What can I do while my child is on the NHS speech therapy waiting list?

Should I stay on the list while I look for other help?

Yes. Keep your child's place, whatever else you decide. Seeing a private therapist does not take your child off an NHS waiting list.

Waits differ a lot from place to place, so I won't quote any. The Royal College of Speech and Language Therapists (RCSLT) says that in some places demand for children's services is very high, and that in some areas a therapist or assistant phones first to find out more about your situation.¹ If that call comes, it's a good moment to ask what happens next and how long you may be waiting.¹

If you think the wait has gone on too long, RCSLT's advice is to contact the speech and language therapy department and ask what has happened. If you still have difficulty after that, it says to contact your local NHS service to discuss the situation.¹

Who can help while we wait?

Your health visitor (if your child is under five), your GP and your child's nursery or school are the people to ask first. The NHS says to talk to your GP or health visitor if you're worried about your child's speech or language, and that you can also refer your child to a speech and language therapist yourself.² RCSLT adds that nursery staff and teachers can refer too.¹

The nursery or school SENCO (the special educational needs coordinator) is a useful person to talk to while you wait. You could ask what the staff have noticed, what they're already doing, and what they could start now: more small-group talking time, a quiet corner for adult-led play, pictures or signs alongside speech. Ask them to note what they try, because it helps whoever sees your child next.

If your child has already been seen by an NHS therapist and given advice, ask whether the nursery or school has a copy. Sometimes advice stays with the family and never reaches the people who spend the day with your child.

What can I do at home?

You can do a lot without any special equipment, and you don't need to turn the day into a lesson. For toddlers the NHS suggests things like repeating words in different ways, adding a few words to whatever your child says, giving simple choices, giving them plenty of time to answer, and switching off the television and background noise so they can hear you.² I go through these in more detail in the late talkers guide.

It also helps to keep a few notes. Write down new words or signs as they appear, the situations where your child gets frustrated or isn't understood, and anything that seems to make talking easier. A short video of your child playing at home, two minutes is plenty, can show a therapist things that don't always happen in an unfamiliar room. Keep it relaxed, and skip a week if you need to.

Every way of communicating counts, including pointing, gesture, signs, pictures and lines from a favourite film. Please don't hold those back for fear they'll stop your child talking.

Is there free advice I can get now?

There is. Speech and Language UK, a children's communication charity, runs a free, confidential advice line for families in the UK. You book a 30-minute call with an experienced speech and language advisor, who can talk through your concerns, explain typical development, suggest ways to support your child and point you to other services, and then you get an email summary afterwards.³ It also runs free webinars for parents of children aged 12 months to 4 years who are worried about talking and understanding words.³

A call like that won't replace an assessment, but it can give you questions to take to the health visitor or the nursery.

When is it worth asking about an EHC needs assessment?

This is for England only, and it's worth asking when your child's difficulties are significant and may need support in nursery or school that goes beyond what the setting can normally offer. An EHC needs assessment is the local authority's process for deciding whether your child should have an education, health and care (EHC) plan, a legal document that can include speech and language therapy.

A parent can ask for one directly. Section 36(1) of the Children and Families Act 2014 says a request may be made to the local authority by the child's parent, and the authority must secure an assessment if it thinks the child has or may have special educational needs and that provision may need to be made through an EHC plan (section 36(8)).⁴ The authority has six weeks to tell you whether it will assess (paragraph 9.11 of the SEND Code of Practice).⁵

You don't have to wait for the NHS therapist to see your child first. IPSEA, the SEND law charity, says it would be unlawful for an authority to refuse a request because you haven't included evidence of earlier involvement from a professional such as a speech therapist, as that isn't part of the legal test.⁶ Still, a request is a big step with paperwork, and not every child on a waiting list needs one. If you're unsure, the nursery SENCO or IPSEA can help you weigh it up. I've written about how EHC plans work on my EHCP and tribunal reports page.

Can I see a private therapist as well?

Yes, and plenty of families do. Seeing a private therapist doesn't take your child off the NHS waiting list, and you don't need a GP referral to see one. RCSLT says independent therapists can usually offer an assessment straight away, followed by therapy.¹

It does mean paying, and my fees are on the fees page. Tell both therapists about each other. The NHS therapist will want to know what your child has already tried, and a private therapist should ask what the NHS has said. An RCSLT article by a therapist who works in both settings describes NHS and independent therapists working jointly and sharing reports with the person's consent. Their example involves adults, but the same idea applies to children, and I am glad to work alongside an NHS therapist.⁷

When should I ask for help sooner?

If something worries you while you wait, the same people are there: your GP, your health visitor, or your child's nursery or school SENCO. The NHS says to talk to your GP or health visitor if you're worried about your child's speech or language.² If your child has difficulty swallowing, don't wait for the list. The NHS says to ask for an urgent GP appointment or get help from NHS 111.⁸

What happens if I get in touch?

You can book a free 15-minute call to talk through what you've noticed, with no GP referral needed. If we go further, the first step is usually an assessment (£270), which is mostly play. The fees page has every price, and the parents page shows how I work with families. Tell me on the call that you're on an NHS list, and we can work out how the two fit together.