051205-healsj-R1213142941

A Joint Agency Strategy for responding to the needs of children with Speech language and Communication Needs

Introduction

The proposed changes set out in the Paediatric Speech and Language Therapy Services support the emerging strategy being developed through a joint agency review being carried out by the Portsmouth City Council Department for Children and Families and the Portsmouth City Teaching Primary Care Trust. This review is considering future arrangements for support to children with speech language and communication needs (SLCN), their parents and their schools. The overlaps and links between health service provision and education are significant. A child's progress at school will depend on their ability to communicate with others, to use speech and language to express their ideas and to understand both adults and other children. A large part of the school curriculum, particularly in primary and special schools, is aimed at developing the child's language and communication skills and promoting the child's language development is a key part of the teacher's role.

Key Principles

The overall strategy for responding to the needs of children with SLCN is founded on the following principles:

· SLCN (Speech language and communication need) is a term which describes a wide range of needs from relatively mild language delays that can be dealt with effectively by school and family working together, to more complex disorders that require intervention from specialist staff.

· Given this range we aim to develop an integrated service network that is able to deliver a graduated response with intervention and support appropriate to the level and severity of need.

· Such a network should be multi-agency in nature, ensuring that there is co-ordination of response between health and education services and an avoidance of unnecessary duplication.

· Interventions delivered must be founded in evidence-based practice.

The Range of Need

A child or young person may show speech and language needs in the following areas:

_ The development of their expressive language skills; the child's ability to use words to communicate with others and express their needs and feelings, their ability to put words together into sentences, their ability to communicate their ideas in an logical sequence.

_ Comprehension of language; the child's ability to understand others, to follow instructions to understand the meaning conveyed by the order of words in sentences etc.

_ Speech Sound Production; the child's ability to form sounds and words in a way that they can be understood and/or their fluency with the production of individual sounds or words.

_ Pragmatic language development; the child's ability to use language in a social context, including the meaning conveyed by tone of voice, gestures, turns of phrase and words that might have different meanings in different contexts.

Children's language development may present as delayed or disordered. SLCNM might include problems of fluency, dysphonia, (voice disorder) dysphagia (swallowing eating difficulties. Some children with sever or complex needs might need access to augmented or alternative means of communication.

The Range of Responses

Given this wide range of need we aim to develop a service network that can respond at different levels. It is envisaged that an integrated network would operate at three tiers of support as detailed in the table below:

Level of support

Range of need

interventions

Roles

Tier 1

Children with mild to moderate language delay

Support through curriculum arrangements in schools and early years providers.
Training provided to school and EY staff to enable them to support children with SLCN

SaLT, Specialist Teaching staff and Educational Psychologists will deliver joint training programmes

Tier 2

Children with severe language delay or moderate language disorders

As above, plus
· support with assessment of the child's needs
· planning of interventions
· agreeing suitable targets
· monitoring progress
from specialist staff from an integrated SLCN service.
Joint training for school staff on working supporting children with language disorders

SaLT involvement with individual children will focus on Key Stage 1 pupils, except for those children meeting the specific criteria for intervention described in the (see paper).
For pupils in Key stage 2-4 individual focused support is more likely to be provided by specialist education staff.
Joint training programmes will be delivered.

Tier 3

Children with severe language disorders

As above, plus direct involvement of the speech and language therapist in joint planning of targets and strategies.
Placement in specialist language provision within resourced mainstream schools where appropriate and where in line with parental preference.

Vision for an Integrated Network.

It is the intention of the Health Care Trust and the Department for Children and Families to develop an integrated service network for children with SLCN such that there will be a range of professionals working in partnership to deliver services in support of children families and schools. The network to consist of

· Speech and Language Therapists

· Specialist Advisory Teachers for SLCN

· Specialists Teaching Assistants for SLCN

This team will work together to:

· Provide training for school and early staff in supporting children with SLCN across the range of need described above.

· Offer consultancy services to school staff in respect of children at Tier 2 above.

· Offer direct intervention and regular support to children and in tier 3 above and to the staff working with them in schools and early years settings.

· Monitor the progress of children with SLCN

· Contribute to strategic planning for this group of children within the department and the trust.

· Undertake action research to evaluate the impact of intervention and support programmes.

Level of support	Range of need	interventions	Roles
Tier 1	Children with mild to moderate language delay	Support through curriculum arrangements in schools and early years providers. Training provided to school and EY staff to enable them to support children with SLCN	SaLT, Specialist Teaching staff and Educational Psychologists will deliver joint training programmes
Tier 2	Children with severe language delay or moderate language disorders	As above, plus · support with assessment of the child's needs · planning of interventions · agreeing suitable targets · monitoring progress from specialist staff from an integrated SLCN service. Joint training for school staff on working supporting children with language disorders	SaLT involvement with individual children will focus on Key Stage 1 pupils, except for those children meeting the specific criteria for intervention described in the (see paper). For pupils in Key stage 2-4 individual focused support is more likely to be provided by specialist education staff. Joint training programmes will be delivered.
Tier 3	Children with severe language disorders	As above, plus direct involvement of the speech and language therapist in joint planning of targets and strategies. Placement in specialist language provision within resourced mainstream schools where appropriate and where in line with parental preference.