Cynulliad Cenedlaethol Cymru | National Assembly for Wales
Y Pwyllgor Plant, Pobl Ifanc ac Addysg | Children, Young People and Education Committee
Y 1,000 diwrnod cyntaf| First 1,000 Days
FTD 08
Ymateb gan: Coleg Brenhinol y Therapyddion Iaith a Lleferydd
Response from: Royal College of Speech and Language Therapists
Executive Summary
1. The Royal College of Speech and Language Therapists (RCSLT) Wales welcomes the decision of the committee to undertake an inquiry into the first 1,000 days of a child’s life and is pleased to present written evidence. Our evidence primarily focuses on one key area within the terms of reference, namely the effectiveness of Welsh Government policies and programmes that;
· focus on improving learning and speech and language development through the home learning environment and access to early years’ provision (including childminders, preschools and day nurseries)
We also discuss why prioritising early language development in the first 1000 days is key in terms of reducing health inequalities and supporting all children in Wales to achieve their potential.
2. Learning to talk is one of the core skills children need to develop before starting school. Early language skills play a crucial role in literacy, a child’s ability to achieve their educational potential, their social mobility, and their life chances. The years from birth to 2 are critical in helping babies learn all the foundation skills for talking. Development of these key skills is dependent on the interactions children have with their parents, childcare providers and peers. Research shows however that poverty can seriously hinder parents’ ability to provide a positive home learning environment and respond to their child’s early language needs.
3. Early language development is increasingly being considered within early years policy development. The Flying Start programme has notably prioritised this area by publishing guidance and employing a speech, language and therapist in each Flying Start project in a consultative role, to support parents and early years practitioners. Evidence of the huge impact of the profession within the Flying Start programme is starting to become clear and is referenced within this response. However, in the view of RCSLT, the consequences of not supporting children’s early language skills, and not identifying long-term or persistent speech, language and communication needs necessitate a broader response and a move beyond pockets of good practice. We would encourage the committee to strongly consider a recommendation that Welsh Government takes a crosscutting approach to this key area and prioritises early language development within training for the early years workforce and in all parenting initiatives.
About the Royal College of Speech and Language Therapists
4. The Royal College of Speech and Language Therapists (RCSLT) is the professional body for speech and language therapists (SLTs), SLT students and support workers working in the UK. The RCSLT has 15,000 members (450 in Wales) representing approximately 95% of SLTs working in the UK (who are registered with the Health & Care Professions Council). We promote excellence in practice and influence health, education, care and justice policies.
Background on Early Language Delay and its impact
5. Good early language skills are central to children’s early years development and school readiness. They play a crucial role in literacy, a child’s ability to achieve their educational potential, their social mobility, and their life chances. Beyond academic attainment, well-developed speech, language and communication skills are fundamental to the ability to form and maintain social relationships with family, peers and friends. The years from birth to 2 are critical in helping babies learn all the foundation skills for talking and parents and carers have a vital role to play as a baby and young child’s first teacher.
6. Not all children have the speech, language, and communication skills they need to fully engage with their education. It is estimated that 10% of all children in the UK have long-term, persistent speech, language and communication needs (SLCN). 7% of these children have specific and primary speech and language impairments, while 1% have the most severe and complex SLCN[1]. Research shows that there is a strong correlation however between poverty and transient early language delay. By which we mean, those children whose language skills are developing significantly more slowly than those of other children of the same age but who do not have a specific disorder. Studies of whole populations reveal a clear social gradient for language development, with children from the most disadvantaged groups more likely to have weaker language skills than those in more advantaged groups.[2] Language skills are a critical factor in the intergenerational cycles that can perpetuate poverty[3].
Scale of the problem
· Over 50% of children in socially deprived areas may start school with impoverished speech, language and communication skills[4]
· On average children from the poorest 20% of the population are over 17 months behind a child in the highest income group in language development at age three.[5]
7. Vocabulary at age 5 has been found to be the best predictor (from a range of measures at age 5 and 10) of whether children who experienced social deprivation in childhood were able to ‘buck the trend’ and escape poverty in later adult life[6] Researchers have found that, after controlling for a range of other factors that might have played a part (mother’s educational level, overcrowding, low birth weight, parent a poor reader, etc), children who had normal non-verbal skills but a poor vocabulary at age 5 were at age 34 one and a half times more likely to be poor readers or have mental health problems and more than twice as likely to be unemployed as children who had normally developing language at age 5.[7]
8. The consequences of not supporting children’s early language skills, and not identifying long-term or persistent speech, language and communication needs, can have a profound impact on children’s school readiness and can lead to a range of potentially negative outcomes later in life. Research shows that:
· Up to 60% of young people in the youth justice estate have communication difficulties.[8]
· 88% of long-term unemployed young men have speech, language and communication needs.[9]
· Without effective help, a third of children with speech, language and communication difficulties will need treatment for mental health problems in adult life[10]
· children with language difficulties have an impoverished quality of life in terms of moods and emotions, and are more at risk in terms of social acceptance and bullying.[11]
Effectiveness of Welsh Government policies and programmes that focus on improving learning and speech and language development through the home learning environment and access to early years’ provision (including childminders, preschools and day nurseries)
9. There is an increasing focus on children’s speech, language and communication skills within early years’ policy in Wales, both within the home environment and, to a lesser degree, within early years’ provision. The strongest influence on the early language skills of young children are their parents and carers. Poverty can strongly reduce parents’ ability to respond to their child’s early language needs and offer a home learning environment that enhances language skills in the early years[12]. Supporting parents to foster a communication and language rich home environment is fundamental to improving children’s early speech, language and communication development.[13] The recently launched Healthy Child Wales programme has a specific focus on speech and language development at the 15 month health visitor family health review, the Parenting – Give it Time campaign incorporates key learning to talk messages throughout the website content and SLTs have also linked into the drafting of the Foundation Phase Profile.
10. Given the strong correlation between disadvantage and early language delay, the Flying Start programme has prioritised speech, language and communication. To support this key strand of work, A SLT was seconded into Welsh Government for six months to write the programme guidance document on speech, language and communication. In addition, a SLT has been employed at every Flying Start team in Wales. Part of the role of the therapist is both to upskill the early years workforce in these areas and to improve parents’ knowledge and skills to support children’s early language development. This strategic approach ensures that;
· The ‘Learning to Talk’ key messages (see Annex A) are shared with all parents as part of the Flying Start Core Health visiting programme and all parents are made aware of the importance of the home environment on long term speech, language and communication outcomes.
· All Flying Start childcare staff have an understanding of speech, language and communication development
· All Flying Start childcare practitioners provide a rich learning environment that fosters language and communication opportunities for all children
11. The positive outcomes of this model are already becoming clear. In 2015, the Bridgend Flying Start Speech and Language Therapists (SLTs) won an NHS Wales award for their work in reducing language delay in two and three year olds. The SLTs worked with Flying Start nurseries in Bridgend to achieve a significant reduction in the number of children with delayed language skills. Out of over 600 children screened on starting nursery, 73% were assessed as having significant language delay, which would impact on future learning development. After the interventions delivered by nursery staff which were planned and supported by the Flying Start SLTs, 68% of the children with the worst language delay had improved.[14]
12. RCSLT believes that whilst it is vital to support ongoing initiatives such as the prioritisation of speech, language and communication within Flying Start, there is a need to ensure that all opportunities to ensure parents, carers and the wider workforce understand the importance of speech, language and communication are exploited and key public health messages are shared. These key messages are included in Annex A. Promotion of these key messages is of particular importance in the first 1000 days. Pregnancy and the birth of a baby are critical ‘windows of opportunity’ when parents are especially receptive to offers of advice and support.[15] Babies begin to hear music and voice even before birth. The earliest experiences shape a baby’s brain development and have a lifelong impact on a child’s mental and emotional health. All parents need to be aware of the benefits of early interaction for their babies and the importance of singing, rhymes and talking.
13. Beyond the home environment, there is strong evidence of the benefits of high quality early education and childcare from the perspective of vocabulary and literacy development[16]. Early years practitioners have a crucial role in supporting children’s development. They share the early learning and skills that provide the foundation for school readiness and support good future progress through education and later life. The early years workforce is also vital in closing the language gap between children from high and lower income families, which begins in infancy, promoting social mobility and offering children the best start in life. Initiatives such as the Welsh Government Ten Years Plan for the Early Years workforce and the implementation of the childcare pledge offer key opportunities to mainstream messages about early language development. Sharing of messages should be supported by high quality training for practitioners. RCSLT believe that a tiered framework would be particularly helpful in this regard and would be happy to contribute to such a discussion. In addition, regulation of childcare settings should take account of this key area when undertaking inspections and outcome frameworks need to reflect progress in speech, language and communication.
14. Professor James Law, a key academic in this field has developed five key language-specific principles which RCSLT believes it may be helpful for the committee to consider when developing the inquiry report. These are attached at Annex B.
Further Information
15. We would be happy to provide any additional information required to support the Committee’s decision making and scrutiny. For further information, please contact:
Annex A: Flying Start Learning to Talk key messages[17]
The main message: Talking is what we need to do and I will learn it all from you.
1. Play your part right from the start
· I can hear your voice from 24 weeks of pregnancy.
· After birth, I can soon recognise voices that I heard in the womb.
· I love to hear you sing to me.
2. Keep our language alive and I will thrive
· I can absorb Welsh and other languages from birth.
· If I am bilingual from birth, I find it easier to learn other languages.
3. Our best place is face to face
· Before I can speak I communicate with you through eye contact, smiling, gurgling and crying.
· Keep me close when you talk to me.
· When we are face to face you can see what I am trying to tell you.
4. Sing me a rhyme at nappy time
· I like hearing the same song again and again.
5. Talk, Talk, Talk. Please Talk to me
· Copy my sounds or words back to me.
· Tell me what I can see and what is around me.
· I need to hear the same words again and again so I can remember them.
.
6. Listen to me, not the TV
· Turn the TV/ music/ computer off when we are talking together.
· Our talking time is special so leave your phone in your pocket.
· I can’t listen to two things at once.
7. Let’s look at a book
· I can’t read yet but I love looking at pictures and listening to you.
· Don’t worry about all the words just talk about the pictures.
· I love it when you use silly voices to tell me a story.
8. Let’s play everyday
· Playing with you is my favourite game - have a go at peepo.
· Meal times, nappy time and bath time. Anytime is play time.
· Talk to me when we are playing and I will learn to hear the same words again and again in my mouth.
9. For clear speech, keep my dummy out of reach
· I only need my dummy when I want to go to sleep
· I’s hard for me to babble and talk with a dummy in my mouth
·
I
don’t need a dummy after my first
birthday.
ANNEX B: The Five Language Specific Principles cited in Early Language Delays in the UK (2013)[18]
1. Communication is key to the fostering of life chances in early childhood. Everyone in the child’s environment has a role to play in fostering the child’s communication skills. This starts at birth and includes immediate and extended family, and potentially a wide range of professionals, health visitors, speech and language therapists, early educators, teachers, psychologists, etcetera.
2. The importance of early communication skills and their implications for the child’s social and educational development across the early years and beyond need to be understood by all parents.
3. All professionals need to be aware of how to identify early language delays and confident about what they can do to enhance language skills.
4. We need to scale up and roll out interventions that have been shown to work, and test their value across whole populations and over an appropriate length of time.
5. We need to sustain the pressure on policy-makers to improve services for the child who is language-delayed, especially in the very early years (ie, before three years).
[1] ICAN Talk Series – Issue 2. (2009) The Cost of the Nation of Children’s Poor
Communication. ICAN
[2] Law, J, Todd, L, Clark, J, Mroz, M and Carr, J (2013a) Early Language Delays in the
UK. Save the Children
[3] Hart B & Risley T.R (2003). The early catastrophe: The 30 million word gap by 3.
American Educator, 27 (1), 4 -9
[4] Locke A, Ginsborg J, Peers I. (2002) Development and disadvantage: Implications for the early years and beyond, International Journal of Language and Communication Disorders, 37(1), pp. 3-15.
[5] Save the Children (2014) How reading can help children escape poverty. London: Save the Children
[6] Blanden, J. (2006) Bucking the Trend – What enables those who are disadvantaged in childhood to succeed later in life? London: Department for Work and Pensions.
[7] Law, J. et al (2010) Modelling developmental language difficulties from school entry into adulthood. Journal of speech, language and hearing research, 52, 1401-1416
[8] Bryan K, Freer J, Furlong C. Language and communication difficulties in juvenile offenders. International Journal of Language and Communication Difficulties 2007; 42, 505-520.
[9] Elliott N (2009) Interim results from PhD in preparation. An investigation into the communication skills of
long-term unemployed men
[10] Clegg J, Hollis C, Rutter M. Life Sentence. RCSLT Bulletin 1999; 571, 16-18.
[11] Lindsay G, Dockrell J, (2012) The relationship between speech, language and communication needs and behavioural, emotional and social difficulties (BESD), Department for Education research report DFE-RR247-BCRP6.
[12] Law, J et al (2015). Early language delays in the UK, Save the Children: London. http://www.ncl.ac.uk/cflat/news/documents/Lawetal2013EarlyLanguageDelaysintheUK.pdf
[13] Sylva, K., Melhuish, E., Sammons,P.,Sira j- Blatchford,I., Taggart,B (2004) Effective
Preschool Provision: Institute of Education
[14] Rebecca Jones (2015). Reducing the impact of language delay on two to three year olds in Bridgend. Abertawe BRO Morgannwg University Health Board: Swansea. http://www.nhswalesawards.wales.nhs.uk/previous-nhs-wales-awards-winners
[15]Wave Trust (2014) 1001 Critical Days: The Importance of Conception to the Age 2 Period. The document may be found here
[16] Havnes, Tarjei & Mogstad,Magne, 2009. “Money for nothing? Universal childcare and maternal employment,” IZA Discussion Papers 4504, InstituTe for the Study of Labour (IZA)
[17] Welsh Government (2015). Flying Start Annex – Guidance on Speech, Language and Communication. http://gov.wales/docs/dsjlg/publications/cyp/150529-guidance-on-speech-en.pdf
[18] Law J, Todd L, (2014). Early Language Delays in the UK. Save the Children:London