The 2 to 2½ year review
A health visitor or nursery nurse checks your child's movement, speech, social skills, behaviour, hearing and vision. You're usually sent a questionnaire (ASQ-3) to fill in first.[1] It's a good moment to say if you're worried about talking.
Getting a speech and language therapy assessment
- Ask your health visitor or GP. They can refer your child to the local children's speech and language therapy service.[2]
- Or contact the service yourself. The NHS says you can refer your child yourself.[2] How depends on your area: some services ask parents to fill in the referral form[3], some only take referrals from professionals[4], and some ask you to try their advice sessions first.[5]
- Find your local service by searching "children's speech and language therapy" with your town or council, asking your health visitor, or looking at your council's Local Offer, which should list speech and language therapy.[6]
What happens at the first appointment
As an example, one NHS service describes a first visit of 45 to 60 minutes: the therapist watches your child play, talks with you, and gives you ideas to try at home.[4]
Waiting lists
Waits can be long. In 2025, 71% of NHS speech and language therapists said they were worried about how long children wait for a first appointment.[7] One service gave a wait of about 36 weeks.[4]
- Start the ideas in What helps at home now. You don't need to wait.
- If the wait is causing problems, PALS (the Patient Advice and Liaison Service) at the NHS trust that runs the service can help.[8]
Help at nursery and school (England)
This section is about England. Wales, Scotland and Northern Ireland have their own systems.
- Talk to the nursery's SENCO (special educational needs coordinator).[9]
- Settings should not delay putting help in place.[6] Support is based on your child's needs.
- The nursery should follow four steps: assess, plan, do and review, led by the SENCO, and can involve a speech and language therapist.[6]
EHC needs assessment
If your child needs more help than the nursery or school can usually give, an Education, Health and Care (EHC) needs assessment can lead to an EHC plan.
- Parents can ask the council for an assessment themselves.[6] IPSEA has a template letter.[10]
- The council must decide within 6 weeks whether to assess, and the whole process should take no more than 20 weeks.[6]
- If the council says no, you can appeal to the SEND Tribunal.[11] The deadline is usually 2 months.[10]
The government has proposed changes to the SEND system in England. As of 2 November 2026, the law has not changed and the current rules still apply.[12]
Free advice
- IPSEA: free legal advice about special educational needs in England.[13]
- Contact: free helpline for families with disabled children anywhere in the UK, 0808 808 3555.[14]
- STAMMA: free helpline about stammering, 0808 802 0002.[15]
Sources for this page
- Your baby's health and development reviews · NHS
- Help your baby learn to talk · NHS
- Cambridgeshire children's speech and language therapy service · Cambridgeshire Community Services NHS Trust
- Children's speech and language therapy · Northamptonshire Healthcare NHS Foundation Trust
- Speech and language therapy referral guidelines: 2 years 6 months to 2 years 11 months · Hertfordshire Community NHS Trust
- SEND Code of Practice: 0 to 25 years · Department for Education
- A profession under pressure · Royal College of Speech and Language Therapists
- What is PALS (Patient Advice and Liaison Service)? · NHS
- Signs of autism in children · NHS
- Asking for an EHC needs assessment · IPSEA
- Children with special educational needs: extra help · GOV.UK
- Don't jump the SEND law gun: the law has not changed · IPSEA
- IPSEA advice services · IPSEA
- Contact: for families with disabled children · Contact
- Help if your child stammers · STAMMA