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Speech, language and communication needs

Torbay’s Guide to the Graduated Response for Inclusion

  • Speech, language and communication needs describes difficulties with:
  • producing speech sounds accurately
  • stammering
  • voice problems, such as hoarseness and loss of voice
  • understanding language (i.e., making sense of what people say)
  • using language including words and sentences
  • interacting with others (e.g., difficulties understanding and using the non-verbal rules of good communication, using language in different ways to question, clarify or describe things, or taking into account other people’s perspectives)

Everyone with speech, language and communication needs is different and may have difficulty with one, some or all of the different aspects of speech, language or communication at different times of their lives. Find out more about the common features of speech, language and communication needs.

Some difficulties are short-term but others will be more permanent and remain throughout childhood and adult life.

  • Over 10% of children/young people have some form of speech, language and communication needs that persists and impacts on social, emotional, mental health as well as educational functioning.
    • 2.34% of these children/young people have a language disorder that is in addition to a biomedical condition such as autism, hearing loss, cleft palate, learning disability, neurodegenerative conditions and genetic conditions – for example, cerebral palsy or Down’s syndrome.
    • 7.58% of these children/young people have language difficulties are not associated with another condition. This is known as Developmental Language Disorder.
  • In addition, in areas of high social deprivation in the United Kingdom between approximately 56% of children start school with below age-related language skills.

It is important to understand that Speech, Language and Communication Needs is known to be a significant risk factor for poor life chances and outcomes which is why it is vital that language and communication are understood as EVERYONE’S RESPONSIBILITY. This video provides details of the impact language disorder, including DLD, can have on a child/young person and adult: SLCN and life chances

Difficulties may include:

  • Speech:
    • sounds used to build up words
    • saying sounds accurately and in the right places
    • speaking fluently, without hesitating, prolonging or repeating words or sounds
    • speaking with expression and a clear voice, using pitch, volume and intonation to support meaning
  • Language:
    • understanding words (vocabulary) and their meaning
    • knowing how words go together to form phrases and sentences
    • understanding and using grammar
    • joining sentences together
    • using higher level skills such as reasoning, inference
  • Expressive language:
    • Having words to describe objects, actions and attributes, using these words to build up sentences, using these sentences to build up conversations and narratives, following the rules of grammar, so that things make sense
  • Receptive language:
    • Processing and making sense of what people say, understanding words being spoken, understanding the rules of grammar used
  • Communication:
    • the way in which language is used to interact with others
    • using language in different ways; to question, clarify, describe and debate
    • using non-verbal rules of communication: listening, looking, knowing how to take verbal turns and how to change language use to suit the situation
    • the ability to take into account other people’s perspectives, intentions and wider context

Every education setting, health setting, social worker and community support worker will:

  • Have a supportive ethos and environment which promotes speech, language, communication and respect, and values diversity
  • Have clear processes in place to:
    • capture each child and young person’s voice
    • respond to concerns raised by parents/carers/children and young people/professionals
    • share appropriate information with partners as part of a multi-disciplinary team approach (e.g., Early Help Assessment partnership enquiries)
  • Have a lead professional for communication (e.g. Communication Champion) and ensure that they have access to appropriate training to enhance their competency levels
  • Have systems in place to ensure that all relevant members of staff have a clear understanding of needs of all children and young people including the adaptations required for groups/individuals (e.g., Child Protection Online Management System, provision maps, pupil profiles)
  • Have systems in place to review whether an environment is ‘communication friendly’ and make reasonable adjustments as necessary
  • Make consistent use of visuals to:
    • enable access
    • support understanding
    • support independence
    • reinforce key routines and expectations
    • enable a child/young person to access and contribute to their learning
    • enable an individual to express themselves
  • Have processes in place to enable parents/carers and staff to understand typical speech, language and communication development
  • Have access to recommended screening tools to enable professionals to identify need and plan provision
  • Have systems to implement a whole school/setting/workplace approach
  • Provide opportunities for all workforces to audit the key skills and knowledge needed to support the speech, language and communication development of all children and young people
  • Provide training for all staff to develop understanding and confidence around supporting speech, language and communication needs that is relevant to their role
  • Support parents/carers and professionals by signposting to resources and sources of information

For information and resources to support the implementation of these please see Appendix 1.

Key principles for supporting children with Speech, Language and Communication Needs

All adults to:

  • prepare the child/young person for experiences and learning opportunities.
  • help the child/young person to understand and name their needs and emotions
  • consider and make reasonable adjustments to the environment including sensory needs
  • give careful consideration to all transitions
  • support friendships, interactions, social-emotional wellbeing and self-advocacy.
  • listen to and engage with the child/young person
  • use language that is appropriate to the child/young person’s level of understanding
  • provide time for the child/young person to process information and respond
  • value the child/young person’s response

SEND support strategies or interventions to support these principles

Prepare the child/young person for experiences and learning opportunities

Help the child/young person to understand and name their needs and emotions

  • Create a ‘one-page profile’ involving parents/carers and the child/young person to identify and record how best to support
  • Ensure there is good communication across settings and other support agencies eg home/school/GP/social care. Sharing information will help everyone to have a shared understanding of the child/young person’s strengths, ways to support to help the child/young person be prepared for new experiences so they can thrive and succeed.
  • Ensure that routines are visually augmented and referred to explicitly (e.g., whole class or personalised visual timetables)
  • Incorporate time for learning breaks as children/young people with speech, language and communication needs often tire easily. Learning breaks may be appropriate for the whole class not just individual children with speech, language and communication needs
  • Begin work on a new topic by building on the child/young person’s existing knowledge and experiences (i.e., start with what they know and understand)
  • Actively teach strategies for what to say and do when they do not understand. This resource can help to structure this.
  • Be aware that the child/young person may have difficulty understanding gestures, facial expressions, tone of voice and jokes
  • Explicitly explain the meaning behind irony, sarcasm, figurative language, rhetorical questions and idioms (e.g., “pull your socks up”, “it’s raining cats and dogs”, “in a minute”)
  • Explicitly teach and link physiological feelings to vocabulary related to emotions (e.g. focus on physical feelings in a body and then build up to using an approach. Here is an example.

Consider and make reasonable adjustments to the environment including sensory needs

Give careful consideration to all transitions

Support friendships, interactions, social-emotional wellbeing and self-advocacy

  • Consider and adapt environmental aspects (e.g. level of noise, seating, space to move around). For more information please see the ‘Communication Friendly’ section below
  • Consider the use of distraction/focus toys, individual workstations and the use of timers to increase awareness of transitions and expectations
  • Support oral presentations and explanations with pictures, real objects, symbols or actions
  • Use visual aids, scaffolding and repetition, and give extra time to process and rehearse
  • Provide ‘scaffolding’ for talking (e.g., talk prompts, key phrases) and writing (e.g., writing frames, word mats)
  • Explicitly highlight and teach vocabulary for a particular topic, stories, concepts or lessons – this includes pre/post-teaching of key words and concepts (see Resources section)
  • Implement supportive strategies for all forms of transition including within a lesson, lesson-lesson, class-class, year group-year group, school-school and preparing for adulthood (see Resources section)
  • Encourage social interaction by supporting the organisation of structured lunchtime clubs, focusing on shared interests or by using a buddy system

Listen to and engage with the child/young person

Use language that is appropriate to the child/young person’s level of understanding

  • Meet the child/young person’s eye level
  • Use the child/young person’s name before asking a question or giving an instruction
  • Keep verbal instructions simple and use them in the order you want them carried out
  • Use signing and symbols to support spoken language and text (see Resources section)
  • Give time for the child/young person to rehearse their answer with a trusted adult before expecting them to engage in partner talk or answering a question in a large group
  • Check for understanding – ask the child/young person to tell you what they have to do
  • Use repetition to support understanding
  • Teach the child/young person how to use visual aids and scaffolding to support understanding and use of language
  • Cue the child/young person into a change of topic of conversation/presentation - say “Now we are going to talk about…”
  • When asking questions, consider the Blanks Levels of Questions framework (see Resources section)

Provide time for the child/young person to process information and respond

Value the child/young person’s response

  • Provide opportunities for alternative methods of communication/recording (e.g., scribe, use of ICT, drawing, drama, art, symbols, signing)
  • Give the child/young person at least 10 seconds of thinking time to respond
  • Use visual support such as mind maps, flow charts, diagrams, social stories, now/next boards, comic strip format, symbols, Picture Exchange Communication System (PECS) (see Resources section)

Helpful Resources

Communication Friendly Environments

A Communication Friendly Environment enables learners (pupils) to develop their social, emotional and academic potential by reducing or removing barriers to communication. The following resources can help to review whether the environment is communication friendly and what reasonable adjustments may be necessary.

School and education settings

Wider workforce environments

Supporting organisational skills

Developing understanding and use of vocabulary

Supporting transitions

Use of visuals including objects of reference, signing and symbols

Asking questions

Social stories and comic strip conversations

Managing Emotions, Zones of Regulation and Incredible 5 point Scale

Suggestions for the SENCO

  • Support staff/parents/carers to identify need:
    • enable parents/carers and staff to understand typical speech, language and communication development
    • provide access to recommended screening tools to enable professionals to identify need and plan provision
  • Plan and implement targeted support, seeking advice from external services as necessary (e.g., Speech and Language Therapists, Educational Psychologists, Early Language Consultants and/or Advisory Teachers)
  • Ensure that appropriate targeted interventions are explicitly planned for and delivered on a rolling programme
    • These should be a minimum of twice a week and measure impact, prior to considering a referral to external specialists. Not all children/young people with speech, language and communication needs will require a referral to Speech and Language Therapy for a specialist assessment.
  • Monitor the impact of intervention using a recommended screening tool and recording system: Speech, Language and Communication intervention record
  • Identify training requirements and provide training for all relevant members of staff to ensure interventions and approaches are effectively delivered
    • Use an evidenced-based audit the key skills and knowledge needed to support the speech, language and communication development of all children and young people
  • Continue the cycle of support (assess, plan, do, review)
  • Consider the link with wider agencies supporting the child/young person/family (e.g., Children’s Centres)
  • Consider referral to Early Help/Family Hubs
  • Consider outreach advisory support (e.g. Mayfield)
  • Signpost parents/carers to the Local Offer
  • Signpost parents/carers to SENDIASS
  • Seek advice on specialist arrangements for examinations and assessments
  • Use resources to aid transition, such as those mentioned above

Assessment and screening tools

Parents/carers and professionals:

Public Health Nursing:

  • Mandated developmental checks by 1 year and 2.6 years using ASQ and ASQ-SE assessments
  • ELIM – an evidenced based assessment and intervention tool for 2- 2½ year olds to support children and young people/families/professionals and service development
  • Use of SLC Monitoring Tool

Early Years Practitioners:

Practitioners within education settings:

  • The Progression Tools aim to support staff to identify children/young people who may be struggling to develop their speech, language and communication skills. They can also be used to track progression of these skills over time of following interventions.

Youth Justice professionals:

Service offer or referral pathway

  • SLT Referrals - Children and Family Health
  • AAC West is commissioned by NHS England to provide an AAC service to the South West of England.
  • Refer to Educational Psychology service through planning meeting with link Educational Psychologist. The Educational Psychology service can offer an assessment of cognition and learning needs, observation, and consultation to discuss what this means and the ways to move forward.

Appendix 1

It is also important to note that many children and young people may have needs across more than one category and certain conditions may not fall neatly into one area of need. When reviewing and managing special educational provision all four broad areas of need must be considered to ensure you can provide holistic support for the child/young person.

With a multidisciplinary approach many children and young people's needs can be met at universal and targeted support so they can make progress therefore, not all children/young people with SLCN will require a referral to Speech and Language Therapy for a specialist assessment.

To help inform this process a series of factsheets are available to help professionals/parents/carers plan the decision-making process for making referrals, what to consider about the child or young person, and how to build a speech, language and communication profile.