Developmental Communication Service

The Developmental Communication Service at Great Ormond Street Hospital (GOSH) offers specialist assessment and intervention advice for children whose communication and learning may or may not be constrained by significant movement (motor) disabilities. The focus is on advice for development of communication and participation.

This service offers specialist assessment and intervention advice for children whose communication and learning may or may not be constrained by significant movement (motor) disabilities. The focus is on advice for development of communication and participation.

Assessment of the child’s developmental skills will precede any practical advice regarding support for communication and learning. The assessment team will vary according to the needs of the child, but will generally include a speech and language therapist, occupational therapist, and a paediatrician. A clinical psychologist can be available if required.

There will be a particular emphasis on developing a detailed understanding of the child’s communication skills. This includes not only the child’s level of receptive language but also his/her current ability to use movement, vocalization and vision as basic expressive communication tools.

Consideration will be given to the optimization of positioning and the team will liaise with local services regarding the child’s positioning needs, where appropriate.

For those children with a difference between expressive (including speech) and receptive language skills, advice will follow on use of augmentative communication strategies and equipment to support expressive communication skills. We will consider potential sensory impairment (vision and hearing) and the impact on communication and learning.

Where appropriate, advice on strategies and equipment may include any of the following: the selection and use of sign and gesture vocabularies; visual materials (pictures and symbols) and voice output communication devices. Where relevant this may also include advice on the development of access skills e.g. pointing; look-choosing (eye pointing); switching; eye gaze control. This will consider all potential access methods and positions, but the overall goals are to support participation, learning and development.

We provide advice and recommendations only. We do not provide Augmentative and Alternative Communication (AAC) equipment as this is the responsibility of local services.

Referral criteria

  • Parents or professionals who have questions about a child’s communication and development that would benefit from an external opinion from a tertiary specialist.
  • This service sees children up to the age of 16. We are able to see children aged 17 with the permission of our Medical Director.

This service is not ACS - The Augmentative Communication Service. If children and young people meet criteria for NHS England funding for high tech AAC then they should be referred to ACS. Augmentative Communication Service

How To Refer

Referrals to the service can be made by the child’s Speech and Language or Occupational Therapist, with the agreement of the child’s Consultant Paediatrician. A referral form is available here DCS Referral Form July 2022.

Referrals can also be made by letter, although we may need to contact the referrer if any relevant information is not included. GP referrals are not accepted.

Referrals should be sent to the Developmental Communication Service, Neurodisability Service, Great Ormond Street Hospital, London, WC1N 3JH

We encourage secure receipt of referrals by email from an email address


On receipt of a referral, a pre-visit questionnaire will be sent to the child’s family and local therapists as relevant. Local therapists and representatives from the child’s school are welcome to attend the appointment.

What happens at an assessment?

The initial assessment lasts up to three hours. At this visit, children and young people, their families, and local professionals, will have the opportunity to clarify the questions raised in the referral and pre-visit questionnaires. Further relevant background information is obtained. The child’s medical history, previous investigations and diagnoses are reviewed.

We will carry out a play/ activity-based assessment with the child or young person to understand their communication and development. Parents are usually present throughout. We encourage families to bring favourite toys/ activities and current communication systems or seating equipment to the appointment.

At the end of the appointment our initial findings, conclusions and proposed next steps are discussed. For some children a second appointment may be required to complete the assessment, and in some circumstances this may take place in the child’s school.

A short summary of assessment findings may be given to parents on the day of assessment. A full written report will be completed later and sent to the child’s family and relevant professionals, as agreed with the child’s family.

Contact us

You can contact the Developmental and Augmentative Communication Service on 020 7405 9200 ext 5293