Speech and Language Therapy Developing Speech Language and

Speech and Language Therapy Developing Speech, Language and Communication in ‘At Risk’ Children

Context Speech, Language and Communication Needs [SLCN] are classed as the most common childhood disability Incidence is significantly higher in particular groups of children, including: Looked after and Accommodated Children living in disadvantaged surroundings Children living in poverty Figures reach 50 – 60% in this population

Context Continued. . . SOGS indentifying significant proportion of children in Airdrie not meeting SLC milestones at 27 months Risk of poor attainment and social, emotional and behavioural difficulties Impact on literacy and future employment Existing systems mean children from vulnerable groups are more likely to be discharged from SLT due to non-attendance

Driver Diagram Parental motivation and engagement 85% of children at Richard Stewart Family Learning Centre will reach their speech, language and communication milestones by 2016 Standardised processes for communication and collaboration with parents and EYWs Increased parental awarness of SLC development Awareness of SLT service role and how to access advice/input Nursery knowledge of when/where appointments are Shared responsibility or planning and implementing intervention and meeting targets Consistent SLT presence in nursery SLT involvement at initial discussion around any SLC concerns with parent High levels of parental and partner engagement for early intervention Increased joint decision making with parents around treatment options and expectations Increased staff knowledge and skills Involvement of staff in identifying training needs Implementation of new knowledge and skills into daily practice Consistent support and carryover of therapy plans Co-location of SLT interventions in nursery

SLT attends enrolment days Joint planning meetings with parents & Key Workers Appts. in nursery vs. clinic Parental Motivation and Engagement Drop-in clinics in nursery Joint sessions with parents & Key Workers

Sharing appt. info. with nursery Review pathway for missed appts. Standardised processes for communication & collaboration Joint planning meetings to agree targets and roles Consistent SLT presence in nursery

SLT involvement at prereferral stage Level 2 services to increase parental knowledge & skills High levels of engagement for early intervention Enhanced joint decision making with parents (treatments, expectations, outcomes) Co-location of SLT services in nursery

Engaging staff in identifying training needs Responding to training needs Increased staff knowledge and skills Support carryover of specific therapy plans Support to embed theory into practice

Who is involved? Margaret Mc. Cluskey, Head of Richard Stewart Family Learning Centre Nursery and her team of Early Learning Practitioners Karen Dixon, Speech and Language Therapy Team Leader (North), Children and Young People’s Services Xenia Dennison, Speech and Language Therapist Advanced Practitioner Naomi Priest, Specialist Speech and Language Therapist Improvement Team, North Lanarkshire Council The children and families attending the Richard Stewart Family Learning Centre

Attendance Data Higher attendance rates appear to be achieved as a result of a combination of factors: • Co-location of SLT service in nursery • Parental involvement in arranging appointments • Reminders • Collaboration with staff • Review of DNA procedures

Identifying Training Needs 4 3. 5 3 2. 5 No. Responses 2 1. 5 1 0. 5 ea s ce ur so Re Training Area Id or ts pp es ut in Vi su al Su er g Ad ap tio n Di Ro so rd la De g tin un ica Co m m tin t en m lo p pp or Su De LC l. S pi ca Ty (Training sessions TBA) y 0 ve Early Learning Practitioners in the 2 – 3 Room were asked what areas of childhood SLC development they would most benefit from support with. It is predicted that a needs responsive training package will improve staff engagement and outcomes for children. Training 2 - 3 Room 2 1= Not Useful 5= Very 4 3 Useful

Ongoing Training Hanen ‘ABC and Beyond’ – Building Emergent Literacy in Early Childhood Settings Session 3 & 4 Feedback 6 5 5 - very useful 4 4 No. of Participants 3 3 - useful 2 2 1 1 - not useful ss Se Se ss io n 1 io Se n 2 ss io Se n 3 ss io Se n 4 ss io Se n 5 ss io n 6 0 Session Blacksheep Press ‘Languageland’ – Language programme for 3 – 7 year olds

The Human Factor My name is Logan and I’m nearly 2 years old. When I started nursery my Key Worker noticed that I wasn’t talking very much and I wasn’t sure how to play with the toys in the nursery. She told my mummy that the Speech and Language Therapist would be in the nursery soon for a ‘Drop-In Clinic’ and it might be a good idea to go along. We went to see Xenia the next week and she listened and gave mummy some ideas for helping me. Mummy was still a little bit worried so Xenia came along to my PLP meeting with my Key Worker. The grown-ups all agreed that it would be a good idea if had an assessment so that they could find out more about how to help me. Mummy is taking me to see Naomi in nursery soon. This case is a good example of: Collaboration with ELPs Early identification Parental engagement Use of different levels of support

Next Steps Continue Testing. . . Factors influencing attendance ‘ABC and Beyond’ to be completed and embedded Languageland to be completed and embedded SLT pre-referral/Level 2 services for parents/carers Benefit of responding to training needs identified by staff Factors central to effectively co-locating Impact on outcomes for children resulting from changes

Next Steps Continued. . . Spreading Current Changes. . . Redistribution of resources Consideration to development of an Early Years Team Review of departmental paperwork and processes New Change Ideas. . . Targeted interventions for children and families e. g. Support groups, information sessions etc. Co-location of additional specialist interventions Increased collaboration with visiting services

“So What? ” Learning reveals. . . Higher levels of family engagement Reduced DNA rate reduced empty clinic space Increased departmental productivity Increased access to evidence based language learning opportunities for children Earlier identification of and support for childhood SLCN Utilisation of learning from other Tests of Change and National programmes e. g. Bookbug, Solihull. . . Improved SLC outcomes for children

Investment of Resources What have you invested into this improvement work? 1 WTE Band 7 SLT 1 WTE Band 6 SLT Capacity in funding for SLT staff to access relevant training EYPs at Richard Stewart Family Learning Centre released for training, meetings etc. Physical space within nursery for SLT use What resources would you hope to reduce/stop in the future by implementing this change? Redistribution of resources to be explored Reduction in staff admin wastage related to DNA Eventual increased SLT service capacity due to access to targeted SLCN supports in the nursery setting

For More Information Karen Dixon 01236 789 909 or Karen. Dixon@lanarkshire. scot. nhs. uk Xenia Dennison 01236 772 280 or Xenia. Dennison@lanarkshire. scot. nhs. uk @Xenia. SLT Naomi Priest 01236 772 280 or Naomi. Priest@lanarkshire. scot. nhs. uk @Naomi. Priest