Jean Gross: education and health should work together to support children's speech and language

Catherine Gaunt
Monday, January 16, 2012

Cuts across the country are a significant threat to vital speech and language services for children and young people, the outgoing communication champion has warned.

As local authorities and the NHS struggle with their budgets, there has been a 58 per cent rise in the last five years in the number of children needing support for speech, language and communication problems.

In a final wide-ranging report, marking the end of the two-year role, Jean Gross sets out 30 recommendations to Government departments for education and health, local authorities, and the voluntary sector.

A key recommendation is that the Health and Social Care Bill, currently going through Parliament, should be amended to make joint commissioning of children’s community health services compulsory, to improve services for the one million children in the UK with speech, language and communication needs (SLCN).

Areas where integrated services are available for children of all ages are in the minority, Ms Gross says, but are ‘a common thread’ in areas where practice is particularly effective.

Although, there has been a rise in speech and language therapy services being commissioned jointly by the NHS and local authorities, this is only happening in three out of ten areas.

Without joint commissioning, the responsibility for meeting children’s SLCN needs can be passed from one agency to another, leaving parents and children stuck in the middle of disputes.

The report gives examples of the impact of these commissioning failures, such as a speech and language therapist being forced to choose which of three disabled children should be given a communication aid.

‘This joint commissioning is vitally important, because the care pathway for children with SLCN includes school and nursery-based provision; effective clinical outcomes rely on what practitioners do, as well as what SLTs do,’ Ms Gross says.

The report coincides with the end of the ‘National Year’ of communication, which grew out of MP John Bercow’s 2008 review into services for children and young people with SLCN, which called for the appointment of a communication champion.

It is based on findings from meetings with local commissioners and service providers throughout England.

During her time in post, Ms Gross visited 105 out of 152 local authority and NHS Primary Care Trust pairings and her report highlights areas of concern, as well as praising some of the excellent work she has witnessed.

Examples of best practice include the Stoke Speaks Out early years campaign that has reduced the percentage of three-and four-year-olds with language delay from 64 per cent in 2004 to 39 per cent in 2010.

The report also says that data shows that the Every Child A Talker programme has led to an average 40 per cent reduction in the proportion of children with delayed listening and attention skills in settings involved in the scheme.

Although Government funding for this initiative ended in March 2011, the report notes that the initiative’s success has led to some local commissioners finding the resources to keep the scheme going.

In her conclusion, Ms Gross said, ‘Much remains to be done, however, and the reductions to front-line services are of great concern. At a time of austerity it is to be expected that commissioners and providers will seek to find savings.

‘Nevertheless, we have to remember that, as the Bercow Review demonstrated, services for children with SLCN come from a low base. Reducing them further seems neither fair nor, in the longer term cost-effective.’

Recommendations for early years

  • fund local professional development for early years practitioners to enable them to assess and support children’s communication and language development, within the revised EYFS
  • ensure that early years settings catering for disadvantaged two-year-olds have staff with appropriate levels of training in language development.

Comments from the sector

‘Jean Gross’s work as Communication Champion has been timely.
Too many of our children do not receive the specialist support they need and provision being made available is a postcode lottery. Parents of children with a specific language impairment (SLI) should be vigilant.

'In a time of cuts and threats to services such as speech and language therapy and advisory teaching, they need to make sure their children are getting all the help they need.

She added, ‘The barriers identified in the Champion’s report are concerning and in the current climate parents need to be proactive in securing the help their children and young people need. We are hopeful that the Government will take forwards the recommendations laid out in this report as protecting children’s ability to communicate is vital.’

Linda Lascelles, chief Executive of Afasic, the UK charity representing children and young adults with speech, language and communication impairments

‘We are pleased with how far the national year has taken us. Without a doubt Jean’s work as champion has expedited growth in understanding and awareness of the vital importance of speech, language and communication. The passion and unique role of the voluntary sector has fuelled so much change that is now starting to benefit children and families. This work has ensured that speech and language is now part of the political zeitgeist.’

She added, ‘However, despite some improvements, speech, language and communication is still a new and emerging issue. This makes it fragile and vulnerable. Huge churn is being felt in the education and health system with for example the growth of academies and changes to SEN provision.

'The Communication Trust’s next five year strategy will focus on supporting primary and secondary schools around developing all children’s communication and meeting the needs of those with SLCN. This builds directly on our successes in early years.’

Anita Kerwin-Nye, director of the Communication Trust, the coalition of 50 charities and an advisory group that ran Hello, the 2011 ‘National Year’ of communication

‘Jean’s report shows the benefits for children’s communication when communities, parents, health, education and social care professionals combine efforts to identify and support those who are struggling.

'Integrated, area-wide approaches and focus on workforce development is illustrated by I CAN’s work with early years staff, settings and local authorities. But we need to expand this approach from the 30 per cent of local areas identified in Jean’s report and plug the gaps in support for school–aged children.’

Virginia Beardshaw, I CAN

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