This service provides a tertiary level second opinion service, specialising in the diagnostic assessment and treatment of complex speech sound disorders. The team has particular expertise in Developmental Verbal Dyspraxia (DVD), also known as Childhood Apraxia of Speech (CAS). The Nuffield Dyspraxia Programme Assessment and the treatment approach are used in our assessments and therapy.
We do not offer an assessment of ASD, ADHD, Developmental Language Disorder, Global Developmental Delay / Disorder, cleft lip and palate, sensorineural hearing loss or stammering.
Clinical services provided:
- Assessment: Children are seen in the multidisciplinary Paediatric Speech Clinic, for a joint assessment with a consultant doctor and a speech and language therapist. After the assessment a joint report is generated and we liaise with the child’s local speech and language therapist. According to need, some children will be offered a review appointment after the initial assessment and some may be offered treatment at our centre.
- Treatment: A specialist, time – limited service is provided with the aim of supporting the local speech and language therapist to meet the child’s needs. We also offer “diagnostic therapy” to explore the child’s speech difficulties in greater detail. It is important to note that primary responsibility for therapy provision remains with the local service.
• Weekly, individual therapy sessions
• Individual Intensive Therapy Courses – for 5 consecutive sessions, offered during the school holidays.
Therapy sessions are tailor-made for each child and the therapy approaches include:
• Nuffield Dyspraxia Programme
• Ultrasound Therapy
• Electropalatography (EPG)
Have a severe or persisting speech sound disorder which is not felt to be due to another condition, or in line with their overall developmental profile
- Be between 3 and 18 years of age
- Be able to participate in formal assessment, involving naming pictures and imitating sounds
- Have had at least one block of therapy targeting their speech
- Have verbal comprehension skills which are at least at a 3 year level on formal assessment, or a three information carrying word level
- Have at least 30 spoken words, used regularly and spontaneously
- Have had some assessment of their learning skills e.g. developmental assessment, educational psychology assessment or information/report from school staff. The results of this assessment must be discussed with parents/carers prior to referral
Please note that this is not a specialist second opinion centre for the assessment of developmental language disorders, social communication disorders including ASD, stammering, cleft palate, sensorineural hearing loss, or global developmental delay/disorder. Where another medical, developmental or learning issue is suspected, this should be investigated prior to referring to our Speech Clinic.
The family are seen by an experienced and Highly Specialist Speech and Language Therapist, and in some cases also by a Consultant in Audiovestibular Medicine. The appointment may last for up to 2 hours. Usually, the doctor will ask about the child’s health and development while the Speech and Language Therapist assesses the child’s speech (sounds). Please note that we do not formally assess understanding/use of language, nor social communication skills, in this clinic.
The doctor will examine the child, and he/she may have another hearing test. Following a short break, the doctor and therapist meet with the family to discuss the results of the assessment.
It may be possible to give a diagnosis, although referrers should note that it may not be appropriate to give a diagnosis to very young children, children with very limited verbal language, or children with complex conditions. We may recommend onward referral for other investigations.
Where possible we will make suggestions about therapy targets, and recommend the type of therapy provision we feel a child needs. However, it is the responsibility of the local service to determine how a child’s needs are best met. The local Speech and Language Therapist is welcome to come to the clinic, with the parent’s permission.
Our speech and language therapist will contact the local therapist by email to give feedback on the assessment. Please make sure we have an email address for the relevant SLT. We will produce a report including both medical and speech information, which will normally be sent to the referring SLT, GP and the parents. Our report may take up to 6 weeks. We do not produce reports/complete forms for EHCPs or SEND Tribunal hearings. However, parents may submit our reports as additional evidence. We are unable to attend review meetings or tribunal hearings.
Many children will be discharged from our service following the clinic. However, some may need to be reviewed by our speech and language therapy team, in order to update management advice and monitor progress. We offer limited therapy at this centre to explore therapy strategies and work on specific areas of difficulty. The responsibility for the child’s speech and language therapy remains with the local service.
Other contact information
Nuffield Paediatric Speech Disorders Clinic, Level 2
Royal National ENT and Eastman Dental Hospitals,
47-49 Huntley Street,
London, WC1E 6DG
Other referral information
Our clinic specialises in developmental speech disorders, with particular expertise in Developmental Verbal Dyspraxia. We offer a tertiary level service, therefore the responsibility for the child’s speech and language therapy lies with the local community service, who remain the primary Speech and Language Therapy care providers.
The speech clinic referral form should be completed by the referring speech and language therapist, and returned to us, accompanied by:
- Parent/carer case history form
- referral form
- GP letter supporting the referral, along with a GP print off/medical summary
- SLT reports
- any relevant medical and/or education reports
Referrals should be sent to by email: firstname.lastname@example.org.
Paper referrals are not accepted and will be returned to the referrer.
Please note that forms are essential for us to accept any referrals. If the forms are incomplete or do not accompany the referral, the referral will be rejected and returned to the referrer. The forms will have to be resubmitted for us to accept the referral.
Photographs of forms are not compatible with hospital patient electronic system. Documents should be scanned and sent via email.
Password protected forms should be accompanied by their password.
Please be aware that referrals that do not include all the required information will be returned to the referrer. We regret that we are unable to discuss referrals. However, we hope that the referral form and these guidelines will answer any queries. Referrals are checked by a speech and language therapist and consultant and they are accepted/rejected on the basis of our referral criteria.
The referrer will be sent a letter if the referral is rejected and the referrer will be advised about it. Please note that we do not send letters of acknowledgment for your referral letters.
The following websites provide information on Developmental Verbal Dyspraxia or Childhood Apraxia of Speech.
Apraxia Kids: www.apraxia-kids.org
Royal College of Speech and Language Therapists’ Policy Statement on Developmental Verbal Dyspraxia: https://www.ndp3.org/documents/rcslt2011dvdPolicyStatement.pdf