Children with specific speech and language difficulties (SSLD) pose a challenge to the education system as a result of their language needs and associated educational and social-behavioural difficulties. Local education authorities (LEAs) in England and Wales have developed language units to meet their needs but previous research has indicated this provision was inadequate. The development of inclusion raises questions regarding this type of provision, compared with full inclusion into mainstream schools. The present study reports on a national survey of LEAs in England and Wales (97 respondents, 49.5% response rate) and interviews with 37 LEA special educational needs managers. Provision varied by age group with designated specialist provision more prevalent at key stages 1 and 2 (age 5?11 years), and relatively little at key stages 3 and 4 (11?16). LEAs' decision-making regarding provision varied, influenced by the lack of common criteria, which was highlighted by the difficulties in distinguishing children with SSLD from those with autistic spectrum disorder. There were also difficulties translating policies into practice, including the shortage of speech and language therapists. The implications of the study are discussed with reference to inclusion.