How do I get help?

A speech and language therapist in a speech language therapy practice uses various methods to assess a child’s language development. For example, by conducting tests. Or by having a conversation with your child. 

The speech and language therapist usually sees your child 1 time a week. Such appointments usually take 30 minutes per session. During direct treatment, the speech and language therapist works with the child. Parents are present during the appointment. Or they receive information about the treatment. In indirect treatment, the speech and language therapist gives parents advice. For example on how to stimulate the language development of their child.  

Speech and language therapist work according to the DLD guidelines (NVLF). They can diagnose (suspected) DLD. 

Find a speech therapy practice in your area. You can do this by using the Zorgzoeker van de NVLF. You can also do this in Google by searching “logopedie” and your place of residence.

Discuss your concerns about the language development of your child with the speech language therapist. For example, write down what signs you recognise from the page Does my child have DLD?. The speech and language therapist will inform you if referral is needed.  

Good to know: 

• A DLD diagnosis is not required to visit a speech and language therapist. 

• You can also visit a speech and language therapist for advice for suspected DLD. 

• Speech language therapy is often fully covered (for children under 18).

Many different professionals work at the Speech and Hearing Centre.
We call this a multidisciplinary team. They assess whether the language problems are due to DLD or other factors, such as hearing impairment or low(er) intelligence.

• An audiologist examines hearing (audiological assessment)

• A speech and language therapist assesses speech and language 

• An educationalist or psychologist assesses the behaviour and learning ability (intelligence). This is called psychological assessment.

The team discusses the results of the tests together.
Then they will share the results with you. 

For assessment at a speech and hearing centre, two steps are required:

Step 1: consultation with a doctor

Schedule an appointment with a doctor. For example, with the/a:  

• GP 

• Youth doctor from GGD. 

• ENT-doctor (if your child is already seeing one)

Discuss your concerns about the language development of your child with this doctor.
For example, write down any signs you recognise from the page Does my child have DLD?. Is your child severely limited by their speech or language problems? Discuss this too and provide specific examples.
 

Step 2: referral to a Speech and Hearing Centre

Request a referral to a Speech and Hearing Centre. There, they will do further assessment. Does your child already go to speech language therapy? Then the speech and language therapist can explain to the doctor why referral to a Speech and Hearing Centre is necessary. 

Good to know: 

• You do not need a DLD diagnosis to visit a Speech and Hearing Centre.

• You do need a referral from the GP, youth doctor or ENT-doctor.

• Assessment at a Speech and Hearing Centre is fully covered for children under 18. Are you 18 or older? Then you pay a deductible.

ZG-zorg is specialised care for children with an impairment in hearing and/or communication. In the Netherlands there are 6 organisations for ZG-zorg. They do not all offer the same care/services. These are the different kinds of ZG-zorg:

Early treatment

Most organisations offer early treatment. That includes toddler treatment groups and itinerant care.

The toddler treatment group is for children with (suspected) DLD between 2 and 4 years of age. The children attend group sessions 2 or 3 days a week. They practice their language skills through play. The team exists of people with different professions. On every early treatment group, there is a speech and language therapist, a pedagogical practitioner and a behavioural scientist.

Parents are very important for treatment. They can attend a toddler treatment group or speech and language therapy. And they can support treatment. They can also follow parent courses or attend information meetings about DLD.

With itinerant care your child receives care in their own environment (for example at home or at the daycare centre). Parents and pedagogical workers learn how they can stimulate language development.

Psychosocial-education

Most organisations also provide psychosocial-education to parents, children and adolescents. And sometimes to other people in the child’s environment as well. Through psychosocial-education you learn what DLD is and what it entails for daily life (at home, at school, with family and friends). And how to deal with it.

Individual treatment

Some organisations also offer individual treatment. During this treatment, children and adolescents can talk about difficult situations or feelings. Or they can learn how to handle them through play or movement. The child practices new situations and skills together with the therapist.

After-school treatment

For children that attend primary or secondary school (from 5 years old and up), there is also after-school treatment. These children experience social-emotional problems or behavioural problems because of their language difficulties. For example, they find it difficult to make contact with other children. Often they cannot express their feelings properly. In the after-school treatment group the child practices language and social skills, together with other children.

Speech and language ambulatorium

A speech and language ambulatorium (in Dutch: spraak- en taalambulatorium) provides help to children and adolescents for whom a diagnosis is difficult to establish. Or in cases where it is unclear which treatment fits best. At the ambulatorium they receive a short and intensive form of assessment and treatment.

Fonopoli / Speech clinic

A Fonopoli or Speech clinic is for children with severe speech problems. For example, they are not easily understood by others. Does a child not make enough progress with the help of a speech and language therapist? Then your child receives a short and intensive form of assessment and treatment here.

Do you want to register your child for ZG-care? Then 4 steps are required:

Step 1: Assessment at the Speech and Hearing Centre

A team of professionals with various disciplines will assess your child. For example, an audiologist for hearing, a speech and language therapist for language and a behavioural scientist for learning ability. We call this multidisciplinary diagnostics.

Step 2: DLD diagnosis

The Speech and Hearing Centre will give the diagnosis (suspected) DLD.

Stap 3: ZG-referral

The Speech and Hearing Centre will give a referral to ZG-care. The DLD has to be severe in order for this referral to happen. Detailed regulations can be found on the website of SIAC (in Dutch). To summarize, the rules are:

• Your child has a disorder in one or more language areas (speech, language production, language perception, language usage).

• The level of language development is significantly lower when compared to peers. Your child scores low on language tests.

• Your child has severe limitations in communicative participation. That means that your child experiences significant difficulties due to their language problems.

• If your child also had other problems or disorders, then the language problems must be the primary concern.

• You have a clear need for support.
  For example: “Help my child to improve their interactions with other children”. The need for support must align with the services of a ZG-organisation.

The medical specialist or clinical physicist audiologist approves the referral. Has your child previously received a ZG-referral? And has the DLD remained unchanged? Then the GP or youth doctor can refer to ZG-care directly.

Step 4: Application Centre

The Application Centre (in Dutch: Aanmeldpunt) determines whether your child indeed qualifies for specialist care. Together with you, they assess which ZG-care is appropriate. The Speech and Hearing centre will provide you with the contact details of the ZG-organisation’s Application Centre near you. You can schedule an appointment yourself.

Good to know:

• If your child needs ZG-care again, contact the Application Centre of a nearby ZG-organisation. They can inform you about the necessary steps to take.

• It is not possible to receive reimbursement for two forms of care simultaneously. For example, a child cannot receive early treatment and go to a speech language practice at the same time. For exceptions, you can contact your health insurance.

• ZG-care can be combined with special education or educational support.

• ZG-care for children is fully covered (up until the age of 18). Are you 18 or older? Then you must pay a deductible..