Before you contact anyone
The single most useful thing you can bring to a first appointment is not a worry. It is a record. Two weeks of notes will change the quality of every conversation you have after this, and will save you paying someone to work out what you already know.
1. Write down what you have actually seen
Not conclusions — observations. "He does not listen" is a conclusion. "He does not respond to his name when the television is on, but does in a quiet room" is an observation, and it is worth ten of the first kind. Note the time of day, who was there, what came immediately before, and what happened next.
Do this for two weeks. A pattern will usually surface that nobody could have described from memory, and often it is not the pattern you expected.
2. Ask the school what they see, in writing
Email the class teacher and the SENCO and ask three questions: what do you notice, when in the day does it happen most, and what have you already tried. Ask for a written reply.
This matters more than it sounds. Verbal reassurance in a corridor evaporates, and a school that has tried nothing will usually say so in writing far more honestly than in person. You also now have a dated record, which is useful later if provision becomes a negotiation.
Then, in this order
3. Rule out the physical first
Hearing and vision. Always, and early. A meaningful number of children referred for communication or attention concerns have a hearing issue nobody checked, and glue ear in particular is common, treatable and easy to miss. It is a cheap test and it removes the most fixable explanation from the board.
Your paediatrician is the right first call for this, and it is worth doing before you spend anything on therapy.
4. Decide whether you need a diagnosis yet
This is the step families most often get backwards, in both directions — either rushing to a diagnosis they do not need to start support, or waiting months for one before doing anything at all.
A formal diagnosis genuinely matters when:
- A school requires one to allocate additional support or funding
- You need exam access arrangements, now or in a few years
- Insurance reimbursement depends on it
- The picture is genuinely unclear and a medical explanation is possible
It matters far less when what you actually want is for somebody to help your child on Monday. A functional assessment — what your child can do, what gets in the way, what the school can deliver — does not require a label and answers a more immediately useful question.
If you do go for diagnosis, go to someone independent who does not also sell the treatment for what they diagnose. That is not a slight on anyone's integrity. It is simply that you should never have to wonder.
5. Get one plan before you buy any hours
The expensive mistake is buying therapy first. It feels like progress, it is available immediately, and six months later you have a speech therapist, a tutor and an assistant who have never spoken to each other and are working towards three different things.
Whoever you use, insist on one written plan first: goals in plain English, how intensively each will be worked on, in which settings, and the dates it will be reviewed. If a provider cannot produce that before taking your money, that is information.
6. Ask what the ending looks like
Before you sign anything, ask what has to be true for this support to stop. Not when — what. A provider with a real answer will describe a condition ("when he is initiating requests with unfamiliar adults"). A provider without one will describe a duration, or change the subject to how every child is different.
Every child is different. That is a reason to write a specific exit criterion, not a reason to avoid writing one.
What not to do
- Do not buy equipment yet. Not weighted blankets, not sensory kits, not apps. Almost all of it arrives without anyone able to say what it is for or how you would know it worked.
- Do not start three things at once. If four things change in the same month and something improves, you have learned nothing about which one to keep paying for.
- Do not let urgency rush the sequence. Early support genuinely works better, and that is also the argument most often used to push a family into signing on a first visit. Both things are true.
- Do not accept a recommendation you cannot repeat back. If you cannot explain it to your partner in two sentences, it is not clear enough to buy.
A reasonable first month
Weeks one and two: keep notes, email the school. Week three: paediatrician, hearing and vision. Week four: a functional assessment, or a conversation with someone about whether you need one. Nothing in that sequence commits you to a programme, and it is the cheapest possible way to find out whether you need one.
If it turns out you do not, that is a good outcome and you should treat any provider who seems disappointed by it accordingly.