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Many parents contact us, asking for advice as to whether their child needs help with communication or for information on how to facilitate their child's speech language and communication skills. Some parents ask for a detailed assessment of their child's needs. Parents' reasons for contacting us have been many and varied:

• Some parents wanted an assessment of their child's language and communication skills and reassurance that their child did not have any problems with any aspect of communication. There is a wide range of normal development in some areas of speech and language development, such as linking words together, and it can be difficult for parents to know if their child has reached a point when he needs some help. Much needless anxiety is experienced as a result. On the other hand, many problems are solved very much more easily and quickly if help is given in the early stages, and many secondary difficulties such as emotional, social and educational problems are avoided.
• Many parents had concerns about their child over a wide range of aspects of speech and language development, from speech sounds to problems with reading or writing. Some parents could be re-assured that their child's development was within normal limits, to their great relief. Others however, needed a detailed assessment to identify the specific areas where their child needed help and specifically tailored, very detailed, step-by-step information about how a language programme could be used to help their child. If there is a problem, parents above all want to know HOW to help their child and what not to do. With the best will in the world, parents who are worried and who want to know what to do often take actions which actually make the problem worse.
• Most importantly, parents want to know what they can do themselves to help their child (and what not to do!).
• Parents want to know if there are likely to be any secondary consequences of their child's problem, such as emotional or behavioural difficulties, and if so how to understand and to minimise these. It's important to them to know what the long-term outlook is for their child. They also want to know the likely causes of their child's problem.
• Parents also need to know the point at which they need professional help for their child from a Speech and Language Therapist if their own help does not entirely solve the problem, and the urgency with which they need this help.
• Parents may need advice about the need for help from professionals other than Speech and Language Therapists, for example an opinion from a psychologist, orthodontist or other professional.
• Other parents want a detailed assessment of their child's identified needs with recommendations of the type of support that their child would benefit from to ensure they get the best available help. Some parents ask for an independent detailed assessment and a written report with recommendations to contribute to their child's educational assessment.
• Parents want specific treatment tailored to their child's individual needs with a programme of recommendations and advice for teaching staff in school.

Difficulties with speech and language development, which can cause problems with interaction and communication, understanding of speech, use of speech or speech sounds, are extremely common. They are in fact the most common childhood difficulties, affecting one in five of all children, and parents experience a great deal of anxiety as a result. That such difficulties are common is not surprising. What perhaps is surprising is the astonishing rapidity with which children can acquire language when all goes well! This development is amazingly complex and rapid, but requires a great many factors to be satisfactorily in place. Some of these are within the child, for example his hearing, and others are within the environment, such as the amount of background noise and the way he processes sounds and speech.

The areas of communication and language where a speech and language therapist can help are:

1. Speech sounds:
   1. single sounds such as 's' or 'sh'
   2. several or multiple sounds, leading to problems with intelligibility
   3. motor speech movements
   
   
2. Understanding speech:
   1. understanding words and sentences
   2. following instructions
   3. understanding inference
   
   
3. Expressive language:
   1. sequencing words together
   2. word finding and vocabulary
   3. sequencing and story telling
   
   
4. The use of language:
   1. conversation skills
   2. using language appropriately
   
   
5. Relating and communicating:
   1. interacting
   2. responding
   3. initiating communication
   
   
6. Social interaction:
   1. friendship skills
   2. social adaptation
   
   
7. Hearing
8. Attention and Listening
9. Reading and writing
10. Fluency and how it develops
11. Voice quality

The full range of assessments, advice and intervention services are provided by highly experienced and specialist speech and language therapist who are experts in their field.

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