Ican Reading Final

The crucial role of health visitors in the early identification of speech, language and communication needs

Despite being a crucial part of early childhood development, speech and language is not currently part of formal health visitor training.

To address this, the Early Voices project, funded by Big Change, trained 60 health visitors across England to become Communication Leaders. They received a day’s introductory training, as well as a fully funded Level 3 qualification in children’s speech, language and communication development. Communication Leaders then cascaded bespoke training to their networks, to develop knowledge of speech, language and communication development in the profession.

Meryl White, a Health Visitor in the Bristol Community Health service, recently completed her Level 3 qualification as part of this project. Meryl spoke to us about the important role of health visitors in the early identification of speech, language and communication needs in children.

  1. What do you feel is the role of health visitors in terms of identifying children with speech, language and communication needs early?

I think we’ve got a hugely important role in promoting good speech, language and communication from a very early age.

If we use each of our five mandated visits per family to promote good speech, language and communication with children, my hope is that we can play a huge role in preventing difficulties. While we can refer to speech and language therapists, their service is very stretched in our area so they won’t accept referrals until the child is 2 years and 4 months old. So, if we are concerned, it’s important that we can give the families some ideas and suggestions of simple things they can do in the home to promote children’s language while they are waiting to be seen.

  1. How has your practice changed in terms of assessing and identifying speech, language and communication skills in the children you work with, since completing your qualification?

I think my understanding of the breadth of speech, language and communication difficulties has broadened.  It’s heightened to me how speech, language and communication skills affect all aspects of the child’s development – their emotional and social development, their relationships, and their learning abilities. It has affected how I view the whole child.

  1. How has your practice changed in terms of speaking to parents about the importance of speech, language and communication skills in children?

I’ve changed hugely, I can’t stop talking about it! I will talk about speech and language development at every visit now, very clearly. Every opportunity I see a lovely example of communication between a mum and child, I cannot help but observe it and comment on it, saying something like, “Isn’t that beautiful what I’m seeing there, that baby is really responding to you”.

I think it’s made me more confident. The more that I talk about strategies that parents can put in place to support their child’s speech and language development, the more confident I become.

  1. Can you tell us about any challenges you have come across?

I think one of our challenges is that we have to refer on. We don’t have a lot of capacity for follow up, and so we do have to refer on to speech and language therapists when we have a concern about a child’s language development. We have to be very clear about what our advice is, and to really encourage that contact with the next professional.

Also, parents vary in terms of how accepting they are of interventions and strategies. I recently saw a family for a routine visit, and I said, “Have you got any books for your children?”, and this parent said, “Reading books? Am I supposed to do that?”. It’s surprising how often people aren’t aware of the very simple things that they can do to promote language, including reading books, singing nursery rhymes and playing with their child.

  1. Are there any resources you were signposted to during the course that you now use in your work with children and families?

I definitely direct them to The Communication Trust website and the I CAN website, and I’m always recommending Universally Speaking – I find that one really useful to refer to.

  1. Do you think there’s a fairly high level of understanding amongst health visitors in terms of speech, language and communication development, or does it vary?

Speech, language and communication development is not something that’s formally covered in our training, it’s more something that we pick up on the job. So certainly by doing some extra training it has given me some insight into typical development, how it works, what to expect, and more crucially, how we can promote speech, language and communication in the visits that we do.

We are a preventative service, and if we can use each one of those visits that we have with families more effectively then I am confident that we can have a positive impact on the development of children.

To find out more about Level 3 training through Platform 3 you can visit our page here.

To find out more about the fundamental importance of speech, language and communication skills, and what you can do to help, you can also access The Communication Trust’s free short course.