Our Children's Therapy Toolkit has lots of ideas and general advice that can be used to help support children’s development. When making contact with any of the Therapy teams you will be encouraged to have a go at trying some of these ideas in our toolkit before considering whether a referral is needed.

If you are concerned about the child’s speech and language development and are unsure whether a referral to see a Speech and Language Therapist is needed, please consult the appropriate section of the Speech and Language Referral Checklist. This gives details of typical development from 9 months to 7 years and will indicate when a referral may be necessary.

Observation Advice/Action

Supporting transition and general classroom advice

General early development advice

Unable to sit without causing a disturbance or
fiddling/difficulty maintaining concentration

Easily excitable/frustrated and has difficulties
calming down

Can’t maintain an upright sitting posture for more
than 10 minutes

Trips and falls/bumps into people and objects

Low energy levels/poor stamina/gives up easily

Difficulties using hands and fingers during activities, including: handwriting and pre-writing activities and development of pencil grip

Difficulty using scissors

Difficulty coordinating two hands together
for an activity

Struggles with sequencing movements and with
organising self and belongings

Difficulties with dressing and undressing and
doing fastenings

Difficulties using eating utensils


Difficulty learning to ride a bike

Speech sound concerns: your child may sound
immature, may be difficult to understand, may
be changing or missing sounds in words.

  • Complete the Articulation Screener and refer for Speech and Language Therapy if they are not yet using all of the sounds expected for their age (please attach the completed Articulation screener)
  • Consult Speech and Language Referral Checklist for your child’s age. This details some sound errors expected for their age
  • Guidance for teachers administering the Phonics Assessment for children with speech sound difficulties available from The Communication Trust

Child is showing features of stammering e.g. repeating parts of words several times, ‘stretching’ sounds in a word, having difficulty getting started with no sound coming out for a period of time.

Advice available from:

Bilingual child with delayed language development

Follow these links for information and advice on bilingual language development.

Only refer for speech and language assessment if your child is showing a delay in their first language.  A delay in English as a second or third language does not require assessment from speech and language therapy.

Not yet using many single words

  • Discuss your concerns with your Health Visitor
  • Try some of the activities from the Creating Opportunities for Communication advice sheet
  • Refer for speech and language assessment if your child is still only using a few single words by 2 ½ years

My child is still using a dummy

My child has back/neck pain

Advice available from:
The Association of Paediatric Chartered Physiotherapists

My child has knee pain

Advice available from:
The Association of Paediatric Chartered Physiotherapists

My child has heel pain

Severs Disease

I am worried about my child’s walking

Gait anomalies in young children

I am worried that my child has bendy, clicky or painful joints and/or falls over easily

My Child has Down syndrome

Advice available from:

The Association of Paediatric Chartered Physiotherapists

Physical Activity 
Screentime health impacts on Children and Families