A Plea for Early Intervention
Communication is a key part of being human. All children are able to communicate in some way, but many require additional support to give them a voice. Around 10% of all children in the UK have some form of Speech, language and communication need. Children under five years are remarkably receptive to treatment and many difficulties can be significantly reduced and sometimes eliminated altogether.
Despite the well documented importance of Early Intervention, Speech and Language Therapy Services have been patchy and under funded since well before the recession. The focus on immediate savings without regard for the long term consequences will have a dramatic impact on our future society. Even a few months delay on treatment or low quality and insufficient treatment can have significant implications for the child’s later academic success, mental health, ability to form relationships and economic success, all of which affect the future prosperity of our country.
In this blog post, we describe an alternative future, where each child receives early and high quality support and discuss how you can help us to make this vision a reality.
An Alternative Future
At present up to 80% of children from areas of disadvantage are entering school delayed language and Speech, Language and Communication difficulties are the most common SEN in primary schools.
With high quality early support for all children with language difficulties, we would see a dramatic reduction in the number of children entering school with delayed language within 2 years. Entering a typical classroom, you would see more happy, engaged children ready to learn the basic literacy and numeracy skills required for academic success.
Within only a few years, you would see decreased need for intensive 1:1 teaching assistant support among children whose language delay would leave them lagging behind peers. In addition, Children with severe speech difficulties, are more likely to succeed in mainstream school with early and high quality support, reducing costs of specialist placements.
In 3-5 years time, you would find calmer, happier classrooms, with teachers able to focus on teaching rather than disciplining pupils. Currently around ¾ of children with behaviour difficulties also have significant language deficits. These children are at risk of being diagnosed with behaviour problems rather than the underlying speech and language difficulty (Snow and Powell, 2012) which often goes untreated. Behaviour difficulties affect not only the child, but also impact on the learning environment of their peers.
In our alternative future, you are likely to see a reduction in childhood mental health difficulties. Children with Speech and Language difficulties tend to have a withdrawn interaction style and are less liked by peers, impacting on self esteem. Left untreated, one third of children with Speech, Language and Communication difficulties will go on to develop mental health problems (Heritage et al, 2011) and research has found that 62% of children in psychiatric populations have speech and language difficulties (with 34% previously undetected).
Fast forward to teenage years, you are likely to find more young people in education, employment and training upon leaving school. Our economy is becoming increasingly centred around communication based job roles. 88% of young unemployed people present with a language impairment and in a recent study 100% of those not in Education, employment or training have a communication difficulty (Lanz, 2009). With early support, our communities would be filled with young men and women who have the skills to apply for jobs, succeed in interviews and develop successful working relationships with colleagues. We would see fewer young people in queues at jobcentres and more engaged in productive work, positive about the opportunities available to them in future.
Early intervention across the country is likely to have an effect on overall crime rates. Speech and Language difficulties are a risk factor for offending (Tomblin et al, 2000) and over 60% of young people in the criminal justice system have a communication disability (Bryan et al, 2007). Reoffending rates for under 18's are around 67% within a year of release and are higher for young people with Speech and language difficulties. Studies have found that addressing communication disabilities and providing therapy significantly reduces the risk of reoffending.
If we can make an impact on reoffending rates by working with an offender whose communication difficulty has become entrenched, imagine the difference we could make if we worked with the individual before they even began school. If we prioritised early intervention today, within 15 years our children would feel safer walking down the street and would be significantly less likely to be the victim of a crime. Our prisons would be emptier, saving a minimum of £40,000 - £250,000 per offender, per year.
How you can help
Realise the important role Parents can play in Intervention
Governments, charities and speech therapy services have often looked to nurseries and schools to support language development, particularly in at risk populations. Parental involvement Is often neglected. Parents are the prime educators of children and should be seen as a key part of the intervention process.
As a private company, we receive regular contact from distressed parents, desperate to learn how to support their child. Regardless of background, we should begin with the presumption that parents are willing and able to help their children's language development when given the right training and support.
Understand Assessment is not Intervention
Early Identification of language difficulties is crucial, but needs to be accompanied by prompt and high quality support. We regularly receive contact from concerned parents on a long waiting list for treatment, or whose children have been discharged following insufficient therapy. Although the UK is making big strides in terms of early assessment, we need to ensure there is funding available so that every child identified with speech and language difficulties receives the support they deserve.
Support Innovative new approaches
We need you to support innovative new approaches to parental involvement, with a focus on pre emptive solutions that skill up parents and carers.
We run two programmes that focus on getting out in to the community and engaging with parents. Our' Twinkleboost' classes are fun and engaging baby and toddler groups, where parents can learn key techniques to promote and enhance speech and language development. These classes are run by a Speech and Language Therapist but are designed to compete with commercial classes such as TumbleTots and JabberJacks. Our second programme, Chatter Away, is a not for profit project, where our therapists visit local baby and toddler groups to chat informally with parents about techniques to support language development.
Although these initiatives are effective at a local level, we need support to grow and opportunities to work together with local children's centres to deliver our interventions to the most vulnerable families.
We know there is a budget deficit and there are difficult decisions to be made, but please do not take a short sighted approach to Early Intervention. Prompt and early support is not a luxury, reserved for times for economic prosperity, but is essential for avoiding unnecessary disability and the enormous costs of late intervention.
As a profession, we have the tools, knowledge and passion to dramatically improve the lives of millions of children in the United Kingdom but we cannot do this without sufficient funding and support. Please leave a legacy that will give so many children the voice they deserve.
Hannah Broughton and Caspian Jamie
Early Intervention Champions and Directors of The Therapy Adventure Limited
Bryan K, Freer J, Furlong C. Language and communication difficulties in juvenile offenders. International Journal of language and communication difficulties, 2007; 42, 505-520.
Crew M, Ellis N. Speech and Language Therapy within Bradford Youth Offending Team, 2008
Heritage, M., Virag, G. and McCuaig, L. (2011). Better outcomes for young offenders. Exploring the impact of speech and language therapy in youth offending teams. NHS Derbyshire Report.
Lanz, R. Speech and language therapy within the Milton Keynes YOT, a four month project. 2009
Snow, P. and Powell, M. (2012). Youth (in)justice: Oral language competence in early life and risk for engagement in antisocial behaviour in adolescence. Trends & issues in crime and criminal justice: No. 435. Canberra: Australian Institute of Criminology.
Tomblin J B, et al. The association of reading disability, behavioural disorders and language impairment among second-grade children. Journal of child psychology and psychiatry 2000; 41:4, 473–482.
This blog is created by Hannah Broughton and Caspian Jamie. Caspian is a Private Speech Therapist and Hannah is a Child development Specialist We have our own company, The Therapy Adventure Limited and live in Ramsbottom, Manchester with our daughter.