Speech delayed 23 mo, w/possibly other delays- can you walk me through how to get him assessed by a developmental pediatrician and referred to speech therapy?

[Mamax4]

We are American, likely moving to greater London in 2 months. In the US, there is what is called "EI" or Early Intervention,where you can have your child assessed by early childhood specialists, bypassing any referrals. I have an older ds on the spectrum, who had a similar delay. Once I am in the UK, what is the fastest way to get a child into speech therapy? Go to GP, take a list of issues w/me, ask for a referral and not take "no" for an answer? Can one go private, or does that require a GP referral as well?

you will need to see the GP to get a paediatrician referral, and may be able to speak directly to the speech therapy department to arrange a referral. If your area doesn't allow that, then you have to go to the GP for a referral. A lot of GPs will probably try and fob you off as there is a chance a child will just be a late talker before they are 3, so not need any help. So be prepared to stand your ground. You may end up seeing a HV (Health Visitor) to arrange referrals/discuss your child's development. A Health Visitor is a trained children's nurse.

A lot of areas have child development centres where developmental paeds, speech therapists, educational psychologists see children, but the exact arrangement and place you see the paediatrician (whether it's a hospital department or in the community) varies from area to area. Waiting times also vary a lot from area to area. If you are unlucky paediatrician waiting lists and speech therapy waiting lists can be up to 12 months. Phone up the departments your child is referred to find out how long the waiting list is.

It is very easy to go private for speech therapy. You do not need a GP referral. If you google for the ASLTIP website, they will have a list of qualified speech therapists who do private work in the UK. Private speech therapy usually costs £50 per hour.

In summary - a hell of a lot varies from area to area. a good starting point for information and local procedures will be your local branch of the National Autistic Society for the London area you will be moving to. (www.nas.org.uk)

Even if you go private, get on NHS waiting lists as well, as the NHS involvement is needed for sorting out support at nursery/school etc.

It is also possible to see developmental paediatricians privately, I have not done this, but am sure others reading this will be able to advise.

As your GP to refer you to the community paediatrian. Child development centres are brilliant.

My DD was diagnosed as developmentally delayed at her 9 month check. From that, we were referred to various therapists (physio, speech and learning, portage, occupational therapy, etc.). It was also part of her 'failing' her development check and every other service seemed to fall into place from that. She has a genetic condition that causes her delayed development but it took us 3 years to get a diagnosis.

I have heard of other parents who have had to fight to get the same level of service that my DD has received. Luckily for me (and my DD) our local council are very 'hot' on providing every service that any child could need.

My DD is now 6, goes to mainstream school but is still receiving speech and learning therapy during school time.

If you return to the UK, you will obviously be registered with a doctor and in this regard you can highlight your concerns. Hopefully a health visitor will then become involved (they deal with children up to the age of 5) and she should be able to refer you to any further services that you need.

My DD (youngest) has not seen a health visitor since her 9 month check because she is seen by more 'specialised' doctors.

availability of speech therapy varies from area to area - my DS's speech delay was flagged at 24 months by a health visitor, who referred him for speech therapy, he received a block of 6 weekly speech therapy sessions when he was 30 months old. These were not sessions where the therapist worked with him, mind you, it was to give advise for me as to how to help him at home. Six months later, he was due to get another block of six sessions but we said no thanks as we had already sought help for him privately (VB home programme)

Now, he is seen by the SALT three times per term in the nursery. Again, these visits are consultation visits where the programme, delivered by well-meaning but hopelessly inexperienced young nursery staff, is monitored and further advice given. This has made very little difference, progress is slow because his needs require intensive, one-on-one speech therapy, which is not available in mainstream settings unless you fight a bloody battle to get it into a Statement of SEN.

If you can afford it and can find one, I'd get a private SALT as soon as you can get hold of one. Don't move to SE London - a services black spot and no SALTs within miles!

I spoke to my Health Visitor when I became concerned about each of my sons and she referred me onto the community paediatrician and other services. Hopefully, once you are registered with a GP a HV will visit you, soon.

All of you are most helpful! THANK YOU. I have a bit of a learning curve ahead of me. Can you guys tell me what the following terms, used by you, mean: SALT (speech and language therapist?), VB.. .and what is VP home programme? And what is a difference between a GP and a community pediatrician? The entire family has a GP, right? or do adults have GPs and children have community pediatricians? Sorry for all these Qs and I appreciate your help in advance. I am already pretty "oriented" thanks to you all!

He has had his adenoids removed bc indeed his hearing was not good bc of them, had a check up afterwards and now is scheduled for an ABR test, which is done during sleep w/electrodes attached, bc the standard test (tympanogram?) shows that he may have a problem. I will of course pusue the hearing issue but because his older HFA brother started with what seemed like a "simple" speech delay, I am worried about spectrum issues, as well. We are now in Italy where there are almost no services of any kind, even if you go private- just no specialists, so I am hoping that the UK will be better (we may be moving for work reasons).

GP is General Practitioner, e.g. the family doctor who refers you to specialists. You do not go direct to most specialists unless you go privately and even then you may need GP referral, depending on Health Care provider and thep professional you wish to see. A good GP is worth their weight in gold so get recommendations from locals once you know where you will live BUT keep in mind that you must live in their catchment area to register.

Where abouts in Greater London are you looking at?