Good Practice: Teaching speech and language skills in Stoke-on-Trent

Project Stoke Speaks Out
Funding About £100,000 a year from Stoke-on-Trent City Council and Stoke-on-Trent Primary Care Trust
Purpose To tackle speech and language difficulties experienced by children in Stoke-on-Trent

Background Local research in Stoke-on-Trent in 2001 found about 70 per cent of children started nursery with a language delay. This worrying statistic led to a multi-agency initiative - Stoke Speaks Out - launched with funding from the Neighbourhood Renewal Fund. The local council, speech and language therapists and other professionals from health, education and the voluntary sector joined forces to devise a 20-year city-wide plan to tackle the causes of language delay and make Stoke "a city that communicates".

Action A key strand was a training framework for practitioners working with children and families. "Before there was variation in quality and practitioners had varying levels of knowledge," says project lead Janet Cooper. "Some were trying to work with children with quite severe difficulties but didn't have the baseline knowledge to do that."

There is now a tiered approach, with professionals across Stoke undertaking basic Tier 1 training, covering early speech and language development and child development. The training is mandatory for all student midwives, student paediatric nurses, health visitors and children's centre staff, including admin workers.

Tier 2 involves professionals, who are mentored, putting their knowledge into practice. "It could be a midwife ensuring some skin-to-skin contact between dad and baby to encourage bonding," says Cooper. "Or a nursery worker creating a quiet area."

Tier 3 features specialist courses, taught by different agencies and covering topics such as autism. These are aimed at professionals such as special educational needs co-ordinators.

Tier 4 involves whole settings or departments being assessed for how "communication friendly" they are. Twenty-five settings have gained a certificate thus far, including nurseries, primary schools, children's centres and one museum and art gallery.

Another development was the Staged Pathway for Communication - a tool to help professionals quickly identify children who might need specialist help. All get a copy as part of Tier 1 training. Initial results suggest it has led to an improvement in the quality of referrals. In addition, speech and language therapists received new guidance on which cases to take up to ensure they were working with children with the most severe problems.

One of the main challenges from the start was to get all the different agencies to commit to the programme, says Cooper. "Other issues include changes of staff, changes in strategic leads and the fact that departments are under different pressures," she says. "But the work has been sustained because people recognise it is so necessary."

Outcome In 2002, 69 per cent of children entered nursery with language delay. That dropped to 59 per cent by 2005, 54 per cent in 2007 and was 48 per cent in 2010. Among just children for whom English is a first language, 49 per cent started nursery with language delay in 2007, falling to 39 per cent in 2010. In 2004, some children and families waited up to two years for specialist speech and language help with an average wait of about a year. Now no family waits more than four weeks for a first appointment.

Cooper says Stokes Speaks Out was a big factor in that change and part of a real "culture shift". "You'd be hard pressed to go into any early years setting in Stoke and not find someone who knows about communication. It is embedded now," she says.

Early Years Foundation Stage results have also improved since the initiative was launched. In 2008, 43 per cent of children scored the benchmark of 78 points with six or more points for personal, social and emotional development and communication, language and literacy. That figure was 51 per cent in 2009 compared to a national average of 52 per cent.

SPEECH AND LANGUAGE IN STOKE

Development

Percentage of children who scored highly in personal, social and emotional development, and communication, language and literacy in the Early Years Foundation Stage

2008 43%

2009 51%

Source: Stoke-on-Trent City Council

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