ABSTRACT
The medical context, at whatever level, provides an excellent opportunity for a holistic view of children's communication difficulties, through both the medical evaluation per se and as a result of the networking of medical practitioners with other childcare professionals. In the UK, a well-developed structure of primary care is intended to provide general medical care to all children. However, in the USA and most of continental Europe, paediatricians with specialist training in child development are primary care providers to all children. General practitioners, who may or may not have paediatric or developmental training, are joined in this task by health visitors, who do receive specific training in developmental issues. Communication development is the result of diverse factors and as such the first evaluation at the secondary healthcare level of a child experiencing communication difficulties needs to be a broad one, but also one capable of generating a swift clinical and inter-agency response.
