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Speech and language therapy

Communication development starts from the moment a child is born and is a process that never stops.  Developing language in the early years is particularly crucial because without good language skills, deaf children will struggle to develop in the same way as other children, to access education and to become independent. Speech and language therapy aims to help all children to communicate as well as possible. 

Speech and language therapy aims to help all children to communicate as well as possible, and develop their speech and language skills. A speech and language therapist will work as part of a team with your child’s audiologist, Teacher of the Deaf, teaching assistants and other professionals to help your child.

A speech and language therapist can:

  • assess how well your child’s speech, language and communication skills are developing
  • identify if your child is experiencing any difficulties and the reasons why
  • develop a plan to address those difficulties and work with you to carry out the plan
  • give advice on your child’s progress and the next steps
  • work with teaching staff to support language-based aspects of the curriculum.

Speech and language therapists can help with different aspects of communication, including:

  • pragmatics – using and understanding language in social situations
  • verbal skills – understanding and using spoken language
  • non-verbal skills – communicating using signs and gestures, body language, turn-taking
  • expressive skills – getting a message across, verbally or non-verbally
  • comprehension or receptive skills – understanding of spoken language and sign
  • voice skills – controlling volume, quality and pitch
  • speech – pronouncing sounds and words
  • literacy – developing an awareness of letter-sounds and language skills that are specifically related to reading, spelling and to understanding written text.

Some speech and language therapists will have done extra training to work with deaf children, and/or may also be able to communicate in sign language. These specialists can be employed by local services/charities or can be contacted through the Royal College of Speech & Language Therapists. These specialists may help the local therapists to plan therapy programmes for the child, or, in some cases, they may see the child themselves.

Some highly specialised speech and language therapists also support children with eating and drinking, particularly if your child has difficulties with swallowing, for example, if your child has additional needs as well as deafness.

There are over 13,000 speech and language therapists working in the UK. Many of them are employed by the NHS, but some work for education authorities, individual schools, charities or privately.

The speech and language therapist will spend some time assessing your child. Assessment involves collecting information about your child’s communication development, their hearing needs, your family and the environment. This helps the therapist to discuss with you what happens next and then decide an action plan.

Assessments can be informal or formal. Informal assessments involve the therapist watching your child playing and interacting, as well as asking you and any other adults who know your child well for information. Formal assessments use tests to compare your child’s communication to that of other children.

The best assessments should give you a complete picture of your child’s strengths and needs, and an idea of how you can help. Your wishes and the wishes of your child, (if they are old enough), should be taken into account when planning actions.

The speech and language therapist will write a report describing the findings of their assessments. Ask for a copy of this report and don’t be afraid to ask if you’re not quite sure what things mean.

Examples of questions that you might ask

  • Where is my child up to? (How are they doing?)
  • What will they do next?
  • What do other professionals working with my child need to do? How will they know?
  • What can I do to help? Are there any activities I can do at home to support my child’s speech and language development?

Download and pass on our resource for education professionals on the different assessments that is available for assessing and monitoring the progress of deaf children and young people in communication, language and listening.

Examples of support from speech and language therapy

Speech and language therapy comes in different shapes and sizes to suit your child’s needs. Some examples are:

  • assessment and advice, plus programmes for school staff and parents to carry out
  • regular reviews at home or school with the speech and language therapist, updating targets and strategies following discussions with the family and teachers
  • a course of intensive speech and language therapy to work on specific targets, carried out by a speech and language therapist or a specially trained speech and language therapy assistant
  • group or paired sessions with other children – children can really benefit from group sessions to help them to learn to listen, take turns and take part in discussions with other children. Your therapist should already have taken steps to make sure that your child will be able to understand the contributions of others
  • parents invited to attend a course about communication development and how to help
  • support and coaching for parents to build targets and strategies into everyday routines
  • ongoing speech and language therapy at school, particularly if your child is in a special school or a mainstream school with specialist provision for deaf children.

For children who go to school or nursery, the speech and language therapist should be working closely with all education professionals, for example, the Teacher of the Deaf, support assistants and class teachers, to make sure that speech and language therapy targets are built into school work and everyday activities, both at home and out and about, to give the child as many opportunities as possible to learn and practise.

Working with your child’s speech and language therapist

  • Let the speech and language therapist know about your child’s likes and dislikes, hobbies and interests – they may be able to include them into therapy.
  • Share important events that may encourage conversation. Let the therapist know about the happy and sad events which may affect your child.
  • Ask your therapist questions about your child’s communication and the targets for therapy.
  • Get involved in your child’s therapy sessions, and ask the therapist for games and activities you can use in everyday life.

Remember, you’re the most important person when it comes to developing your child’s speech and language skills and communication; there are a lots of different things you can do at home to support them. Download or order our booklets for ideas and tips.

Helping Your Deaf Child to Develop Language and Communication (0 to 2 years)

All Teachers of the Deaf will have had training on supporting deaf children’s language development and will be able to give you advice on what you can do at home to make sure your child makes good progress. They’ll also be able to advise staff working in any early years settings that your child goes to.

A speech and language therapist will have had more specialist training on speech and language. In particular, they will be able to provide specialist advice if your child is struggling with their speech or language beyond what would normally be expected, or if your child isn’t responding to any of the actions taken by your Teacher of the Deaf. They may also be able to carry out more specialist assessments of your child’s speech and language needs.

Teachers of the Deaf and speech and language therapists work together closely to meet the needs of deaf children and, in some areas, they work together in the same team in the local authority.

If you’re concerned about your child’s speech and language development, talk to your Teacher of the Deaf, GP, health visitor or nursery staff to ask if your child needs a referral to a speech and language therapist. Or, you can contact your local speech and language therapy service yourself – contact your local NHS provider and ask for the number. You can find the number for your local health provider online, in the phone book, or from your GP.

Alternatively, if you live in England, you can look at the Local Offer for your area. The Local Offer should be on your local council’s website.

Some parents have told us that they sometimes find it difficult to get an appointment with a speech and language therapist. This could be because, for example, there are too few therapists in your area. If you find this is an issue, you can ask for help from other professionals, such as your GP or Teacher of the Deaf in getting an appointment. You could also make a formal complaint using the complaints processes for your local NHS provider.

If your child is having difficulties with speech and language or accessing support and this is affecting your child’s education, you should talk to your child’s school or Teacher of the Deaf. The school may try to provide support from within the school’s own resources.

However, if this isn’t effective, you may want to consider whether the child’s need for specialist support should be formalised in an Education, Health and Care (EHC) plan (England), a statement of special educational needs (England, Wales and Northern Ireland) or a coordinated support plan (CSP) (Scotland).

These are legal documents that describe your child’s special educational needs (or additional support needs in Scotland). They set out the provision required to meet those needs. You may not need an EHC plan, statement or CSP to access speech and language therapy, but parents’ experiences in this area can vary. In Scotland, some children may receive support through a Child’s Plan instead.

If your child does have a plan/statement, it’s important that speech and language therapy is ‘quantified’. This means that it should be clear on:

  • who will provide the support (for example, a speech and language therapist or another professional)
  • how it will be provided
  • the amount of therapy provided (for example, the numbers of hours each week).

Some parents have told us that if the plan/statement is not quantified it can lead to confusion and to arguments with the local authority over how much support should be provided. For example, stating that support will be provided by ‘an appropriate professional’ at ‘regular intervals’ is less specific than saying that support will be provided by ‘a qualified speech and language therapist’ for ‘x hours a week’ or ‘xx number of sessions lasting x hour(s) each.’

Which part of the EHC plan or statement should speech and language therapy go in? (England, Wales and Northern Ireland)

If your child has an EHC plan or statement, it’s important that information about your child’s speech and language therapy is in the right part of the plan or statement. It should be in the section that covers education needs and provision and not the health or ‘non-education’ sections. This is because language and communication is seen as fundamental to how a child learns. Even though speech and language therapy is often provided by the NHS, it should still be viewed as educational provision.

If your child has a statement, speech and language therapy should appear in part 3 of the statement (covering special educational provision). If your child has an EHC plan, it should appear in section B (covering the child’s special educational needs) and section F (covering any special educational provision that the child requires).

If speech and language therapy provision is not in the right place in the EHC plan or statement covering educational needs, this means that the local authority (or education authority in Northern Ireland) is not legally required to make sure this support is provided.

The Child’s Plan (Scotland)

Under the Children and Young People (Scotland) Act 2014, a ‘Named Person’ (a lead professional who is responsible for identifying and coordinating any support that your child may need), may help you and your child to access support from speech and language services if they agree that your child would benefit from this. This will be set out in a Child’s Plan which sets out any ‘targeted interventions’ that your child needs.

If your local authority agrees that your child needs speech and language therapy as a targeted intervention, the law says that they must provide this unless it would be unreasonably impractical to do so.

Please note: Following a Supreme Court ruling in July 2016, duties on local authorities to provide a Named Person and produce Child Plans have not yet been formally introduced.

However, many authorities are already using this model, or are expected to be working towards it. Currently, the Scottish Government expects this duty to become law in 2018. For more information, visit the Scottish Government website.

If your child has one, the need for speech and language therapy may also be set out in a coordinated support plan (CSP), a legal document which set out the additional support needs that your child may need.

Changes to the special educational needs system (England, Wales and Northern Ireland)

In England, in 2014, the Government made a number of changes to the special educational needs system. Statements of special educational need must be replaced by Education, Health and Care (EHC) plans before April 2018.

Currently, Governments in Wales and Northern Ireland are proposing or starting to bring in a range of changes to the special educational needs system in each nation. These changes are expected to start to take effect from September 2018 in both Northern Ireland and Wales. It’s expected that it will take a few years before all the changes come into force.

“I’m not happy with the service I’m receiving. We’ve been waiting so long for an appointment.”

Ask to speak with the speech and language therapist or their manager so that you can discuss your concerns. Try to be as clear and specific as possible about what your concerns are. If the speech and language therapist works within education services, you could speak to the head teacher or the person responsible at your school for children with special or additional needs (known in England as a SENCO) about your concerns.

“I’m concerned that my child isn’t receiving the right kind of support.”

“I’m worried they’re not making enough progress.”

You can ask the local authority/education authority to carry out a statutory assessment of your child’s special educational needs.

“My child isn’t getting support even though they already have a statement.”

You should contact your local authority or education authority. It’s their responsibility to make sure that the provision set out in a statement/plan is made. This might involve commissioning a private therapist if the local speech and language therapy service is unable to deliver the provision. If the authority fails to make sure that provision is made, you could contact a specialist education lawyer to discuss the possibility of a judicial review.

The agreed support isn’t being provided and my child doesn’t have a plan.”

You should speak to the school and the therapy service to find out why. While you don’t have the legal guarantee of provision which a statement or plan gives, the school and the local authority are still required to use their ‘best endeavours’ to make sure that a child’s needs are met. If therapy isn’t being provided, in spite of the need for it having been identified, the only way to try to make sure that your child receives therapy may be for you or the school to request a statutory assessment for an EHC plan (England), statement (Wales/Northern Ireland) or CSP (Scotland).

Some parents wish to pay for private speech and language therapy for their child. If so, visit the Association of Speech and Language Therapists in Independent Practice website, to find one that is local to you. Make sure the therapist who works with your child has had the appropriate training and has experience of working with deaf children. You may want to ask the therapist how many deaf children they’ve worked with previously, and if they’ve gone on any short courses or training to support deaf children. If your child is a sign language user, you may want to find out if the therapist uses sign language, and if your child is at school, ask how the private therapist plans to liaise with the education team who support your child.

Speech and language therapist

Caroline, a speech and language therapist, explains how speech and language therapy can help children with a hearing loss.

We would like to thank the Royal College of Speech and Language Therapists for their contribution to the development of this information. 

Royal College of Speech & Language Therapists logo