LTP Priority: Children and Young People
Population Intervention Triangle: Segments (link to Section 1 PHE PBA): Service
Type of Interventions: A strong start in life for children and young people; Expanding the number of nurses, midwives, AHPs and other staff (including speech and language therapists)
Major driver of health inequalities in your area of work
Early language development is a significant health inequalities issue.
18–31% of children aged 19–21 months living in disadvantaged communities have language delay that warrants referral for specialist assessment.
Around 50% of children in areas of highest social disadvantage start school with delayed language or other identified SLCN.
The evidence base suggests that early language skills are powerful predictors of later life chances. Longitudinal studies have shown that without appropriate intervention, children with SLCN are at higher risk of negative long-term outcomes on their wellbeing, including poorer educational attainment and employment, and mental health.
The 2010 Marmot Review on health inequalities emphasised ‘giving every child the best start in life’ as a high priority recommendation. The Review identified reducing inequalities in the early development of physical and emotional health, and cognitive, linguistic and social skills as a priority objective, noting communication skills as crucial for ‘school readiness’.
Speech and language therapists (SLTs) play an important role in primary prevention and targeted approaches to improve the communication and interaction skills of children with delayed or disordered speech, which are particularly high in areas of social deprivation.
Speech, language and communication services for under fives
Supporting families and providing early years services that help children to be ready to thrive at school is a national priority for the economic prosperity and future health of society and to close significant inequalities gaps. Language delay is major of cause of children not being ‘ready for school’. If uncorrected, evidence shows the delay gets worse resulting in poorer attainment and employment opportunities which impacts on long term health and later costs on NHS. Improving the number of children having good speech, language and communication skills by five is a national priority with investment from government departments for improvement and reduction of inequalities. The NHS has a significant contribution through providing specialist advice and services which support the drive for improvement. This proposal is for the NHS to increase capacity and transform speech, language and communication services to enable all children to have the level of support required to realise their full potential. The recent report from the Office for the Children’s Commissioner (June 2019) highlights inequalities in provision of speech and language therapy services and makes recommendations to narrow the gaps between rich and poor children https://www.childrenscommissioner.gov.uk/publication/we-need-to-talk/
Language delays cause significant harm to children and their families. Without appropriate and timely intervention, children with Speech, Language and Communication Needs (SLCN) are at higher risk of negative outcomes, including on their educational achievement, employment prospects, behaviour and involvement in the justice system, as well as their social, emotional and mental health. More than 10% of all children and young people (1.4 million in the UK) have long-term speech, language and communication needs[i]. Studies have shown that low vocabulary skills at school entry are associated with adult literacy at 34 years and also mental health and employability [ii] with the subsequent impact on the NHS. Early language development is a major inequalities issue. Around 50% of children in areas of highest social disadvantage start school with delayed language or other identified SLCN.[iii] 18–31% of children aged 19–21 months living in disadvantaged communities have language delay that warrants referral for specialist assessment[iv]. Bercow: Ten Years On[v] review of provision for children and young people with SLCN in England (2018) that found 55% of parents of children with SLCN reported that their child waited more than 6 months to get the help they needed. Only 15% of respondents felt that speech and language therapy was available as required in their local area. In addition, the CQC/Ofsted report, Local area SEND inspections: one year on[vi], also found that therapy services were too overstretched to deliver what was needed in their local areas. The Office for the Children’s Commissioner in their report “We need to talk: Access to speech and language therapy” https://www.childrenscommissioner.gov.uk/publication/we-need-to-talk/ identified inequalities in provision for speech and language therapy services and makes recommendations to reduce the gap between rich and poor children.
[i] Bercow: Ten Years On (2018) https://www.bercow10yearson.com/wp-content/uploads/2018/03/337644-ICAN-Bercow-Report-WEB.pdf
[ii] Law, Rush, Parsons and Schoon, 2009
[iii] Law et al, 2011; Locke et al, 2002
Guidance for Commissioners
Available Oct 2019