Communication across the life course Intergenerational cycles and how we could change them     James Law Professor of Speech and Language Science . “Growing Communication Assets for Scotland’s Future” Scottish Government’s Communication Summit 26th October 2016

What’s the problem?

The changing nature of the world of employment and the increasing importance of communication “During most of human history a person with a communication disorder was not thought of as “disabled”. The shepherds, seamstresses, plowmen, and spinners of the past did not require optimal communication skills to be productive members of their society, as they primarily depended on their manual abilities. Today a fine high-school athlete—a great “physical specimen”—who has no job and suffers from poor communication skills is not unemployed, but, for the most part, unemployable. On the other hand, a paraplegic in a wheel chair with good communication skills can earn a good living and add to the wealth of the society. For now and into the 21st century, the paraplegic is more “fit” than the athlete with communication deficits. “ Ruben 2000, p. 243 Clearly it is not just a matter of asserting that SLT should be considered as a part of public health we need to establish criteria for inclusion

Where does it all start - Life chances What are those capacities that best suit an individual to modern society? “professional families were observed preparing their children for symbolic problem solving, providing them with experience of language diversity, supporting and encouraging them in their problem solving and nurturing their confidence and motivation, whilst only one-third of working class families and none of the welfare families were observed similarly preparing their children.“ Hart and Risley 1995.

Life chances Life chance indicators (Field 2010)

The social gradient

Data from Scotland Growing up in Scotland

Language and socio-economic status Here we see language performance at 5-7 years in England, Scotland, Australia and the US. The scales vary a little as to the measures of social disadvantage but the patterns remain the same.

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But how does this change over time? The Millennium Cohort Study (MCS) is a national birth cohort of children born in the UK in 2000/2001with seven sweeps surveys (10 months, 3,5,7 and 11 years) . Over 18 thousand children were initially sampled; At 3,5,7 and 11 different scales of the British Ability Scales (BAS II) were used (Naming Vocabulary [at 3 and 5], Single word Reading at 7 and verbal similarities at 11). At three years we also have the Bracken Scale of School Readiness. And now we move on to changes over time.

Millenium Cohort Children (UK) Months of development ahead or behind the average at 3 subsequent ages “School readiness” at 3 years At five years (vocabulary) At seven years (single word reading) At eleven years (verbal similarities) Delayed (bottom 10%) -13.9 -9.8 -14.1 Advanced (top 20%) 8.0 8.4 9.5 Very Advanced (top 5%) 13.0 16.4 17.0 Difference between top and bottom 26.9m 26.2m 31.1m % of age

Millenium Cohort Children (UK) Months of development ahead or behind the average at 3 subsequent ages “School readiness” at 3 years At five years (vocabulary) At seven years (single word reading) At eleven years (verbal similarities) Delayed (bottom 10%) -13.9 -9.8 -14.1 Advanced (top 20%) 8.0 8.4 9.5 Very Advanced (top 5%) 13.0 16.4 17.0 Difference between top and bottom 26.9m 26.2m 31.1m % of age 44.8 31.2 23.5

Bradbury, B. , Corak, M. , Waldfogel, J. , and Washbrook, E. (2015) Bradbury, B., Corak, M., Waldfogel, J., and Washbrook, E. (2015). Too many children left behind. Russell Sage Foundation: New York. From ECLS K cohort in the US

And adult outcomes…?

And the adult outcomes.. British Cohort Study (BCS70), one of Britain's richest research resources for the study of human development with over 18,000 persons born in one week in April 1970; At 34 years Literacy – adapted measure of reading and writing – nb split at level two literacy, (with poor literacy being defined as being equivalent to a grade D or lower in the national GCSE exam); Mental health – four scales measuring Malaise, Satisfaction with life, Control over life, and Self-efficacy - nb split at none/ three or more areas of concern identified; Employment - months spent unemployed between April 1986 and March 2004 – nb split at +/- one year

At thirty four years * significance at the 0.5 level Variable Literacy Mental health Employment Specific language impairment 1.59* 2.24* Non-Specific language impairment 4.35* 2.90* 1.88* Gender 2.05* Maternal education 1.66* 1.22* Mother single parent 1.39* 1.92* Overcrowding 1.36* 1.64* Pre-schooling 1.24* 1.33* Parent reads to child 1.21* Parent history of reading difficulties Mother smoked during pregnancy 1.15* 1.27* Small for dates Behaviour - neurotic 2.13* Behaviour – anti-social 1.40* Seen a speech-language therapist

But is it language or “soft skills” ..or both?

Effects of SLCN in adulthood from HILDA*,** 22,738 observations at two time periods (11,369 individuals) 4 years apart (2005 and 2009). Includes individuals who had marked Speech, Language and Communication Needs. *Household Income and Labour Dynamics in Australia ** Analyses from Joe Willoughby, Newcastle University

Soft skills Heckman and Kautz (2012) define soft skills as “personality traits, goals, motivations and preferences that are valued in the labour market, schools and many other domains”. The same skills have also been known by “character”, “personality traits”, “non-cognitive skills”, “non-cognitive abilities” and “socio-emotional skills”. They also have a variety of taxonomies, such as the Big 3, Big 5, Big 9 or MPQ Conscientiousness Openness to Experience Extraversion Agreeableness Emotional Stability (Antonymous to Neuroticism)

Median and Quartile Effects showing the distributions Mental health * significance at the 1% level Average Effects Median and Quartile Effects showing the distributions The higher “floor” for those with SLCN is assumed to have come from a lower number of observations reducing the potential range.

* significance at the 1% level Psychological distress * significance at the 1% level

Life satisfaction * significance at the 1% level Higher score represents higher life satisfaction

Kessler’s Psychological Distress Scale SLCN in relation to soft skills and adult outcomes * significance at the 0.5 level Kessler’s Psychological Distress Scale Mental Health Life Satisfaction Conscientiousness -0.75 (0.06)* 1.23 (0.12)* 0.075 (0.01)* Openness to Experience 0.13 (0.06)* -0.07 (0.01)* Extraversion -0.69 (0.05)* 2.26 (0.105)* 0.17 (0.013)* Agreeableness 0.14 (0.07)* 0.48 (0.13)* 0.14 (0.017)* Emotional Stability -2.22 (0.06)* 6.0 (0.11)* 0.24 (0.014)* SLCN 2.25 (0.98)* -9.36 (1.88)* -0.47 (0.23)*

What do we know about the effects of language interventions?

Source http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004110/pdf

The Education Endowment Foundation has taken this one step further in their evidence toolkit. They conclude that oral language interventions “as a whole” lead to a five months advantage over the course of a year for the children treated

And the “What works” (WW) for children with speech and language needs and the Communication Trust WW interactive website:- www.thecommunicationtrust.org.uk/schools/what-works

In summary Language and communication are central to “Life chances”; Clear and consistent evidence for social gradient with implications for the role of parents; Early language skills ARE associated with adult outcomes; Intervention with young children has been shown to work in clinical samples and it has come to be acknowledged that schools need to be commissioning targeted services; Much more evidence needed on interventions in the latter stages of primary school, into secondary schools and beyond; the impact such interventions can have on social inequalities and over time.