Speech, Language and Communication Needs (SLCN) encompasses a wide range of difficulties related to all aspects of communication in children and young people. These can include difficulties with fluency, forming sounds and words, formulating sentences, understanding what others say, and using language socially (Bercow Report, 2008).
Speech, Language and Communication Needs may be a child's primary need and may include specific difficulties of which there is often no obvious cause. A significant proportion of children and young people in both primary and secondary school with special educational needs have SLCN as their primary need. In contrast, secondary SLCN are associated with other difficulties that the child may have such as autism, cerebral palsy, hearing loss or more general learning difficulties. Speech and Language Therapy provisions should cater for both primary and secondary need within the framework of services. Primary and secondary SLCN can occur regardless of socio-economic background.
However, in addition, children and young people who live in deprived areas are often more 'at risk' of developing SLCN. Approximately 50% of children and young people in some socio-economically disadvantaged populations have speech and language skills that are significantly lower than those of other children of the same age. These children need access to early years provision which is specifically designed to meet their language learning needs and they may also benefit from specific targeted intervention at key points in their development.
In Newcastle approximately 33% of children and young people aged 0-18 years, live in areas identified nationally as being in the top 10% of most deprived areas, (Child Poverty Evidence Summary 2008). This suggests the prevalence of need may be concentrated within these socio-economically disadvantaged areas, and as such is a key concern.
Children and young people who have, or develop, SLCN do not only come from deprived areas. Throughout the city there are children and young people with SLCN. These needs can be the result of disabilities, illness, learning difficulties and specific speech and/or language disorders. Therefore Speech Language and Communication provisions are delivered city wide through a range of services.
When are Speech, Language and Communication Needs apparent in children and young people?
What is the Impact on Speech, Language and Communication Needs for children and young people?
When looking at the trends we can see that where Speech, Language and Communication services are well established there is a positive impact for children and young people:
However, despite this progress:
- Significant increase in referral rates for Speech and Language Therapy and the Speech and Language teachers at SENTASS, (Special Educational Needs Teaching and Support Services). Figures below include referrals for regional specialist Speech and Language Therapy services;
Preschool referrals have increased over the past two years across the whole city, indicating that children are being referred at a younger age, (early intervention). However, there is also a trend towards increased referrals of older children, (upper primary and secondary age).
The number of children active on each services caseload of under 18's as of 19th July 2010 was:
There have been positive changes in recognition of SLCN and an increased focus on language and communication, particularly in the early years. However, there is also a clear trend towards greater identified need and more referrals across the city, thereby increasing pressure on current Speech, Language and Communication provision. Current capacity is not in line with observed trends.
Currently there is no formal system for collecting views and opinions about children with Speech, Language and Communication Needs and the provision of Speech, Language and Communication services. Therefore, we have chosen to use the views that were collected as part of the Bercow review of Speech, Language and Communication services and provision, bearing in mind that some evidence was gathered from Newcastle.
Bercow (2008) conducted a national review of SLCN and provision visiting many cities within the country, including Newcastle. He found that -
Children and Young People
Parent and Carers reported:
The current situation is not satisfactory for parents. They sensed a lack of leadership from local authorities and the NHS.
Professionals and Managers reported:
Overall 65% of respondents to the Review's consultation agreed that resources should be directed towards early intervention and preventative work to ensure better outcomes for children and young people.
Although no formal consultation was completed in Newcastle the Paediatric Speech and Language Therapy Service have received the following informal feedback;
Views of Children, Young People, Parents and Carers -
Current Activities and Services/Current Provision for SLCN in Newcastle
There is a range of support available for children and young people in SLCN, provided at universal, targeted and specialist levels -
The key providers for Speech, Language and Communication in Newcastle are:
Speech and Language Therapy services, currently provided from two NHS Trusts:
Specialist teaching support, provided by the Local Authority as part of SENTASS (Special Educational Needs Teaching and Support Service).Families may also access support from independent therapists or voluntary agencies.These key providers work with a wide range of other services and agencies to implement strategies for the development of speech, language and communication skills at universal, targeted and specialist levels.
The provision is described under the following headings:
Newcastle Upon Tyne Hospitals NHS Trust (NUTHT)
Paediatric Speech and Language Therapy Service
Preschool and school age provision - mainstream PCT funded service
Preschool Provision - Sure Start Children's Centre Local Authority Funded Service
- Develop knowledge and skill in developing young children's language,
- Enable children and families to access speech and language activities and support,
- Ensure early intervention for children with difficulties as locally as possible.
School Age Provision for Specific Settings - Local Authority Funded Service
Allocated Speech and Language Therapy sessions for the following settings during term time:
Speech and Language Therapy Provision for Specific Disorders - mainstream PCT Funded Service and/or Regional Health Service Specialist Commissioning
The Paediatric Speech and Language Therapy service employs a number of highly qualified Speech and Language Therapists who provide assessment, advice and intervention at a specialist level for specific disorders. This may be in community or acute (hospital) settings depending on the disorder. Specialist Speech and Language Therapy is provided for a wide range of disorders including:
Northumberland Tyne and Wear NHS Trust
Community Team Learning Disability
Community Team Learning Disabilities Speech and Language Therapy currently provides a community Speech and Language Therapy service to children with a learning disability and communication difficulties, who have a Newcastle GP. This is provided as part of a wider multidisciplinary team and operates an open referral system. The Community Team Learning Disabilities service offers a range of intervention from focussed individual work to more generic teaching and training alongside joint curriculum development within school.
Child and Adolescent Mental Health (CAMHS)
The Child and Adolescent Mental Health Services are provided by Northumberland Tyne and Wear (NTW) NHS Trust. However at present there is no specific Speech and Language Therapy input to CAMHS. NTW NHS Trust Paediatric Speech and Language Therapy provide a limited assessment, advice and intervention service for referred children and young people. Some joint work has been undertaken with individual Child and Adolescent Mental Health Services staff.
Regional Communication Aids Service
NTW NHS Trust is also commissioned to provide the Regional Communication Aids Service. This service provides assessment and advice in relation to all aspects of communication aids. The service is accessed by referral from Speech and Language Therapists across the region.
Newcastle Local Authority
The Local Authority provides specialist teaching and support for children and young people with Speech, Language and Communication Needs through SENTASS (Special Educational Needs Teaching and Support Service).
Joint Working and Service Provision across Speech and Language Therapy and SENTASS
SENTASS Young Children Team
The Team consists of 6 specialist teachers and 6 Nursery Nurses and offers a range of multi disciplinary groups to pre school children and their families with an emphasis on speech and language development. These jointly run groups include Speech and Language Therapy, Educational Psychology Services and Social Care.
The Young Children's Team also provides the Rhythm and Rhyme group, which focuses particularly on developing attention and listening skills, (underpinning any speech, language and communication learning).
SENTASS Specialist Speech, Language and Communication Teachers
Two teachers are employed to provide assessment of individual children and advice andsupport to schools across the city. Close working has developed with Paediatric Speech and Language Therapy to ensure efficient use of this resource. The Specialist Teachers also provide training to schools and have taken the lead in running speech and language focused conferences and courses in Newcastle.
Joint Referral System
Referrals for school age children with SLCN are managed via a joint system involving SENTASS speech and language teachers and staff from the Paediatric Speech and Language Therapy service. Referrals are directed to the Paediatric Speech and Language Therapy base and then allocated to the most appropriate service according to agreed criteria. The service includes assessment, advice, consultation and access to all paediatric Speech and Language Therapy pathways and specialist Speech and Language Therapy as required.
The Newcastle Specific Language Impairment Team
The multi disciplinary Newcastle Specific Language Impairment Team is for primary age children with severe speech and language difficulties. The Newcastle Specific Language Team is part of the pathway for consideration for a place in a speech and language ARC. The aim of the Newcastle Specific Language Impairment Team is to maintain children in their mainstream school where possible, improving outcomes for children and reducing the waiting list for a place in a speech and language ARC.
Independent/other Provision accessed by Newcastle Children
Some Newcastle children with very complex needs are placed in out of area provision such as Percy Hedley School and Thornhill School. Speech and Language Therapists are employed directly by some independent schools. Where placement is in a local authority school in another area the local Speech and Language Therapy service may provide some input as part of the local arrangements for that school.
Current Commissioning Arrangements
Currently there is no coordinated and coherent commissioning plan for Speech, Language and Communication Needs in Newcastle.
Limitations of Provision
Joint work across services and agencies and flexible use of resources enables the key providers to make the most efficient and effective use of the resource available. Clear systems and pathways, avoidance of duplication, and provision of workforce training all help to maximise resources. However there are limitations and gaps, both explicit and hidden, including:
The Youth Offending Team
There is currently no provision for Speech, Language and Communication Needs within the Youth Offending Team.
Every Child a Talker
Paediatric Speech and Language Therapy Training Initiatives (Sure Start Children's
Centre and Mainstream Speech and Language Therapists)
Makaton Training (SENTASS and Paediatric Speech and Language Therapy and Community Team Learning Disability Speech and Language Therapy)
There has been a drive to provide Makaton training to all early years and school age staff. Benefits include:
ELKLAN (Paediatric Speech and Language Therapy and SENTASS)
Accredited training course for Learning Support Assistants that enables them to carry out specific speech and language programmes with Speech and Language Therapist or specialist teacher support.
Inclusion Development Programme (SENTASS with some Speech and Language Therapist Involvement)
The Inclusion Development Programme for speech, language and communication has been distributed and the materials are seen as a useful resource for schools and early years settings. However there is recognition that ongoing support is needed to ensure that the resource is used.
The same applies to the more recent Autism Spectrum Disorder Inclusion Development Programme.
SENTASS Specific Training
CTLD Speech and Language Therapy Training
The Speech and Language Therapy team offers a range of training to parents and carers of children and young people with learning disabilities and communication difficulties, and professionals working with these children. These include:
Northern Open College Network Autism Course
A course accredited by the Northern Open College Network, 'An Introduction to Autism', has been developed and delivered in association with SENTASS and Thomas Bewick School to a range of staff working with children and young people with autism.
When looking at the workforce we need to recognise that there are other professionals with specialist skills relevant to SLCN, especially when looking at the following specific areas:
Alternative and Augmentative Communication
Access to additional therapy services is key to the appropriate level of service delivery when looking at children who need alternative and augmentative communication aids, from low-tech switches through to more complex high tech communication aids. Access to skilled physiotherapy and occupational therapy services is required when assessing the child's seating and positioning, or how they will be able to use a piece of equipment e.g. with a head pointer or switch. There is also a requirement for staff to keep up to date with the most recent technological developments.
Recent developments within the field of sensory perception has led to an increase in joint working between Speech and Language Therapists and occupational therapists, looking at the sensory needs of individuals prior to looking at their communication needs. Often children are overwhelmed by sensory processing difficulties and it is only by working to change their sensory environment and 'sensory diet' that their communication and interaction needs can then be met.
There is currently limited provision for occupational therapy to support the above.
The Government wishes to address the root causes of child poverty, impoverished communication, poor learning skills and social exclusion. These factors can result in low aspirations in young people, restricted life chances through poor educational attainment and a descent into criminality.
National and Local Drivers
The Bercow Report (2008) increased the focus on the importance of addressing SLCN. It made it clear that Speech, Language and Communication provisions needed to be transformed to improve the experiences and outcomes of children and young people with SLCN and their families. During the review five key themes were identified as issues that need to be addressed for real change and improvement to happen. The five themes are:
There are also other national policies and documents that give added impetus to the work of Bercow. The following represent the key policy drivers: -
'Every Child Matters' and Children's Act 2004 set out the government approach to the well being of all children and young people from birth to 19 years. A very important aspect of the Act that followed is the expectation of much closer co-operation between agencies responsible for the well being of children, such as schools, social services, the police and health professionals.
Every Child a Talker: Guidance for Early Language Lead Practitioners November 2008 - Every Child a Talker is designed to strengthen children's early language development by improving the quality of language provision in early years settings. Every Child a Talker aims to create a developmentally appropriate, supportive and stimulating environment in which children can enjoy experimenting with and learning language. It can be implemented whether children are in Early Years settings, with a child minder, or at home with their parents. Through everyday fun and activities which reflect children's interests, Every Child a Talker will encourage early language development right from the outset, extending children's vocabulary and helping them build sentences so that before they start school children are confident and skilled communicators.
In 2001, the government published the Special Educational Needs Code of Practice and the Disability Act, which delivered a strengthened right to a mainstream education for children with Special Educational Needs. The 2001 Act amended the Disability Discrimination Act, 1995 to make unjustified discrimination by education providers against disabled pupils and students and unlawful. The Disability Discrimination Act 2005 took things further, giving most public authorities a positive duty to promote disability equality. In practice this has led to many educational and child care workers identifying the need for additional training and support.
National Service Framework, for Children and Young People; Standard 8 - Children and young people who are disabled or who have complex health needs receive co-ordinated, high-quality child and family-centred services which are based on assessed needs, which promote social inclusion and, where possible, which enable them and their families to live ordinary lives.
National Service Framework for Children and Young People; Standard 9 - All children and young people, from birth to their eighteenth birthday, who have mental health problems and disorders have access to timely, integrated, high quality, multi-disciplinary mental health services to ensure effective assessment, treatment and support, for them and their families. The section on improving service equity notes that children with a learning disability and mental health problems have not received sufficient input from Child and Adolescent Mental Health Service. An increase in capacity may be required to ensure that all children and young people attending education settings and mainstream or special schools have equal access to therapy.
National Service Framework Autism Exemplar - The exemplar follows one child's journey with autism, from early childhood to adulthood. It includes best practice and standards at each phase of the child's journey, demonstrating optimal care pathways.
Lord Bradley's Review of people with mental health problems or learning disabilities in the Criminal Justice System April 2009. This clearly illustrates the link with learning disabilities, mental health and offending behaviour.
Royal College of Speech and Language Therapists - is the professional body for speech and language therapists in the UK. It is responsible for setting, promoting and maintaining high standards in education, clinical practice and ethical conduct. The Royal College of Speech and Language Therapists has developed a position paper that explains the essential role of speech and language therapy within integrated children's services.
Newcastle Children and Young People's Plan for 2011-2014 (currently in consultation) - This focuses on:
The plan will set out how partners will work together to make a difference to the life chances and outcomes of children and young people in Newcastle. It covers all children and young people in Newcastle aged 0 to 19 years old and some groups of young people up to the age of 25 who have learning difficulties and/or disabilities. It includes children and young people from other areas who are attending Newcastle schools or college, and those in the care of the local authority who live outside the area.
Aiming High for Disabled Children - Launched in May 2007, this government plan was designed to help disabled children and their families get the support and chances they need to live ordinary family lives. All local areas in England have received extra money to increase support and services for disabled children and young people.
Promoting the Health of Looked After Children Department of Health November 2009 -. Improving the health of looked after children is a multi-agency responsibility involving Councils and health agencies. This guidance sets out the responsibilities on all agencies to work together to provide services which meet the needs of these children and young people. It also sets out the values and principles which should underpin the delivery of services.
Valuing People Now: a three year strategy for people with learning disabilities Jan, 2009 - Following consultation, Valuing People Now sets out the Government's strategy for people with learning disabilities for the next three years. It also responds to the main recommendations in Healthcare for All, the independent inquiry into access to healthcare for people with learning disabilities.
Lamb Enquiry 2009 - The Lamb Inquiry has investigated a range of ways in which parental confidence in the Special Educational Needs assessment process might be improved. It produced a Plan focusing on the following five key areas:
Achievement for All - Achievement for All was announced by the Department for Children Schools and Families in the Children's Plan Progress Report in December 2008. It stated:
Pupils with Special Educational Needs and disabled children make the best progress in schools where there is a strong ethos that all pupils should make good progress academically as well as in their personal and social development. Too many are leaving education without the skills and qualifications needed to become independent adults.
The evidence shows that there are still too many children and young people with special educational needs and disabilities who:
The Achievement for All pilot project will showcase how schools can work together with children with Special Educational Needs and disabled children and their parents to ensure they achieve their full potential.
This section brings together the information in the previous section to identify what we know is working and what we need to do next.
Joint Service Planning and Delivery
1) Within Newcastle a joint referral system exists between Education Services (SENTASS) and the Paediatric Speech and Language Team to ensure that children/young people who are referred to these services are directed toward the appropriate support pathway as efficiently as possible. This may be SENTASS only, Paediatric Speech and Language Therapy only or a joint intervention.
The joint referral system allows for initial assessments to be carried out by the appropriate service and a programme of intervention to be implemented by the appropriate service, team or individuals.
The system prevents unnecessary duplication of assessments and interventions thus meeting the needs of individuals in a more timely fashion.
This integrated working relies on the capacity of each of the services being maintained.
2) There has been very successful integrated working in the form of the multi-disciplinary Newcastle Specific Language Impairment Team. This Team comprises staff from Paediatric SLT, SENTASS and Educational Psychology, including Learning Support Assistants, Speech and Language Therapists, a specialist teacher and Educational Psychologists. The Team is responsible for providing assessment and intervention for children and young people who have severe Speech, Language and Communication Needs. It ensures that the majority of these children/young people can have their needs met within their local mainstream setting in a timely and effective way. The Team also contributes to the appropriate placement of children and young people whose needs are severe enough to require intervention in a specialist school or setting.
The Team was created using funding from the Area Based Grant (previously the Standards Fund). This has continued to be awarded thereafter on a year on year basis; however, funding has not been mainstreamed and secured.
This care pathway has worked well and the effectiveness of the Newcastle Specific Language Impairment Team has been recognised nationally, appearing in national publications, as good practice.
3) Paediatric SLT and SENTASS Young Children's Team jointly run a number of preschool groups. Some groups also have input from Educational Psychology and Paediatric Physiotherapy, depending on the needs of the children.
These groups provide both assessment and intervention function. The multi-agency approach reduces the number of appointments that parents are required to attend and prevents duplication of assessments and reporting. It also ensures a holistic view of a child's needs, develops skills and understanding of other professionals roles and informs decisions such as future educational placement or need for longer term support.
Joint individual assessments with professionals from different services are also carried out, for some children for example children with suspected Autism Spectrum Disorder.
4) The Sure Start Children's Centre Citywide Speech and Language Therapy team provides very effective locality based early intervention for preschool children and families. A key focus is on developing skills in the workforce to support speech and language development and to identify delays and difficulties. The Sure Start team also works very closely with other Children's Centre staff to engage with vulnerable families
The Sure Start Children's Centre Speech and Language Therapy team works with children and families individually and in groups to develop language skills and support access to mainstream Speech and Language Therapy services. It is part of the overall citywide Speech and Language Therapy service, integrating closely with other therapists to ensure cohesive preschool intervention across the total population (universal, targeted and specialist services).
The team can demonstrate successful outcomes, e.g. raising the confidence of practitioners in recognising speech and language delay and improving early referral rates for children with recognised difficulties.
5) There is good integrated working between the Newcastle Hospitals Trust Speech and Language Therapy Service and the Northumberland, Tyne and Wear Trust CTLD Team at the following transition points: -
entry into special school or nursery,
when children transfer from mainstream to special school,
when a child leaves school but still requires access to Speech and Language Therapy.
There is a transition protocol in place to support the transfer between services and this is aided by a specific post that works to support children with speech, language and communication needs with learning disabilities in mainstream school. This Speech and Language Therapist post works jointly with the CTLD multidisciplinary team.
6) The CTLD Speech and Language Therapy team are fully integrated within the multi-disciplinary learning disabilities team so there is good joint working with community nursing, psychiatry, physiotherapy and clinical psychology. This work is also often around the management of behaviour and or around complex health needs.
CTLD works closely with education and families within the special school context and alongside agencies supporting children and families. For example all Speech and Language Therapy recommendations are incorporated within IEP targets and reviewed at least annually, these are also adapted to support children accessing respite care.
Child-adult transition within the CTLD Speech and Language Therapy service is supported by the fact that the team is a lifespan team.
7) Service level agreements have been in place between Newcastle Local Authority and Newcastle Upon Tyne Hospital Trust for a number of years. Good relationships are in place between key individuals to review the agreements and monitor outcomes.
New service level agreements have been agreed when there has been an identified need for additional speech and language input to a specific area e.g. into a Special School, the Sure Start Children's Centres and the Every Child a Talker programme.
Joint working between Strategic and Middle Management
8) At the service delivery level provision of Speech and Language Services are continuing to become more integrated and joined up.
This includes some joint working with other speech and language therapy services across the region e.g. provision of groups for young people who stammer.
The Children's Trust Arrangements around the Children's Be Healthy work stream are fairly well developed and Speech, Language and Communication falls within the scope of several of the planning groups, for example, Children With Disabilities, SEND etc.
Each of the Speech, Language and Communication services individually collects data and measures outcomes for children and young people with speech, language and communication needs.
The Newcastle Speech and Language Therapy Service managers meet within the Regional Speech and Language Therapy Managers Group, where issues relating to Paediatric SLT service delivery are discussed. Individual meetings are arranged around specific local issues or projects relating to Newcastle services as required.
Meetings between the Speech and Language Therapy service managers and relevant Local Authority managers are arranged as needed, around specific topics.
There has been some multi-agency involvement in recruitment, particularly around Sure Start Children's Centre Speech and Language Therapy appointments, the appointment to the Every Child a Talker consultant and the appointment of a SENTASS specialist teacher.
Managers of services for speech, language and communication needs are making the best use of their resources by joining up where possible and integrating. For example, the Speech and Language Therapist post working with children with learning disability in mainstream schools, based in the Paediatric Speech and Language Therapy service. This post also works very closely with colleagues in CTLD to ensure that children and families have full access to appropriate support.
Other examples include the joint referral system and joint groups across Speech and Language Therapy and SENTASS.
Services are also working towards a joint approach to training the early years workforce.
9) Managers of services for Speech Language and Communication endeavour to maximise available resources within their separately funded services and organisations, to provide as comprehensive a service as possible. This includes development of joint working practices to provide a more efficient and streamlined service for children and families.
10) Speech, Language and Communication training is available for the children's workforce in a variety of ways. This includes nationally developed training packages such as the online Inclusion and Development Programme. There are also accredited programmes, for example ELKLAN as well as locally developed training tailored for specific groups.
These training programmes support the whole Children's Workforce to develop their knowledge, understanding and skills relating to Speech, Language and Communication. This raises awareness of the need for early identification of children/young people who have Speech, Language and Communication Needs and how to support them.
There are also training packages available for more specific communication related disorders e.g. Autism which are delivered in partnership with education, as well as training on specific approaches to speech, language and communication needs.
11) The Every Child a Talker had evaluated very positively. A therapist and specialist teacher were seconded as Every Child a Talker consultants to work together with 30 preschool settings across the city, to improve the communicative environment and raise the skills of the staff in recognising and supporting speech and language difficulties.
The Every Child a Talker project was closely linked to the work of the SURE Start Children's Centre SLT team, with therapists supporting the Every Child a Talker input in their locality area.
Every Child a Talker and SURE Start Children's Centre have worked together with other professionals including early years consultants and Sure Start teachers to begin developing a more integrated speech and language training framework for early years staff. SURE Start therapists have also developed a Speech and Language training package which has evaluated very well.
Funding for Every Child a Talker was from central government for a fixed term period, which has now ended. However the therapist and teacher have been seconded for a further period as Inclusion Consultants, with the intention of embedding the Every Child a Talker work in other settings.
12) There is a wide range of specialist Speech and Language Therapy and other expertise available in the city. Theses specialists and experts play a key part in workforce development at all levels (specialist, targeted and universal).
13) Trained Speech and Language Therapy assistants and learning support assistants are an essential and highly valued part of the service for children and young people with a speech, language or communication need. There is evidence of positive outcomes for children and young people where a trained assistant practitioner has carried out intensive work under the guidance of a Speech and Language Therapist or specialist teacher.
14) The Paediatric SLT service works very closely with the Speech and Language Sciences Department at Newcastle University, where speech and language therapists are trained. The service offers a wide variety of student placements, including a clinic held at the University site, supported by clinical staff at the University. This joint approach supports the provision of a range of therapy options, whilst ensuring that students acquire therapeutic skills within a variety of contexts.
15) As CTLD Speech and Language Therapy currently offers a lifespan service this supports recruitment and development of staff with the required level of experience to work with people with learning disabilities. The experience of working with adults is also key when supporting parents in being able to explain about longer term speech, language and communication needs.
Communication with Parents and Carers and Children and Young People
16) The indications are that communication between Speech, Language and Communication services and the children/young people and their families who access these services is well received. Parents and carers seem to be generally satisfied with the way information is communicated to them.
Informal feedback and small scale surveys and questionnaires indicate satisfaction with the service received and the involvement of families in their child's therapy.
The CTLD Speech and Language Therapy team have also been heavily involved in supporting social care in the development of their user feedback and the team have Investing in Children status.
17) When the parents and carers of children and young people with Speech, Language and Communication Needs gain access to Speech, Language and Communication Service they get appropriate information regarding the service they are involved with.
Equity for a Changing Population
18) There is evidence that integrated working across speech and language therapy and the local Authority is improving outcomes and equity for children and young people who need to access the services.
Early intervention is recognised as being key to improved outcomes for the children/young people. Services for speech, language and communication are working towards improving access and waiting times, with evidence of improvement particularly in the early years.
19) Newcastle has a very diverse population who speak a wide variety of languages. Interpreter services are available to Speech and Language Therapy for many, but not all, languages.
Training has been given to staff in early years settings on recognising and referring children with language delay where English is not the first language.
The number of languages and cultures represented in Newcastle is increasing. This is a significant challenge for service provision, as assessment and intervention with these families is generally more complex and time consuming, due to the need to assess more than one language.
20) Significant medical advances have meant that the survival rates of preterm babies and/or babies with complex medical needs are improving. Children with acquired injuries also have a greater chance of survival.
21) Where possible services for speech, language and communication work closely with other therapy services, particularly with children with complex needs for example running joint groups.
22) The Regional Communication Aids service offers access to specialist Speech and Language Therapist and clinical engineering advice about high-tech devices which support communication and has also offered advice and training to staff in relation to low-tech communication support.
The service works in tandem with the local therapists and has a remit to provide specialist equipment for children who live in Newcastle.
The Regional Communication Aids service ensure the safe maintenance of the electrical equipment and also provide a loan service which enables the trial of the specialist equipment - long term and short term.
In order to ensure that the areas of good practice identified in the previous section continue to work well and that the areas of difficulty and inequity are eradicated Newcastle has developed a Speech, Language and Communication Action Plan. The action plan is focusing on reviewing current Speech, Language and Communications services, the way they are commissioned, performance measured and funded in order to make the best use of available resources.
The action plan focuses on five themes;
1) Ensuring that Joint Working between services is promoted and maintained to maximise resources,
2) Ensuring that strategic and middle management communicate and work together to provide good leadership for individual services,
3) Ensuring that the Children's Workforce develops and retains skilled staff for children and young people with speech, language and communication needs,
4) Ensuing that communication with parents and carers and children and young people is appropriate and accessible,
5) Ensuring that services develop and maintain equity for the changing population so that services are available for all children and young people who require them.
Through these five themes, and the actions identified against them, Newcastle aims to ensure that services within the city are able to meet the needs of children and young people with Speech, Language and Communication Needs, now and in the future.
The information provided in this Joint Strategic Needs Assessment has been used to inform the Newcastle Speech, Language and Communication Needs Action Plan (October 2010).