Barking and Dagenham: an integrated, cost effective service for
children with speech, language and communication needs
The context
 Total population 164,572
 23% under 16
 41% of children live in poverty (England average 22%)
 18 Children’s Centres
 47 primary schools
 9 secondary schools
 1 special school
Drivers for change
 Primary schools were reporting high numbers of children with speech, language and
communication needs and asking for more speech and language therapy
 Parents were complaining publicly about lack of speech and language therapy
 The borough’s Health Scrutiny Panel commissioned a report on speech and language
therapy provision
 The borough was experiencing rising numbers of pupils at risk of exclusion
 SEN resources had been increasingly delegated to schools and there was a need to
ensure that resources were being used to best effect
Aims of strategy
 Early identification of children’s speech, language and communication needs, and
appropriate intervention
 Increased capacity of staff in settings and schools to meet needs
 Reduction in numbers referred inappropriately for specialist speech and language
therapy help
The journey
The Director of Children’s Services set up and chaired an ‘Empowered Voice’ steering group,
with senior membership from across the local authority early years, school improvement
and inclusion services and from public health. This high-level steering group built on a longestablished and effective speech, language and communication needs strategy group,
chaired by the Head of Inclusion, and made up of the Head of the Speech and Language
therapy service, speech, language and communication needs advisory teachers, the
voluntary sector (AFASIC), group managers of Early Years and Childcare and Inclusion, and
primary and secondary headteacher representatives.
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Early Years
An initial piece of work was a re-shaping of Early Years services. Building on four early Sure
Start local programmes, a borough-wide strategy of training for early years staff was
developed. Joint health and children’s services funding was identified for a new workforce of
dedicated Play and Communication workers, based in each of the 18 Children’s Centres.
These workers are trained to NVQ Level 3 and have received extensive additional training in
speech, language and communication. They are managed by speech and language therapists
in conjunction with Children’s Centre managers, and work directly with children and their
parents.
All children are assessed on a speech, language and communication profile via parent
interview; therapists then develop a care plan that might be attending the groups or
workshops, or outreach support.
Play and Communication workers run weekly groups for parents and children - Baby
Massage, Babbling Babes, Toddler Talk, Messy Play. These groups are tightly structured and
are evaluated by parent self-rated growth in skills. The workers also deliver outreach,
Portage Community Home Visiting and other tailored services.
Speech and language therapists run monthly drop-in advice sessions for parents, a four week
Play and Language workshop for parents, and provide monthly supervision for Play and
Communication workers. At these supervision meetings individual children’s carefully
tracked progress is reviewed.
Every Child a Talker operates in 32 settings plus 23 linked settings. Lead practitioners receive
intensive training in order to support staff development.
There is a consistent focus on early identification of children’s needs. 20 schools use
computer-based screening for language comprehension level (Language Link) with all
children, including those with EAL, at the start and end of the Reception year. The costs of
screening are jointly met by the Primary Care Trust and the local authority. Depending on
the child’s comprehension level, screening can lead to either referral to the speech and
language therapy service or school based intervention supported by advisory teachers with
training and resources.
Training and development for school staff
The local authority appointed two advisory teachers whose role was to empower schools to
meet speech, language and communication needs (SLCN). Together with an educational
psychologist and speech and language therapist they developed a speech and language
handbook for each Key Stage, with accompanying whole-school training delivered by an
advisory teacher and psychologist or speech and language therapist. All schools have now
taken up this training.
This awareness level training is complemented by more advanced training.
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Awareness level
Target audience
Whole-school staff
Enhanced level
A teacher /teaching
assistant pair per school
Enhanced level
Teachers and teaching
assistants wanting to
know how to help a
specific child in their
class , or develop their
skills
Specialist
A small number of
school-based staff
Content
How to maximise opportunities
to develop speaking and
listening, identification of need
based on developmental
milestones, intervention and
tracking progress
Accredited training on speech,
language and communication
plus planning a piece of
development work for the
school, with two or three
targets. The staff involved meet
termly at network meetings to
share progress in their
development plans and receive
further training on specific
topics such as language and
maths, or stammering
Modular training programme
offered centrally in the autumn
term – 12 stand-alone sessions
that can also be delivered in
school, covering for example
articulation, grammar,
vocabulary, word finding,
speech games, visual support
strategies.
This course is tutored by the
advisory teachers and includes
a research investigation.
There is a network of teachers who have undertaken action research on speaking and
listening and opportunities for dialogue within their classrooms, supported by advisory
teachers for English. Advisory teachers for science have supported schools in developing
oracy across the curriculum, following work with the two speech, language and
communication advisory teachers.
Provision for school-aged children
The speech and language therapy service is community-based and therapists are organised
into three geographical areas.
From Key Stage 1 upwards each primary school has an allocated therapist and therapy
assistant who work with the school for one term per year. The therapist and advisory
teacher meet with SENCO and /or SLCN enhanced skill professional at the beginning of term
to determine priorities. Advisory teachers pick up staff training issues arising from the
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meeting. The speech and language therapist and therapy assistant typically provide blocks of
direct input with a child or group, modelling approaches to professionals in the school who
continue these programmes at the end of the block and continue to support schools with
provision management. In the next two terms the advisory teachers follow up children to
make sure their programmes continue as planned.
Local authority provision includes mainstream primary and secondary resource bases, which
have dedicated SLT input throughout the year.
At secondary level, the speech and language therapy provision is run on the same basis as in
primary schools with each school receiving input for one term per year. Eight schools are
involved in the Enhancing Language and Communication in Secondary Schools (ELCISS)
initiative, through which teaching assistants are trained to run six-week, 13-hour, small
group language interventions targeting vocabulary and narrative language. ELCISS also
provides whole-school staff training.
Current services for children and young people with speech, language and communication
needs
Phase
Early Years and Foundation
Stage
School-age (KS1 +)
Primary resourced SLCN
provision for six pupils
Secondary resourced SLCN
provision for 6-8 pupils
Other SLT provision (Clinical
Lead SLT, Dysfluency,
Deafness, Feeding difficulties
and Portage)
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Staffing
Preventive work
1.0 FTE SLT employed by LA (who shares the Every Child a
Talker consultant role with an Early Years advisory
teacher)
20 Play and Communication workers (6 employed by NHS,
14 by LA)
2 FTE SLTs (employed by NHS)
Intervention work
2.4 FTE SLT Assistants(employed by NHS)
3.3 FTE SLTs(employed by NHS)
2 advisory teachers (employed by LA)
Primary Schools
2.0 FTE SLT Assistant Practitioners(employed by NHS)
4.3 FTE SLTs(employed by NHS)
Secondary Schools
0.4 FTE SLT Assistant Practitioners(employed by NHS)
1.6 FTE SLTs(employed by NHS)
Teaching staff
0.3 SLT Assistant Practitioner(employed by NHS)
0.2 SLT(employed by NHS)
Teaching staff
0.2 FTE SLT(employed by NHS)
0.3 FTE SLT Assistant Practitioner(employed by NHS)
5.6 FTE SLTs(employed by NHS)
Impact
Foundation Stage Profile results show a rising number of children in Barking and Dagenham
achieving an appropriate level on the Communication, Language and Literacy scale, and
substantial improvements for the lowest achieving children.
The impact of Every Child a Talker training has been evaluated using direct observation (by
Early Years consultants) of practitioners’ use of 14 key interaction skills. Before the training,
practitioners used an average of six of these 14 key skills. After the training, the average had
risen to 11. Individual child progress monitoring of the children involved has shown that the
percentage of children at risk of delay in attention and listening has fallen from 22% in
November 2009 to 17% in March 2010. In understanding of language, the percentage at risk
of delay has fallen from 30 to 24%, and in speech sounds and talk from 37 to 26%. There
have been substantial increases in the percentage of children ahead of age norms on all
these scales, and also on a social skills scale.
The results of the six- week group ELCISS: intervention programme to develop secondary
pupils’ ability to recount a narrative, delivered by a trained teaching assistant to Year 8
pupils with language impairment, are shown below.
Oral story telling measure scores
21
20.5
20
19.5
19
Intervention
18.5
No intervention
18
17.5
17
16.5
16
Pre-Intervention
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Post-Intervention
18 Year 7 pupils took part in another ELCISS group intervention, with end of Key Stage 2
English levels ranging from P8-4c. Three pupils had Statements of SEN, two were on School
Action Plus and two on School Action. Their levels of progress in English by the end of Key
Stage 3 are shown below;
1 level of progress
2 levels of progress
3 levels of progress
Number of students
5
11
2
ELCISS also involves whole-school training. Over 70% of school staff said they would change
their teaching practice as a result of the training received.
Critical success factors
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High-level strategic support and a shared understanding that speech, language and
communication skills are key to raising attainment and improving wellbeing
Committed and consistent leadership from the Head of Inclusion, Head of Early
Years and Head of the Speech and Language Therapy service
Alignment of budget streams: local authority budgets, health budgets, SEN training
grant, SEN regional hub funding,
Working systematically to develop shared health/education performance indicators
for children’s language development in the early years
Strong evaluation – the EP service and advisory team published a paper evaluating
the impact of training on early years staff skills, and City University are evaluating
ELCISS
Partnerships - joint work with a neighbouring local authority (Redbridge), and with
the third sector (AFASIC, I Can)
An effective staff development model in which experts work with teachers, then
step back while teachers form networks to evaluate and improve their own practice.
The local authority provides ongoing support to these networks.
What next/challenges
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The long term aim is to have all workforce trained in speech, language and
communication at a minimum of awareness level
Language across the curriculum – the challenge has been to get this on secondary
schools’ agendas and secure CPD time
Developing and evaluating structured time-limited group interventions
Helping schools promote parental support for language development
May 2010
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