Speech Therapy Referral Guide

• The child is hard to understand, even when the context of conversation is known.

• The child appears to have multiple sounderrrors (says 't' for 'k', 'w' for 'r', 'p' for 'f').

• The child deletes sounds at the beginning or ending of words ('at' for 'cat').

• The child has a slushy sound to their speech or mumbles their speech a lot.

• The child reduces consonant blends after 4 yrs ('poon' for 'spoon', 'pay' for 'play')

• The child has vowel distortion or cant say vowel sounds consistently

ARTICULATION: How sounds are formed. The chart below shows the typicaldevelopment of speech sound milestones. Preschool students should be 85-90%intelligible to unfamiliar listeners. Grade R students should be 90-95% intelligible tounfamiliar listeners. All older students should be 100% intelligible.

2-3 YEARS P B D M N H W

3-4 YEARS T K G NG F Y

4-5 YEARS V S Z SH CH J L

5-6 YEARS TH (VOICED) ZH R

6-7 YEARS TH VOICELESS

LANGUAGE: While articulation problems may often be obvious, language difficulties may take a little longer to identify. These are some areas to look for when considering a referral for a possible language delay.

• The child is having difficulty learning and retaining basic skills such as colors, shapes, letters, numbers (even after lengthy instruction and repetition).

• The child has difficulty following simple commands or directions.

• The child can not express their thoughts, feelings, needs, and wants.

• The child has obvious oral grammar errors that are not age appropriate.

• The child is behind in curricular areas (can’t seem to keep up with his/her peers, not related to socio-economic or environmental factors).

OTHER: Some additional areas of concern may include the following.

IMPORTANT: Multi-lingual children may have some language differences and will develop all languages being learnt at a slightly slower pace than single language speaker, this is not a basis for a referral (unless they are delayed in all languages).

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• Dysfluency (stuttering): This is when a child may repeat a sound/word multiple times or seem to get “stuck” on a word. They may “stumble” a lot in their speech.

• Hearing: When a child doesn’t seem to hear you, asks others to repeat what they said, wants to sit close to the speaker, or doesn’t respond to their name.

• Voice: When a child’s voice seems breathy, hoarse, or has a nasal quality. He/she may also speak too loud or too soft.

• Pragmatics (social skills): The child may have difficulty relating to adults and peers. Doesn’t seem to understand jokes, body language, facial expressions, etc…