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Memorandum submitted by I Can
1. Executive Summary
1.1. I CAN, the children's communication charity, welcomes the opportunity to feed into the Committee's inquiry into Sure Start Children's Centres. Children's Centres play an invaluable role in improving outcomes for children across the country. Our experience has, however, also found that they have the potential to deliver much more. In this submission we have used our experience to highlight the following areas:
§ The positive effect that Children's Centres have had on children in their early years. § The key role that Children's Centres have played in supporting children's speech and language skills. § The importance of partnership working in the development and delivery of services in Children Centres. § The role of Children's Centres in enhancing current community-based provision and enabling a greater degree of coordination between professionals and voluntary sector providers. § Ensuring that Children's Centres' work around early intervention remains focused on those children living in the most deprived circumstances. § That comprehensive, reliable information reaches families. § The need for local providers and commissioners to audit need, commission services and disseminate information to parents, carers and practitioners.
2. About I CAN
2.1. I CAN is the children's communication charity. We work to develop speech, language and communication skills for all children, with a particular focus on children who have Speech, Language and Communication Needs (SLCN). I CAN works to ensure all people who have a responsibility to children, from parents and teachers to policy makers, understand the importance of good communication skills. We do this through:
§ Direct service provision through two schools for children with severe and complex speech, language and communication needs (SLCN), and a network of early years centres § Consultancy and outreach services through I CAN's § Information, training, support and online resources for children, families and professionals § Raising awareness through campaigns such as Make Chatter Matter
2.2. I CAN uses its expertise from working directly with children with SLCN to develop information packages, training and programmes to develop the communication skills of all children and young people. I CAN is delighted that the issue of children's speech, language and communication has risen up the political agenda significantly over the last few years. Our Make Chatter Matter campaign has engaged support from a range of Parliamentarians from all sides of the political divide and has spearheaded a shift in Government priority for the issue. Make Chatter Matter has been underpinned by I CAN's 'Cost to the Nation'[1] report which set out the evidence base for the scale of the issue.
3. Background to Speech, Language and Communication Skills
3.1. Speech, language and communication (SLC) are the
foundation life skills for the 21st Century, the bedrock on which children
learn, achieve and make friends.
Communication is one of the ten core life skills listed by UNICEF,
UNESCO and the World Health Organisation. Based on information from prevalence
studies and from schools census data, I CAN estimates that around 10% of all
children, across the age range, have SLCN.
5-7% of children and young people have SLCN as their main difficulty but
there are also children who have SLCN as a result of another condition such as
autism, hearing impairment, general learning difficulties etc. Many more children - in some parts of the
3.2. Unaddressed, speech and language needs carry with them high risk of problems with literacy, numeracy and learning. A child who struggles to speak may struggle to read and write[4]. They are less likely to leave school with qualifications[5] or job prospects and are in danger of becoming NEET (Not in Employment, Education or Training at 16-18). SLCN also causes difficulties with social relationships and behaviour; and - in the worst case - offending. In adolescents and young adults, speech and language needs are strongly associated with mental health problems as well as other social emotional and behavioural difficulties[6].
3.3. The communication environment in the early years has been identified as being crucial in ensuring school readiness and in lowering the risk of low attainment[7]. At the root of this is the link between early spoken language skills and subsequent reading and writing skills[8]. Competence in oral language and the resulting transition to literacy is seen as crucial as a protective factor in ensuring later academic success, positive self-esteem and improved life chances[9].
3.4. There appears to be a 'critical age' for developing speech and language skills in preventing the development of associated social and academic difficulties. A study found that children whose language difficulties were resolved by 51/2 were more likely to go on to develop good reading and spelling skills[10]. Given this 'critical age' effective support or intervention in the early years is crucial[11].
4. The role of Children's Centres in supporting the development of speech, language and communication skills
4.1. I CAN understands that the needs of families, particularly disadvantaged families, do not occur in neat compartments that single services can easily provide for. I CAN, therefore, believes that a Children's Centres programme that combines various services can improve the life chances of children. The findings from the Effective Provision of Pre-school Education (EPPE) study show that high quality integrated care and education centres, as well as nurseries, have been shown to promote better outcomes than other settings[12]. We would like to see all Children Centres provide accessible sources of advice, and social networks that are not available through other services.
4.2. Recognising the importance of the early years
environment in supporting children's speech and language development, I CAN has
developed its Early Talk Programme to
aid the communication development of all pre-school children. In May 2006 I CAN
worked with the Department for Children, Schools and Families and the
Department of Health to roll out
4.3. We would like to see more of a focus on practitioners working in partnership with parents and using children's centre settings to help parents support their children's speech, language and communication development, through modeling good practice and delivering information and packages such as I CAN's Exploring Communication Development and other parent partnership packages such as PEAL..
4.4. Whilst there is no doubt that Sure Start Children's Centres have had a positive effect on children in their early years, I CAN is concerned that this has not translated fully into improving children's speech, language and communication development. The most recent evaluation of Sure Start, The Impact Of Sure Start Local Programmes On Child Development And Family Functioning[13], recognised this problem and called for an increased focus within centres on speech and language development.
4.5. I CAN is delighted that the Government has taken positive
steps to place early years at the heart of policy to address health inequalities
through Sure Start. Whilst we are
encouraged by the extension of Sure Start across the country, we feel it is
crucial that early intervention remains focused on those children living in the
most deprived circumstances, and the impact of Children's Centres must be
rigorously monitored. We would therefore like to see Early
Talk and other programmes that target the development of speech and
language being directed into areas of high disadvantage. This could be done by extending the
4.6. I CAN is concerned that there is still a lack of information about what Sure Start Children's Centres offer. For example recent statistics published by the Department for Children, Schools and Families found that only that 22% of participants were aware that centres offered advice and support around speech and language development[14]. In addition it was found that this advice/support was only being accessed by 2% of respondents and 5% of all users[15].
4.7. I CAN has long campaigned for all families to automatically receive information on speech and language development and we were delighted this need was recognised in the Bercow Review and the Government's Better Communication Action Plan. One of I CAN's strategic goals is that every child has contact with at least one adult who is able to support speech, language and communication development. To this end, we have recently produced a simple leaflet (Talk Together) which identifies the importance of communication development, what can go wrong and how families can help. We would be very happy for this leaflet to be distributed widely to families through Sure Start Children's Centres.
4.8. I CAN is also committed to supporting children through informing and supporting the children's workforce. We therefore believe that local providers and commissioners need a comprehensive, reliable information source in order to help them audit need, commission services and disseminate information to parents, carers and practitioners.
4.9. We would like to bring to the committee's attention
Talking Point (www.talkingpoint.org.uk), the
5. How well Children's Centres work with partners and services
5.1. Collaboration underpins the effective development and delivery of services to support children and young people's speech, language and communication. Partnerships between education, health and social services have been shown to be most well established in the early years[16] . While evidence of the impact of integrated working is as yet limited[17], some of the longer-standing Sure Start programmes report improved outcomes in positive parenting and social/emotional development as a result of more integrated working. We believe that the Children's Centre model of integrated working with a strong universal preventative offer of support for speech and language, offers a solution for meeting Every Child Matters outcomes in the early years. Also the integrated system of commissioning for children that is developing within Children's Trusts under the banner of Every Child Matters could be used to focus the resources already in the system to better meet the needs of children with SEN and to develop new expertise within the school workforce.
5.2. The benefits of integrated working are clearly identified[18], and strongly advocated as best practice in supporting children's speech, language and communication development[19]. Collaboration between agencies and in turn professionals is a key identified element in supporting both children's language and communication development[20] and in ensuring success in programmes which support children with SLCN[21] [22]. Initiatives such as the 2 - 21/2 year check lead by Health Visitor teams means that good inter-agency work is essential.
5.3. For children with SLCN, this is particularly important as inter-agency collaboration is recognised as the only effective solution to the management of complex problems[23]. I CAN would therefore support disadvantaged families receiving a guaranteed home visit from a trained health visitor which includes a discussion on communication skills/support and signposting to further services at the local Children's Centre.
5.4. I CAN supports plans to give local authorities a duty, working with their partners in Primary Care Trusts, to assess the need for Sure Start Children's Centres in their area. In 2006 the National Audit Office Report into Sure Start Children's Centres found that only five of the 27 local authorities examined had formally agreed with Primary Care Trusts what services to provide through Children's Centres[24]. In addition, the Sure Start Journey - Summary of Evidence[25] concluded that more work was needed to engage both parents and children's centre staff in promoting children's speech and language development.
5.5. In terms of reinforcing partnerships, I CAN would like to see Primary Care Trusts and local authorities working together to identify potential speech, language and communication needs across the age range with particular emphasis on key transition points. We would also recommend that Primary Care Trusts adopt the recently updated Healthy Child Programme (formerly the Child Health Promotion Programme) which highlights a child's speech and language development as one of eight priority topics for health and development reviews of children. I CAN is also in the process of feeding into guidance being developed to inform the 2-21/2 year check carried out as part of the programme to ensure that it effectively screens on speech, language and communication.
6. Workforce
6.1. I CAN feels strongly that an understanding of speech, language and communication should underpin the work of the entire children's workforce. We would like to see a skilled and confident workforce able to ensure timely identification and appropriate support of children's communication and SLCN at every age and stage. This could be achieved through the adoption of programmes such as Early Talk which gives early years workers the knowledge and skills to support and develop children's communication skills.
6.2. A Sure Start study on the development of speech, language and communication recognised the value of the relationship of parents with both midwives and health visitors as trusted adults, who could impart information and support activities around speech and language and other areas of development[26]. Therefore it is essential that health visitors have the right levels of knowledge about children's speech, language and communication development to identify difficulties as early as possible.
6.3. I CAN would like to draw the Committee's attention the Speech, Language and Communication Framework (SLCF)[27] developed by The Communication Trust. The SLCF sets out the skills and knowledge needed by practitioners to support the speech, language and communication development of all children. The Framework aims to support managers in assessing the skills and knowledge of their staff and to identifying staff training and development programmes that help staff develop appropriate skills. The Communication Trust has developed a number of units for the Qualification and Curriculum Framework (QCF) around speech, language and communication based on the SLCF.
6.4. I CAN would support a plan to improve the skill levels across the entire children's workforce to be agreed with CWDC, building on what has been successful within initiatives like the Inclusion Development Programme and including training on working in partnership with parents of children with SEN. We would support mandatory training for Early Years professionals in speech, language and communication development.
7. Structure
7.1. I CAN supports the vision of Children's Centres being established to improve community-based provision and to enable a greater degree of coordination between both professionals and voluntary sector providers.
7.2. However, it is important that the roll-out of Children's Centres does not simply look at numbers but also at quality of service provision. Ensuring services reflect that need locally is vital, but too often this is not the case. For example, the National Audit Office[28] report notes that too few Centres are carrying out active performance monitoring or allocating funding based around need. This needs provision is particularly important in deprived areas where, as the NAO report notes, too few children are accessing the services provided by Children's Centres. We hope that this inquiry will help highlight these concerns.
7.3. It is vital that these Centres should provide a core universal offer around speech, language and communication as well as acting as a communication-supportive environment for the children, young people and families they serve.
7.4. I CAN supports the principle of embedding early intervention at the local level through the Children's Trust and through Local Strategic Partnerships. We fundamentally believe that the development of speech, language and communication skills should be promoted for all children. There should be a specific requirement for Children's Trusts to ensure speech, language and communication development features in local Children & Young People's Plans and Directors of Children's Services should be tasked to commission and implement local SEN strategies for their area, as a priority within their local commissioning responsibilities.
7.5. I CAN welcomes plans for a duty to be introduced allowing Ofsted to inspect Sure Start Children's Centres at the request of the Secretary of State. I CAN would like to see Ofsted inspect joint working arrangements between schools, local authorities and local health services. We would also like to see inspections consider the contribution of community health services commissioned by Primary Care Trusts and the effectiveness of local authorities support for educational establishments on improving outcomes for children and young people with speech, language and communication needs.
7.6. We would also like to see inspections consider the contribution of community health services commissioned by Primary Care Trusts and the effectiveness of local authorities support for educational establishments on improving outcomes for children and young people with a speech, language and communication need.
8. Next Steps
8.1. I CAN therefore proposes that:
o A strategic approach which includes Early Talk and other programmes that target the development of speech and language are directed into areas of high disadvantage. o More information is available for parents to help the work of Children's Centres reach the wider community. o There is a joint strategy for supporting speech, language and communication development which assists Primary Care Trusts and local authorities work together to undertake surveillance of children and young people to identify potential speech, language and communication needs across the age range with particular emphasis on key transition points. o Collaboration between different agencies should underpin the effective development and delivery of services to support children and young people's speech, language and communication - with speech and language therapists adopting a preventative role within the team. o Disadvantaged families are supported in receiving a guaranteed home visit from a trained health visitor which includes a discussion on communication skills/support and signposting to further services at the local Children's Centre. o Children's centres to ensure that key information is delivered to all parents. This information should include the importance of communication skills, what is expected at different ages and how carers can help develop communication skills. o The principle of early intervention should be embedded at the local level through the Children's Trust and via Local Strategic Partnerships. o The establishment of a plan to improve the skill levels within the whole of the children's workforce to be agreed with CWDC, building on what has been successful within initiatives like the Inclusion Development Programme or Every Child a Talker. o Mandatory training support is provided for Early Years professionals in speech, language and communication development.
October 2009
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