Speech and Language Therapy - Children (Richmond)

This section aims to give you tips and ideas for helping your young child’s speech, language and communication development at home. 

Emotional regulation

Emotional regulation is something we all need to learn effectively and maintain our wellbeing. Your child will be developing these skills and at this time may have particular difficulties regulating their emotions as they are outside of their usual routine.

Young children with speech, language and communication difficulties can have challenges identifying and expressing their emotions using language.

Zones of Regulation by Leah Kuyper’s uses a colour coded system to support students with this.

Zones of Regulation Explained

An advice sheet explaining The Zones of Regulation

Video resource

A video tutorial on Zones of Regulation 

Zones of Regulation Board

This Zones of Regulation Board can be used to show and remind your child of the different zones and the emotions that belong to them

Emotions Choice Board

These emotion cards can be used to support children to identify how they are feeling

Inside Out Zones of Regulation

The Zones of Regulation with Disney’s ‘Inside Out’ Characters

Zones Tools

These cut out ‘Tools’ cards can be used to support students to identify ways they can re-regulate and get into the Green Zone.

Language

Children with language difficulties can find it hard to understand instructions, express wants and needs to others, and use communication to play and interact with peers.

We have gathered together a selection of handouts with information, suggestions and tips for supporting children’s language in the home environment:

Talk about talking - an introductory talk for parents/carers

This video contains information about how language and communication develops, as well as tips and strategies for you to try with your child if you are concerned they are not developing their language and communication skills as you would expect compared to other children you know.

4Ss

This leaflet gives advice on 4 simple language-enhancing strategies you can integrate into your daily routines and communication with your child.

Special time

This leaflet gives advice on special time. Special time is a time for you and your child to engage in 1:1 distraction-free play to support with your child’s language development.

Strategies to support language and communication development

This leaflet gives a range of different activities you can try with your young child to facilitate their communication development. 

Early Imitation Skills

One of the most important ways that young children learn is through imitation of those around them.   This sheet gives you ideas of ways to explore imitation with your child.

Help me to communicate ‘before words’

This leaflet gives advice on how to support your child’s communication before they are using words.

Help me to communicate ‘with single words and phrases’

This leaflet gives advice on how to help your young child when they are starting to talk (e.g. labelling objects) and to extend these into sentences so that they can express what they want and how they  feel with other people.

Help me to communicate ‘with longer sentences’

This leaflet gives advice on how you help your young child when they are able to use sentences but need some help starting and joining in with conversations, listening and responding to others, coping with changes and managing emotions.

Developing language through play

These advice sheets give you top tips on how to develop your child’s language skills through play.

• Play advice
• Play and its importance

Increasing commenting

Making comments rather than asking lots of questions supports language development. This link will take you to a video with ideas on how to increase commenting

Tiny Happy People

The BBC have launched a website for families with young children – there are lots of activities on there that support language development grouped by age range – have a look and we’re sure you’ll find something new and fun to try at home. They also have an Instagram page you can follow: @bbctinyhappypeople

Aided Language Displays

Single page displays with core vocabulary for specific activities for students who have difficulty expressing their wants and needs using language:

• Information on Aided Language Displays
• Games and activities
• Home routines
• Learning activities
• Numbers
• Puzzle
• Week

Splingo’s Language Universe App – app for iPhone and iPad. 

This app costs about £5 and has fun engaging games for children to follow instructions from 1-4 key words.

Environment

The restrictions on social and structured activities outside of your home are likely to change your own and your young child’s routine for the short while. We want to support you to set up an environment within your home which facilitates your child’s communication development.

A Communication Friendly Environment at Home

This advice sheet gives top tips on how create a structured, predictable and low distraction learning environment.

Everyday routines

Everyday routines are great opportunities for your child to learn language and concepts. This sheet gives you ideas on how to support your child’s learning of language through functional activities.

Creating the opportunity to communicate

This sheet gives you ideas on how to create communication opportunities and optimise your child’s motivation to interact.

Now/Next Boards

Now/Next Boards is a simple and visual way to implement structure and predictability throughout your child’s day. Now/Next boards support children’s attention and listening skills. 

• How to use a Now/Next Board
• Now/Next Board

Visual timetables

Visual timetables are another way of supporting your child’s focus on the tasks at hand and supporting their understanding of the routine. You can cut out the ‘Daily Routine Symbols’ and place these onto the ‘Visual Timetable Template’. This can be used beyond learning tasks, for example, to support your child with their morning routine. 

• How to use a Visual Timetable
• Visual timetable for home
• Daily Routine Symbols

Special Time

This leaflet gives advice on special time. Special time is a time for you and your child to engage in 1:1 distraction-free play to support with your child’s language development.

Tips and resources for early communication development in babies

Communication starts developing even before your baby is born, so it is never too early to focus on communication. This section gives ideas on how to support your baby’s communication development between the ages of 0 – 18 months. Our ‘babbling babies’ resources below each give examples of how the same activity to support your child’s communication development can be adapted for 0-6 months, 6-12 months and 12-18 months.

• Special playtimes 0-6 months
• Special playtimes 6-12 months
• Special playtimes 12-18 months
• Bubbles
• Building Towers
• Copy cats 
• Keep a record of how your baby communicates
• I can be a…
• Making noise
• Musical instruments
• Noise is all around us
• Peek a boo
• Sharing a book
• Tickling
• Treasure baskets
• Traffic light system (shows you how to follow your child’s lead)

Social Communication - Parent information talk

Take a look at video below to find how to support your child to develop their language and communication skills. 

Social Communication - Parent information talk

Talk about talking - Getting ready for school

This video is specifically designed for parents of children with language and communication difficulties who will be starting in Reception year in September. It contains information about how language and communication develops, skills needed to access Reception year as well as tips and strategies for you to try with your child if you are concerned they are not school ready in terms of their language and communication skills.

Talk about talking - Getting ready for school

Part 1: Parent Talk 

Part 2: Initial Intervention Pathway 

Part 3: Review Pathway

Starting primary school is an important transition for children and young people with SEND and their families. Our transition pathway, which describes our role in the process is here:

Starting school

The document below explains what to expect from speech and language therapy if you live in Richmond or Kingston and your child attends a state-funded mainstream school in Richmond.

Richmond Mainstream Schools Service

This section will provide you with resources to support your school aged child's speech, language and communication skills. 

Mainstream School Resource Handbook

Our Mainstream School Resource Handbook contains advice, activities and general resources for education staff to use to support children with speech, language and communication needs who attend mainstream school. The handbook was designed with school staff in mind but contains resources that parents and carers may also find useful.

Emotional regulation

Emotional regulation is something we all require in order to learn effectively and maintain our wellbeing. Your child may have difficulties regulating their emotions outside of their usual routine, there are ways you can support your child to identify and regulate their emotions at home:

Label the emotion
“I think you might be feeling frustrated because this task Maths is difficult”

Empathise
“I feel annoyed too when I find something difficult.

Validate
“It’s OK to be frustrated”

Set Limits – If needed
“It upsets me when you push your work on the floor, because it means we need to print it out again”

Problem Solve
“Maybe we can try another activity, and come back to this when you feel calmer”

Children with speech, language and communication difficulties can have challenges identifying and expressing their emotions using language. Zones of Regulation by Leah Kuyper’s uses a colour coded system to support students with this. 

Zones of Regulation Explained

An advice sheet explaining The Zones of Regulation

Video resource

A video tutorial on Zones of Regulation 

Zones of Regulation Board

This Zones of Regulation Board can be used to show and remind your child of the different zones and the emotions that belong to them

Emotions Choice Board

These emotion cards can be used to support children to identify how they are feeling

Inside Out Zones of Regulation

The Zones of Regulation with Disney’s ‘Inside Out’ Characters

Language

Children with language difficulties can find it hard to follow spoken instructions, express their ideas clearly to others and keep up with the pace of interactions with others. This means that daily tasks can take longer for children with language difficulties and they can find learning challenging.

The handouts below contain information, suggestions and tips for supporting children’s language in the home environment:

Creating a Supportive Language Environment

This advice sheet gives parents advice on how to support their child’s receptive (understanding) and expressive language at home. 

Aided Language Displays

Single page displays with core vocabulary for specific activities for students who have difficulty expressing their wants and needs using language:

• Information on Aided Language Displays
• Games and activities
• Home routines
• Learning activities
• Numbers
• Puzzle
• Week

Aided Language Stimulation and Modelling

Take a look at the document above for advice on how to model Aided Language Displays and other Augmentative and Alternative Communication (AAC) systems.

Colourful Semantics Programme

Colourful Semantics by Alison Bryan is a colour coded visual approach which supports student’s understanding and expression of ‘wh-’ words (‘who’, ‘what doing’, ‘what’, ‘where’). This handout created by ‘London Speech Therapy’ will show you how to navigate through this programme.

Vocabulary Book

Encourage your child to identify key words they are learning about in their lessons and to fill out the word maps. The word maps reinforce students understanding of the meaning and sound of the word. 

Find the link between these words

These cut out cards can be used as a game to exercise your child’s ability to link words by their underlying meanings. This is an important skill for word learning. 

Story Planner

This Story Planner resource supports students to identify key information in a story and sequence this to create or recall a narrative.

Inferencing skills

This resource can be used to develop student’s inferencing skills (forming links between meanings which are not obvious). 

• Blank level questions 1 
• Blank level questions 2

Developmental Language Disorder (DLD) 

Developmental language disorder (DLD) is a type of speech, language and communication need (SLCN) that affects the way that children understand and use language. Take a look at the resources below for ideas on how you can support children and young people with DLD. 

Supporting Children and Young People with Developmental Language Disorder (DLD) - a toolkit for practitioners

Environment

At school your child will be used to a predictable, structured and sociable environment. With students learning in different ways (e.g. google classroom), and parents potentially working from home, we want to support you to set up an environment which facilitates your child’s communication and learning. 

Advice: Setting up the learning environment

This advice sheet gives top tips on how create a structured, predictable and low distraction learning environment.

Advice: Creating interaction opportunities at home

At school, your child will be used to a highly sociable environment where they mix with their peers and have opportunities throughout the day to interact. It is important to continue to create opportunities for your child to socialise. Please see top tips for how to create simple interaction opportunities within the home environment

Interaction Activities by STEM Learning

Please see ideas for more interaction activities by STEM Learning.

Now/Next Boards

Now/Next Boards is a simple and visual way to implement structure and predictability throughout your child’s day. Now/Next boards support children’s attention and listening skills. 

• How to use a Now/Next Board
• Now/Next Board

Visual Timetables

Visual timetables are another way of supporting your child’s focus on the tasks at hand and supporting their understanding of the routine. You can cut out the ‘Daily Routine Symbols’ and place these onto the ‘Visual Timetable Template’. This can be used beyond learning tasks, for example, to support your child with their morning routine. 

• How to use a Visual Timetable
• Visual Timetable Template
• Daily Routine Symbols

Task Planner

Task planners encourage students to break down task demands into smaller steps. This is particularly useful for students who have difficulty processing, retaining and understanding lengthy instructions

Space Reward chart

Identify a behaviour you want to reinforce, e.g. completing a non-preferred activity, requesting help etc. Then agree on a suitable motivator for your child. You can adapt this space chart to fit in with your child’s motivators. When you observe your child carrying out the behaviour you want to see, show them by ticking a star.  

Traffic Light System

Support your child to check their own levels of understanding of a task by regularly identifying what ‘traffic light’ colour they are. Agree with your child before they start their learning for the day what to do if they need help.

Stammering

Take a look at the 'Stammering at School' video in the 'Children who Stammer' section of the website to find out how to support children who stammer at School.

Starting secondary school and leaving school to progress to education, training or employment at 16 or 18 are important transition points for children and young people with SEND and their families. Achieving for Children provides help and support with the process of Preparing for Adulthood as part of their local offer. You can find out more here:

Achieving for Children 

If your child has an EHCP their link therapist will work with school staff to support them through these points of transition.  Our transition pathways, which describe our role in the process are here:

Starting Secondary School 

Post 16

Post 18 

Starting secondary school and leaving school to progress to education, training or employment at 16 or 18 are important transition points for children and young people with SEND and their families. Achieving for Children provides help and support with the process of Preparing for Adulthood as part of their local offer. You can find out more here:

Achieving for Children 

Starting a new school is an important transition for children and young people with SEND and their families. Our Special School and Specialist Resource Provision transition pathways, which describe our role in the process is here:

Starting School 

Starting Secondary School 

Post 16 

Post 19

This section contains specific information for children and young people with social communication difficulties or a diagnosis of Autism Spectrum Disorder.

Please also look at the sections which correspond with your child’s age above for more information on how to support your child’s emotional regulation, create a structured a predictable environment and support their language skills. 

Resources

People Games

When trying to build interaction routines with your child, you can try ‘people games.’

• People Games video (YouTube)

Now/Next Boards

Now/Next Boards is a simple and visual way to implement structure and predictability throughout your child’s day.

• How to use a Now/Next Board
• Now/Next Board     

Visual timetables

Visual timetables are another way of supporting your child’s focus on the tasks at hand and supporting their understanding of the routine. 

• How to use a Visual Timetable
• Visual Timetable Template
• Daily Routine Symbols

Take a look at the app below to access the 'Choiceworks' app where you can create and view visual timetables, schedules and calendars on an apple device. 

• BeeVisual Main Site

Attention Autism

To build attention play ‘attention bucket’ games and extend to stage 2 ‘Attention Autism’ by Gina Davies

• Attention Autism video (YouTube)

Social Stories

A social story is a short story written in a specific style and format which describes what happened in a specific situation and describes what people do, why they do it, what they think and feel and what the common responses are. Social stories can be useful for children who find social situations confusing and may have difficulty understanding neurotypical expectations of certain situations. 

• Writing a Social Story

Check out the link below to access a free app called "Stories Online for Autism (SOFA)" where you can create and read social stories on your phone and tablet. 

• SOFA - Stories Online For Autism - The Inspire Foundation

National Autistic Society    

The National Autistic Society has a wealth of information and support on their website including a Parent to Parent helpline

www.autism.org.uk  

Social Thinking 

Social Thinking by Michelle Garcia Winner is an approach for students who have solid language skills, but require support with their social communication. The approach provides students, their families and professionals with a shared vocabulary and frameworks in which to make sense of our own and others’ thoughts, feelings, and intentions in context.

www.socialthinking.com   

Parents often ask how they should respond if their child stammers.  

• When your child is talking show them you are listening and interested in what they are saying by nodding, waiting and giving them time.
   
• Avoid interrupting your child to finish their sentence or tell them to take a breath or slow down as this can add increased pressure for the child (although it is not intended!) 
   
• Parents are often worried about whether to comment on the stammer and may fear that making this will make it worse. If you child is having a particularly hard time it is okay to acknowledge this in a neutral and supportive way, e.g. “Oh that was a bit tricky wasn’t it! Well done, you got there in the end!"
  
  There is no need to give it a label, but showing the child that it is fine to mention it may help them to feel better about it.  If your child is not bothered then no need to mention it and just keep on listening, interacting and talking! 
   
• Set up special 1:1 times with your child (you may need to do this with all your children)  on a regular basis (at least 3x a week) and allow your child to choose the toy/game/activity and take the lead in the play. Make sure it is a time when you relaxed and not in a rush.    These 1:1 special times can be a nice way to have calm, quality interaction with reduced pressure. 
   
• You can play games as a family to help with taking turns in conversation and everyone to listening to the ‘speaker’.  You can make up stories together or talk about your favourite things. Please see attached ‘The Microphone Game’ sheet from the Michael Palin Centre.
   
• We know that slowing our talking down and pausing can help all of us to plan what we want to say, choose words we want to use and support our fluency and ability to communicate our message clearly.  Avoid telling your child to slow down, and instead, model slow talking and pausing in your own speech.  
   
• Support your child’ confidence and self-esteem by focussing on what your child doing well, giving praise and celebrating their successes. 
   
• Supporting your child to get enough sleep, eating a good meal, establishing a routine and slowing down their ‘pace of life’ can indirectly support their fluency.

Tips for talking to your child

Please see top tips for talking with your pre-school child from ‘The Stuttering Foundation’:

• Top tips video (YouTube)

Michael Palin Centre

Specialist centre for stammering - click on the parent advice section for further advice:

www.whittington.nhs.uk

Information and Advice for Parents

Please see Information and Advice Sheet for parents by the Michael Palin Centre

The Listening Game and The Microphone Game

These games are great ways to encourage your child to implement strategies to support their talking

• The Listening Game
• The Microphone Game

Stammering Information for Schools

Take a look at the video below to find out how to support children who stammer at School. 

Stammering at School

Important information: If at any time your child has difficulty breathing, in any way, you should contact NHS 111 or if an emergency, call 999. It is likely that a Paramedic would be sent to your home to advise on next steps i.e. either to go to A&E or you will be given further advice / strategies at home by the Paramedic or a home-visiting medic.  

SLT Feeding Team

Speech and Language Therapists (SLT) are experts in the anatomy, physiology and psychology behind the skills required for all aspects of eating and drinking. We provide assessments and support for those experiencing difficulties with eating, drinking or swallowing. When the ‘mechanics’ of eating, drinking or swallowing go wrong – this is known as dysphagia.

What is Dysphagia?

This is where a person may have difficulty with:

• keeping food or fluid inside their mouth
• moving food and drink around their mouth
• chewing 
• the act of swallowing

What are the risks?

When swallowing, the food or fluid should go down the food pipe (also known as the oesophagus); however, it may go down the ‘wrong way’ resulting in coughing or choking. This means the food or drink has entered the airway. If this occurs regularly, then it could signify a risk of aspiration (food or fluid entering the lungs) and could potentially lead to a chest infection or aspiration pneumonia.  

A person who has difficulty feeding and or maintaining a healthy weight, may require enteral feeding such as tube feeding i.e: Nasogastric tube (NGT) or Percutaneous Endoscopic Gastrostomy (PEG). This would only be recommended after other strategies have been trialled and always as part of a discussion with Parents, SLT, Dietitian and Consultant Paediatrician.

Resources

Recommendations for Dysphagia

This sheet provides recommendations for children with dysphagia (chewing / swallowing difficulties)

Cough & Symptom Diary

Please complete this diary if you have concerns about your child’s feeding and share the information with your speech and language therapist

Advice sheets

These advice sheets give information on how to support your child to move on to different textures of food:

• Advice on Textures
• Advice on Textures Purees
• Advice on Textures Finger Food
• Advice on Textures Moving on

Pacing strategies

This advice sheet gives you information on how to pace food and fluids slowly to support your child

IDDSI Information

The IDDSI framework has been developed to introduce standardised and consistent terminology internationally for modified diet and thickened fluids and to provide clear descriptions of these textures. 

IDDSI framework

The International Dysphagia Diet Standardisation Initiative (IDDSI) outlines the different consistencies for food and drink.  

IDDSI handouts

The International Dysphagia Diet Standardisation Initiative (IDDSI). This refers to the different descriptions for food / drink. Your SLT may recommend a modified diet if your child is having difficulty with a particular texture and also a particular ‘level’ of fluid may be required to minimise any risk of aspiration.  Your SLT would have given you specific advice for which level to follow.

Sensory-Behavioural Feeding Difficulties 

Sensory Behavioural Feeding Difficulties are when a person has an aversion to eating or drinking. This may be based on the sensory properties of food or can be caused by a negative feeding experience such as prolonged tube feeding. 

What is Fussy-Picky Eating?

Fussy picky eating can be part of normal development, and this is known as neophobia.  Each child is different, some may grow out of neophobia and for some children this may be lifelong.

What is Sensory-Behavioural Feeding Difficulties?

Some children demonstrate significant reluctance to trying new foods. They may avoid wet sticky foods like sauces on pasta and prefer only dry, crunchy consistencies such as bread sticks or they may prefer foods presented in the same way at each meal (known as food jagging). This may result in a very limited diet.  

What is Avoidant Restrictive Food Intake Disorder (ARFID)?

ARFID is a significant and extreme sensory-behavioural feeding difficulty. As described in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders-V, 2013), it includes:

An eating or feeding disturbance (e.g. lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) shown by persistent failure to meet nutritional or energy needs with one or more of the following:

• Significant weight loss (not always the case)
• Significant nutritional deficiency 
• Dependence on enteral feeding/oral nutritional supplements
• Marked interference with psychosocial function. 

It does not occur exclusively during the course of anorexia nervosa or bulimia nervosa and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced. It is not attributed to a co-existing medical condition or disorder. 

It is important to remember that the child is not being stubborn or difficult about food, but are experiencing a fear or anxiety around food.

Please remember:

It is important that you try not to worry. You really are not alone in this as so many children develop a degree of fussy-picky eating. Try and follow the professional guidance outlined below and if you are concerned that they are losing weight or are unusually lethargic, contact your GP as a referral to a dietitian may be required.

Your Sensory-Behavioural Feeding Journey

Please explore the image below to see how we can support you and your child on your sensory-behavioural feeding journey.

Strategies for Home and Education

Away From Meal Times:

• Encourage them to have fun with food by: 
  • Food preparation e.g. cutting vegetables for the family dinner with no pressure to eat
  • Helping with food shopping and putting shopping away
  • Making a shopping list. 
• Messy Food Play - this helps the desensitisation process as they are not expected to eat during this activity.

During Meal Times:

• Keep to regular meal and snack times. This helps to regulate the appetite.
• Try to eat as a family whenever possible, even if it is just once per week. This allows your child to see what and how you are eating
• Do not force-feed your child. This sets up a negative situation for both of you. We want eating to be a positive experience. 
• Try to serve the meal at the dining table, rather than plate up in the kitchen, so they can see the whole meal.
• Encourage your child to serve the food to others at the dining table. This is a desensitisation approach and enables them to interact with food from a slight distance.
• Try to offer multi-vitamins each day. These may be available from your Health Visitor or Children's Centre.
• Try to offer preferred foods that are already 'fortified'. This means that they will get some extra nutrients in their diet.

Resources

"Food Refusers course for parents" video

To help parents understand fussy-picky eating and sensory-behavioural feeding difficulties and provide further strategies. 

Sensory Play Toolkit

The fun way to help avoidant, picky or fussy eaters.

Food Diary

To help you identify which foods your child mainly eats.  It can also help to highlight which food groups may be missing from their diet.

Love it-Like it-Learning it Meal Planner

This is to help you meal plan and identify which foods to offer to try and expand their diet.

32 Steps to Eating

This demonstrates the different steps we all need to take before we will eat something

Matching Fun with Food

Another approach to encouraging your child to try something.

NHS Fussy Eaters

Advice with links to understanding challenging behaviours as well as meal planners.

• Fussy eaters - NHS Website

ARFID Awareness UK

This is specifically for children with significant sensory-behavioural feeding difficulties or who may have ARFID.  However, it has a number of resources for all those with challenging eating / limited diets.

www.arfidawarenessuk.org

Infant & Toddler Forum

This has a range of advice sheets on fussy-picky eating and although aimed at younger children, would benefit school-age children also.

• Infant & Toddler Forum website

Tiny Tastes

This is a reward based programme to help children try different foods.

• Tiny Tastes 

Speech sound screening tool

Click the text above to access our speech sound screening tool. 

Resources

Helping your child’s speech sounds

This is an advice leaflet containing strategies to support your child’s speech sound development.

Making music listening activities 

This is an advice leaflet containing a range of listening activities which will benefit your child’s speech sound development. This is aimed at younger children.

Developing listening skills for speech

This is an advice leaflet containing a range of listening activities related to making music to support your child’s speech sound development This is aimed at older children.

Referred families

You may have been advised to complete the All About Sounds Course by your Speech and Language Therapist, if this is the case please access the All About Sounds Movie and Dragonfly Sessions below:

All About Sounds movie

Click on this link to launch a video with information on how speech sounds develop as well as tips and strategies for you to try with your child if you are concerned their speech is not as you would expect compared to other children you know. 

Dragonfly Sessions

Please find here guidance on activities to try with your child to support their speech sound development once you’ve listened to and watched the All about sounds powerpoint presentation with narration

Session 1

There are 5 videos for this session. Please watch all 5 and try out the activities with your child. We advise you practise these activities with your child little and often (e.g. 5 minutes at least 3 times a week) for a few weeks before moving onto session 2. 

• Episode 1
• Episode 2
• Episode 3
• Episode 4
• Episode 5

Session 2

There are 4 videos for this session. Please watch all 4 and try out the activities with your child. Once you have watched both sessions, you can practise the activities from both sessions with your child little and often. You will start to notice changes in your child’s speech over the next few months.

Some of the changes will be very subtle so listen out for them – remember to praise any attempt your child makes to change the way s/he is pronouncing words. 

• Episode 1
• Episode 2
• Episode 3
• Episode 4

Our service works closely with parents, early year’s practitioners and teachers to encourage families to best support multi language development. 

The Royal College of Speech and Language Therapists (RCSLT) recognises that bilingualism in children and adults is an advantage. Using more than one language is something that should be celebrated, promoted and supported. Bilingualism stimulates brain development and helps children learn because they can think about their ideas in two (or more) languages.  

Please also look at the sections which correspond with your child’s age above for more information on how to support your child’s speech, language and communication skills.

Bilingualism key points

• Bilingualism does not cause or contribute to a speech, language or communication disorder
• Only you can teach your child your native tongue, you must be the one using this language around them
• Parents should use their strongest language with their child, this helps to build a good language foundation and the second language can then map on top 
• Speaking more than one language comes naturally to babies, whose brains are wired for all language, you can speak a range of languages to your child from birth 
• At a very young age a child learns to tell the differences between the languages used around them 
• If your child is mixing languages in a sentence (known as code-switching) this is a strength it shows that your child has a good knowledge of multiple languages 
• It is important to identify who speaks which language to your child – try to be consistent with this, your child will learn to associate who to speak which language to
• If you are confident in speaking your home language and English you can speak both languages to your child. It may help to allocate times or places to speak certain languages e.g. speaking one language at home and one language in the community or speaking one language when you are alone and one language when your partner or other friends/family are present
• Try to use both languages in a range of environments and activities so your child learns the range of vocabulary they need  - it may help to find a community group for your home language
• English as an additional language (EAL) Key Points: 
• If you are not confident in speaking English please use your native language at home, your child will be exposed to English at nursery and school - it is much more important that your child has a good foundation language for English to map onto 
• When your child is learning a new language it is common for them to go through a ‘silent period’. This is where they are taking in and understanding the new language around them before they begin to use it in their talking
• Visual materials may help a child learning English as an additional language in their nursery or education setting. They will be able to apply their knowledge from their home language to the visuals being used e.g. photos or symbols 
• Playing with other children and participating in a wide range of activities that encourage communication is the best way to support a child’s bilingual development 

When to refer

We refer children to our service under the same criteria for bilingual and monolingual children 
If there is a delay in your child’s first language and they are making limited progress with secondary languages it is worth seeking further advice.

You can contact our telephone advice line on 020 8614 5333.

Advice sheets

Biligualism - English as an additional language (ICAN factsheet)

This advice sheet is from the ICAN charity for children’s communication. It provides further information on frequently asked questions regarding bilingualism. This advice is suitable for early years and school aged children. 

Supporting bilingual children in early years settings (ICAN factsheet)

This advice sheet is from the ICAN charity for children’s communication. It provides further information on how to support children in early years settings learning multiple languages. This advice is suitable for early years foundation stage children (up to 5 years). 

Teaching your home language - top tips for parents (National Literacy Trust)

This advice sheet is from the National Literacy Trust for supporting early language development. It provides further tips on good communication techniques to support your child’s language development in your home language. This advice is suitable for early years foundation stage children (up to 5 years). 

Useful websites

National Literary Trust

Bilingual resources for early years children in a range of languages 

More information and advice sheets for bilingualism in the early years 

ICAN Communication Charity

Resources from the ICAN communication charity - click on the 'resources for speakers of other languages' drop down menu. You will then find their 'Talk Together' booklet for babies and toddlers in a range of languages. 

ICAN parent resources

This section contains specific information for children and young people with any degree of hearing impairment.

Our service works closely with other members of the multidisciplinary team including Audiology and teachers of the deaf to support the needs of your children.

Research supports early help and prevention for children with hearing impairment and therefore the Richmond service offers an early help and prevention service for a child identified with a permanent hearing loss who has been referred into the service prior to any communication delay being identified.

Please also look at the sections which correspond with your child’s age above for more information on how to support your child’s language skills and their emotional regulation skills as well as their speech sound pronunciation.

Glue ear

Glue ear is a very common childhood illness; it can affect one in five pre-school children at any one time. It results in a temporary fluctuating hearing loss.

How my child’s communication may be affected

• Attention and listening – may not respond to their name, may demonstrate difficulties maintaining attention.
• Social interaction – may begin to stop playing with others and prefer to play alone, may demonstrate a change in behaviour
• Receptive language (understanding) – may not follow instructions or respond to questions you ask. 
• Expressive language (talking) – may have a delay in their talking e.g. how many words they have compared to other children their age; may say ‘what?’ to you a lot of the time. 
• Speech (pronunciation) – may have difficulties hearing particular speech sounds, which can impact upon how the child learns to use the sound and therefore the clarity of their speech. 

Parental strategies for glue ear

• Get down to your child’s level and get eye contact with your child before speaking to them.
• Reduce background noise as much as possible (e.g. radios, TV, washing machine).
• Make their teacher is aware of your concerns and ask for them to sit at the front.
• Make sure you have their attention before speaking to them, by saying their name and touching them if necessary.
• Use gesture alongside language and encourage them to do the same.
• Slow your talking down rather than speak louder.
• If your child is struggling, use a shorter sentence. Repeat the main point again to make sure they have heard it.
• Ask your child to repeat back an instruction to check that they have heard it properly.
• Support verbal information with visuals e.g. gesture, Makaton, pictures
• See speech sound section for specific listening/speech based activities. 

Resources

Glue ear guide NDCS

This resource was produced by the National Deaf Children’s Society. It outlines more details about glue ear for parents.

Permanent hearing impairment

Babies and toddlers

It is important to notice communication attempts from your baby, these may be subtle (e.g. kicking legs), and then be sure to respond to these communication attempts. It may be useful to keep a record of how your child is trying to communicate with you.

Help my baby communicate advice sheet

This advice sheet gives a range of strategies to support your baby’s communication development. 

How is my baby communicating monitoring sheet

Use this resource to track how your baby is communicating with you, it may not be verbally. You can also track what this is in response to and therefore what your baby is motivated by.

University of Sheffield videos

This series of YouTube videos explore how babies learn to communicate as well as communication tips for supporting babies and toddlers with a hearing impairment.

Children

For older children with a hearing impairment, it is important to continue to consider environmental adjustments, especially minimising background noise, and also the communication partner’s communication style with the child.

Parents and school staff need to be aware of the impact of listening effort on a child with a hearing impairment.

It is also important for school staff to encourage and praise self-advocacy when a child has a hearing impairment, for example, the child informing staff that they did not hear something, the child informing staff that their hearing aid is not working. 

Resources

Strategies for parents of children with a hearing impairment – under 5yo

This advice sheet provides advice for parents with regards to environmental adjustments and communication style with a child with a hearing impairment. Mostly relevant for child under 5 years old. 

Strategies for parents and teachers of children with a hearing impairment

This advice sheet provides advice for parents and teachers with regards to environmental adjustments and communication style with a child with a hearing impairment. Mostly relevant for school-aged children.

Creating good listening conditions for mainstream schools NDCS

This resource was created by NDCS in 2016 to support mainstream teachers in ensuring they have good listening conditions for mainstream schools for children with hearing impairments to ensure they can fully access the curriculum.

Useful websites

National deaf children’s society

This website contains useful information for parents, children and young people and professionals.

Sound foundation for babies and toddlers

This website gives ideas on how to support your child’s early communication through everyday activities.

Tips and resources for Early Years Practitioners

This section is specifically for early years practitioners to support with children who have speech, language or communication needs in their setting. These resources can also be used universally to support all children within the nursery setting with their communication development. 
This section also recommends particular websites that would be relevant to early years practitioners.

Richmond Speech and Language Therapy information and practical advice for Early Years and Pre-School Settings

Take a look a the video above for practical advice on supporting speech, language and communication needs in Early Years and Pre-School Settings.

What to do if you have concerns about a specific child in your setting

•    If you have concerns about a specific child in your setting, it is important to raise these concerns with the child’s parent in a timely manner. The Communication Trust have created a video on their website that can support you with preparing for this conversation.  The Communication Trust advises that ‘the video is intended to be used as a professional development resource, to enhance confidence and skills in talking with parents about their child’s speech, language and communication development and skills’.​​​​​​​

The Communication Trust - A Professional Development Video: Talking to parents

•    You can contact the Richmond speech and language therapy early years setting advice line directly if you would like advice about whether a referral is appropriate – 020 8614 5333.