Last reviewed 18 February 2022
It is “everybody’s business” to promote good communication, speech and language skills in children, as it is to safeguard children. Rebecca Fisk investigates how early years providers fit into a speech, language and communication pathway.
In 2020 guidance was produced by Public Health England for local areas to develop the best start for children in their speech, language and communication. This has involved collaboration between Public Health England, the Department for Education and the Department for Health and Social Care.
Being able to communicate is the most fundamental life skill a child can develop. It directly impacts their future life chances through their ability to learn, connect, and develop relationships.
Speech, language, and communication (SLC) needs encompass a range of communicational challenges in children and young people, including difficulties with forming words and sounds, fluency, forming sentences, using language socially, and understanding what others say. In developing a local approach, the pivotal role of those closest to children, ie their primary caregivers/parents, cannot be overstated. Early years providers must encourage and help parents/caregivers to support their children’s development by affecting the context in which children live and providing resources and information to encourage their role as primary educators and communicative partners for their children. After all, education starts well before nursery and school.
To help address SLC needs, SLC pathways have been developed in some local areas to provide guidance for early years providers, other professionals, and parents to help them meet the SLC needs of children. Specific pathways have been developed for children from birth to five years old. These can be separated into different periods: pregnancy, birth to two years, two to three years, and three to five years.
Regular contact with midwife and health visitor antenatal review.
Holistic health needs assessment by midwife and an assessment of the risk factors for SLC needs carried out by a health visitor.
Signposting to community-based resources, including children’s centres, libraries, local voluntary and community sector services, family hubs, clinics, etc. Engaging with families to support the home learning environment.
Promoting parent-infant relationships by encouraging parental awareness of the needs of their unborn child. Promoting parental bonding, parental sensitivity, and reflective function during pregnancy, as well as helping mothers and partners to identify with the baby and bond prenatally.
In targeted services, families are signposted and supported to access local services, such as children’s centres, parent infant mental health services, perinatal mental health services, and drug and alcohol services to meet any identified needs. Furthermore, some home visiting provision such as the Family Nurse Partnership is recommended for adolescent parents.
Birth to two years
Regular contact with midwife. Health visitor to carry out a new birth review (10–14 days), as well as newborn hearing screening and a six to eight-week review by a health visitor. GP practice immunisations and a 12-month review by a health visitor.
Holistic health needs assessment by midwife and an audiology assessment carried out by a health professional. Ongoing review of risk factors for SLC needs and review of communication milestones/developmental flags carried out by the health visitor and early years practitioner. An early years practitioner will monitor progress through ongoing observations during Early Years Foundation Stage educational play activities under the communication and language area of learning.
Signposting to community-based resources, including children’s centres, libraries, local voluntary and community sector services, family hubs, clinics, for example.
Engaging with families to support the home learning environment. Provision of a high-quality, language-rich early communication environment and curriculum in childcare settings.
Parents should be supported to understand the importance of participating in the progress checks for their children so that any SLC needs can be identified, and timely support received. Promote communication strategies to support language learning, such as language in everyday routines, interpreting gestures, infant-directed speech, book sharing, joint-attention activities.
Two to three years
Health visitor to conduct a two-year review/integrated review. Early years Foundation Stage two-year progress check.
Holistic health needs assessment carried out by health visitor at two-year review. Review of child development using the Ages and Stages Questionnaire carried out by the health visitor as part of a holistic assessment.
Promotion of early education for eligible families, such as free education and childcare for two-year olds. Ensure parents have taken part in their child’s two-year old health review and progress check.
All children aged two should receive a Health Child review. Eligible parents should be supported to access the funded two-year-old early education offer. Concerns about children’s development should be investigated either by a health professional or the Special Needs Coordinator in the early years provision, and a graduated response made to meet the developmental needs. This may include an individual plan to target additional support or strategies to help the child progress. Promoting lots of talk with children and extending their vocabulary through real life experiences, songs, rhymes and books.
Three to five years
Early Years Foundation Stage Profile at age five (Reception). This includes achievement on communication, language, and literacy early learning goals.
Entry to school review – transfer from health visitor to school nursing; transfer of information from early years setting to school.
In targeted services between birth and five years of age, families are signposted and supported to access local services, both universal and targeted services. Furthermore, families with identified risk factors will be supported according to local health visiting pathways, with specific attention given to reviewing communication milestones. Where key communication milestones are not reached by specific ages, further assessment should be made of the risk factors present, developmental “flags for review,” and general development of the child. Evidence-based intensive home visiting programmes can be provided for low income/targeted families, or intensive home visiting support from the health visiting service to support parents and improve the quality of the home learning environment. Additional evidence-based support/enriched curriculum can be provided in settings to accelerate progress.
In specialist services between birth and five years of age, there is access to specialist interventions for children with a range of SLC needs under the guidance of a speech and language therapist. Support is also available for children with additional complex needs in early years settings through the Special Educational Needs Inclusion Fund (SENIF), which is administered by local authorities. This specific support and training from specialists enables early years settings to support children with severe, specific, or complex SLC needs. Parents should be provided with specialist support to facilitate their ability to support their child’s communication development. There will be multidisciplinary support to continue monitoring the child’s needs and progress. In addition, individual education plans and, if appropriate, statutory assessment will be available, which might lead to an Education Health Care Plan. Further support may be provided by other specialists, such as portage workers or community paediatricians.
It is key for early years providers to support and encourage parents and caregivers to be their children’s primary educators.
SLC needs should be consistently assessed and reviewed by early years providers so they can be identified and responded to as soon as possible.
Early years providers should strive to signpost parents and caregivers to resources to foster SLC development, particularly from birth to age five.
Early years providers should also help families identify when their children might not be reaching milestones and signpost targeted and specialist services where relevant.
Further reading and resources
Best start in speech, language and communication, Public Health England (2020)
Hungry Little Minds A government campaign of simple, fun activities for children from newborn to five to support parents and carers.
Tiny Happy People Resources to help develop children’s communication skills with activity and play ideas.
NASEN A range of training opportunities and resources from the National Association for Special Educational Needs.
ICAN The children’s communication charity ICAN’s Talking Point gives parents/carers and practitioners the information they need to help children develop their speaking and understanding skills. ICAN also delivers a help enquiry service for parents.