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First links

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Who is referred?

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Children with complex medical and learning needs which are likely to be long term.


First Links, Who is Referred, Image of baby

Babies from birth – 18 months.


First Links, Who is Referred, Image of children

Children aged 18 months - 2years may be accepted for assessment only.


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Children must be under the care of a Community Paediatrician and registered with a doctors surgery in Shropshire or Telford and Wrekin.


Decision making process

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A Health Professional makes a referral.


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The referral is triaged by a Speech and Language Therapist (SLT), and either accepted or rejected.


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The Paediatrician is informed if the referral is rejected, and an alternative pathway will be recommended.


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Children's names are shared at the Child Development Centre (CDC) triage panel for information and to check for onward referrals and actions.


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If the child is accepted onto the pathway, a letter is sent out to parents/carers including the dates/times/location of the group.


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Transport can be arranged to the group if this is needed.


During the therapy sessions

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An initial appointment is arranged to gather information. This will ideally be in clinic with a Speech and Language Therapist (SLT), a Speech and Language Therapy Assistant (SLTA) or a Specialist Nursery Nurse (SPNN).


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The child is invited to attend First Links group. This takes place term time only.


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There will be up to 6 children and their parent carers in the group.


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The first links team includes SLTs, SPNNs, SALTAs, Occupational Therapists (OTs), Physiotherapists (PTs), Portage, The Sensory Inclusion Service (SIS) and the Disabled Children's Team (DCT).


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The child has their therapy within the group with SLTs, SLTAs and SPNNs to support the child’s development.


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Professionals will make observations during the sessions as part of the assessment process.


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Individual appointments with the SLT can be made for specific eating, drinking and swallowing advice if needed.


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Telford: Child may have a standardised Developmental Assessment with a SPNN when they are aged 27-30 months


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Shropshire: Assessment session with Educational Psychology Service (EPS) when they are aged 27–30 months, using a standardised developmental assessment where appropriate.


After the therapy sessions

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The Paediatrician, The First Links team and any other relevant professionals have a video call on Microsoft Teams to share information with parent carers about the child’s strengths and next steps.


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An Education and Health Care Needs Assessment (EHCNA) will be requested by the Special Educational Needs and Disability (SEND) team if it is needed.


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Aim within 4 weeks

A multi-disciplinary report will be finalised and sent out electronically to families (with permission) The report is sent as soon as possible.



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The child will no longer attend First Links group sessions. The child will be seen three times yearly by a member of the First Links team at home, in clinic or in their early years setting depending on their need.


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Once the child reaches school age, they may be transferred to the speech and language therapist supporting their school or they may be discharged depending on their needs.


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The Child Development Centre (CDC), Occupational Therapy (OT) and Speech and Language Therapy (SALT) advice lines are available if parents have further questions.


NOTE: All timeframes provided are estimates.




Further information

First Links pathway information sheets available to download

CDC - Glossary v2

Find out more in the glossary of terms


CDC Signposting Information image

Find signposting information for Telford and Wrekin

Find signposting information for Shropshire



Page last reviewed: 20 May 2025
Next review due: 20 May 2026