How effective are interventions in Reception?

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A London SLT team investigated how effectively universal and targeted interventions can bring children up to speed

Guy’s and St Thomas’ NHS community speech and language therapy (SLT) team offers a commissioned service for mainstream schools across Lambeth and Southwark. In this area children entering nursery and reception were not school-ready, with a high number having known Speech Language and Communication Needs (SLCN), unknown SLCN and English as an additional language (EAL). One school chose to allocate some of their SLT commissioned time to the Early Years Foundations Stage (EYFS), and this service model was evaluated with the following aims:  

  • fewer children at risk of ongoing SLCN
  • avoid entering the specialist SLT caseload at a later point in KS1 or KS2
  • help develop language skills and core skills for children, so they can better engage in a more structured curriculum with their transition to KS1 

The children who participated were children of reception age who were suspected or confirmed as having SLCN, children with English as an additional language (EAL), reluctant talkers and children with attention and listening difficulties only. The children were identified by the class teachers and the class teaching assistants (TAs) with informal discussions with the SLT.

Four TAs, with variable levels of experience and training, were responsible for running the groups and collecting outcome measures. An informal screen was used to collect language levels pre and post intervention. The TA’s running the groups administered the screener and collected the results for each child in a one-to-one setting. For measuring outcomes, they used a tracking tool with a rating scale (1= Significant difficulty; 4= No difficulties) to rate the following core skills for each child, with the first and last measures being taken as the pre and post measures for each child:

1. increase in expressive language (main group focus) 

2. attention and listening, initiating interaction

3. turn-taking

4. confidence

The interventions were carried out by the TAs with groups of 3-4 children. The Talking Tables intervention was used across all groups, a universal based child-led intervention aiming at increasing overall expressive language through the use of structured adult-child interactions. The groups were recommended to run 3 times a week for 10-15 minutes within the classroom. 

The TA’s required modelling and coaching from the SLT pn using the outcome tools, administering the reception screener and setting up and running the group interventions.

Results

Twenty-one children were included in the evaluation and their outcomes are summarised below:

  • Children with attention difficulties needed about fifteen sessions (3-4 weeks) of group intervention to show enough positive progress to transition back into whole class learning.
  • Children with English as an additional language (EAL) needed approximately thirty sessions of consistent intervention (10 weeks) before they passed the post screener and transitioned back into whole-class learning.
  • Children with SLCN showed improvements in their post screen after 30-42 sessions, but they still failed at least one area of the screen, demonstrating the need for ongoing targeted interventions.

Overall, 80% of the children showed positive progress with expressive language. All children with attention difficulties made a positive increase with their attention and listening skills. Confidence had the highest positive change across all participants with 95% showing positive progress. 

Based on the pre and post screen and core skills ratings, five of the children did not make positive progress. However, this may have been down to inconsistent school attendance, inconsistent number of sessions, or the level of TA experience.

The results suggest that targeted interventions can help children with SLCN and EAL and may prevent future communication problems for children later in school, and ease the need for specialist SLT support at transition into KS1 and beyond. The targeted groups were put in place three years ago, and only one of the 67 children who accessed these groups in this time has subsequently needed a referral for specialist support in KS1 (note: children requiring specialist input at the beginning of reception would already have been identified to the specialist intervention pathway). 

The tools used here to collect the outcomes can aid successful early identification of children for appropriately targeted interventions. 

The universal and targeted group interventions have helped us better understand the number of sessions each cohort of children needed according to their presentation. Having this information can help with future long term SLT planning for other EYFS settings, and provide settings with a method of supporting a wider range of children. This process also helps to speed up settling-in periods for children transitioning into reception with EAL, attention and listening difficulties, and SLCN.

The study also highlighted the importance of workforce training and development. Staff who had prior knowledge and experience in supporting these targeted interventions were able to get the groups up and running faster and required less support from the SLT at those initial stages  than the less experienced TAs. The children in groups run by less experienced staff showed slower progress overall and the groups were run less frequently.

Claire McMahen
Author: Claire McMahen

Claire McMahen
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Claire McMahen is a Specialist Speech & Language Therapist at Guys’ and St Thomas’s NHS Trust.

evelinalondon.nhs.uk/communityspeechandlanguage

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