Talk Boost A targeted intervention for 4-7 year olds with language delay Wendy Lee Professional Director, The Communication Trust Mary Hartshorne Head of Quality and Outcomes, I CAN

Rationale In parts of the UK, particularly in areas of social disadvantage, around 50% of children enter school with poor language. Proficiency in speech, language and communication is critical to a child’s emotional well being, learning, cognitive development and literacy, making these children extremely vulnerable. Many of these children are unlikely to catch up without support and evidence suggests long term impact is a high risk With such large numbers in these cohorts, the needs of children with language impairments may be masked. Many targeted interventions focus on one particular area of language or communication.

Aims To develop a targeted intervention to support development across all areas of language, for children starting school To design an intervention developed and supported by specialists, implemented by non specialists To determine whether such an approach could impact positively on children with language delay An additional aim was to support schools to identify children with language impairments, enabling early identification and onward referral to speech and language therapists

Development of an intervention Desktop research – Evidence to support language interventions; content, structure and delivery – Links with educational context – Pedagogy and adult learning theory – Researching and evaluating impact Development of – A programme of work with key principles for language teaching – Training and support for identification – Parent materials – Research design to ensure robust data collection Building on previous work

Programme Structure The programme developed breaks language down into 5 simple areas each with key principles for teaching language There are 3 sessions each week for a total of 10 weeks Each week there is a particular focus on one of the 5 areas, though all are covered This focus introduces a key activity to teach the skill and ensures links with the classroom There are materials to support and include parents Language and Communication 5 a day Attention and listening Vocabulary Sentence building Story telling Conversations

Research Methods In a single evaluation, 160 children were identified in 12 schools, which were randomly allocated to an intervention and control group. Complete pre and post data were collected for 137 children who were assessed blind on a standardised language assessment, informal speech and language therapy assessment and teacher rating before and after the intervention. Schools recruited 160 children assessed Autumn term 50% children receive the intervention Children are reassessed Spring term Other 50% of children receive intervention summer term

The children The children referred into the project varied A number of children were very delayed and fell below the standardisation of the test Some children had a delay across all three measures, where for others there was a more “spiky” profile. On the whole, the speech and language therapy informal assessments reinforced that these children presented with delayed language and communication skills. %InformationGrammarBus story Children falling below test minimum age score 25%28%17%

Analysis of results The random assignment of schools to the intervention and control groups led to an unequal distribution of children with English as an additional language in the two groups There were very few children with English as an additional language in the control group We therefore compared the two intervention groups (English first language and English as an additional language) with the control English first language children Two factor mixed Analyses of Variance were used to compare the progress made by the treated groups and the untreated group.

Information scores

Grammar scores

Bus story

The Results English as a first language The comparison of the treated and untreated English first language groups gives strong support for the effectiveness of the treatment. Two of the assessments gave highly significant advantages for the treated group and the third approached significance. The groups were at similar levels before intervention on each of the assessments so the greater improvement made by the treated group cannot be due to any difference in their severity. English as an additional language The comparison showed significant interactions for the RAPT grammar and RAPT information scores. The result for the Bus Story was not significant Greater caution is needed in interpreting the results for this group. They had significantly lower scores than the untreated English first language group. Their improvement was significantly stronger on two of the three measures but might be due to greater scope for progress due to starting at a lower level. Although probable that it was effective with these children, a control group for children with EAL would be needed to make a direct comparison

Age scores

Results ExampleBeforeAfter Jack; 5 years and 6 months in Year 1. She’s broke her glasses cos she’s fall down the stairs Crying He’s getting the cat from up there Information 4;6-4;11 Grammar 4;6-4;11 She’s fallen downstairs and broke her glasses Crying because the dog has taken off his shoes Going up the ladder to get the cat on the roof Information 6;6-6;11 Grammar 7;0-7;5 It has made a real difference – this is just what our children need” Head teacher “The children are so much more confident – every one of them” Teacher “They are having a conversation; they didn’t know how to do conversations before!” TA

Next Steps Lessons learned were used to support the national project, where Talk Boost sat within the national “A Chance to Talk” project More than 400 children have subsequently taken part in the Talk Boost intervention. Analysis continues to show positive outcomes in children’s language Final report due October 2012

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