Foundation Years - Sure Start Children's Centres

Written evidence submitted by The Communication Trust

Background to The Communication Trust and Speech, Language and Communication

1. The Communication Trust is the campaigning voice for children with speech, language and communication needs (SLCN). We raise awareness, influence policy, and promote best practice among the children's workforce and commission work from our Consortium members. We're a coalition of nearly 50 leading voluntary sector organizations and an advisory group, which includes the Royal College of Speech and Language Therapists, Association of Educational Psychologists and the General Teaching Council.

2. Speech language and communication skills are the basis for other key life skills: learning, literacy, positive relationships and regulation of behaviour and emotions [1] . Speaking and listening skills underpin pupil outcomes; young people with good communication skills have a wider range of life chances [2] . As many as 10% of children in the UK, over 1 million, have speech, language and communication needs, which are not caused by language neglect, or by having English as an additional language or other external factors. This means that in the average classroom, there are two or three children with such communication difficulties.

3. Speech language and communication skills are the basis for other key life skills: learning, literacy, positive relationships and regulation of behaviour and emotions [3] . Speaking and listening skills underpin pupil outcomes; young people with good communication skills have a wider range of life chances [4] .

4. As many as 10% of children in the UK, over 1 million, have speech, language and communication needs, which are not caused by language neglect, or by having English as an additional language or other external factors. This means that in the average classroom, there are two or three children with such communication difficulties. Of this group, a large cohort – between 5-7% of the child population - have specific language impairment (SLI), meaning that they have difficulties with learning and using language that are not associated with factors such as general learning difficulties, or other conditions, such as cerebral palsy, hearing impairment or autistic spectrum disorders. A child with SLI might be bright, but struggle to understand the language used in the classroom, and thus struggle to attain and achieve.

5. The Department for Education annual SEN statistics for 2011 found that speech, language and communication needs is the most common type of primary need for pupils with SEN statements in maintained primary schools, with 27.9% of all statemented children in this age group having SLCN as their primary need [5] . In some parts of the UK, those with high unemployment and poor housing, the prevalence rate of SLCN rises. In areas of social deprivation upwards of 50% of children, equivalent to as many as 17% classroom, are starting school with language delay [6] . There is also evidence of a high incidence of communication difficulties (often unidentified) in those who are young offenders [7] , looked after children [8] and those who have conduct disorder [9] as well as other social emotional and behavioural difficulties [10] [11] .

The new Core Purpose of Sure Start children’s centres, how this has evolved and is different from the original design and purpose of Sure Start

6. Whilst there is no doubt that Sure Start Children’s Centres have had a positive effect on children in their early years, the Trust are concerned that this has not translated fully into improving children’s speech, language and communication development. An evaluation of Sure Start, The Impact Of Sure Start Local Programmes On Child Development and Family Functioning [12] , recognised this problem and called for an increased focus within centres on speech and language development.

The effectiveness and impact of Sure Start children’s centres to date, including the role of Ofsted inspections

7. The Trust 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 and the effectiveness of local authorities support for educational establishments on improving outcomes for children and young people with SLCN.

The range of services and activities provided at Sure Start children’s centres, and their desired outcomes, and whether/how these differ from family centres, early Sure Start local programmes and early years settings

8. Early identification and intervention for children with SLCN needs to become central to work of children’s centres. Communication skills are fundamental to children’s life chances: vocabulary aged five is the best predictor of whether children who experienced social deprivation in childhood were able to ‘buck the trend’ and escape poverty in later life.

9. The Trust are delighted that the revised Early Years Foundation Stage (EYFS), which began on 1st September 2012, puts communication and language as one of the three prime areas for children’s healthy development. We feel 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.  It can also be achieved through the mainstreaming of SLC development in the initial training and qualifications of the wider children’s workforce.

10. Within the early years workforce the Communication Trust supports the continuing rollout of Level 3 Children’s Workforce Diploma which includes mandatory and optional units based on the Speech, Language and Communication Framework and we believe the Level 3 diploma should, over time, be the minimum qualification level for early years practitioners to equip them with the skills and knowledge to support early intervention. This is supported by the findings of Ofsted’s report on The Impact of the Early Years Foundation Stage which demonstrated that developmental outcomes can be improved when an EYFS practitioner has receiving specialised training in language development.

11. The Trust would also like to bring to your attention the Level 3 Award in Supporting Children and Young People's Speech Language and Communication. This award has been designed for early years practitioners, teaching assistants from all educational settings, support staff in a variety of childcare settings, people working in health, social care, play work, youth justice, youth and support work settings. The aim of the award is to make a positive impact on the communication development of children across the country. This is done through enabling members of the entire children's workforce to gain accredited continued professional development in speech, language and communication.

12. In addition, whilst we welcome the Government’s plans to expand the health visitor workforce, we are cautious about focusing solely on the role of health visitors in early identification (including identification of speech and language difficulties), as many young children, particularly those from poorer backgrounds, are not in early years settings or in any contact with such early years professionals. It will be important to ensure that health visitors are equipped to identify children with SLCN, that there are clear and explicit pathways for communicating and sharing of information between health visitors and early years workers, and that appropriate referral mechanisms are in place to allow accurate and timely referral to specialists such as speech and language therapists where appropriate.

13. The Communication Trust welcomes the proposal in the Children and Families Bill to replace statements of special educational needs with an ‘Education, Health and Care Plan’ to join up provision between education, health and social care services in meeting children’s needs. However, we would like to see greater detail as to how these plans will work in practice. The one step that would make single Education, Health and Care Plans workable is pooled budgets and joint NHS/local authority commissioning of the range of services from which a Plan would draw.

How to strengthen integrated working between health, social care and education as part of a multi-agency early help offer, including how to improve information-sharing and the proposal for children’s centres to have access to a "named social worker"

14. As the Government takes forward its reforms to the NHS, the Trust believe it will be important for the Government to ensure effective joint working across commissioning bodies, not just within the health sector, but also between education and health commissioners, including schools and special schools as they take on greater commissioning powers. Arrangements need to be in place to ensure that commissioners are in a position to commission in the round for services provided by NHS and non- NHS agencies, whether at the local or regional level, and to ensure that local commissioners do not simply ‘shunt’ responsibility up the chain. We welcome the proposals in the Children and Families Bill to require joint commissioning between local authorities and clinical commissioning groups.

15. The benefits of integrated working are clearly identified [13] , and strongly advocated as best practice in supporting children’s speech, language and communication development [14] . Collaboration between agencies and in turn professionals is a key identified element in supporting both children’s language and communication development [15] and in ensuring success in programmes which support children with SLCN Initiatives such as the 2 – 2½ year check lead by Health Visitor teams means that good inter-agency work is essential.

16. 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 [16] . We 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.

17. In terms of reinforcing partnerships, we would like to see health and local authority partners 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 the Healthy Child Programme is adapted because it highlights a child’s speech and language development as one of eight priority topics for health and development reviews of children.

How to increase the involvement of families (especially fathers, disadvantaged families, minority ethnic groups and families of children with SEN and disabled children) in the running of children’s centres and in their regular activities

18. We are concerned that there is still a lack of information about what Sure Start Children’s Centres offer. For example statistics published by the Department for Education found that only that 22% of participants were aware that centres offered advice and support around speech and language development [17] . In addition it was found that this advice/support was only being accessed by 2% of respondents and 5% of all users [18] .

Talk of the Town

19. For many years now experts in the field of speech, language and communication have known that early intervention and integrated working are vital components of improving services for children and young people with SLCN. In responding to this challenge we would like to bring to your attention that The Communication Trust has developed Talk of the Town (TOTT), a community approach to early identification of SLCN. TOTT is an integrated, community led approach to supporting speech, language and communication in children from 0-19 which is being piloted in a small community in Wythenshawe, South Manchester. It aims to facilitate early identification, encourage joined up working and improve outcomes for children with SLCN. It addresses the worryingly high need of language delay that exists, especially in areas of social deprivation.

20. We have included alongside the submission a case study of TOTT and we think that the model can become an exemplar to be used across other parts of the country.

December 2012