Home - Services - Children’s Services - Specialist Children’s Services - Paediatric Speech and Language Therapy - Service Pathways

Service Pathways

To ensure you get the right support, we offer different service pathways. This page explains who each pathway is for, where we will see you, and how long you might wait for an appointment. You can also find information and guidance to support you while you wait.

We can help with:

  • Late talking or limited vocabulary (e.g. not using expected words for age)
  • Unclear speech or difficulty producing sounds (e.g. difficulties being understood by others)
  • Difficulty understanding language (e.g. not following instructions)
  • Difficulty using language to communicate needs (e.g. relying on gestures or minimal interaction)
  • Social communication difficulties (e.g. limited interaction, poor attention or engagement)
  • Stammering or fluency concerns
  • Underlying medical or developmental conditions affecting communication (e.g. Down syndrome, cleft palate, neurological conditions

What happens when your child is referred to us?

When your child is referred to us they will be offered a pre-school screen appointment.

These appointments are with a Speech and Language Therapist and provide an opportunity to:

  • discuss your concerns
  • observe your child’s speech, language and communication skills
  • give you strategies to help support your child’s speech, language and communication development
  • enable us to direct you and your child to the most appropriate support.

This appointment should take around 30 minutes, and you should leave knowing the next steps of support for your child.

Pre-school screen appointments are available at the following locations:

  • Harrogate District Hospital
  • Catterick Health Centre
  • Colburn Children’s Centre
  • Bedale – Glebe House Surgery
  • Ripon – North House Surgery
  • Thirsk Health Centre
  • Northallerton- Friarage Hospital

What support do we offer?

Universal Support

Universal support is available to everyone and can be accessed without referral to Speech and Language Therapy.

Useful links and resources:

Speech & Language Training for Families & Professionals

We offer specialised Speech and Language Therapy training to parents, carers, education staff, and health professionals.

Several of our Therapists and Assistants are certified Makaton Tutors and provide official training courses for both families and professionals.

For more information, please see our ‘Next steps and resources’ section.

Targeted Support

We offer targeted, small-group sessions designed to give parents and carers practical skills to support their child’s specific communication needs.

  • Creating Communicators – A practical group for parents/carers of children who are not yet talking or using words, focusing on early interaction and play skills.
  • Singing and Speech – A fun, music-based group using rhymes, rhythm, and repetition to encourage early talking and sound development.
  • Language Leapers – A structured group focused on boosting vocabulary, building short sentences, and helping children understand spoken language.
  • Happy Hands – A specialised group introducing simple signs, gestures, and visual tools to help children communicate their needs before their speech develops.

Specialist Support

Specialist support is available for parents/carers and children who need a more tailored therapy approach.

  • Hanen Parent Programmes – Evidence-based, structured coaching courses that empower parents with the exact strategies needed to build their child’s language during everyday routines.
  • 1:1 Therapy (Home, Clinic, or Nursery) – Individualised, direct therapy sessions delivered in the environment that best suits your child’s comfort and learning.
  • Speech Sound Therapy – Targeted, one-on-one exercises and games to help children who struggle to pronounce specific sounds clearly.
  • Alternative and Augmentative Communication (AAC) Assessment – Evaluating and introducing specialized communication tools, from picture boards to high-tech voice-output devices, for children who cannot rely on speech alone.
  • EHCP Assessments – Formal, comprehensive communication assessments used to contribute expert evidence toward an Education, Health, and Care Plan (EHCP).

Who is this for?

Children and young people aged 5 to 19 who present with speech, language and communication difficulties.

We support children and young people who have:

  • difficulties with their speech (difficulty pronouncing words/mixing up sounds)
  • difficulties with their attention and listening skills
  • difficulties understanding and following language use in the classroom (following instructions/understanding questions)
  • difficulties expressing themselves (making sentences and using appropriate grammar)
  • a stammer / dysfluency
  • additional needs that affect communication and interaction (e.g. Autism, Down Syndrome, Hearing Loss)
  • difficulties with their voice (not speaking at all/hardly at all, unusual quality e.g. hoarse, breathy, croaky or pitch too high/low)
  • selective/situational mutism (can speak freely at times, hardly or not at all in other situations)

What support do we offer?

Universal Support

Universal support is available to everyone and can be accessed without referral to Speech and Language Therapy.

Useful links and resources:

Selective Mutism

Stammering / dysfluency

Voice

Targeted Support

  • advice and strategies for parents, carers, schools and settings
  • assessment to better understand a child or young person’s strengths and needs
  • therapy programmes or activities to be carried out at home and/or in educational settings
  • group intervention where appropriate
  • training and coaching for school staff and families to support carryover of strategies in everyday environments

Specialist Support

  • comprehensive specialist assessment
  • direct, individualised intervention
  • goal-focused blocks of intervention for specific speech, language or communication targets
  • specialist advice and programmes for home and school
  • support for complex speech, language, communication, stammering, voice and selective mutism needs
  • multi-disciplinary working with other professionals involved in the child or young person’s care
  • review, monitoring and longer-term planning where needed

Who is this for?

Children and young people with more complex or long-term communication needs, including those who may need support with early interaction, understanding language, expressing themselves, or using Augmentative and Alternative Communication (AAC).

What support do we offer?

Universal Support

Universal support is available to everyone and can be accessed without referral to Speech and Language Therapy.

Useful Links and Resources:

  • MindMate – Neurodiversity Information Hub – Advice and support for children and young people with autism, ADHD, communication and sensory needs.
  • Makaton Charity – Information and resources to help children and young people communicate using signs and symbols alongside speech.
  • Intensive Interaction – A relationship-based approach that supports early communication skills such as attention, turn-taking and shared enjoyment.
  • Ace Centre – Specialist advice and support around AAC and assistive technology for children and young people with complex communication needs.
  • Contact Charity – Useful family-facing support organisation for parents of disabled children and young people, as well as those with complex needs.

Makaton Training for families and professionals:

We offer Makaton training to parents, carers, education staff, and health professionals.

For more information, please see our ‘Next steps and resources’ section.

Targeted Support

  • Joint target setting with teaching staff in the Special Schools and the children and young people’s families.
  • Provision of training to support implementation of programmes and strategies.
  • Provision of an Intervention Plan for school and home.
  • Advice on using visuals, Makaton and low-tech AAC supports
  • Support with modelling communication and building interaction skills
  • Liaison with education staff and other professionals
  • Monitoring and review to help decide whether specialist support is needed

Specialist Support

Seek urgent medical help if your child:

  • is choking frequently
  • has difficulty breathing during feeding
  • has chest infections linked to eating or drinking

Call 999 in an emergency.

Call 111 or contact your GP for urgent medical advice.

Who is this for?

This service is for children and young people who experience difficulties with eating, drinking, and/or swallowing (dysphagia).

Signs of eating and/or drinking difficulties include:

  • coughing on drinks, medication or other liquids
  • coughing or choking on food
  • difficulties with chewing skills, including preferring softer foods or taking longer to eat
  • difficulties sucking on bottle, breast or straw
  • unexplained chest infections

Signs of swallowing difficulties include:

  • coughing
  • gagging
  • wet breath sounds or other changes to breathing
  • eyes become pink or watery
  • facial colour change
  • looking like they’re struggling to swallow or taking extra swallows

What happens after your child is referred to us?

Your child will be seen in the environment that best suits their needs:

  • At home, in a clinic, or at their nursery, school, or college.
  • If your child is currently staying in the hospital, they will be seen on the ward.

During the appointment, the therapist will:

  • Talk through your child’s medical history and any current feeding concerns with you.
  • Observe your child eating and drinking their usual foods or liquids in a relaxed way.

Once the assessment is complete, we will build a clear plan to support your child. This may include:

  • Detailed Report – Your therapist will write a full report outlining their findings and recommendations. With your permission, this will be shared with other professionals involved in your child’s care
  • Mealtime Plan – If needed, you and your child’s education or care setting will receive a personalized mealtime plan. This details exactly how to keep your child safe and comfortable, including safe sitting positions and specific food or drink textures to offer or avoid.

What support do we offer?

Universal support

Universal support is available to everyone and can be accessed without referral to Speech and Language Therapy.

Targeted support

  • Information session / workshop for parents and carers
    • Support around sensory differences, mealtime routines, anxious eating and how to encourage children and young people to explore and accept a wider range of foods.
  • Advice and strategies for sensory-based feeding difficulties
    • Resources to help parents and professionals understand how sensory processing can affect eating, drinking and mealtime participation.
  • Training for education and early years staff (in development)
    • Training to help nursery and school staff support children and young people with eating and drinking difficulties safely and consistently in their setting.

Specialist support

  • Dedicated feeding clinics
    • Assessment and support for children with more complex feeding needs, including difficulties with chewing, swallowing, food refusal, or a very restricted diet.
  • Specialist assessments
    • This may include assessments such as videofluoroscopy (a moving x-ray of your child swallowing) where needed, to help us understand how your child is managing food and drink safely.
    • Specialist multidisciplinary support
      • Some children may also need joint support from other professionals such as paediatrics, dietetics, occupational therapy or specialist hospital teams.