Joining the Dots: Neurodiversity and the Urgent Need for Speech and Language Therapy

Imagine a 7-year-old child in a classroom, brimming with ideas but unable to express them. They want to participate, but their words fail to connect to their thoughts.

For many neurodivergent children — particularly those on the autism spectrum or with ADHD — this is a daily reality. Their intelligence, curiosity, and potential are clear, but their ability to communicate is limited, leaving them at risk of falling behind academically, socially, and emotionally.

Speech and language therapy (SALT) provides the bridge between a child’s potential and their ability to connect meaningfully with the world. Yet across the UK, SALT services are struggling to meet growing demand, creating delays that have wide-ranging consequences for children, families, schools, and local authorities.

The Scale of the Challenge

Recent research underscores the urgency:

• 1.9 million children are struggling with talking and understanding words, representing a 26% increase over the last two years (Speech and Language UK, 2023).

• 21% of children and young people on NHS waiting lists are waiting for SLT services, which cover communication, eating, drinking, and swallowing (Nuffield Trust, 2025).

• Waiting lists are growing: 44% for adult services and 9% for children and young people, with high vacancy rates particularly in posts supporting people with learning disabilities (Nuffield Trust, 2025).

• By November 2024, over 65,000 children were on SLT waiting lists, nearly half waiting more than 12 weeks (UK Parliament, 2025).

• In socially deprived areas, up to 50% of children start school with impoverished speech, language, or communication, with downstream effects on literacy, learning, and social integration (UK Parliament, 2025).

These numbers are stark reminders for councils: the demand for speech and language therapy is high, and delays have long-term consequences for children’s outcomes, school readiness, and social inclusion.

Why Neurodivergent Children Require Tailored SALT

Children with autism, ADHD, or overlapping profiles often have unique communication needs. SALT is not about “fixing” differences; it equips children with strategies to communicate effectively, build confidence, and navigate social and educational environments.

• Autistic children may struggle with social reciprocity, interpreting tone or body language, and expressing abstract ideas.

• Children with ADHD may experience impulsive speech, difficulty organising thoughts, or challenges sustaining attention in conversation.

• Children with overlapping profiles may face multiple intersecting challenges, requiring integrated approaches to assessment and therapy.

Research shows that SALT is highly effective: 79% of children receiving therapy improve in one or more areas including speech/language needs, communication, or participation in education and social activities.

Yet many children remain unidentified: up to 40% of young people with speech, language, and communication needs (SLCN) go undetected. Among children referred to mental health services, 64% have SLCN, with 40% unidentified. It's a stark reminder of the nuanced, intertwined relationship between language and communication needs and wider neurodiverse and mental health landscape. 

The Broader Implications

And it doesn't just stop there. The impact of delayed or inadequate SALT extends beyond the classroom:

• Academic outcomes: Children who struggle with communication are six times more likely to be behind in English and eleven times more likely to be behind in Maths by age 11.

• Employment outcomes: Children with persistent SLCN are twice as likely to be unemployed as adults.

• Social inclusion: Poor communication skills can lead to isolation, frustration, and behavioural challenges, contributing to long-term social and mental health concerns.

• Justice system: Over 60% of children in Young Offender Institutions have communication difficulties.

Teachers also report challenges: 53% feel undertrained to support pupils with SLCN, and 73% believe the issue is not prioritised by the government. These gaps compound delays and increase pressure on schools and local authorities.

Why Councils Should Take a Holistic Approach

Many councils focus first on ADHD assessments, recognising the impact of attention, impulsivity, and executive function on children’s education and behaviour.

While this is crucial, ADHD assessments alone can miss overlapping needs, particularly in communication and social interaction. Without integrating speech, language, and autism assessments, some children may receive partial support, limiting their long-term outcomes.

A holistic approach — starting with ADHD assessment and incorporating SALT and autism expertise — allows councils to:

• Gain a complete picture of each child’s needs, identifying both neurodevelopmental and communication challenges.

• Coordinate interventions across communication, attention, social skills, and executive function, reducing gaps in support.

• Streamline pathways, avoiding duplication and ensuring faster access to the right services.

• Plan more effectively for education, social care, and wider community services, allocating resources where they will have the most impact.

Our sister companies, ADHD 360 and Autism 360, provide specialist assessments that complement SALT, giving deeper context to each child. By combining ADHD assessment with SALT and autism input, councils can ensure that interventions address both underlying neurodivergent profiles and communication needs, reducing missed opportunities and improving long-term outcomes for children.

Recommendations for Councils

1. Invest in Early Intervention: Prioritise timely SALT and neurodiversity assessments to reduce downstream educational and social impacts.

2. Explore Online Providers: Virtual assessments and therapy can be delivered at scale by expert providers.Specialist support is no longer bound to what is (or rather, isn't) available locally.
   
   

3. Adopt Holistic Assessment Models: Integrate ADHD and autism assessments alongside SALT to address overlapping needs.

4. Encourage Multi-Agency Collaboration: Schools, health services, and local authorities should work together to ensure consistent strategies.

5. Monitor Outcomes: Use data-driven approaches to track improvement in communication, participation, and social inclusion.

6. Support Workforce Development and CPD: Equip school staff, educational psychologists, and local authority professionals with the knowledge and skills to support children’s speech, language, and communication needs.
   
   Mable Academy offers accredited CPD training ranging from introductory SLT courses to specialist topics such as selective mutism, ensuring staff are confident and capable in supporting neurodivergent children in classroom and community settings.

By combining holistic assessment, targeted interventions, and ongoing professional development, councils can deliver coordinated, evidence-based support that maximises outcomes for children and reduces long-term social, educational, and emotional costs.

Looking Forward

Rising speech and language therapy waiting lists are a clear challenge for local authorities, but they also present an opportunity: councils can adopt holistic, evidence-based models that address neurodiversity and SLCN simultaneously.c

By integrating speech and language assessments with ADHD, autism, and broader neurodiversity evaluations, councils can gain a complete picture of each child’s needs and ensure tailored, effective support:

• Ensure children with overlapping profiles are fully assessed

• Reduce delays in intervention

• Support schools in embedding effective strategies

• Improve long-term educational, social, and emotional outcomes

Children with neurodivergent profiles deserve coordinated, tailored support.

When councils invest in holistic assessment and intervention, they not only improve outcomes for individual children but also strengthen communities, reduce future social costs, and ensure every child has the chance to thrive.

Successful assessments at scale

See how Mable Therapy worked with Calderdale & Huddersfield NHS Trust to cut waiting list backlogs, provide over 280 timely speech and language assessments, and give families the strategies and confidence they needed.

Read the SEND Success Case Study