How I work

How I work

How I work

How I work with early years settings to provide support for speech, language and communication development: information for child-minders, pre-schools and nurseries

Professionals working with pre-school children in early years settings have good knowledge of supporting the speech and language skills of children who are following the typical pattern of development. From my work with early years workers in numerous settings across different locations, additional advice is needed when the children don’t make progress with the support the staff put into place or children are known to the speech and language therapy service and are waiting to be seen but without a clear plan of action.

I was recently contacted by the manager of a local pre-school asking whether I could provide help with:

  • Children who had a speech and/or language delay and were already known to the local speech and language therapy service. These children were waiting for follow up appointments.
  • Children who the staff had identified as having a delay. These children had been supported by the staff and had made some progress. The staff were not sure whether they should be referred to the speech and language therapy service.

Before the visitHow I work

We organised a time for me to visit and the staff made sure all of the children that staff had raised concerns about attended. This involved some children coming in especially for that session.

All parents were aware that I was visiting and the parents whose children I saw for assessment gave specific consent for my observation. Parental feedback was very positive with parents reporting that they were delighted that the pre-school had taken a proactive approach to support their children.

What happened in the session?

The child and their key worker came to work with me. As this was a natural and familiar environment for the children, they were relaxed and happy. For one child, with more complex social communication difficulties, his mum was also invited to come into the session.

For each child, I was able to undertake a brief assessment and gather information from the key worker. The adult helped the child with the activities and I was able to see how the child communicated with a familiar person.

We spent time after the session summarising the outcome of the assessment for each individual child.

Following the session

A summary email was sent to the pre-school manager, outlining the actions I had suggested. This included specific information which would support a referral to the NHS speech and language therapy service, where this was indicated. Where resources were recommended (e.g. visual support, language programmes), these were also provided. I also provided email feedback to the speech and language therapist involved in the care of individual children (with parental consent).

How I workHow can these visits be funded?

The pre-school manager utilised higher level needs funding to pay for the visit. There was clear evidence of the benefit of using this funding source to directly support children with identified additional needs.

Future support – what next?

Through discussion with the pre-school manager we agreed that termly visits are ideal. This is enough time for staff to work on the targets suggested with a scheduled visit to ensure that these targets are updated to reflect the child’s progress.

Feedback from the staff:

“I think one of the main benefits is having precise information for us to make referrals that are accepted by Speech and Language.  Plus, of course, having strategies that we can use and regular progress checks.”


Consultation visits are charged at £300 (3 hours). This includes:

  • 1:1 assessment with up to 5 children (a key worker needs to be present with the child)
  • Parents can be invited to the assessment
  • A de-brief following the session
  • Support to develop a communication friendly environment
  • A summary email following the visit and resources or resource recommendations
  • Liaison with NHS/education colleagues

Please get in touch if you would like to discuss the support I can provide to children in your pre-school, nursery or child-minder setting.



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