Creating a supportive environment for early years children with speech, language and communication delay has always been important, but the need is greater than ever following the pandemic.
Covid restrictions affected some young children’s development by limiting time spent socialising and gaining new experiences that help them to learn new words and gain the skills to converse.
Sue Howlett, assistant head teacher at The Grove Nursery School in Peckham, London, says, ‘We are seeing an increase in the numbers of children entering nursery requiring some additional support for communication development because they have perhaps missed out on opportunities for early socialisation that they need.’
The Evelina London speech and language therapy (SLT) team has developed the Evelina Award to support early years practitioners working with children with speech, language and communication (SLC) delay. The award, developed for PVI settings, aims to strengthen the communication environments that children experience during their early years to mitigate the risk of them starting school with delayed language skills.
Evelina London speech and language therapist Laura Tewkesbury, who is working with The Grove, says, ‘The award aims to skill up the whole staff team within a setting so they can set the culture for the nursery. Working towards the award is very tangible, it is not just about gaining the skills but actually implementing them.’
The training aims to equip practitioners to:
- identify SLC needs and refer children to an SLT team if needed
- improve children’s communication and language through quality interactions
- track the progress of SLC development for children in their setting
- track the setting’s journey to becoming an Evelina-awarded Communication Friendly Environment.
AUDITING PRACTICE
Before starting to work towards the award in April 2021, individual therapists would occasionally visit The Grove to observe specific children on their caseload and give advice. ‘This meant that we acquired lots of snippets of information as to how to support communication development effectively,’ says Howlett.
‘However, the award ensures that everybody is working collectively towards the same goals and we are all using the same knowledge and strategies.’
An audit is conducted at the start of the award, which takes around a year to achieve, to evaluate strengths and weaknesses so that training can be tailored to the specific setting. The audit has five sections:
- Adult-child interaction.
- The enabling environment.
- Snack time.
- Ongoing assessment and identification of SLC needs.
- Working with parents as partners.
‘It was good to be able to prioritise the areas that we wanted to work on,’ says Howlett. ‘For us, one area was enhancing communication opportunities at snack time. We now ensure everything is prepared and on the table ready so that the adult can remain seated with the children throughout and focus on the conversations that are happening.’
Training is delivered through a number of approaches, including workshops during staff meetings, observation of staff interacting with children and video coaching sessions. ‘One of the things that this highlighted for us was the number of questions we still asked children as practitioners,’ says Howlett. ‘Now we are focusing much more on commenting on what the children are doing or saying, and extending this by adding extra words, depending on each child’s language ability.’
Practitioners are now more mindful of using visuals to support children, including visual timetables, now and next boards and picture choice boards to give children more independence.
‘We now understand not just how speech and language develops but also the important role that visual cues play in this process,’ Howlett adds. ‘We start initially with objects and gradually progress to photographs and then symbols. If a child is not responding to these, it’s probably because they’re not ready, so we go back to the previous stage for a bit longer and then try again.’
Staff teach Makaton to children and share the week’s sign with parents to use at home. They have also held SLC workshops for parents and share tips and strategies.
NEXT LEVEL
The Grove completed the Evelina Foundation Award in March last year and is now working towards the enhanced level. Results from the foundation post-audit evaluation include:
- 100 per cent of staff surveyed are now getting face-to-face, following the child’s lead and using simple language – an 80 per cent increase in comparison to the baseline measure.
- 90 per cent of staff are adding a word and giving choices – nine out of ten are ‘confident’ or ‘very confident’ with using more comments and fewer questions, in contrast to six out of ten on the previous survey.
- Staff identified more examples of appropriate strategies, which reflects the knowledge learnt in the year and that they are integrating the use of strategies and visuals across the day.
A staff member said, ‘It made me reflect on what I do and how I can use many forms of communication, but also how children communicate with us.’
Along with gaining knowledge and confidence, Howlett believes that working towards the Evelina Award has helped the staff team to become more collaborative when supporting communication development. ‘Everyone is willing to share concerns, try to share ideas as a group and take on other people’s suggestions,’ she explains.
‘When you’ve got a child who is completely non-verbal and maybe has social communication difficulties and doesn’t really notice you’re there, it can be quite hard to know what to do and what your role is. We now have the tools to employ a strategy like intensive interaction and involve ourselves with that child as an equal partner, which can set a spark going for them and begin simple engagement. That makes staff feel very good and benefits the child.’
Tewkesbury believes that practitioners are now in a good position to employ a variety of SLC strategies with new cohorts of children. Howlett agrees, ‘There is not a member of staff now who would look at a child and not know what to do. They have all got resources in their “toolbox” to try and see what works.’
CASE STUDY: The Grove Nursery School in Peckham, London
Child A, who has a language delay, joined The Grove Nursery School in September 2022. They had not previously been to nursery, and settling in took some time, with so many new people to meet, new resources and activities and new routines to follow, coupled with the adjustment of separating from their parents. There was also exposure to some new and unfamiliar vocabulary, and it was clear at times that this combination felt overwhelming.
Staff worked collaboratively with Child A’s parents and each other to identify ‘communication-friendly’ strategies that everyone could employ to help convey all this new information to the child in a way that was supportive and easy to understand. These included:
- Using ‘intensive interaction’, ‘people games’ and ‘playing alongside’ to develop a positive relationship with Child A.
- Paying close attention to Child A’s non-verbal cues and vocalisations, and verbalising these using single-word or short phrase commentary to ensure that Child A felt heard and understood, despite being non-verbal.
- Giving nursery instructions in the same way as parents so that Child A was immediately familiar with the framework, which would help reduce any anxiety, and they could understand that there was an expectation to ‘do’ something attached to the words being said.
- Using visual cues to help the child understand, anticipate and undertake routines and transitions.
- Engaging Child A in small group activities with a focus on developing listening and joint attention.
As a result, the child settled exceptionally well and is growing in confidence. Alongside an increased understanding of the setting’s routines has emerged a very clear and intentional desire to communicate with both adults and peers that is very effective, even with the additional barrier of language delay. The child’s speech therapist recently visited the nursery and immediately noticed a positive change, particularly with peer relationships and interactions with adults.
Staff are planning to introduce non-verbal sentence-building as a next step. They feel confident that if Child A displays a future need for more support, as a result of the Evelina Award training, they can provide this effectively.
FURTHER INFORMATION
- Contact 0203 049 8181 to find out more about how to take part in this award
- https://www.leaplambeth.org.uk/practitioners/communication-and-language-development/speech-and-language-therapy-evelina-award