Woodfield Primary School Additionally Resourced Centre for Children with Speech, Language
and Communication Needs
Child’s Name: Date of Birth: School Attending:
Name of Parents/Carers: Home Address:
Speech, Language and Communication Needs
What aspects of the child’s speech, language and communication needs are causing concern?
Please tick all that apply:
Unwilling to give eye contact or attach significance to language.
Attention/understanding of spoken language.
Expressive language is unusually delayed in comparison to receptive language skills.
Production of speech sounds.
Social Communication skills.
Speech and Language Therapy Intervention
Has the child had a recent assessment by a Speech and Language Therapist?
Please summarise the key points from the most recent Speech and Language Therapy Service
If the child is receiving therapy have you got a recently updated copy of their programme that you
are able to use to provide support to them when they are in school?
Educational Psychology Service Intervention
Please summarise the key points from the most recent Educational Psychology Service Report.
Special Educational Needs
What support/intervention is provided by the school the child is currently attending?
What do the parents think about a placement in the Resource Centre?
Team Around the Child
Please specify which other children’s services are involved in supporting the child. If none, please
Profile of the Child’s Educational Needs
If the child is in the Foundation Stage – please specify recent judgments made against the stepping-
stones and early learning goals. If the child is in Key Stage One please outline their recent
Signed: Name/Designation: Date:
Please return this form to: Ken Shaw, Teacher in Charge, ARC Woodfield Primary School,
Gurney Road, Balby, Doncaster DN4 8LA