Guidelines for Referral

Speech - refer if the child

  • is difficult for familiar persons to understand at age 3
  • is difficult for unfamiliar persons to understand at age 4
  • has many sound errors
  • seems to mumble
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Language - refer if the child

  • does not respond to words by age 1
  • uses no words by 18 months
  • uses no word combinations by age 2
  • does not communicate in play by age 4
  • does not speak in complete sentences by age 4
  • makes grammar errors in speaking after age 5
  • has a limited vocabulary for his/her age
  • has trouble relating events, giving specific explanations, or generally getting the message across
  • has difficulty following oral directions, or needs directions repeated often
  • has difficulty with listening skills
  • has trouble interpreting the meaning of verbal information
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Voice - refer if the child

  • sounds hoarse or breathy
  • sounds nasal (like air is coming out of nose) or denasal (like he/she has a cold) most of the time
  • is inappropriately loud or soft
  • has an abnormally high or low pitched voice
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Fluency - refer if the child

  • repeats words or parts of words
  • frequently hesitates or prolongs sounds when speaking
  • struggles to get words out
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Reading/Spelling - refer if the child

  • has or previously had difficulty with pre-reading skills like rhyming, identifying beginning sounds, etc.
  • has trouble reading sight words or sounding out unfamiliar words
  • has trouble with reading comprehension
  • misspells many words in written work, even if words are correct on spelling tests
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