Language Leads Approach pilot in Nottingham City: Training and supporting language champions within early years settings

The interactions that Early Years practitioners have with children provide an excellent opportunity to enhance children’s speech, language, and communication (SLC) development. The evidence-based Language Leads Approach (LLA), which consists of training and mentoring a designated practitioner to become the SLC lead in their setting, was piloted in Nottingham City. Despite the positive impact of the LLA, the pilot, ran in 2021/22, saw a very high attrition rate amongst the private, voluntary, and independent settings (PVIs). Staff cover during the COVID pandemic was the barrier to attendance, with the need to develop flexible approaches to the LLA training.

Small Steps Big Changes (SSBC) in Nottingham is one of the 'A Better Start Programme' sites funded by The National Lottery Community Fund. SSBC is a test-and-learn programme aimed at improving child development outcomes in 0 - 4 year olds, with speech, language and communication (SLC) as one of its focus areas. 

Predicted levels of SLC needs in 0-4-year-olds in Nottingham are high in comparison to national data [1] . At the same time, fewer children in Nottingham are referred to and access NHS speech and language therapy than their same age peers nationally. This gap in referral and access has worsened as a result of COVID-19. Enhancing the offer of SLC support within early years settings is a significant opportunity for early intervention, both for children with SLC needs and the wider early years population. The current expansion of childcare entitlements is expected to lead to an increase in demand for childcare places.

The LLA aims to create systemic change in supporting SLC development with an emphasis on improving interactions between practitioners and children. It is an evidence-informed approach, whereby a designated practitioner is supported to become a lead for SLC within the setting through training and mentoring. Additional, ongoing, and regular networks aim to ensure sustained continuing professional development (CPD). This ensures that LLA settings will benefit from a systemic approach to SLC that includes developing staff and the setting environment, identifying need, supporting SLC development in children, and working with parents and specialist services.

SSBC funded participation for 10 PVI early years settings in a cross-sector LLA pilot in 2021/22. This cross-sector approach, which also included 10 schools from the Nottingham Schools Trust who self-funded their LLA places, ensured equality of access and to demonstrate efficacy across the range of settings comprising the early years landscape in Nottingham. The pilot was led by the Early Intervention Speech and Language Team of Nottinghamshire Healthcare NHS Foundation Trust and delivered in partnership with Nottingham City Council, who supported the project through traded services (Education Psychologist) and non-traded services (Early Years Specialist SEND teacher). This pilot built on previous learning from the LLA in Nottinghamshire County.[2]^,[3]

The LLA training offer consisted of the three training courses which had previously been developed by Nottinghamshire Early Intervention Speech and Language Team.

• Talking Matters 
  This course aims to raise practitioner’s awareness of the importance of speech, language, and communication. Typical language development is covered alongside what can go wrong and why. Basic strategies to support children’s speech language and communication are considered alongside the jigsaw of support which is available from other services.
• Communication For All
  This course supports practitioners to understand the importance of visual environments for developing children’s speech, language, and communication. Nationally, it is well known that signs and symbols can be used to support children’s development.  They are particularly effective when used in the Early Years to support behaviour, emergent literacy, attention and speaking and listening skills and their use is advocated within the Early Years Foundation Stage. 
• Let’s Interact- An adaptation of Learning Language and Loving It™ by The Hanen Program® for Early Childhood Educators/ Teachers 
  This course builds upon the interaction skills of practitioners with young children and is based on the internationally renowned Hanen approach. There is a wide evidence base for the effectiveness of the approach at developing practitioner skills and children's speech, language, and communication skills.[4] Much of the learning for this course is completed through video feedback.

In order to support Language Leads with their individual action plans to bring learning into their setting’s provision, practitioners were offered four individual coaching support sessions in the workplace by the Early Intervention Speech and Language team and the Early Years Teaching Team.

The LLA pilot ran from Sept 2021 to Aug 2022. Due to the COVID-19 pandemic, a blended delivery approach was taken, with some sessions changed at short notice to online delivery rather than face-to-face due to changes in COVID-19 restrictions. Group sessions were more difficult to convene due to staff absences and/or sickness.

The LLA pilot successfully trained 13 practitioners from different settings. These included a mix which included teaching assistants, early years leads, a preschool manager, SENCO and nursery room leads.

Evaluation of the LLA pilot in Nottingham included pre and post training feedback, professional reflections of implementation successes by Language Leads, case studies of the LL journey as well as anonymous language profiles of children selected by Language Leads (LLs) and feedback from PVI managers. The main findings are as follows:

• Practitioner confidence increased across all competence and knowledge measures following full training. 31 per cent of responses were ‘a little unsure’ pre training vs 0 per cent post training, whereas, only 7.7 per cent of responses were ‘very confident’ pre training vs 64 per cent ‘very confident’ post training.
• The highest gains in confidence scores were in monitoring children’s progress, describing a child’s SLC stage of development and identifying next steps in support.
• All LLs submitting their Language Lead journeys felt that the training had a positive impact on SLC development for the children within the setting. Most LLs referenced implementing specific training strategies. One LL noted the following outcomes for the setting, ‘[A] made progress in all areas of her learning. As practitioners we could see the massive positive impact the strategies from the Language Lead project can have.’
• The opportunity to reflect on practice was referenced across evaluations. Several LLs highlighted the efficacy of using videos. One PVI LL had introduced video feedback in her setting to encourage reflective practice and as a coaching tool for her team. Another LL shared that: ‘It really helped to notice things I was doing, like I didn’t realise how many questions I asked.’
• Feedback illustrates participants reflections on the training sessions:

“A really great course that promotes reflection. A lot of positive outcomes!”

“Very supportive and accommodating the individual needs. Thank you for helping me with new strategies and giving me a chance to improve myself”.

“I have come on a great journey through this process, it’s nice that staff on the course and managers back at my setting have noticed this as well. I have learnt a lot to feedback to my team.”

Two of the participants noted specifically about the move away from focused interventions towards more high-quality interactions within the provision, which is the ultimate goal of Let’s Interact- An adaptation of Learning Language and Loving It™ by The Hanen Program® for Early Childhood Educators/ Teachers. 

The Early Years SEND Team Teacher continues to facilitate termly Language Lead network meetings to continue to share learning and promote support strategies for all children’s speech, language and communication.

On completion of the LLA pilot and delivery of all the training sessions the support by the Early Intervention Speech and Language team concluded.  However, an established network of LLs supporting children, parents and peer workforce in SSBC wards and in the wider city has been maintained.

Following the conclusions drawn from this pilot, project leads have secured commitment from specialist professionals (including Early Years Educational Psychologists, an Early Years Advisor and the service lead from Nottinghamshire Healthcare NHS Foundation Trust Children and Young People Speech and Language Therapy service) to invest in bespoke training development. This will address the lessons learned during the pilot with a view to eliminating identified gaps, dovetail training more coherently with changes to the EYFS framework and closer alignment with current EYFS strategies and programmes (such as the Early Maths programme). Funding has been secured from the Early Endowment Foundation to progress these future plans.

Although the evaluations were overwhelmingly positive, there was a very high attrition rate amongst the PVIs with only three fully completing the training, two partially completing the training and five dropping out entirely. In contrast, all Nottingham Schools Trust participants finished the training. Best efforts were made for LLs to catch up on training missed by holding additional sessions and allowing attendance at other planned training events, but gaps remained.

Follow up conversations with managers and directors of the settings who did not complete the training were undertaken. All cited staff cover, largely due to COVID-19 restrictions at the time, as being the biggest barrier to completion. This also impacted some staff not wanting to attend face to face sessions due to anxiety around COVID-19.  Despite offering funding for PVI settings to release staff, only one setting claimed the amount. One organisation with three pilot settings reported many children needing one-on-one support due to undiagnosed behavioural concerns. These children did not receive funding for this one-to-one support. This caused the settings to be unable to release staff to attend the LL training courses as they were not able to find suitable staff cover.

Given the high level of predicted SLC needs in the SSBC wards where all the PVI settings were located, attrition rates are particularly concerning. Best efforts must be made to address the barriers to access for these settings.

Recommendations to prevent attrition include:

• pre-booking supply cover before training
• updated resources that promote managerial support for LLAs within the Early Years setting
• flexible approaches to training such as INSET training
• sharing the LL role between two EY settings.
   

[1] Better Communication CIC. (2019). Needs Analysis Summary Report for Early Years Nottingham City

[2] Kent, J and McDonald, S. (2020) What are the experiences of Speech and Language Therapists implementing a staff development approach in early years settings to enhance good communication practices? Child Language, Teaching and Therapy.

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• A Better Start | The National Lottery Community Fund (tnlcommunityfund.org.uk)
• Local Family & Parents Support | Family & Group Activities | Nottingham | SSBC (smallstepsbigchanges.org.uk)
• The language lead role | Nottinghamshire Healthcare NHS Foundation Trust