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Supporting your Child with Speech and Communication


Speech and communication is a critical part of a child’s development and many parents have concerns about their child. Although children do develop at different rates, there are key milestones when young children begin to communicate.

The Royal College of Speech and Language Therapists report that 5% of children enter school with speech and language difficulties and some children will need help and support from a speech and language therapist.

Speech and language therapists assess and treat a person with specific speech, language and communication problems to enable them to communicate to the best of their ability.

Speech and language therapists can support children with a wide range of speech and communication issues, from speech sound issues to specific language disorders.

Early speech and language milestones

Children learn to talk at different rates however, it is natural to feel worried if your child seems to be a later talker compared to children of the same age. The following are some key milestones which can help parents to how talking develops and what happens when.

  • By 6 months babies will usually watch your face when you are talking and smile and laugh with you
  • By 1 year of age, babies will try and get your attention and and point or shout for something. They will start to understand words like ‘bye bye’ and will look at you when you speak
  • By 18 months, toddlers will understand some simple words/phrases, point to familiar objects when you ask them too and enjoy games such as ‘peek a boo’
  • By 3 years, toddlers will speak in sentences, stop relying on pointing at things and will understand ‘who’, ‘why’, and ‘what’ questions
  • By 5 years, children will be able to have conversations, will talk to other children, will be able to put longer sentences together and adults will be able to understand what they are saying

The charity Afasic, which supports and provides information for children and young adults who have speech, language and communication needs recommends watching out for:

For babies/toddlers:

  • Poor eye contact
  • Sometimes doesn’t seem to hear or pay attention when you talk
  • Not pointing at simple familiar objects
  • Understands and says fewer words than other children the same age
  • Not being able to understand anything or very little that your child says

For primary school aged children:

  • Needing to repeat things lots of times or you need to make instructions much simpler
  • Speech that is regularly difficult to understand
  • Regular frustration or giving up trying to tell an adult something
  • Regularly forgetting the words or missing out important pieces of information
  • A child of this age sounding muddled and disorganised in their talking
  • A child who doesn’t speak outside their home to certain people or in certain settings, and this continues for at least one month (2 months in a new setting)

    For older children:

  • Watches others carefully to know what to do
  • Always takes things literally
  • Has difficulty learning and remembering subject specific vocabulary
  • Talks in short sentences
  • Finds it hard to keep a topic of conversation going
  • Doesn’t adapt the way they talk to different listeners, for example friends, teachers.

Click here for overview of speech and communication milestones from Afasic

Types of speech and communication difficulties

Attention and listening difficulties

Some children have difficulty focusing on a specific task or concentrating on what they are hearing. These skills are important in the development of language. Children with attention and listening difficulties may:

  • Have difficulty sitting still
  • Appear distracted
  • Be constantly moving
  • Find it difficult to follow directions

This can impact on a child’s ability to learn and develop social skills.

Understanding language difficulties

This is also known as receptive language difficulties. Children will struggle to understand and again meaning from things they hear or read. Difficulties can include:

  • Struggling to follow instructions
  • Misunderstanding what has been asked or said to them
  • Struggling to understand what they have been taught in the classroom
  • Developing spoken language more slowly

Expressive language difficulties

This is also known as spoken language difficulties. Children expressive language difficulties may:

  • Be late to develop or have an absence of babbling or using words
  • Use a limited range or small number of words for their age
  • Use simple sentences
  • Have difficulty using grammatical rules in speech such as past tense

Developmental Language disorder (DLD)

A severe ongoing difficulty with talking and/or understanding what other people say – and for which there is no obvious cause. DLD can affect children across all areas of language and communication e.g. attention and listening, speech sounds, social interaction and the use and understanding of language.

The main difficulties include:

  • Struggling to find the words they want to say and structuring sentences. Children may sound as if they are muddled up when talking and may be difficult to understand
  • Struggling to understand the words used and instructions given
  • Retaining spoken information. It can take a long time for children to process and respond top what they have heard
  • Significant impact on a child’s ability to learn and access the curriculum, express themselves, participate in conversation, follow instructions and develop friendships

Selective mutism

An anxiety disorder characterised by a child being fearful to talk in certain situations. A child may be chatty at home but unable to talk in other places such as at school. If this is persistent and the child’ s inability to speak interferes with their education and development and the lack of spoken language is not as a result of a communication disorder, they are likely to be diagnosed with selective mutism.

This can impact a child’s learning as it will be difficult for school to accurately assess their learning, such as reading, for example. It also impacts a child’s ability to develop socially.

Social communication and interaction difficulties

Social communication and interaction refers to the ability to communicate and interact with others, for example taking turns in conversation, listening, use of appropriate gesture/body language/eye contact and playing with others. Children with a diagnosis of Autism often have social communication and interaction difficulties.

Children with these difficulties can:

  • Struggle to interact with children their own age and/or develop friendships
  • Misinterpret meaning through not understanding body language, tone of voice etc.

Speech sound disorder (SSD)

A child with a speech sound disorder has difficulty producing speech sounds accurately or difficulty using the correct speech sound in the right place.

Main difficulties include:

  • Having trouble producing specific sounds, long after children og the same age can produce them
  • Using a specific sound in the wrong place, for example, may use the ‘s’ sound also for all ‘d’ sounds
  • Impact on a child expressing themselves clearly or being understood
  • Impact on child’s literacy development particularly spelling
  • Child being frustrated or embarrassed when they can’t be understood


A neurological condition that impacts the fluency of speech. A stammer typically develops in early childhood – around 2 to 5 years. Around 8% of children will stammer at some point, but most will go on to talk fluently. Up to 3% of adults have the lifelong condition.

Stammering can impact a child’s willingness to speak, which in turn impacts all aspects of their life, including socially and academically.

Speech and Language therapists can also support children with a:

  • Hearing impairment
  • Cleft palate
  • Learning difficulty
  • Dyslexia
  • Swallowing difficulty

What you can do

If you are concerned about your baby or child’s developing communication, there are steps you can take:

  • Talk to someone who can help

This could be your GP, Health Visitor or school SENCO. They should be able to make a referral to speech and language therapy if they think it is necessary

  • Helping your child

There are resources and advise available for you to help your child and your GP, Health visitor or School SENCO may be able to signpost you to appropriate resources.

  • Leeds Children’s Speech and Language accepts referrals from parents and carers and anyone who has sought parent/carer consent for a referral to be made. There are guidelines to help: find your child’s age and consider their needs. The red row tells you if you should refer to Speech and Language.

CSLT Referral Guidelines update 2023.pdf

LCH SLT Contact and Referral (leedscommunityhealthcare.nhs.uk)

How are children with speech and communication difficulties supported in Leeds?

Children that are under 5 are usually seen at a clinic at one of the health centres across the city. School age children may be seen at a clinic but are often seen in their school setting. Many schools across Leeds buy in NHS speech and language services or pay for a private speech and language company to assess and work with children who have speech and language needs. This always needs parental consent.

The NHS speech and language offer is for children who have been assessed as needed speech and language therapy to be given a block of intervention, then discharged and can then can re-access services if needed.

Additional support from Leeds MENCAP

Speak to other parents with children with SEN and disabilities on our closed Facebook group.

Follow us on Facebook to hear about our upcoming events.

Check out the rest of our Family Support offer. We have:

  • Weekly Chats and Tots coffee morning
  • Family Support workers who can offer advice, signposting and support
  • Lots of tips and resources about speech and language on our website

Additional support and Resources:

This information is not affiliated with Leeds MENCAP.

Read about the role of a Speech and Language therapist here: Factsheet – Role of the Speech & Language Therapist – Communication Matters

Access Afasic’s website here: Home – Afasic

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