The development of a model pathway for services for children 0-5 to promote language and early identification/ interventions for children with SLCN Faye Spooner – Principal Speech and Language Therapist London Northwest Healthcare / Harrow Community Services

Establishing a network of Harrow Early Language Practitioners (HELPs) to support pre-school children with Speech Language and communication needs (SLCN). Children Centre Staff received accredited training in identifying and developing children’s SLCN . With ongoing 1;1 and group support, supervision and training from a speech and language therapist, they provide an extensive programme within Harrow Children Centres to support children with SLCN and their families. Longer Lives

Background - Harrow Harrow’s population - 243,000 23% of our population is under 17 years of age Over the past 5 years our under 4year old population has increased by 32%. More than 60% of our children speak English as a second or additional language. We have significant pockets of deprivation, increasing mobility with high levels of need among our incoming population. We have higher numbers of EHCPs in early years than our statistical neighbours. We have had a significant increase in social care activity over the past 5 years. Child In Need assessments are up 67%. Longer Lives

Background – Preschool SLT Service In the last 3 years we have seen a 15% increase in the number of pre- school children referred to speech and language therapy (SLT). In line with national trends there are increasing numbers of children with complex SLCN needs and high demand from the more deprived wards in the Borough. The average age of referral is age 3 years with significant numbers of children not referred before their 4th birthday. Significant numbers of children with SLCN attend Early Years settings in Harrow where staff have limited knowledge and skills in meeting the needs of children with SLCN and their families . Longer Lives

Steps Taken Accredited intensive training for Early Years Practitioners who then become HELPs Termly 1;1 and group support and supervision Ongoing training sessions to develop knowledge for specific areas and therapy approaches Support to set up language Talk Groups in children centres Training for carrying out 2 year checks 8 Triage sessions in Children’s Centres per term Longer Lives

Changes Children with mild/moderate language difficulties now discharged from SLT and supported by HELPs Average age of referral lowered by 7 months More appropriate referrals An increase in more hard to reach families accessing SLT Longer Lives

Impact 91% of children who attend Talk Groups make good progress and do not need re-referral to SLT More time to provide therapy for children before starting school Earlier referrals to specialist services Less time wasted on unnecessary assessments Longer Lives

The Pathway Longer Lives

Feedback “I feel more confident as I have gained extensive and valuable knowledge on supporting children’s learning and language development”. “The staff in my setting are more confident about Ofsted coming in. We take pride in what we learnt and are implementing it”. “The children are achieving their next step of learning and development in less time and effectively”. “They all interact more and use more language” “This is the best training I have ever received” “We can really support parents to come to come to terms with their child’s difficulties” Longer Lives

Challenges Lack of funding for training of Early Years Settings Frequent changes of staff and staff roles in Early Years Increased demands on SLT services with a finite resource so reducing the available time to support universal services and provide targeted / specialist support . Longer Lives

Next Steps Work with colleagues in early years to develop the HELP role in Early Years Settings Work with colleagues in Local Authority and Public Health to influence strategy for speech language and communication skills in early years. Longer Lives