we work in schools 

Our therapists will work in different ways according to the needs of the child or young person and the school. The needs of the children or young people and the level of support to be offered are discussed by the therapist and agreed with the school’s special educational needs coordinator (SENCO).

We empower school staff to support children and young people with speech and language needs – including those not directly on the speech and language therapy caseload.

• Advice sheets and videos :: Central and North West London NHS Foundation Trust

We support school staff to:

• Make use of whole class strategies in lessons
• Make use of child specific strategies in lessons
• Run school-led intervention groups.

The service provides schools with resources, advice and training which they can use to support children – including those who are not on the speech and language therapy caseload. This includes:

• Training sessions Training :: Central and North West London NHS Foundation Trust
• Resources Advice sheets and videos :: Central and North West London NHS Foundation Trust
• Termly link planning meetings where schools can get advice about children not on the caseload

Coaching and modelling therapy

We use a coaching approach and model therapy interventions for school staff. This way, school staff can run follow up sessions with your child in between the therapist’s visits.

This also means that schools can include children in interventions who are not on the speech and language therapy caseload, but where a school might have concerns about the child’s speech and language skills.

Allocation of time

Each school is allocated an amount of time per year depending on the level of need for the children at the school i.e. larger schools with higher levels of need will be allocated more therapy time, when compared to a smaller school with a lower level of need. The amount of time that each school is allocated is reviewed and adjusted each year.

Link planning meetings

The SENCO and the school’s link therapist have a termly link planning meeting where they agree the plan for the term. This includes the opportunity to get advice about children and young people who are not on the caseload and to discuss and agree any potential new referrals.

Children and young people with an EHCP

Children or young people who have an Education Health and Care Plan (EHCP) with speech and language therapy needs identified in the plan will receive their therapy as described in their EHCP or updated annual review report.

If there is a gap in service then children or young people with an EHCP will be prioritised and any sessions owed will be made up in the following terms. The therapist will write an annual review report which details the progress your child has made and update the level of speech and language therapy your child needs for the coming year.

The therapist will aim to write a termly care plan with targets and send this to you as well as a copy for school. 

The therapist will aim to call you at least twice during an academic year. You are welcome to contact the service at any time by e-mailing or calling the service. 

Children and young people without an EHCP

Term on / term off model 

The speech and language therapy service offers a "term on-term off" model for children who do not have an Education and Health Care Plan (EHCP).

The speech and language therapist will show a member of school staff how to run intervention/therapy sessions and advise schools on strategies that can be used to support your child's communication during your child's "term on".

School staff will be expected to continue to support your child and run any necessary intervention sessions during your child's "term off".

The speech and language therapist will then review your child's progress the following term.

The therapist will aim to write a care plan with targets and send this to you as well as a copy for school during your child’s “term on”.

The therapist will aim to call you during your child’s “term on” and you are welcome to contact the service at any time by e-mailing or calling the service. 

Discharge after two years for children and young people without an EHCP 

If your child does not have an Education and Health Care Plan (EHCP) then the speech and language therapy service will discharge your child after two years of speech and language therapy support in school.

Discharge

Children will be discharged from the service when they meet our discharge criteria. The service aims to let parents know about this well in advance of the final decision and explain the reasons.

The speech and language therapist will have given your child's school lots of advice and support and shown school staff how to run intervention/therapy sessions during your child's time on the speech and language therapy caseload.

School staff will be expected to continue to support your child and run intervention and/or therapy sessions if these are still needed.

School staff can continue to get advice from the link speech and language therapist without needing to re-refer your child by discussing your child at the termly link planning meetings. 

Parents can get further advice without re-referring by calling the advice line and asking to speak to the duty speech and language therapist. If following discussions your child needs a re-referral back into the service then this can be agreed. 

Who else do we work with

We work alongside a range of professionals including teachers, learning support assistants, SENCOs, educational psychologists, paediatricians, occupational therapists, physiotherapists and the SEND Advisory service. 

To make sure that your child receives the best care, it may sometimes be helpful for us to contact other professionals about your child and share information together. We will seek your consent beforehand.

What if my child is not attending a Hillingdon state school?

Special schools in Hillingdon, along with Special Resource Provisions (SRPs), directly employ their own speech and language therapist and you can contact your child’s school to find out about their arrangements for speech and language therapy.

For children and young people attending independent or out-of-borough schools without an Education, Health and Care Plan, or for children formally being electively home schooled, we can offer a review every term in a clinic or health centre with a home and/or school programme if parents want to access this service.

Children or young people attending an out-of-borough school who have an Education, Health and Care Plan from Hillingdon will have their speech and language therapy delivered in school.

Please note that we do not provide a service for children and young people who are being educated other than at School – known as EOTAS.

We work with children and young people whose speech and language therapy needs are primarily due to permanent hearing impairment.

The Hearing Impairment Team provides a specialist speech and language service to children and young people who have a moderate to profound permanent sensori- neural hearing loss and who wear hearing aids or cochlear implants or are waiting to get them.

They work closely with audiology, teachers of the deaf and specialist assessment centres to make sure there is coordinated support for the children.

Having a hearing loss will affect how a child is able to hear and understand language. There are many things that parents/carers can do to support their child to develop their listening and attention skills, understanding and speech. The Hearing Impairment Team can support them to do this effectively.

The speech and language therapist will always try to provide the sessions within the most appropriate setting for that child/young person. This may be in the home, children’s centre, school or nursery. The therapist will discuss this when booking appointments for the child.

Many children can benefit from learning some signs to communicate when they are young. This can help to reduce frustration and develop language and communication before they are able to talk. This can be particularly helpful for children with a hearing loss.

As well as advice for developing speech, language and communication skills, parents and carers will be able to discuss how they may want to communicate with their child. For example, using signs, using spoken language, using pictures and other visual support. The therapist will be there to support parents in the decision they make.

Where appropriate, sessions will be offered jointly with teachers of the deaf to provide a more integrated service and to help parents to set joint targets. The speech and language therapist may also attend appointments at specialist centres if appropriate.

There are two local authority specialist provisions for children and young people who are hearing impaired or deaf.  Visit Glebe Primary school and Vyners Academy Secondary school for more information.