Misunderstood

Supporting children and young people with

speech, language and communication needs

1
2
Contents
 

1. Why should I read this booklet?......................................... p5

2. What
 are speech, language and communication?.............. p6

3. W
 hat are speech, language and communication
needs?.............................................................................. p10

4. H
 ow do speech, language and communication
needs affect children and young people?......................... p20

5. H
 ow can I tell if someone has speech, language
and communication needs?.............................................. p24

6. H
 ow can I support a child or young person with
speech, language and communication needs?................. p32

7. D
 oes my child have speech, language and
communication needs?..................................................... p38

8. Where can I find further information?.............................. p43

9. Credits.............................................................................. p47

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4
Why should I read
this booklet?
Almost everything we do involves speech, language and/or
communication. Everyday tasks, learning, sorting out problems,
having a conversation, getting a job, making friends and having
fun all rely on our ability to communicate.

Being able to say what you want to say and to understand

what other people are saying is the most important skill we
need in life. Yet many people take communication for granted.
Some children and young people have difficulty communicating
with others; they have speech, language and communication
needs - often referred to as ‘SLCN’.

This short booklet provides information about children and

young people who may need some additional help with their
communication, some signs to look out for and some ways to
provide further help.

This booklet is for parents and anyone who works with children
and young people.

5
What are speech,
language and
communication?

6
Speech refers to:
• Speaking with a clear voice, in a way that makes speech
interesting and meaningful
• Speaking without hesitating too much or without repeating
words or sounds
• Being able to make sounds like ‘k’ and ‘t’ clearly so people
can understand what you say

Language refers to talking and understanding:

• Joining words together into sentences, stories and
conversations
•Knowing and choosing the right words to explain
what you mean
• Making sense of what people say

Communication refers to how we interact with others:

• Using language or gestures in different ways, for example to
have a conversation or to give someone directions
• Being able to consider other people’s point of view
• Using and understanding body language and facial
expressions, such as:
- knowing when someone is bored
- being able to listen to and look at people when having
a conversation
- knowing how to take turns and to listen as well as talk
- knowing how close to stand next to someone

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Speech, language and communication develop gradually
based on good attention, listening and play skills.

Communication Development Pyramid

Communication Development Pyramid

Speech
Sounds

Interaction and Talking

Understanding

Play

Attention and Listening

Adapted from a model used in many speech and language therapy services across the UK

Adapted from a model used in many speech and language therapy services across the UK

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What are speech,
language and
communication
needs?

10
Children with speech, language and communication
needs find it difficult to communicate with others.

This may be because they can’t say what they want to, they
don’t understand the words that are being used or they don’t
know how to have a conversation. It may be a combination of
these problems or it may be that they don’t have enough words
so they don’t talk as well as they should for their age.

With help, lots of these children can catch up, though many
will take much longer than others. Some will have difficulties
throughout their childhood and at school and some into
adulthood. However all can make progress with the right
support.

Children whose first language isn’t English are at no greater risk

of speech, language and communication needs than any other
child. However there can be challenges with identifying the
speech, language and communication needs of children who
are learning English as an additional language.

Every child with speech, language and communication needs is

different, and their needs change as they get older. This means
that every child can have difficulty with one or many of the
different aspects of speech, language or communication as
described on page 7.

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In some children, language is the only difficulty they have,
everything else is OK.

When Jack started school, his mum was worried as he seemed

bright but wasn’t talking much - his sentences were only made
up of 2 or 3 words and his speech was hard to understand.

Tests showed he was of above average intelligence, but he

found understanding what people were saying to him really
difficult.

Now Jack is 13 and lots of things about school are hard for
him. However, because Jack has had extra support with his
language, he does well at maths and science, especially with
practical activities.

He still really struggles with English but he works hard, is

popular and sociable, and loves playing football. Jack can get
frustrated as he knows that he can’t do the same things as his
friends.

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For other children, their speech, language and
communication needs are part of another condition.

Sara has learning difficulties. She started in a mainstream

nursery class 4 years ago although she couldn’t talk and
was very withdrawn. She learnt sign language to help her
communicate, then all of her class learnt it so that she can join
in lessons and make good progress.

Theo is 11 and has Asperger’s Syndrome, a form of Autism1. He

is bright and wants to socialise with others but his voice sounds
monotonous and often others make fun of him. When Theo
gets excited or anxious he makes loud noises.

There are overlaps between speech, language and

communication needs and other conditions such as Autism,
Dyspraxia2 and Dyslexia.1 Sometimes, having one particular
diagnosis can mean that other needs may be hidden. Close
working between different professionals and parents is
therefore important to ensure a focus on all the needs of the
child and not just one condition.

1 Autism is a disorder that makes communicating and interacting with other people difficult,
for more information visit www.nas.org.uk.
2 Dyspraxia is a condition which makes organising movement difficult, for more information
visit www.dyspraxiafoundation.org.uk.
3 Dyslexia is a learning difficulty affecting the skills needed for reading and spelling, for more
information visit www.thedyslexia-spldtrust.org.uk
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Speech, language and communication needs can be very
severe and complex.

Michael is 12 and has cerebral palsy - a physical disability that

means he can’t speak because he can’t control his mouth
muscles or tongue. Michael does understand when other
people speak, just like any other child his age.

Michael has poor control of his hands meaning he can’t use

sign language. This means it’s very hard for him to make his
thoughts and ideas known, especially to people who don’t
know him.

Michael uses a communication aid with an electronic voice. This

means he’s able to ask and answer questions in lessons but it
takes a lot of effort for him to press the buttons so it can be a
slow process.

Around 1 in 10 children and young people like Jack, Sara,

Theo and Michael have speech, language and communication
needs that will last into adulthood.4 That’s on average 3 in every
school class.

4 Law et al (2000) Provision for children’s speech and language needs in England and Wales:
facilitating communication between education and health services DfES research report 239
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Some children have less severe forms of speech, language
and communication needs. In poorer parts of the country
there are higher numbers of these children.

At least 50% of children in poorer areas have speech, language

and communication needs.5

When Kylie started school she knew only a few basic words,
many of which were in baby-form, such as ‘da-da’ for dad and
‘dinky’ for drink.

She got her message across by pulling, pointing and smiling

but often became tearful and frustrated when this didn’t work.
Kylie found it hard to sit still and listen with other children at
story time and was constantly restless.

She often missed what the teacher said or did the wrong
thing as she could only understand and remember one simple
instruction at a time.

Children like Kylie may struggle to listen well, know fewer

words or talk in shorter sentences than other children the same
age. Their difficulties are probably less severe and with the right
support they can catch up.

5 Locke, A., Ginsborg, J., and Peers, I., (2002) Development and Disadvantage: Implications
for Early Years IJLCD Vol 27 No 1
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How do speech,
language and
communication
needs affect
children and
young people?

20
Speech, language and communication needs can have
a huge impact on many aspects of children and young
people’s lives, inside and outside of school.

Difficulty
understanding
words about
S witching off feelings
or acting up in Difficulties
lessons explaining what
they want or need
Bullying

Many children with speech,

language and communication
Behaviour needs may experience...
problems

Failure at school or
poor exam results if
Difficulties with additional support is
reading and not provided
writing

Loneliness and
isolation, difficulty
making friends
Difficulties
adjusting to
changes in
routine

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For children and young people with speech, language and
communication needs, there’s a higher risk of unemployment
and relationship breakdown. For some young people there’s
even an increased risk of getting into trouble with the police -
between 60-90% of young offenders have speech, language
and communication needs.6

But this doesn’t have to be the case.

There are some very successful ways of helping children and

young people who struggle to communicate to enjoy life at
home and at school and to fulfil their potential. Some of these
are included from page 32 onwards.

Whatever the cause or seriousness of a child’s difficulties,

the first important thing to do is to identify that there’s a
problem. Often, because children with speech, language and
communication needs look just the same as other children,
their difficulties can be hidden or be mistaken for something
else such as learning difficulties or bad behaviour.

6 Bryan, K., Freer, J., and Furlong, C., (2007) International Journal of Language and
Communication Disorders Vol 42 No 5
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How can I tell
if someone has
speech, language
and communication
needs?

24
In younger children, it’s usually easier to spot a problem
with speech, language or communication.

By the time most children start reception class, they should be

able to:

• sit still

• pay attention

• play well with others

• understand long instructions

• know and use a useful range of words

• speak clearly in sentences

• make themselves understood to friends and family

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If a pre-school or primary aged child has speech, language
and communication needs you might notice some of the
following:

• you often need to tell them several times or even show them
before they understand what you mean

• people who don’t know them well can’t follow or understand

what they’re saying; their speech is not clear, sentences are
short or unusual or explanations get muddled and are difficult
to follow

• they only say a few different words

• they might not want to take part in activities that involve

talking or they might really want to join in games but don’t
know how to

• they might be struggling with reading, spelling or maths

• they might get angry or show frustration when they don’t

understand

• you may get no response to questions or children may repeat

back part of what you’ve said to them because they don’t
understand

• at home they might understand familiar routines, but struggle

when things change

• at home they might struggle to tell you much about what
they do at school or who their friends are

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Most young people starting secondary school are able to
listen for half an hour or more. They can:
• remember new words after hearing them just a couple of times
• understand word play in jokes and give a clear explanation
when something has gone wrong
• cope with the change to a more independent way of learning
and if they don’t understand something they ask questions
• they’ll be able to have conversations and can negotiate in
family discussions
In older children and young people it can be harder to recognise
difficulties with speech, language and communication.

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If a young person has speech, language and
communication needs you might notice some of the
following:

• they seem to ignore what you’ve asked them to do or they

do the wrong thing because they’ve misunderstood what you
meant
• they really struggle to learn and remember new words and
they might try to explain the word they’re trying to say. For
example, for tripod they might say “that science thing with
three legs, it’s metal”
• they might have difficulty doing tasks because of the way
they’re explained. For example, when asked to “evaluate a
multi-cultural product”, they won’t understand that this asks
them to describe why they liked curry or chilli
• they might be fine in a conversation with one other person
but in a group they appear very quiet and may even not
respond as they struggle to keep up
• they find it hard to produce written work and what they
manage is very basic
• at home they might sound muddled or disorganised when
explaining experiences and events
• at home they can consistently struggle with homework and
organising themselves

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How can I support
a child or young
person with speech,
language and
communication
needs?

32
Wherever they are - at home, school or in social situations
- we can support children and young people with speech,
language and communication needs by understanding
more about their strengths and difficulties.

“The most important thing – people

need to be aware that there are
children who have hidden difficulties”
(parent of a child with speech, language
and communication needs)

“The best people, they understand

the nature of my condition - I’d
say that was the most important
thing”
(young person with complex speech,
language and communication needs)

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It’s important to know how to interact with children. The
following tips will help to support all children and young
people’s communication, but particularly those with
speech, language and communication needs.

Speak a little more slowly than you usually do

Allow time after asking a question for them to listen, think and
work out what has been said

Demonstrate
Use gestures, pictures or anything else visual to help understanding

Clarify
Ensure they understand your instructions by asking them to
repeat what they think they have to do

Use shorter sentences and simpler language in instructions

For example say:
“Finish the sentence you’re working on”. Pause
“Put your books away”. Pause
“Then get changed for PE”
Say “make” instead of “produce”
“finish” instead of “complete”

Cut down the amount you talk

Allow children time to talk so that you both get a fair share of
the conversation

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Comment on what children are doing
This is less pressured than asking questions and encourages
children to join in. For example, “You have a robot on your
t-shirt” rather than “What’s that on your t-shirt?”

Give specific praise about what they’ve done well

“You really joined in well there” or ‘’Well done, you got
dressed all by yourself today.” Praise for effort is useful

If they can’t think of what to say, help them

Give the words and phrases they need to use. For example,
when a child wants to join in a game being played by his
friends: “Ben, you could say ‘Can I join in?’”

Avoid colloquialisms, sayings and idioms

They can be confusing and children may take them literally. For
example, “Pull your socks up”

Demonstrate how to say a word or sentence

This is instead of telling them they’ve said it wrong. For
example, if they say “Car blue school” you can continue the
conversation by adding “So you saw a blue car on the way to
school”

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Expand on what children say
This helps them build bigger sentences. For example, if they say
“Daddy going shopping” you could say “Yes, daddy’s going
shopping to buy some bread”

Ask children and young people what helps them

Sometimes the results are surprising

These suggestions will support all children and young people’s

communication, but some may need more specialist help from
speech and language therapists or specialist teachers. It’s also
important that any adult working with children and young
people with speech, language and communication needs has
the right training.

Parents know their children best of all. Sharing ideas of what

works for a child between their parents and professionals that
know them can work really well for children.

37
Does my child have
speech, language
and communication
needs?

38
If you think your child has speech, language and
communication needs, you may want to talk about your
concerns to your friends, family or someone else such as your
child’s teacher.
Talking to others about your concerns can be difficult because
speech, language and communication needs can be very hard
to explain. Speech, language and communication needs may
also be hidden by other things which are easier to see such as
reading difficulties or behaviour difficulties.
To help you to explain what’s worrying you, it might be useful
to think about the following things:
• Look at the descriptions of speech, language and
communication on page 7. Perhaps these can help you
describe where your child is having difficulties (as well as the
things they can do well)
• K
 now what to expect from your child’s communication for
their age. You can find this out at www.talkingpoint.org.uk.
If you have this information you can point out where there
are differences or gaps.
• Gather some examples to help you explain your worries.
Write down some of the words your child says, sentences
they use or instructions they don’t understand.

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A speech and language therapist can tell you about the
development of your child’s communication skills.
Taylor is 4 and started to talk at the same time as other children,
but he had always been difficult to understand. As he got older,
Taylor’s mum noticed that his difficulties became more obvious;
friends and family found it hard to understand what he was
saying. He wasn’t saying the right sounds in words, so his mum
made a note of some of the things he said: “dat” instead of ‘bat’
and “unny” instead of ‘mummy’.
Taylor’s mum talked through her worries with her GP, who made a
referral to a speech and language therapist. She did an assessment
and agreed that his speech was unusual for his age. He’s now
waiting to be seen for regular speech and language therapy to
help his speech improve.

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Some children can understand what’s being said but they
have difficulties talking in sentences. For more complicated
difficulties they may need a detailed assessment by more
than one person.
Henry’s parents were happy when he said his first words. But
by the time he was 3 years old, Henry still wasn’t joining words
into phrases or making short sentences like other children, so his
parents started to worry.
Making friends at nursery was difficult for Henry as he didn’t have
the language skills to do it. His parents felt he was becoming
isolated and his behaviour at home was becoming difficult
because he was so frustrated.
When Henry started school his parents talked to the staff and
his health visitor about their concerns. Henry was assessed by an
educational psychologist and a speech and language therapist,
which showed that he had a specific language disorder. Henry
now receives the support he needs at school.

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Where can I
find further
information?

43
Where to go for further information
The website www.talkingpoint.org.uk has a range of
information about speech, language and communication
development and ways to support children and young people.
It also has a progress checker for you to check what to expect
from children’s speech, language and communication skills at
different ages.
Talking Point also includes a database of local support services
including speech and language therapy departments. You can
search for your local services at www.talkingpoint.org.uk/talkinglinks,
simply type in your postcode.
Or you can talk about your concerns with your child’s health
visitor, GP or teacher. They might be able to answer your
questions or give you more information about local services.
Sometimes you may have to wait to see a speech and language
therapist. Some parents don’t want to do this so they pay to have
a private assessment. You can find details of local private speech
and language therapists at www.helpwithtalking.com.
Contact www.ican.org.uk or www.afasic.org.uk for advice and
information – or to discuss your child and your concerns. The
websites also give information about a range of places to go for
more specialist independent assessment.

44
The Royal College of Speech and Language Therapists has
information about the work and expertise of speech and
language therapists. Please go to www.rcslt.org.uk for more
information.
If you work with children and young people the Speech,
Language and Communication Framework (SLCF) outlines
what you need to know and be able to do in order to support
children’s communication. For more information about the
SLCF go to www.talkingpoint.org.uk/slcf
The website www.hello.org.uk contains information on the
Hello campaign, the 2011 national year of communication. The
website explains how you can get involved in Hello, find out
about activities in your area and download free resources.
Further information and support can be accessed through The
Communication Trust’s consortium members via
www.thecommunicationtrust.org.uk/partners

Useful resources

We have a range of resources for parents and those who work

with children and young people available to order from
www.hello.org.uk/resources
 
Don’t Get Me Wrong: A sister publication to Misunderstood,
which is for people who already have some understanding
about speech, language and communication needs but would
like to find out more. This publication is ideal for special
education needs co-ordinators (SENCOs).
45
Universally Speaking: A series of three booklets for professionals
to show where children and young people are likely to be at with
their communication at a given age. The booklets are divided into
age groups: Early Years (birth-5), Primary (5-11) and Secondary
(11-16), produced with the support of Pearson Assessment.
Small Talk: A booklet for parents of children aged 0 to 5
years to give them information and advice on their child’s
communication development. Produced with the support of BT.
Early years training materials: If you work in an early
years setting, a speech, language and communication unit
has been included as a mandatory part of the new Level 3
Diploma for the Children and Young People’s Workforce. The
Communication Trust has developed free, expertly written
materials for trainers and learners to support the delivery of this
unit. These materials will include video footage, activities and
handbooks.
Contact [email protected] for
more information or to order these free training materials.
Alternatively to view online please visit
www.talkingpoint.org.uk/eymp
 
SLI Handbook: A book written by I CAN and Afasic that
explains what a specific language impairment is, gives advice
and support and shows where to go for further information. To
order, please visit www.ican.org.uk/resources or call
0845 225 4073.

46
Credits
Misunderstood has been produced in partnership by The
Communication Trust, The Dyslexia SpLD Trust and
the Autism Education Trust.

The Communication Trust

The Communication Trust consists of over 40 voluntary sector organisations that bring
together their expertise to ensure that the speech, language and communication needs
of all children and young people are met through signposting specialist training support
and guidance to people working with children.

The Communication Trust was founded by Afasic, BT, Council for Disabled Children
and I CAN.

If your organisation would like to become a member of The Communication Trust’s

consortium please go to www.thecommunicationtrust.org.uk/partners/consortium
for more information or e-mail [email protected]

47
Members of The Communication Trust consortium:
1 Voice, ACE Centre North, ACE Centre, Action for Children, Afasic, Ambitious
About Autism, Association for the Rehabilitation of Communication and Oral Skills
(ARCOS), Auditory Verbal UK, Barnardo’s, British Stammering Association, Candle,
CENMAC, Chailey Heritage Clinical Services, Communication Matters, Contact a Family,
DialogueLab, Elklan, Find A Voice, I CAN, KIDS, Language for Learning, The Makaton
Charity, Mencap, MERU, National Association of Professionals concerned with Language
Impairment in Children (NAPLIC), National Autistic Society (NAS), National Deaf Children’s
Society (NDCS), National Literacy Trust, Paget Gorman Signed Speech (PGSS), Radio In
Schools, St Catherine’s, Scope, Selective Mutism Information and Research Association
(SMIRA), Social Emotional Behavioural Difficulties Association (SEBDA), Symbol UK, The
Children’s Society, The Children’s Trust Tadworth, The Learning Partnership.com, The
Michael Palin Centre for Stammering Children, The Signalong Group.

The Dyslexia SpLD

The Dyslexia SpLD Trust is a consortium of organisations involved in promoting
improved practice and outcomes for individuals with dyslexia and specific learning
difficulties. The Dyslexia SpLD Trust was established to provide information on
effective provision for educating and supporting individuals with dyslexia and specific
learning difficulties.

Members of The Dyslexia SpLD Trust consortium:

British Dyslexia Association, Dyslexia Action, Helen Arkell Centre, The Professional
Association of Teachers of Students with Specific Learning Difficulties (PATOSS),
Springboard for Children, Xtraordinary People
For further information and advice about supporting young people with dyslexia,
contact the British Dyslexia Association helpline on 0845 251 9002 or visit
www.thedyslexia-spldtrust.org.uk

The Autism Education Trust

The Autism Education Trust works to raise awareness of autism education across the
children’s workforce. They bring together organisations involved in delivering autism
education services, to share good practice and information, and to involve children
and young people with autism and their carers to enhance and improve autism
education in England.

48
Members of the Autism Education Trust steering group include:
Autism Alliance, Wessex Autistic Society, National Autistic Society, TreeHouse,
Council for Disabled Children, Blackpool Local Authority, West Midlands Regional
Hub, South Gloucestershire Local Authority, Autism Centre for Education and
Research at University of Birmingham, University of Bristol, Autism Outreach, Torfield
School, NORSACA, Training and Development Agency, Asteroids Autism, Blackburn
Local Authority
For further information on Autism Spectrum Disorders, contact the National Autistic
Society helpline on 0845 070 4004 or visit www.autismeducationtrust.org.uk

Written by Mary Hartshorne, Head of Quality and Outcomes, I CAN, with Melanie
Cross and Maxine Burns

Thank you to those who made additional contributions to this publication.

For further copies of this booklet please go to www.hello.org.uk/resources

Designed by: The Design Conspiracy - www.thedesignconspiracy.com

Photography by: Deborah Ripley - www.deborahripley.com

This booklet can be reproduced in whole or in part for non-commercial use. When using
material from this booklet you must reference The Communication Trust.

Second Edition, published May 2011. First published in January 2011.

49
Hello is the 2011 national year of communication – a
campaign to increase understanding of how important
it is for all children and young people to develop good
communication skills.
It’s estimated that over 1 million children have some form
of speech, language and communication need that requires
them to have extra help to communicate. This can affect them
severely and for life.
Hello aims to make children’s communication a priority in
homes and schools across the country by providing information
on typical communication development, how to spot if children
are struggling and where to go for help and support.
Visit www.hello.org.uk to find out more about the campaign
and sign up for regular updates.

Hello is managed in partnership with the

Office of the Communication Champion.
The Communication Trust
8 Wakley Street
London
EC1V 7QE

www.thecommunicationtrust.org.uk

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