1. Speech & Language Therapy

2. AGENDA Steps for language and literacy Monitoring language Development Skills involved in Speech Language and Communication What might go wrong Types of Speech, Language and communication difficulties How we work General Strategies to support

3. W HAT DO THE TERMS MEAN ? Communication Involves successfully sending and receiving messages - can be verbal and/or non-verbal Language Is a system used to receive and convey messages e.g. English, British Sign Language etc. Speech Our ability to listen to and discriminate speech sounds then sequence and produce them accurately.

4. S TEPS TO C OMMUNICATION & L ITERACY Writing Reading Speech Speech sound discrimination Expressive Language Understanding Listening Play Attention Interaction

5. Skills needed for communication Vocabulary Expressive Language Understanding Attention and listening Fluency Play Social Skills Speech Sounds

6. Some stats 1 in 10 children have difficulties with speech, language and communication 1 million across the UK 1-2 children in every classroom. In areas of high deprivation this can rise to 1 in 2 children (ie half the classroom)

7. Impact mental health problems as adults Two thirds of 7-14 year olds with serious behaviour problems have language impairment. Only one quarter of children with SLC needs reach the expected levels for their age in English and Maths at age 11 years. Only 6% get 5 good GCSEs including English and Maths. 70% of young offenders in England and Wales have untreated language difficulties.

8. Narrowing the gap SLC needs are found across all social groups but social disadvantage adds to the problem. On average, a toddler from a socially disadvantaged family hears around 600 words per hour, with a ratio of two prohibitions to one encouraging comment. A child from a professional family will hear over 2000 words per hour, with a ratio of six encouraging comments to one negative.

9. Development of understanding Birth- 6 months: responds to sounds and intonation 6-18 months: understands words used in familiar situations or routines e.g. ‘bye bye’. Understands single words. 2 years: can understand commands containing 2 key words 3 years: can understand commands containing 3 key words

10. W HY CHILDREN MIGHT HAVE DIFFICULTIES UNDERSTANDING English as an additional language Lack of experience Hearing / auditory difficulties Difficulties with attention and listening Global delay Associated conditions – Downs, ASD Specific language difficulty

11. Development of spoken language Birth- 1yr: coos, cries, tuneful vocalisations, babbling from 6 months 12 months: begins to use single words, approx 20 words at 1 ½ years 2 years: begins to link 2 words together, has a vocabulary of about 50 words 3 years: linking 3 or more words together, vocabulary of about 200 words

12. SPEAKING (EXPRESSIVE LANGUAGE) How might children with expressive language difficulties present? No or little expressive language Poor language structure e.g. few nouns (names), verbs (doing words) or immature pronouns (using me instead of I) Excessive use of empty, unspecific or filler words e.g. ‘erm’, ‘there’ Unintelligible (unclear) speech sounds Dysfluency (hesitant speech or difficulty getting words out) Copying or principally using learnt phrases

13. Speech Development Babies begin to copy and practise using speech sounds – babbling At around a year babies are beginning to use a few single words Continuing to develop musculature required for speech though babbling and development of feeding skills Earliest sounds are those which are easy to see/copy include p, b, w Speech develops in clarity from this early stage until around 7 years Things to check ; dummy use, hearing

14. The normal development of Speech sounds Sounds (phonemes)50% of children90% of children all common vowel sounds1.5 to 2 years3 years /p/ /b/ /t/ /d/ /m/ /n/ /w/ 1.5 to 2 years3 years /k/ /g/ /f/ /h/ /y/ as in yet 2.5 to 3 years4 years / s / / ng / as in sing 2.5 to 3 years5 years /l/3 to 3.5 years6 years / sh / as in shoe / ch / as in chin / j / as in joke / z / and / v / 3.5 to 4.5 years6 years /r/ / th / as in thin / th / as in then /s / as in measure 4.5 to 5 years7 years Cluster sounds / blends tend to develop later – 4 – 5 years

15. Fluency Between 2-5 years old normal to repeat words & phrases Young children often stop, pause, start again & stumble over words when learning to talk

16. SaLT assessment Once a referral is accepted SaLT will: Case history Speech and/or language formal/informal assessments. Send referrer report re decision to treat or not. Possible onward referral e.g. ENT, CDU, Portage Interventions 1:1, groups, via school, training. Keep referrer informed re outcome of intervention.

17. Referrals and assessment Early intervention is vital. Establish when the child started talking; did they babble; do parents feel that the child understands and can they follow simple instructions; do they have good eye contact, are they able to attend to tasks of their own choice? Do not hesitate to refer to Speech and Language Therapy using the general speech/language milestones.

18. General advice to give to parents: Attention & Listening Reduce distractions Turn taking games Listening to everyday sounds Understanding Get the child’s attention before speaking Use gestures Use key words

19. Spoken language Repeat words Give choices Sing nursery rhymes Use gestures Speech sounds Repeat correct forms of words Play with sounds Encourage child to use other ways to communicate

20. Fluency Slow down own rate of speech Tell parents not finish sentences or tell them to ‘slow down’ or ‘stop’ Tell parents to remain calm when it happens

21. Other Resources for parents Local children’s centre – advice and sharing ideas Talking Point – website providing advice and tips for parents and professionals www.talkingpoint.org.uk Talk to your baby – information for parents and professionals www.literacytrust.org.uk/talktoyourbaby Early Support Programme- advice and support booklets available in England but web access UK www.earlysupport.org.uk www.earlysupport.org.uk I CAN – advice leaflets for parents and professionals www.ican.org.uk www.ican.org.uk British stammering association – www.stammering.org