Getting Speech Therapy and Occupational Therapy Through School in Scotland

In theory, speech and language therapy (SALT) and occupational therapy (OT) are part of the multi-agency support framework that underpins Scotland's Additional Support for Learning system. In practice, many families find that NHS waiting lists are long, therapists work in silos, and the school either doesn't know how to apply recommendations or claims it doesn't have the staff to do so.

This post covers what the system is supposed to look like, the most common failure points, and what you can actually do about them.

How Therapy Is Supposed to Connect to Education

Scotland's ASL framework explicitly recognises that some children's educational barriers require input from services beyond education. The Co-ordinated Support Plan (CSP) was specifically designed for children who need significant support from both the education authority and an "appropriate agency" — which includes NHS Health Boards delivering speech therapy or OT.

The key legal principle, established by Upper Tribunal case law in Aberdeenshire Council v. CD, is that health input counts toward the CSP threshold only when it is directly relevant to the child's educational needs. A SALT programme focused on functional communication and literacy acquisition, for example, is educationally relevant. The same therapist providing support primarily for social communication at home may not be.

This matters because it defines where the duty lies. If your child needs speech therapy to access the school curriculum — to understand teacher instructions, to participate in class discussions, to develop phonological awareness for reading — that is an educational need. The education authority cannot simply direct you to the NHS and wash its hands of the matter.

The Failure Points

NHS waiting lists. SALT and OT have long waiting times across most Scottish health boards, in some areas exceeding two years. Schools sometimes tell parents they must "wait for the referral" before implementing any support. This is legally incorrect — the duty to identify and provide for ASN exists regardless of NHS waiting lists. The school can and should put in place interim support while the NHS assessment is awaited.

Advice without delivery. A common outcome is that a SALT or OT assessment happens, a report is produced with recommendations, and then nothing changes at school. Teachers don't have time to implement strategies. No one coordinates between the therapist and the classroom. The report sits in a file.

NHS-education disconnect. Therapists employed by health boards often have different referral management systems, caseload priorities, and reporting lines from the education authority. Coordination requires active effort. Under GIRFEC, there is supposed to be a mechanism for multi-agency coordination, but in practice the Named Person often lacks the capacity to drive it.

What You Can Do

Request a school-based SALT or OT programme in writing. Don't just ask — put it in writing as a formal request under the authority's duty to provide adequate and efficient ASN support. Name the specific barrier to learning (for example: your child cannot access written tasks independently due to motor difficulties, which OT should address through a handwriting programme or assistive technology provision). Request a written response.

Ask how existing SALT or OT recommendations are being implemented. If your child has already been assessed by a therapist, ask the school in writing to detail how each recommendation in the most recent report is being implemented, which member of staff is responsible, and how frequently. Vague assurances that staff are "aware of" the report are insufficient.

Push for SALT or OT delivery at school rather than in a clinic. Therapy delivered at school — where the child is in their natural learning environment and the therapist can work directly with teachers — is more effective for most children than clinic-based sessions. The Code of Practice supports a model of therapy that is embedded in the educational context rather than happening separately from it.

Assess whether your child meets the CSP threshold. If your child's needs require significant input from NHS SALT or OT that is directly relevant to their educational functioning, and those needs are complex and likely to persist for more than a year, you may have grounds for a formal CSP request. A CSP would specify exactly what SALT or OT the authority and the NHS Health Board must provide, making it enforceable.

Commission an independent assessment if NHS wait times are too long. Independent SALT and OT assessments are expensive, but they provide a detailed, current picture of your child's needs and generate specific educational recommendations that you can use both in school communications and in any formal dispute process. Any independent report submitted to the ASN Tribunal must explicitly link clinical findings to educational barriers — generic diagnostic reports are much less persuasive.

CALL Scotland and Assistive Technology

For some children, particularly those with dyspraxia, motor difficulties, or complex communication needs, assistive technology can be a more immediate and effective intervention than waiting for NHS OT or SALT. CALL Scotland (Communication, Access, Literacy and Learning) specialises in assessing and supporting children who need technology-based solutions to access the curriculum. Their assessments can inform requests for assistive technology provision to be written into an IEP or CSP.

For the full escalation pathway when the education authority is failing to coordinate or deliver therapeutic support, the Scotland ASN Appeals Playbook covers both the letter templates and the formal dispute routes available under the ASL Act.

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