Case Studies

Case 1: Language delay in a child

Daisy was 19 months old when her parents referred her to the health visitor, as they had noticed that Daisy only said a few words, was easily distracted and did not interact well with other toddlers. The health visitor told Daisy's parents that they were unnecessarily worrying and that Daisy was developing normally.

When Daisy started at school, the class teacher expressed her concerns about Daisy's behaviour and hurt Daisy's parents by suggesting that the cause of her behaviour was poor parenting.

The school called in the Behaviour Support Team who noted that Daisy did not always understand what was said to her, but they did not suggest a language assessment. They were also clear that Daisy did not have a behavioural problem.

One of Daisy's mother's friends was a learning disability nurse. On a visit one day, she noticed that Daisy's communication skills were quite poor and she seemed to lack attention, flitting from one thing to another without a sense of purpose. The friend suggested that Daisy's parents carried out a self-referral to the speech and language therapy service.

At the age of 5 years, Daisy was assessed and diagnosed with specific language impairment.

Daisy's needs were so severe that she was given a statement of special educational needs and received teaching assistant time in school. The teaching assistant had experience in specific language impairment and this was really helpful.

• 1. What factors contributed to a delay in referral for Daisy?

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  Correct answer:

  • Health visitor not being attuned to the concerns of Daisy's parents.
  • Daisy's parents not knowing the systems for referral.
  • Pre-school and school staff not being aware of developmental milestones to compare Daisy against.
  • Focus remained on Daisy's behaviour, and there seemed to be no desire to look at underlying factors that may have led to the behaviours.

• 2. What might be the positive outcomes from intervention?

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  Correct answer:

  • Following on from speech and language therapy (SALT), Daisy has improved confidence and self-esteem and interacts well with her classmates.
  • Daisy's mainstream school is now supportive and can see the benefits of Daisy receiving one-to-one support.
  • Early intervention is likely to result in better outcomes for Daisy in terms of speech, social, emotional and intellectual development.