Therapy Services in Lewisham for Children: Facts and figures

Supporting Information

Key Facts

  • The number of children in Lewisham with a disability is unknown, and estimates vary widely, from 3-4% of the population to 7.3%
  • Over 7600 pupils in Lewisham schools in 2007 has Special Educational Needs, of who under 1200 had SEN statements
  • Therapies are cut-effective: every pound invested in Speech and Language Therapy generates more than £6 in life time earnings

According to the Census 2011, the population of Lewisham is 275,900. This is a 14% increase since 2001. Almost a quarter of Lewisham's population are aged 19 years and under with under 5s and primary school children each making up some 8% of the total population. The following chart shows the overall breakdown, rounded to the nearest 100 in each age group.

Evelyn is the largest ward (total population 17,456, of whom 4634 are aged <20 years) but Downham (total population 15,268) has the largest number of children and young people aged <20 (total 4,639). Downham also has the greatest proportion of children and young people <20 years (Figure 4.2) (GLA Round 2011 estimates, as Census 2011 figures are not available at the time of writing)

The Equality Act 2010 defines a person with a disability as someone who has a physical or mental impairment that has a substantial and long-term effect on his or her ability to carry out normal day-to-day activities1. The definition of disability encompasses a broad range of impairments, including the autistic spectrum, Tourette’s syndrome and communication difficulties. It has been suggested that between six and seven per cent of children are disabled, and three-quarters of these children also have special educational needs (SEN) . Data regarding the prevalence of disability in children is extremely sparse though it is accepted that this information is needed to plan services for these children. Estimates of the prevalence of disability are highly sensitive to the measures used2. In 2009, Read et al conducted a comprehensive search and evaluation of data sources with information on disabled children. They included 30 data sources: nine cross-sectional surveys, nine longitudinal and panel studies, seven administrative data sets, four specific condition databases and one other type of study. They found that all studies used different criteria or methods of obtaining data, and all had significant and numerous limitations3.

In 2011, Dr. Tony O’Sullivan (Consultant Community Paediatrician) estimated the numbers of children up to 16 years of age with disability within the population of Lewisham in 2011, by category of disability. The results are shown in the following table.

The Triangle Schools Project in the north of the borough found prevalence rates of Speech, Language and Communication needs of 30% in 5-16 year old children. However, over a 3 year period of therapy input into the Triangle Schools (assessment, advice and intervention for children from nursery to year 6 both with and without statements), prevalence rates of SLCN needs dropped to 7%, in line with the national average4.

Analysis conducted in 2007, showed that the total number of children, reviewed in the previous three years, on the Lewisham Health Needs Register was 3958. In order to be included on this register, children must be aged 0-19 years and should have at least one impairment of moderate or greater severity when assessed by the community paediatrics team. Using 2001 Census figures, the total number of children living in Lewisham was 63,954. Thus the overall prevalence of children with disabilities in Lewisham was estimated to be 6.2%.

Actual numbers recorded for Lewisham are shown in the following table.


The prevalence of children with therapy needs in Lewisham

Policy related to the prevalence of therapy needs in children comes entirely from the area of Speech and Language therapy (SLT). The national prevalence of Speech, language and communication (SLC) needs was identified in the Bercow Report in 2008 to be 7%5. The figure identifying SLC needs in children is extensively quoted as ranging between 6-8% of children aged 0-11 years, with 1% of children having severe, complex and long-term SLC needs requiring specialist support6,7. When the prevalence rate of 7% used in the Bercow Report is applied to under 5 population in Lewisham (as estimated by the Greater London Authority in 2011), 22040, this equates to approximately 1543 children. However, the prevalence of SLC needs in under 5s in areas of high deprivation can be as high as 55%. The prevalence of SLC needs (10%) in 5-16 year olds applied to the Lewisham population at this age (37925) equates to approx. 3973 children. It is important to note that the prevalence of SLC needs in 5-16 year olds can be as high as 35% in areas of high deprivation8.

Approximately 1% of children entering school have the most severe and complex speech, language and communication needs. This equates to approximately 220 children in the population aged under 5 years, and 397 children aged 5-16 years with the highest level of SLC need.




  1. Equality Act 2010
  2. Disability follow-up to the Family Resources Survey - Aims, methods and coverage
  3. Read J, Blackburn C, Spencer N: Disabled children in the UK: a quality assessment of quantitative data sources. Child: Care, Health and Development 2009, 36(1):130-41.
  4. Department of Health. National Service Framework for Children, Young People and Maternity Services. Oct 2004.
  5. The Bercow Report: A review of services for CYP 0-19 with Speech, Language & Communication Needs 2008
  6. Gascoigne M. (2006) “Supporting children with speech, language and communication needs within integrated children’s services”, RCSLT Position Paper, RCSLT: London
  7. I CAN Talk Series – Issue 9
  8. Department of Health. National Service Framework for Children, Young People and Maternity Services. Oct 2004.





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