Working together to support

Speech, Language and

Communication Needs: SEND

partnership launch

January 2019

PHE supporting ‘best start in life’ :

Remit Letter deliverables

• Work with local government and health visitors on ‘Best start in life’ to drive improvements in child health outcomes at scale with a particular focus on infant mortality, child health speech, language and communication needs and school readiness

• Assure local delivery of the five 0-5 universal checks (to all children, everywhere)

• Provide evidence on priority interventions in universal plus and universal partnership plus service

• Support the development of a strategy to address the needs of children living with alcohol dependent parents

• Lead the prevention workstream within the national Maternity Transformation Programme working across the local NHS and local government

2 Partnership working

Supporting parents in vital early years

All Our Health topic: https://www.gov.uk/government/publications/healthy-beginnings-applying-all-our-health

3 Partnership working

Best Start in life

• Ensuring that every child has the Best Start in Life: “ready to learn at two and ready

for school at five” is a priority for PHE.

• The Early years High Impact Area 6: Health, wellbeing and development of the child

aged two is one of the six high impact areas for health visiting.

• Improving early language acquisition has been identified as a government priority in

the Social Mobility Plan (2017): “Unlocking Talent, Fulfilling Potential”

• PHE are working in partnership with DfE to promote the home learning environment

and the importance of early language development. This follows the announcement

by the Secretary of State for Education on 31st July where he proposed an Autumn

Summit bringing together key stakeholders to advance this work

4

Reducing the word gap - Speech and language

Partnership working

Key messages from the evidence

5 Partnership working

ref: Marmot M, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, et al.. Fair Society, Healthy Lives:, London; 2010.

“The foundations for virtually every aspect of human development –

physical, intellectual and emotional – are laid in early childhood. What

happens during these early years (starting in the womb) has lifelong

effects on many aspects of health and well-being– from obesity, heart

disease and mental health, to educational achievement and economic

status.”

“health inequalities are not inevitable and can be significantly reduced”

Michael Marmot, Fair Society, Healthy Lives, 2010

Children from

disadvantaged families are

as likely to

experience

language delay

Inequalities in Speech, language and communication

6Partnership working

5-8% of all children

in England have

speech and/or

language

impairment

2 X

In areas of deprivation up to 50%of children start school with

language delay

Children from higher

income families have

heard over

30 million more words by age 3

years

Speech, language and communication development

7 Partnership working

Presentation title - edit in Header and Footer

Heritable/

biological

factors

Environmental

factors

Quality of

parent

child

interaction

Socio-

economic

status

Access to

resources:

books, toys

educational

experiences

“Word gap”

**exposure

to fewer

words and

limited

vocabulary

Sensori-

neural

losses

Autistic

spectrum

disorders

Learning

disabilities

Access to

enriching

year

years

provision

The right environmental support can make a real difference to how a child learns

language

Difficulties in early language development are associated with a range of long term outcomes. This can impact on a child’s health and behaviour but also economic and social

prospects in future life.

Emotional and behavioural difficulties

Increased risk of ADHD and

anxiety disorders in adolescence

Criminal Justice

50% of the UK prison population have language difficulties

(compared to 17% of general population)

Risky behaviours

More than 70% of young people in the youth offenders system

have a communication disability

Educational disadvantage:

Communication is the key to access learning

Reduced school readiness/ Poor academic achievement

The link between language and other social, emotional and learning

outcomes makes early language a primary indicator of child wellbeing

Economic disadvantage

12% lower earnings due to inadequate literacy skills

Twice as likely to be unemployed at age 34

Mental Health problems

3x Increased risk of mental health problems in adulthood

Social Emotional

LearningSpeech

Language

Communication

Difficulties in one

area of

development lead

to problems with

the others

Why does early language matter?

Where are we now?Bercow ten years On Review (2018) key themes:

• Communication is crucial to children’s life chances. Yet awareness of its

importance among the public and decision makers is not sufficient.

• Strategic system-wide approaches to supporting SLCN are rare; very often

SLCN does not feature in national or local policies.

• Services are inaccessible and inequitable. Too often support for children’s

SLCN is planned and funded based on the available resources, rather than

what is needed, leading to an unacceptable level of variation across the

country.

• Support that makes a difference is based on the evidence of what works.

However, service design and cuts frequently do not take account of the

evidence we have.

• Too many children with SLCN are being missed, and are not getting the vital

support they need. 55% of parents reported that their child waited over 6

months to get the help they needed and only 15% of people felt that speech

and language therapy was available as required in their area.

9 Partnership working

Overview of programme• The Secretary of State for Education has set out his ambition to halve

the number of children who do not achieve the expected level of

communication and language standards for early years (from 28% to

14%). Three domains of focus to improve child outcomes:

The home – convening/campaigning

Local services – supporting “place based” sector led improvement

Early years settings – improving practice in pre-reception settings and schools

• PHE in partnership with DFE will be working on three areas for

development:

1. Training of Health Visitors to support the identification of Speech, Language and

Communication Needs (SLCN) at age 2

2. Development of a SLCN pathway to support the early years workforce in identifying

services to meet children’s needs

3. Development of an assessment tool to identify and support children with early SLCN

10Partnership working

Early

identification

of difficulties

Universal

monitoring of

all children

throughout

childhood

Maximise

opportunities

in the Healthy

Child

programme

and Early

Years service

Strategies

supporting

parents

throughout

childhood

Supporting

language rich

environments:

home, early

years settings

and school

11 Partnership working

Translating

evidence

into action

A workforce

skilled in

promoting

language

Early Years support

Access to

early

intervention or

specialist

support when

needed

Joint

commissioning

: local

authorities and

CCGs

Using data to

promote

transparency

and improve

services

Speech, Language and

communication services

Child language should be

viewed as a public health

wellbeing indicator

Identification of need

Establishing collaborations: developing a local

response

12 Partnership working

Courtesy of NHS Forth Valley

• Putting children and families first

• Understanding local needs and

current provision

• Whole system approach- looking

at the big picture

• Developing local shared aims:

common values; culture built on

partnership and trust

• Tolerating dilution/ re- description

• “How do our ideas fit a need that

they have?”

• Changing the conversation at the

point of request/ proximal model

Partnership working

• Inclusion of partners in local pathways development.

• Ensuring working together in Action Learning Sets and Communities

of Practice.

• Getting to know your local area leads, champions and SLCN health

visitor trainers.

13 Partnership working

Contact us:

Jo Howes

Health Visitor Advisor, PHE – Joanna.howes@phe.gov.uk

Salma Dewji

Project Support Officer, PHE – Salma.Dewji@phe.gov.uk

14 Partnership working