We wanted to know if the Specialist Speech and Language Service (SLT) supported Universal Services to deliver a targeted language intervention it would:

• Dovetail services
• Provide better quality of support for families
• Reduce the number of referrals into the SLT service.

We used a targeted support for language delay and worked alongside the other services involved in supporting children with language delay.

The project was split into 3 phases:

1. Working in the established group at the Children Centres
2. Working on a 1:1 with families with the HV team
3. Working in an Early Years setting (a nursery)

Phase 1 showed the established groups in the Children Centre offer high quality support but are not accessed by many families.
Phase 2 showed working at home with families who can’t access the groups has a high impact but staff capacity means this is not widely offered.
Phase 3 has started and is showing how working in an Early Years setting is an effective way to see lots of children. The challenge is how to involve parents so they can support their child at home.

Outcomes:

• Through working together we have been able to dovetail services. There is a much clearer understanding of what each service offers and what is available to every family.
• We have realised there is already a high-quality offer for families whose children have been identified with language delay.
• We have not yet seen a reduction in the number of children being referred to the SLT service. Before the project we thought this was because the targeted support was not effective. We now understand it is because families aren’t widely accessing the support and children are being directly referred to the SLT service.

We are working hard to find ways to engage families and support Universal services to change this pattern.

The next step is to use the findings of the project, along with other work, to influence a change commissioning. This will enable us to keep working with Universal services and to find a way forward to ensure children are supported by the right service at the right time. Similar experiences from the Q Community will help to give further insight and guidance to this journey.

The Project has got off to a good start; everyone has been supportive and interested.

It is a small piece of work but is already helping the different services involved in delivering Speech, Language and Communication support to Derby City to understand each other’s offer and how they can work together more effectively. It follows the Balanced System principle of Specialist services supporting targeted services.

Phase one was based in the Children Centres.

Phase one objectives:

1.    SLT Team to be trained in the Wellcomm Toolkit

2.    SLT Team to attend Children Centre language development groups based on the Wellcomm Toolkit and understand how they work, make observations, give Quality Assurance

3.    SLT Team to spend time with Children Centre staff to understand their thoughts around the groups.

4.    SLT Team to understand the process of referral to the groups

5.    Develop understanding how the support is used by families.

6.    A bank of toys to be ordered for Phase 2 of the project which is based in families’ homes.

7.    Regular meetings with Project Lead to update and check direction

All the of the objectives were achieved and we identified the following main outcomes:

·       Confidence that the Wellcomm Toolkit is an appropriate package to support children with language delay

·       The groups in the Children Centres are of a high quality and there is lots of good work happening

·       activity cards have been developed as prompts to be used during the sessions/take home

·       an easy read leaflet has been made explaining the group – looking how it can be translated into other languages

·       training session on language development delivered with children centre staff

Areas to focus on:

–       Ensuring children with more complex needs are referred to a different, more appropriate, group as this group  is focussed just on Language Delay – this is being addressed via the Wellcomm screening

–       Structure in the groups with the practitioners working alongside/coaching families was more impactful than modelling alone.

–       Developing uptake and attendance at the groups; uptake and attendance are low despite high numbers of children being identified at the 2 year assessment as needing support for language development. In January 2024 there will be a virtual offer of the Wellcomm group for families, this should help to support a few more families.

There has been a change to the proposed plan due to numbers at the groups being low. In a bid to reach more children and families and understand how support for language delay can be offered more widely the project has been elongated (fewer sessions each week but for a longer period) and will concentrate on different services each phase.

Phase 2 January – April 2024

This phase will be based in the Health Visiting team and will focus on home visits.

Phase 3  May -August

This phase will be based in Private and Voluntary and Independent nurseries and look at setting up small groups and integrating principles of the Toolkit into everyday play.