What next for SLCN?

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    The National Year of Communication may be over but its legacy is strong

    My role as Communication Champion – one of the recommendations from the 2008 Bercow Review – enabled me to work in partnership with The Communication Trust, a 50 strong voluntary sector coalition, to deliver the National Year of Communication (the Hello campaign).

    In this article, I will reflects on the findings in my Two Years On report, published in January 2012, and outline the continued need for improvement in services for the one million children and young people in the UK with long-term speech, language and communication needs (SLCN).

    An important part of my role was to meet with local leaders, raising awareness of the issues. In two years I visited 105 of the 152 local authority/NHS Primary Care Trust pairings in England, and saw much innovative work to support children with SLCN. Particularly impressive were the local areas that had developed a community-wide strategy for language, such as Stoke on Trent’s “Stoke Speaks Out” and Sheffield’s “Every Sheffield Child Articulate and Literate by 11” programmes.

    It was also good to see some growth in joint commissioning of SLCN services across health and education. Joint commissioning is vital; without it (as is sadly still the case in seven out of ten local areas), the responsibility to meet children’s SLCN can be passed from one agency to another, with parents and children stuck in the middle and little chance of the Government’s proposed single plan working effectively.

    The policy context

    We have seen some measurable improvements. Between 2010 and 2011 there was an increase in the percentage of children achieving at age-appropriate levels in the Language for Thinking scale of the Early Years Foundation Stage Profile at age five.
    There has also been a reduction from four per cent to three per cent in the percentage of five-year-olds showing very significant difficulties on this scale, over the same period, and a slight narrowing of the gap between the percentage of children with SLCN achieving expected levels in English and mathematics at age 11 and their peers.

    There have been some helpful policy developments, such as the requirement to promote “articulacy” in new professional standards for teachers, and the inclusion of a new judgement on “how well teaching enables pupils to develop skills in communication” in the revised Ofsted inspection framework for schools.

    The most notable policy development has been the joint work of the Department for Education and Department of Health to establish communication and language as a prime area of children’s learning, which as a nation we have to get right for as many children as possible, before they reach the age of five.

    In some ways, future policy looks hopeful for SLCN. I welcome government proposals to provide more information to parents on how to support their child’s early development, and to ensure that all children will have a joint health and education review at the age of two. When implemented, this will ensure that SLCN are identified early.

    In other ways, however, my report highlights real concerns about the future. It documents increasing evidence of significant cuts to the front-line services on which parents and children depend, as a result of the double whammy of NHS and local authority budget reductions. These cuts coincide with rising incidence of SLCN, with a 58 per cent growth over the last five years in numbers of school-age children with SLCN as their primary special need.

    Another concern is the increasing trend towards inequity, with the provision a child receives dependent on whether their mainstream or special school purchase enhanced SLCN services, or how active and able their parents are in pressing their child’s case.

    Good practice in schools

    In my two years in post, I saw a welcome growth of local strategies to build the expertise of school and early years staff, and good evidence of the impact of training programmes.

    Another encouraging growth has been in support for secondary-aged pupils, who have often missed out in the past. I saw local speech and language therapists (SLTs) providing a menu of opportunities that include working with whole subject departments to improve curriculum differentiation, modelling small-group interventions, providing bespoke training to staff, and supporting screening and assessment processes.

    An increasing number of schools are adopting a whole-school approach to SLCN, which includes three waves of provision: at Wave 1, classroom and subject teaching that promotes all children’s communication skills , at Wave 2 additional, evidence-based small group interventions from trained teaching assistants for children with language delay, and at Wave 3 effective partnership with specialists.

    The Wave 3 partnership involves having a very highly trained teaching assistant able to work under the direction of an SLT to implement intervention programmes. The most effective schools are commissioning a period of enhanced support from SLCN specialists to train staff and help the school set up this three-wave model.

    In my report, I recommend that more schools take this approach. I also note that there is a continued need to ensure that class and subject teachers adapt their day to day teaching to meet the needs of children and young people with SLCN, rather than just relying on teaching assistant support for individuals and groups. I found that in many schools this was still more or less the only form of differentiation in place.

    Getting it right for future generations

    The National Year of Communication has come to an end but the need for our collective voice to be heard on these issues is as strong as ever. As the work carries on through charities and professional organisations, it is vital that we all lend our support and pull together to help bring about lasting improvements in provision for those with SLCN.

    Spotlight on Enfield

    Enfield redesigned its speech and language therapy service to tackle long waiting lists and is a good example of how health and education can work together.

    Before the changes, SLTs saw the majority of children in clinics. In the early years, children are now seen for a screening assessment or initial advice at drop-in sessions within children centres. They can then join a rolling programme of intervention groups running across localities.

    SLTs introduced school-led early screening and identification, increased the number of Wave 2 interventions routinely used in schools, delivered free training packages to increase the skills of education staff and increased the range of strategies and adaptations used in the classroom.

    They also developed a formula allocating SLT time to schools, with the incentive of additional sessions for schools which identified a “language lead” from their own staff, to work closely with the SLT.
    The outcomes of Enfield’s service redesign have been significant, with measurable improvements in early identification, parent confidence and children’s language skills.

    Further information

    Jean Gross is the outgoing Communication Champion. Her report, Two Years On: Final report of the Communication Champion, can be downloaded at:
    www.hello.org.uk

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