Why Speech Therapy Referrals Are Rising in Grades 3–5 (and What to Do About It)

Hey, speech friend! 👋🏼

We’re in a really unique time in the world of speech therapy—and yes, it all circles back to one big event: COVID.

(I know, none of us want to hear about that anymore, but stay with me—it’s important!)

Lately, there’s been a noticeable uptick in referrals for language support among students in 3rd through 5th grade. If you’re in the schools or private practice, you’ve probably felt it too. Your inbox is full of evaluation requests, teachers are flagging more kids, and caseloads are ballooning faster than you can print new data sheets.

So what’s going on? Why are we suddenly seeing so many upper elementary students referred for language services?

Let’s dig in 👇🏼

How COVID Created a Language Gap

It’s wild to think about, but the pandemic hit more than five years ago. When schools and early intervention programs went virtual—or shut down completely—children who were in Pre-K, kindergarten, or first grade at that time lost out on critical foundational language experiences.

Those are the years when kids learn through play, peer interaction, and exposure to rich, structured language in the classroom. For many children, that didn’t happen as it normally would.

Fast forward to now, and those same students are in upper elementary…where academic expectations are steep, and language demands are high.

Reading comprehension, writing, and critical thinking all rely on a solid foundation of language skills—and when that foundation isn’t strong, we start to see gaps emerge.

So it’s not that these kids “suddenly” developed language difficulties. It’s that they’re finally reaching an academic stage where those early language weaknesses are becoming more visible.

What We Should Be Looking For 👀

By 3rd grade and beyond, children are expected to have mastered basic language skills. They’re no longer learning what words mean—they’re using language to learn new information.

That means their language goals and challenges look very different from those of a kindergartener or first grader.

Here are the key areas to assess and monitor when you’re working with 3rd–5th graders:

• Synonyms and Antonyms: Understanding relationships between words is essential for reading comprehension and vocabulary expansion.

• Multiple Meaning Words: Words like “bark” and “bat” require flexible thinking and strong contextual understanding.

• Idioms and Figurative Language: As literature becomes more complex, kids need to interpret non-literal expressions accurately.

• Context Clues: Using surrounding text to infer meaning builds independent reading skills.

• Compare and Contrast: Foundational for both comprehension and written expression.

• Sequencing (5–6 steps): Helps with summarizing, retelling, and organizing ideas.

• Inferencing: Critical for understanding implied meaning in stories and social interactions.

• Describing: Supports vocabulary, grammar, and expressive clarity.

• Why and How Questions: Moves beyond surface-level recall to deeper understanding and reasoning.

These skills are not only tied to academic success—they’re also the foundation for higher-level thinking and effective communication.

Why Traditional Screeners Might Miss the Mark

Here’s the tricky part: many standardized language screeners aren’t designed to pick up these higher-level skills. They’re great for identifying basic deficits but may overlook those subtle weaknesses in figurative language, inferencing, or contextual understanding.

That’s why informal assessments are your best friend with this age group. You’ll get a clearer, more authentic picture of what your students actually understand—and where they’re struggling.

When I started noticing this wave of 3rd–5th grade referrals, I needed something quick, effective, and flexible enough to use for screening, direct therapy, and progress monitoring.

That’s when I created (and now swear by) my No-Print 3rd–5th Grade Language Tool.

It checks off all the boxes:

• Covers every major language skill listed above

• Editable PDF forms so you can type right into the document

• Perfect for informal assessments, therapy activities, and progress checks

• Completely digital (no printing, cutting, or laminating needed!)

When you get five new referrals in one day—and let’s be honest, it happens—having a ready-to-go tool like this makes life so much easier.

I’ll start by using it informally to identify strengths and weaknesses, then transition right into using the same materials for targeted instruction. Later, I pull it back out for progress monitoring or review. It’s seamless, efficient, and actually enjoyable for the kids.

A New Normal for Language Therapy

This wave of upper elementary referrals isn’t going away anytime soon—and that’s okay. It’s a chance for us as SLPs to make a huge impact by filling those language gaps before students move into middle school.

By assessing and supporting the right areas—figurative language, inferencing, vocabulary, and complex comprehension—we can help these kids not just catch up, but thrive.

So the next time your inbox fills up with another round of 3rd–5th grade referrals, take a deep breath. You’ve got this.

With the right tools (and maybe a little coffee), you can confidently support these students, one context clue and idiom at a time. ☕✨

Ready to simplify your assessments and keep therapy easy?

Check out my No-Print 3rd–5th Grade Language Tool for quick informal screening, direct therapy, and progress monitoring—all in one easy-to-use resource.