Mary Hartshorne I CAN Head Of Evidence

Change for good – Let’s change the system

We know that to make the biggest difference, we need to bring about systemic change that will serve and support children and young people with speech, language and communication needs (SLCN) for years to come. Mary Hartshorne explores…

It will soon be six months since I CAN the children’s communication charity and the Royal College of Speech and Language Therapists (RCSLT) launched Bercow: Ten Years On: an independent review of provision for children and young people with speech, language and communication needs (SLCN) in England.

One of the key findings arising from the review was that strategic, system-wide change approaches to supporting SLCN are rare; very often SLCN does not feature in national or local policies. This was the case in local areas, in early years settings and in the school system. In evidence sessions, a range of reasons for this were suggested.

Within local areas people felt there was a lack of awareness about the importance of children’s language development.  Commissioners lacked knowledge about SLCN, (our survey showed only 40% people felt commissioners had knowledge about (SLCN)) and where there were financial challenges there was a reluctance to pool resources for the joint commissioning that is most effective for children with SLCN.

In schools, people felt the lack of a strategic approach was due to the low priority placed on spoken language. The curriculum no longer has a separate programme of study for speaking and listening, spoken language no longer counts towards a GCSE and there is no statutory requirement to track and report on progress in spoken language beyond age 5.

During the Bercow: Ten Years On review, we heard evidence from many schools and services where there was no clear strategy for children’s SLCN. Thankfully, there were also some excellent examples of well-embedded, effective systems-based, strategic planning.

Language for Life

In Nottinghamshire, we heard about their ‘Language for Life Strategy’. They have maintained this over a number of years now and cite strong leadership, a well-defined, accessible and rewarded career progression for practitioners to achieve qualifications and accreditation in supporting children’s SLCN. This is in addition to awarding higher status roles to lead practitioners in maintaining enthusiasm and energy around the agenda. They recognise the central role of children’s centre staff, speech and language therapists as well as other community practitioners who provide regular peer networks and training. This is the trusted route for many of the harder to reach families. Relationships are key. They say, “language development issues are kept high on the agenda locally and language delay is prevented, identified and supported by the whole community.”

Central also to the success of the longevity of the strategy in Nottinghamshire is the commitment to measuring impact. Their year of evaluation provided data for the business case which is used to influence the continued strategy.

Stoke Speaks Out

Evidence has also been important in Stoke, where the city-wide Stoke Speaks Out strategy has been in place for over a decade.

Stoke’s universal programme has trained over 7000 practitioners locally. They are all able to evidence the impact of the training on their work, following the course through their Stoke Speaks Out level 2 projects. Training and embedding skills in schools and settings is crucial to ensure children’s needs are met on a daily basis. The impact? Many children’s needs are now met within their setting rather than a referral to the speech and language therapy service.

Public Health England recently commissioned a return on investment study on Stoke Speaks Out which shows a positive economic benefit. Funding is rarely secured long-term and this evidence is instrumental in ensuring continuity.

Creating language pathways

In an oral evidence session, we heard how the speech and language service had embedded a language and communication pathway into the new devolved 8 stage assessment model in Greater Manchester. This has ensured that young children’s speech and language is screened from 18 months as part of the work community practitioners already do; true systems integration, with common language and shared outcomes. They have seen an increase in referrals, specifically appropriate referrals.

Embedding development

This strategic approach has also been seen in schools. Hanley Castle in Malvern has embedded SLCN into their SEN development plan. They have used a number of strategic development tools to support this.

The Communication Trust’s Speech, Language and Communication Framework (SLCF) is an online self- audit tool which benchmarks how confident adults are in their ability to identify and support students with SLCN. They have also used the Balanced System ; a framework which takes schools through a process, looking at pupils’ needs across five strands and at three levels. Each classroom has a toolkit to support understanding, task management, vocabulary and oral/written narratives and there is a rolling programme of training for all staff. A ‘Communication Teaching Assistant (TA)’ scheme means that TAs are trained to deliver a range of targeted interventions with students, supported by checklists in each classroom for subject teachers to support differentiation. Because of the excellent collaboration between the schools and local speech and language therapy services, best use is made of specialist input with highly individualised programmes for students who have identified SLCN, together with ‘surgeries’ for school staff so that everyone is involved. The school team recently spoke about their approach which you can read more of here.

Leadership

Key to the success at Hanley Castle has been strong leadership and commitment. This is also important to a cluster of twelve primary schools in Kirkby in Merseyside. They have joined together to commission a three wave model of support from their local speech and language therapy service. Called A Chance to Talk in Kirkby, the speech and language therapist works closely with the schools offering a combination of training, advice, demonstration, developing and providing resources and specialist support. This ensures school staff have the knowledge skill and support to enable them to take responsibility for supporting pupils’ SLCN.

The therapy and education team are currently working to measure the impact and benefit of this cluster-based model of commissioning. As well as pupil data, they are identifying less tangible but important benefits. These include less school time missed by attending appointments; improved and efficient staff development as the therapist is part of the school team and can respond in real time to queries and concerns, a wealth of practical ideas as they are shared between schools and improved progress as the therapist can adopt a more holistic approach and understand children’s language difficulties in the round.

If more services and schools take a strategic approach, based on local prevalence and need, the future could indeed be bright. Keep up to speed with progress in Bercow: Ten Years On by following #Bercow10 or check out our resources on www.bercow10yearson.com to help make a difference in your school.

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