Speech Pathology Referrals

A Guide for Speech Pathology Referrals for Children up to Five Years

Are you a professional who works with children aged 0 to 5?

This referral guide is designed to help you identify children who may benefit from speech pathology services.

We invite you to view the following information when considering your next speech pathology referral.

If at 18 Months

• No clear words
• Not able to understand simple questions (e.g. Where is the ball?)
• Lacks interest in interacting with others
• Does not play early turn-taking games (e.g. peekaboo, rolling a ball)

If at 2 years

• Using less than 50 words
• Not putting words together (e.g. ‘push car’, ‘bye teddy’)
• Less than 50% of speech can be understood by an unfamiliar person
• When playing with toys tends to bang, drop or throw them rather than use them for purpose (e.g. cuddle dolls, build blocks)

If at 3 years

• Less than 75% of speech can be understood by an unfamiliar person
• Not using simple sentences (e.g. ‘no more drink’)
• No interest in pretend play or interacting with other children
• Difficulty noticing and understanding feelings (e.g. happy, sad)

If at 4 years

• Less than 100% of speech can be understood by an unfamiliar person
• Not able to follow directions with two steps (e.g. ‘Put your shoes away and get your hat’)
• Unable to count to five or name a few colours
• Unwilling or unable to play cooperatively
• Not able to ask questions

If at 5 years

• Not using long well-formed sentences that can be understood by most people
• Not able to answer questions in a simple conversation (e.g. ‘What’s your name? • Who is in your family? What do you like to watch on TV?’)
• Difficulty telling a parent what is wrong
• Play is different to same age peers and friends

Other Referral Indicators (Any Age)

• Strong Parental Concerns
• Significant loss of skills
• Poor interaction with adults or children
• Lack of, or limited eye contact
• Stuttering
• Voice has hoarse/husky quality and/or high/low pitch
• Not achieving developmental milestones as per key indicators (left)
• Lack of response to sound or visual stimuli

Send a Referral

The details in this resource are not exhaustive and should not be relied on as a substitute for professional advice when making decisions about a child’s speech pathology needs.

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