The key indicator for referring a child with speech delay to speech and language services is when children aged over 2 years present with abnormal speech development NICE NG127.
It is also important to be aware that delay or regression in speech and language can be a symptom of autism NICE NG127. If there is regression in language, children younger than 3 years should be referred to the autism team NICE CG128. For children older than 3 years with language regression, the initial referral should be to a paediatrician or paediatric neurologist NICE CG128. When considering the possibility of autism, inquire about the child's use and understanding of their first language NICE CG128. Do not assume that language delay is solely due to English not being the family's first language or to early hearing difficulties NICE CG128.