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Planned Care Innovation Exemplars

A Prudent Social Communication Pathway (in Speech and Language Therapy)

Natasha Bold, Highly Specialist Speech & Language Therapist

Cwm Taf Morgannwg University Health Board


Speech and Language Therapy (SLT) is one of the first services children are referred to when they are presenting with social communication difficulties or early signs of Autism Spectrum Disorder (ASD). The prevalence of ASD is significantly higher than previously reported with around one in 57 (1.76%) children in the UK with a diagnosis (Roman-Urrestarazu, R et al. 2021). Prior to the Covid-19 disruptions to services, the pressure on the SALT service due to referrals for children with social communication difficulties and/or emerging ASD were high. Adding in the aftermath of Covid-19 which delayed feeder services to provide early input and referrals to our service, the demand has now reached a peak resulting in our current model of working as insufficient.


To develop and pilot a new social communication pathway in speech and language therapy which encompasses the Prudent Healthcare Principles, with the intention of:

– Reducing clinical case load sizes

– Reducing the length of episodes of treatment

– Increasing parental satisfaction with the service

– Increasing parent and Early Years Practitioner (EYP) skills and knowledge to support children

– Increasing therapist wellbeing and job satisfaction


  • Pre-intentional referrals triaged into ‘Building Blocks for Communication Workshops’
  • Workshops offered to parents and EYPs in NHS and local authority – those who directly support the children


Outcomes/ Benefits

– 80 hours to deliver traditional input to 8 families reduced to 16 hours

– Clinical caseloads reduced by 18%

– Increased parent and EYP confidence and satisfaction

– Better outcomes and support for children until they reach an age that they can benefit from treatment

What next?

– Project outcomes and resources to be shared with SLT colleagues nationally

– Inform the All Wales Social Communication Pathway

– Support wider adoption

View project posters and slides from the PCIP National Showcase Event