Supporting early identification – we have won the argument but devil in the detail, Anita Kerwin-Nye, Director

The Communication Trust is delighted that our lobbying efforts over the last 5 years have been rewarded with such strong mentions for speech, language and communication (SLC) in the Foundations Years Strategy and Healthy Child Programme and across work on reducing social inequalities. While it easy to take these successes for granted there has, as lead researchers have noted, been a substantive shift in recognition of the importance of early SLC skills for school readiness and best life outcomes.

Particularly pleasing is the focus on early identification (and with this early intervention). On Monday, the Royal College of Speech and Language Therapists hosted a roundtable of therapists, researchers, the Trust and the Communication Champion to start to put the ‘meat on the bones’ of what early identification should look like. With the government committed to assessment at age 2 and ½ we have a real chance to build on the best of what is already working to further improve the system.

As a starting point the group identified the following as the 10 potential characteristics of effective early identification programme for a community – be that a single nursery setting or an entire county.

What do people think? What is missing? What matters most? Does it matter what screening tool is used? Do we need a screening tool at all? Which staff most likely to do this? The Trust will be doing more work on early identification over coming months so please do share your thinking as we probably have a once in a generation chance to influence so really positive developments.

What matters in early identification?

1. Staff who are appropriately skilled and trained to undertake observational assessment

2. Observational and ongoing assessment, undertaken in conjunction with the family and other carers

3. Coverage of full age range – 0 to 2 as well as at 2 and 5 year progress check, and coverage not only of the early years but in the primary or secondary school – recognising that children may have slipped through the net , and that children’s needs can change.

4. Provide for ongoing monitoring – for example between 2 and 5 , rather than just being used at fixed points

5. Be capable of picking up children with comprehension problems as well as speech and language

6. Be capable of distinguishing English as an additional language from speech, language and communication needs (SLCN)

7. Be differentiated to meet the needs of families from different groups and cultures

8. Assess the context for the child’s language learning – parent-child interaction and the home learning environment - as well as the child’s developmental level

9. Lead to action to address any needs identified

10. Be consistent, so that a child would be entitled to high quality progress checks wherever they live

What makes a grown up and (fairly) level headed woman bash her head on a desk? I’ll tell you – the third call of the day to a major utility provider. A problem with billing should have been a two minute call. Instead I had to work my way through multiple choice machine questions and key in my account number before I could speak to a real person. Then the real person really had not got a grip on either my accent (English southern) requiring three attempts at spelling my surname and struggled to pick up the exasperated (but still polite) tone in my voice. Then the phone cut out (maybe they HAD got the tone). Then ringing to complain I got stuck in a loop of referrals between people and machines and hold tones. Cue one dent in desk.

I'm not alone. The Guardian reports that Brian Evans of Bristol attempted to make an appointment using an automated system for an eye appointment only to find that the system did not get his, not so broad, accent. The Guardian then did an, oh so ‘funny’, investigation ringing up phone lines with a range of accents and a lisp.

Except it’s not a joke is it. If I struggled – being fairly articulate and confident - and all the systems tested by the Guardian failed, then how accessible are these services for those who struggle with speech, language or communication? How do voice recognition systems work for people who stammer or use AAC? How can people with SLI navigate systems that use complex language or business jargon and where even the real people that you get through to struggle to be understood? It’s not on.

There have been several attempts at creating a Communication Charter or Kitemark for organisations that are ‘communication friendly’ and work in Scotland is quite advanced on developing a culture where it’s as unacceptable to deny access on grounds of communication as it would be to put a flight of stairs into a public building with no ramp. We need to get there too. It would save me buying a new desk.