Warning alert

This page contains materials produced by Hounslow and Richmond Community Healthcare NHS Trust (HRCH). On 1 July 2024, all adult and children’s community services in the London Borough of Hounslow provided by HRCH transferred to West London NHS Trust. Whilst we are in the process of re-producing these materials, patients and referrers can still refer to the information contained within them.

Our Speech and Language Therapy (SaLT) service provides support to babies, children and young people (BCYP) with their:

  • Swallowing and safe eating and drinking
  • Understanding and use of language
  • Social interaction and communication
  • Speech and voice
  • Stammer
  • Selective mutism or speaking anxiety

Our service aims to:

  • provide information, assessment, advice and treatment for babies, children and young people with Speech, Language and Communication Needs (SLCN)
  • provide information, assessment, and management of Dysphagia (unsafe swallow)
  • provide training and support for families and other people involved in the care of those with SLCN.
  • provide training for professionals who work with babies, children and young people with SLCN.
  • carry out general and targeted supportive work in the community to prevent or reduce communication difficulties from developing.
  • participate in research and development and student therapist training.

We work with other professionals in health, education, and social care services as well as with voluntary and charitable organisations.

Our service

Pre-school Team

Speech and language therapists from the Pre-School Team work with children who are under statutory school age (Reception class age) and their families who present with a range of speech, language and communication needs.

Therapists will complete an assessment of the child’s needs and provide tailored advice and strategies to their families and other caregivers to support their speech, language and communication development. This may be face-to-face or virtually.

Current waiting times:

Initial appointment = up to eight weeks

Follow-up appointment = up to five months

We apologise for the impact this wait may have on your child and family at this time. Please be assured that we are working hard to reduce these waiting times. 

Pre-school Special Needs Team

We also have a small team of therapists who work with babies and children who have complex and specialist communication needs. Input may be delivered in 1:1 sessions, in groups, or by providing tailored advice, strategies and training. This may be face to face or virtually.

Current waiting times:

Initial appointment = up to eight weeks

Follow-up appointment = up to five months

Speech and language therapists from the Mainstream School Team provide a consultative service to children and young people (CYP) who are over reception age and above.

They work with CYP who present with a range of speech, language and communication needs. Therapists will complete an assessment of the child’s needs and provide tailored advice and strategies to support families and education staff to support their speech, language and communication development.

Current waiting time:

Initial appointment = six to eight weeks

Follow up appointment = n/a

Speech and language therapists work with children and young people who stammer. Input may be delivered in 1:1 or group sessions or by providing tailored advice, strategies and training. This may be face to face or virtually.

Current waiting times:

Initial appointment = 6 weeks

Follow up appointment = 6 months

We apologise for the impact this wait may have on your child and family at this time. Please be assured that we are working hard to reduce these waiting times.

Speech and language therapists work with children and young people who have difficulties with speech sounds (pronunciation) or voice where this is affecting their communication skills.

Input may be delivered in 1:1 sessions or by providing tailored advice, strategies and training. This may be face to face or virtually.

Current waiting times:

Initial appointment = 8 weeks

Follow up appointment = 8 months

We apologise for the impact this wait may have on your child and family at this time. Please be assured that we are working hard to reduce these waiting times.

Speech and Language Therapists work with children and young people who have an Education, Health and Care Plan and attend a Hounslow Specialist Centre/Unit.

Due to commissioning arrangements in Hounslow, Education Speech and Language Therapy no longer provides therapy input (communication needs) for the Special Schools, including Oaklands, Lindon Bennett, Marjory Kinnon, Cedars and Woodbridge (including specialist nursery settings). 

Speech and language therapists work with babies, children and young people who have an unsafe swallow (dysphagia) and associated difficulty feeding.

Input may be delivered in 1:1 sessions or by providing tailored advice, strategies and training. This may be face to face or virtually.

This is not an emergency service, and if you have any immediate / serious concerns, i.e. if your child/ infant is presenting with any of the signs below when feeding you are advised to contact your GP to seek help and advice or attend your local A&E (emergency department):

  • coughing/ choking
  • changes to colour
  • changes to breathing pattern
  • eye watering

Current waiting times:

Initial appointment = six weeks

Follow up appointment = six to eight weeks

We are currently recruiting to this specialist post. Children continue to be seen by our experienced Speech and Language Therapy Team.

Children with a diagnosis of moderate to severe bilateral, sensori-neural hearing loss and also have speech, language and communication needs are seen by the specialist speech and language therapy team.

Input may be delivered face to face or virtually in 1:1 sessions, in groups, or by providing tailored advice, strategies and training and in close liaison with the Teachers of the Deaf.

Current waiting times:

Initial appointment = six weeks

Follow up appointment = six to eight weeks

Speech and language therapists across the service support children and young people with social communication difficulties or Autism Spectrum Disorder.

Social Communication Pathway

For individual queries on waiting times for assessment for autism, please contact the Social Communication Pathway Coordinators:

Email: hrch.socialcommunicationpathway@nhs.net

Tel: 020 3771 5983

Useful links

Social Communication Pathway

The video below is for parents of children who are on the social communication pathway (otherwise known as the autism pathway).

It explains the process we follow in Hounslow in this video.

NHS: Help for families of autistic people 

This website has useful tips, advice and further links from the National Health Service.

National Autistic Society 

For safe, accurate and up to date information on autism, including support, guidance, and advice, as well as information on campaigning for improved rights, services and opportunities to help create a society that works for autistic people.

Hounslow Youth Justice Service (YJS) conducts routine screenings of young people's speech, language, and communication skills. If a young person presents with speech, language, and communication needs they are offered tailored support during their time with the service.

Input may be delivered directly by the Speech and Language Therapist (SLT) in 1:1 sessions or groups. Support is also given by providing tailored advice, strategies and training to families, case officers, and other YJS specialist staff as well as external organisations such as schools, CAMHS, and social care.

The aim of the YJS Speech and Language Therapy Service is for young people to be able to access the important work delivered within the YJS service, and to take away effective skills and strategies to support them to be capable and confident communicators.

Advice

AAC refers to tools such as communication boards, books, signs & devices that supports someone to communicate.

AAC supports people who are not using spoken language to communicate for all the reasons they need to.

We all use forms of AAC to help us communicate (e.g. gestures, texts etc.)

To find out more, please download these handouts:

Bilingualism is the ability to understand and/or use two or more languages. The term therefore encompasses ‘multilingualism’ which is the knowledge and/or use of several languages.

To find out more please download our handout: Bilingualism advice handout (Hounslow SALT).

For more information on Bilingualism please visit these websites:

Bilingualism Clinical Excellence Network

Literacy Trust

NALDIC | EAL National Subject Association

Children learning more than one language - Speech and Language UK: Changing young lives

Down syndrome is a naturally occurring genetic condition caused by an extra chromosome.

To find out more information about Down’s Syndrome and about ways to support children and young people with Down’s Syndrome, please visit these websites:

Downs Syndrome Association

See and Learn - educating children with Down syndrome

21&Co 

High 5 Pack

The High 5 Pack includes a Parent Information Presentation and some Family Activity Ideas to inspire you to do some everyday activities a bit differently.

We share some strategies to help you focus on your child’s speech, language and communication development while you have fun together as a family.

Watch our video presentation to find out more

High 5 Pack resources

Family activity ideas (large document)

Strategies and advice handout

Managing my feelings

Watch this video for strategies to support your child to manage their feelings here.

Using visual support

Watch this video to learn about different types of visual supports and how they might benefit your child here.

Visual support resources

Learning Language

We think children use two ways to learn language.

Analytic Language Processors (ALP) who tune into single words in a sentence.  They develop language starting with single words and building up to sentences.

Gestalt Language Processors (GLP) who hear intonation in language and focus on melody. They develop language by starting to say whole chunks of language and then breaking the chunks down into single words before putting them together in new ways.

To find out more information about Gestalt Language Processing (GLP) and ways to support children and young people who are GLP, please visit the Meaningful Speech.

Developmental Language Disorder

Developmental Langauge Disorder (DLD) is a type of speech, language and communication need that affects the way that children/young people understand and use language.

To find out more please download our handout:

Developmental Language Disorder (DLD) – Hounslow SALT 

For more information about Developmental Language Disorder (DLD) and ways to support children and young people with language difficulties, please visit these websites:

RADLD - Raising Awareness of Developmental Language Disorder

NAPLIC | NAPLIC

DLD | Developmental Language Disorder | Language Disorder

Afasic

Preschool effective communication videos

The videos below share strategies we recommend to families who want to support their preschool child to develop their speech, language and communication skills.

Language and communication: Watch this video here for strategies to support your child’s language and communication skills

More information about effective communication

Following your initial appointment with our team you might be asked to complete this parent assessment tool: how and why is my child communicating?

Speech sounds

Watch this video here  for information on the typical development of speech sounds and strategies to support children who need help to develop their speech sounds.

More information about speech sounds

Following your initial appointment with our team, you might be asked to complete this parent assessment tool: speech intelligibility.

Dysfluency: Watch this video here for information on stammering and strategies to support children who need help to become more confident and effective communicators.

More information about dysfluency

​​​​Following your initial appointment with our team, you might be asked to complete this parent assessment tool: stammering.

We have created videos to give advice and support with getting ready to start school. 

Attending to learning: watch our video here.

Resources:

Visual support video (Hounslow SALT)

How to use objects, pictures and signs (BBC Tiny Happy People website)

  • Making myself understood: watch our video here.

Resources:

Talking about my day video: watch our video here

Selective mutism (or situational mutism) is a term used to describe children and young people who are able to talk comfortably and freely in some situations (usually at home with family and close friends) but not in other situations (usually with less familiar people outside of home).

Selective Mutism is a phobia of speaking. Children and young people with Selective Mutism may:

  • become more anxious when under pressure to speak.
  • freeze and be unable to communicate with words or gestures.
  • whisper or say very few words.
  • look blank and expressionless and find it difficult to look at you when anxious.
  • avoid situations that trigger anxiety.
  • be very sensitive to the reactions of others – they may misinterpret these reactions.

Information and advice

Selecting Mutism handout (Hounslow SALT)

Further information and online resources to explain Selective Mutism can be found here Selective Mutism Information & Research (SmiRA Website)

Creating a supportive environment

Selective mutism dos and don'ts (Hounslow SALT)

The Do’s and Don’ts When Interacting with a Child with Selective Mutism (YouTube)

Personal experiences

Selective mutism: personal stories (Hounslow SALT)

Selective Mutism in the words of People with Selective Mutism (ISpeak Website)

Life Stories (SmiRA Website)

 

What is stammering?

Stammering (or stuttering) is when someone:

  • repeats sounds, syllables or words e.g. “mu-mu-mu-mummy”
  • stretches sounds e.g.  “mmmmmummy”
  • attempts to say a word but no sound comes out.

You may also notice that the person makes physical movements when they are trying to get their words out e.g. stamping feet, shifting position, moving head, blinking, tapping fingers.

Stammering can vary at different ages and in different situations for children and young people.

About 5% of young children experience some disruption with their fluency while they are learning to talk, especially when they feel under pressure to communicate. However, many of these children will go on to be fluent speakers without intervention.

What causes stammering?

No one knows exactly what causes stammering, but we know that it is not caused by anxiety, nervousness, laziness or low intelligence.

We know that it can be affected or influenced by a range of factors such as:

  • Personality/emotional state (while not caused by anxiety, children or young people can stammer more when they are anxious, tired, unwell or under stress)
  • Speech and Language skills (stammering tends to start when young children are developing their language skills rapidly e.g., between 2 – 5 years.)
  • Gender (stammering is more common in boys than girls)
  • Speech motor skills (adults who stammer have slightly less efficient speech motor skills. Researchers are looking at whether this is the same for children who stammer)
  • Genetics (stammering has been found to run in families)
  • Environment (some people stammer more in pressured situations, like speaking in front of a lot of people or when everyone talks quickly, and the conversation is fast.

We know that stammering is not caused by a child or young person’s environment, however making changes to their environment can help to improve their fluency.

What can you do to help?

Here are some ways we can support children and young people who stammer to be confident and effective communicators:

  • Give specific praise. Using specific words when praising helps children and young people to generate a positive image of themselves. The praise ideally includes two components: a description of the action and a word or phrase which summarises the child/young person’s attribute e.g. ‘I notice you tidied your room’, that was very helpful of you’. This enables the child or young person to consider themselves to be a helpful person.
  • Reduce negative language when talking about a stammer. Using negative language can reinforce negative thinking a child or young person may have about their stammer. A positive approach will support children and young people who stammer to become confident communicators and live happy and successful lives.
  • Encourage and support turn-taking in conversation. This will allow a child or young person to feel they are being listening to and have plenty of time to respond, which will encourage them to relax and take their time.

When to seek advice?

There are certain factors which make a child more vulnerable to stammering.  You may want to consider seeking advice and support if they:

  • Have been stammering for over 1 year.
  • Have a stammer that has been getting worse.
  • Have a family history of stammering.
  • Have moments of stammering that appear to be very tense.
  • Are aware or concerned about their speech.
  • Give up on what they’re trying to say or avoid speaking in certain situations.
  • Have other speech, language or communication difficulties.

Information and Advice

Stammering advice handout (Hounslow SALT)

Stammering teens advice handout (Hounslow SALT)

Stammering schools advice handout (Hounslow SALT)

Dysfluency Clinic Parent Workshop - Vimeo

Dysfluency Clinic Young Person Workshop - YouTube

For more information and advice on stammering for parents and education staff please refer to Michael Palin Centre for Stammering

British Stammering Association

International Dysphagia Diet Standardisation Initiative

The International Dysphagia Diet Standardisation Initiative (IDDSI) is a global standard with terminology and definitions to describe texture modified foods and thickened liquids used for individuals with dysphagia of all ages, in all care settings, and for all cultures.

The IDDSI framework consists of a continuum of 8 levels (0-7). Levels are identified by text labels, numbers, and colour codes to improve safety and identification.  The standardised descriptors and testing methods will allow for consistent production and easy testing of thickened liquids and texture modified foods.


The Communication Trust

The Communication Trust is a collaboration of charities who works with children and young people in England to support their speech, language and communication. This website has resources for parents with suggested activities to support children’s speech language and communication development.

Afasic Voice for Life

Afasic is a parent-led organisation to help children and young people with speech and language impairments and their families. They provide information and training for parents – and professionals – and produce a range of publications. Members meet in local groups in many areas of the UK. Parents can access useful practical advice with games and activities to help children develop skills and language within the ‘Help at Home’ section.

ICAN 

ICAN is a charity whose mission is that no child should be left out or left behind because of a difficulty speaking or understanding. Their vision is a world where all children have the communication skills they need to fulfil their potential.

NAPLIC 

National Association of Professionals concerned with Language Impairment in Children (NAPLIC) is an association for all professionals concerned with children who have speech, language and communication needs (SLCN).

RADLD

A campaign created to raise awareness of developmental language disorder

Tiny Happy People

Tiny Happy People, to help you develop your child's language skills. Explore  simple activities and play ideas and find out about amazing early development.

The British Stammering Association 

This website provides information, resources and support to those who stammer as well as those close to them such as family, friends, educators, employers and colleagues. A webchat and free confidential and anonymous helpline are available for advice on 0808 802 0002, open weekdays 10am-12pm and 6pm-8pm.

There is also a ‘Your Voice’ section which includes stories from parents of children who stammer, some who stammer themselves and others who don’t.

Michael Palin Centre for Stammering  

This website offers information and help for children, young people who stammer, their families and their teachers. It offers top tips on ways to support fluency.

A helpline is available weekdays, 9am-5pm on 020 3316 8100

Mommy Speech Therapy Blog

This blog/website has lots of information, resources and ideas on how to support a child’s speech sound development, as well as s for other speech, language and communication needs.

National Deaf Children's Society

“We’re here for every deaf child who needs us – no matter what their level or type of deafness or how they communicate.” 

On this website you can find a range of information and activities, including how to support your child’s speech and language and information on glue ear. 

Referrals

We have an open referral system – anyone, for example, parents, health visitor or school nurse, GP, school, nursery or children’s centre staff can refer a child or young person.

Referrals will only be accepted if the child has a Hounslow GP and consent is obtained from the parent or main caregiver.

Schools must include a Language Screener alongside the referral and information on the targeted interventions that have been implemented over two terms to support the child or young person’s language and communication needs. Please note, only a language screener is required for children with speech/dysfluency as primary need.

Hounslow SLT School age Referral Form

Referrals to the Dysphagia Service are only accepted from medical professionals.  Referrals should be made where there are signs of an unsafe swallow.  Referrals relating to issues with texture progression during weaning or with rigid and restrictive texture/ taste preferences do not meet the criteria for accessing this service.

If you are concerned about your child’s swallow safety and they are showing signs of:

  • Coughing/ choking whilst eating/drinking (happening regularly i.e. several times every day)
  • Changes to colour (face going red or pale) when eating/ drinking
  • Eye watering
  • Wet voice immediately after eating/ drinking
  • Changes to their breathing pattern during and after eating/drinking

Please contact your GP to request a review and discuss referral to the Dysphagia service.