City of York Council introduced a strategy in 2019 to improve outcomes for disadvantaged children with a focus on speech, language and communication. The Early Talk for York approach aims to improve outcomes for communication and language skills for children aged birth – five.
Introduction
York had a significant and longstanding gap in outcomes between disadvantaged children and their non-disadvantaged peers. A 2017 government report on social mobility, ‘Unlocking Talent Fulfilling Potential’ highlighted that 46 percent of disadvantaged children in York achieved a good level of development in comparison to 71 percent nationally.
To tackle this, a strategy was introduced in 2019 to improve outcomes for disadvantaged children with a focus on speech, language and communication. The Early Talk for York approach aims to improve outcomes for communication and language skills for children aged birth – five.
The challenge
Disadvantaged children in the early years are at risk of not being identified with speech, language and communication needs (SLCN). Therefore, missing opportunities for important early identification and timely interventions.
Despite being a small unitary local authority, the opportunity for working in partnership and developing a consistent and shared approach with clear messages around SLCN, and their long-term impact, was inconsistent in York. A collaborative and systems led approach with clear commissioning arrangements was identified as an area requiring strengthening.
Children and their families were facing long waiting times to access specialist support from speech therapies; initial conversations with practitioners supporting children in the early years highlighted that they would prefer direction and guidance from the local authority in using an identification toolkit alongside a responsive training offer to upskill the sector and in turn to build confidence to meet the needs of the children that they were supporting.
The solution
The pilot area was initiated in 2019 with a targeted cohort of 458 children from three schools, five early years settings and three childminders. The initial pilot was delivered initially in the West of York; this area represents a ward with high numbers of families facing socio-economic inequality.
The initial project group included early years practitioners, speech and language professionals, health visitors and children and family service teams. This group provided oversight to ensure that decisions were evidence based and that strategies being introduced were working well.
The Early Talk for York approach adopts three key strands of focus:
- Strategy and commissioning- uniting the early years sector around a common outcome to develop better partnerships, strategic decision making and commissioning arrangements.
- Workforce development- ensuring those working with children and their families have the knowledge, skills and tools to provide the right level of support at the right time
- Communication and community – sharing Early Talk for York with parents and carers so they could support the aims of the approach in the home learning environment.
A positive impact was demonstrated on children’s communication skills in the pilot. Partners across the piece worked together to gather evidence through qualitative and quantitative evaluation methods. Further expertise from a local research school and university was utilised to evaluate research methods and examine data against a matched control cohort of pupils allowed the working group to identify six ‘active ingredients’; that are fundamental to the success of the Early Talk for York approach:
1. A relentless focus on speech, language and communication as a top priority that impacts on whole life outcomes.
2. Investment in high quality training that is sustained and quality assured.
3. Supported cascading of training to influence the development of whole teams.
4. Universal screening of children’s needs using a standardised tool.
5. Ongoing support of specialists who are proactive in responding to emerging needs.
6. Peer and social support and accountability on delivering the elements above, including working with partnership with parents/carers.
The impact
The pilot project demonstrated significantly improved speech and communication skills at five years, compared to children who did not receive the same programme of support.
It should be noted that the impact of the pandemic was visible for all cohorts of children during this time with outcomes for non-disadvantaged children in all York schools, control group schools and Early Talk for York schools dropping slightly but following similar trends. However, initial impact evidence demonstrated that between 2019 and 2021 outcomes for disadvantaged children outcomes in the Early Talk for York cohort were improved. The use of a control group in a quasi experimental design approach, gives further confidence that these improved outcomes related to Early Talk for York.
The findings from the initial pilot demonstrated that Early Talk for York was meeting it’s primary objective in improving communication and language outcomes for children from disadvantaged children.
In order to support with scaling, the approach has been broken down into steps to increase accessibility.
An update on the Early Talk for York approach as shared in a September 2023 report highlighted that 34 group based schools and settings are following all steps of the approach.
93 per cent of schools and group based settings are using the WellComm screening tool to universally screen their children (Step 1 of the approach); with many childminders doing so too (using a borrowing system from local libraries). This means Early Talk for York is working with around 4000 children every year.
WellComm data is being used to understand need across the city and is collected by the Local Authority. This data is used to target resource through training and ongoing support from partners across health and early years services.
Schools and settings following all steps of the approach have achieved ‘Communication Friendly Status’ which means that their whole staff team have participated in accredited, quality assured training and their practice has been independently audited.
Feedback from a Leader in an Early Talk for York primary school is a typical summary of the type of report from professionals working in the approach:
‘Our staff in (Early Years Foundation Stage) are now more confident in identifying when children may have a speech and language need, which is allowing us to support the children, with relevant interventions. The staff are now more confident at knowing how to support these children, and when they should refer them to a speech and language therapist.’ Multiple Ofsted inspections of education settings involved in Early Talk for York have commented on the expertise and skill of staff and the positive impact on children’s development.
A well as engaging with the same training as settings, the Healthy Child Service (health visiting professionals) work with families to offer universal screening (Using ELIM) and WellComm interventions where appropriate. They also work much more closely with early years settings and for the first time in York’s history, a feasible approach to an integrated two year review has risen out of this partnership working.
City of York Council’s Family Learning team have worked closely with Early Talk for York to establish a new model of working that supports families alongside other services with much greater integration between support for adults and their children.
The University of York have also adapted their model of community focused support to add significant voluntary capacity from their student population into Early Talk for York and have continue to evolve this in response to shifting challenges.
In December 2022, a local area inspection of SEND in York by Ofsted and CQC noted: "An example of joint commissioning impacting positively on the lives of children, young people and their families is ‘Early Talk for York’ (ETfY). This initiative was in its infancy in 2019. Many children with speech, language and communication needs have now been supported through ETfY. The vast majority of these children, including those who are disadvantaged, have made progress and caught up with their peers".
The impact of Early Talk for York continues to be monitored using the statutory assessment of children’s development at age 5 using the Early Years Foundation Stage Profile (EYFSP). It should be noted that the framework changed in 2022 and children were assessed against the revised criteria.
The gap between non disadvantaged children nationally and in the ETFY area has reduced from 34.5 percent to 2.5 percent (2022) and remains small at 4.5 percent in 2023.
How is the new approach being sustained?
The Early Talk Approach is being sustained through ongoing partnership working across services and with the commitment of early years group providers and schools at step 1 and above to pledge to universally screen their children and share this data with the local authority.
The training offer to achieve ‘Communication Friendly Status’ embeds a quality universal offer which relies on cascading training and upskilling the workforce. This also supports a workforce where there are new staff members and promotes practitioner confidence in their support of children’s speech, language and communication development.
The Early Talk for York team continue to work alongside partners in the Healthy Child Service, Family Learning and the University of York as well as establishing new partnerships as the approach continues to gain momentum.
Partnership working with specialists at York Teaching Hospital facilitate delivery of appropriate resources and support. This allows a package of support to be flexible and responsive.
The approach continues to gather strength as it becomes embedded in each service that works alongside children and their families. There is a drive to build on the rollout of the approach and in particular to facilitate a high quality training offer for the early years workforce and partner organisations.
Recently Early Talk for York won the coveted ‘Learning Award’ at the Children and Young People Now Awards. York also celebrated at an Early Talk for York conference; allowing early years experts from across the city to learn and celebrate together.