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Alison Morton, Best Start in Life Programme Manager, Public Health England
Recent developments in language and inequality and why
school readiness is a critical opportunity to change
children’s lives
LGA, London
24th January 2018
Summary• Early language impacts on many areas of child development; it contributes to children’s ability to
manage emotions and communicate feelings, to establish and maintain relationships, to think
symbolically, and to learn to read and write (EIF, 2017).
• Almost all children learn to communicate through language, yet there are strong and persistent
differences in their ability to do so, with a pronounced social gradient in early language acquisition.
• The link between language and other social, emotional and learning outcomes makes early language
a primary indicator of child wellbeing.
• PHE provide the expertise and evidence to help understand the needs of the local population and
publish data against the Public Health Outcomes Framework to promote transparency and
improvement. Speech and language development data forms part of school readiness evaluation.
• Speech, language and communication outcomes can be improved by early intervention
2 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
Policy Context• Ensuring that every child has the Best Start in
Life: “ready to learn at two and ready for school
at five” is a priority for PHE.
• The Early years High Impact Area 6: Health,
wellbeing and development of the child aged
two is one of the six high impact areas for
health visiting.
• Improving early language acquisition has been
identified as a government priority in the Social
Mobility Plan (2017): “Unlocking Talent,
Fulfilling Potential”
3 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
What is School readiness? ‘Making sure a child is able to start school ready to learn, able to make
friends and play, ready to ask for what they need and say what they think.’(1)
UNICEF (2012) three dimensions of school readiness:
(1) Ready children, focusing on children’s learning and development.
(2) Ready schools, focusing on the school environment along with practices that
foster and support a smooth transition for children into primary school and
advance and promote the learning of all children.
(3) Ready families, focusing on parental and caregiver attitudes and involvement in
their children’s early learning and development and transition to school.
School readiness is associated with:
• early childhood factors that influence the capacity to learn,
• education attainment.
Ensuring that children are ready for school is an important measure of success for
programmes aimed at improving children’s outcomes.
4 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018 . Ref: (1) Children’s Minister 2012
PHE Fingertips – Indicators and Profilespromote transparency and improvement approx. 200 indicators
5 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
https://fingertips.phe.org.uk/profile-group/child-health/profile/child-health-early-years
Evidence and Intelligence
6 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
“We found this information very useful
for setting priorities and assessing
interventions”
Drawing conclusions
Child Health Profiles
Articulating Best Practice
Atlas of Variation
Highlights variation
Highlights opportunities
Improving Outcomes- reducing inequalities
in early language:
• School Readiness: 1.02i - Children achieving a good
level of development at the end of reception.
• Child development at 2: 2.5ii Proportion of all children
aged 2-2½yrs offered Ages and Stages questionnaire
(ASQ-3™), as part of the Healthy Child Programme.
• Outcome sub-indicator(s): Collection of scores using the
Ages and Stages questionnaire (ASQ-3™). The tool
produces a score for five separate areas of development:
Communication, Gross Motor, Fine Motor, Problem solving,
Personal-social
Speech and language needs assessment reports are
published for each upper tier local authority.
7 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
Key messages from the evidence
8 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018 ref; Marmot M, Allen J, Goldblatt P, Boyce T, McNeish D, Grady M, et al.. Fair Society, Healthy Lives:, London; 2010.
“The foundations for virtually every aspect of human development –
physical, intellectual and emotional – are laid in early childhood. What
happens during these early years (starting in the womb) has lifelong
effects on many aspects of health and well-being– from obesity, heart
disease and mental health, to educational achievement and economic
status.”
“health inequalities are not inevitable and can be significantly reduced”
Michael Marmot, Fair Society, Healthy Lives, 2010
Reviewing the evidence on early
language developmentLanguage as a Child Wellbeing Indicator (EIF,
2017):
The report evaluates the link between language
acquisition and life chances.
Early Language Development: Needs, provision
and intervention for preschool children from
socio-economically disadvantage
backgrounds (EEF, 2017);
The review focused on children in England aged
0–5, and the carers, services and settings that
support their language development.
Talking About a Generation - a review into
current policy, evidence and practice for
speech, language and communication (The
Communications Trust, 2017)
99 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
Early sounds
develop into
babbling,
copying sounds
and gestures
Single words
develop into
short sentences
Complex
sentences and
abstract
thinking
Babies are
born ready to
communicate
Pointing is a
significant
milestone for
communication
Speech, language and communication provide a
foundation for children to be understood, learn, develop,
build relationships and socially interact with others
Behaviours like
crying and
cooing form the
basis of infant
interaction with
others.
Starts in the
womb; babies
recognise
familiar sounds
and voices
Early Language Development
10Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
The development of a child’s brain architecture provides the
foundation for all future learning, behaviour, and health.
11 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
• First 1001 Critical Days:
Early Childhood is an
important period of rapid
brain growth
• More than 1 million neural
connections form every
second
• By the age of 2 years old,
the brain is about 80% of
the adult size.
• The interactions of genes
and experience shape the
developing brain
Most children develop language effortlessly, but a
significant minority do not; at least two children in every
Reception class
12Recent developments in language and inequality and why school readiness is a critical opportunity to change
children's lives, London 2018 Slide courtesy of Jean Gross (2017)
Differences start early
13 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
Source: Hart, B., & Risley, T. (1995). Meaningful
differences in the everyday experiences of young
American children. Baltimore, MD: Brookes.
• By age 3 there is already a 17
month income-related language
gap.
• Language development at the
age of 2 strongly predicts
children’s performance on entry
to primary school.
Roulstone et al , 2011, Investigating the role
of language in children’s early educational
outcomes, DfE Research Report
14 Recent developments in language and inequality and why school readiness is a critical opportunity to change
children's lives, London 2018 ref: Law J, in EIF (2017) Language as a Child Wellbeing indicator
Child development outcomes at 2-21/2Population measure in development for PHOF
ASQ-3 questionnaires which cover five domains of development
including;
• communication - babbling, vocalising, listening and
understanding,
• gross motor skills
• fine motor skills
• problem solving
• personal-social development
15 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
WORK IN PROGRESS - FOR ILLUSTRATIVE PURPOSES ONLY
No shortage of theories
16Recent developments in language and inequality and why school readiness is a critical opportunity to change
children's lives, London 2018
Learning
disabilities
Quality of
parent- child
interaction
Children from disadvantaged groups are
as likely to experience
language delay 2X
Autistic
spectrum
disorders
Sensori-
neural
losses
of all children in England have speech
and/or language impairment
5-8%
“Word gap”**exposure to
fewer words
and limited
vocabulary In areas of high
deprivation up to
of children
start
school with
language
delay
50%
Socioeconomic
status
Access to
resources:
books, toys
educational
experiences
Access to
enriching
Early Years
provision
Speech, Language and Communication Needs
**Children from higher
income families have
heard over30
millionmore words (aged 3)
Heritable/
biological factors
Environment
It’s what you do not what you earn
The child’s communication environment (the early
ownership of books, trips to the library,
attendance at pre-school, parents teaching a
range of activities and the number of toys and
books available) was a more important
predictor of language development at two,
and school entry ‘baseline’ scores at 4 than
socio-economic background .Roulstone et al (2011)Investigating the role of language in children’s
early educational outcomes
1818Recent developments in language and inequality and why school readiness is a critical opportunity to change
children's lives, London 2018
Difficulties in early language development are associated with a range of long term outcomes. This can impact on a child’s health and behaviour but also economic and social
prospects in future life.
Emotional and behavioural difficulties
Increased risk of ADHD and
anxiety disorders in adolescence
Criminal Justice
50% of the UK prison population have language difficulties
(compared to 17% of general population)
Risky behaviours
More than 70% of young people in the youth offenders system
have a communication disability
Educational disadvantage:
Communication is the key to access learning
Reduced school readiness/ Poor academic achievement
The link between language and other social, emotional and learning
outcomes makes early language a primary indicator of child wellbeing
Economic disadvantage
12% lower earnings due to inadequate literacy skills
Twice as likely to be unemployed at age 34
Mental Health problems
3x Increased risk of mental health problems in adulthood
Social Emotional
LearningSpeech
Language
Communication
Difficulties in one
area of
development lead
to problems with
the others
Why does early language matter?
We can make a difference• Community-wide public health
strategies
• Training the early years workforce
• Targeted direct instruction intervention
programmes in early years settings
• Programmes and practices to support
parent-child interaction and shared
reading at home
(Jean Gross, 2017: PHE Communication
First)
20Recent developments in language and inequality and why school readiness is a critical opportunity to change
children's lives, London 2018
Investment during this period to
improve attachment security, the
quality of parent–child interaction,
including the quality of
conversations parents have with
their children improves child
outcomes across the life-course
and has considerable cost
benefits.
1) Begin before birth
Antenatal contact:
Promote a language rich environment:
access to books, toys and educational
experiences and responsive parenting
End of Reception:
Early Years Foundation
Stage Profile (4+years)
Review progress against
expected levels of
speech and language
development.
Targeted plan for
children with additional
needs
2) New birth visit (10-14 days)
3) Post natal review (6-8 weeks)
4) One year health review (9-12 months)
Promote a rich language environment
Identify families in need of additional support
and children at risk of poor outcomes.
Signpost children with speech, language and
communication needs to early support
5) 2- 2.5 year check
Review of health and development.
Identification of children with speech, language
and communication needs.
Support uptake of early intervention;
Strategies should support the quality of parent–
child interaction
Ages and Stages Questionnaire provides a
population measure of communication.
Early Years Progress check at
age 2:
Communication and language is
one of three prime learning and
development areas.
Targeted plan for children with
speech, language and
communication needs
2,3,4
5
1
Health Visiting:
5 Mandated universal reviews
2 year
check
EYFS
Early Years:
Progress checks and Profile
A focus on language rich early
environments and high quality
Early Years provision
Reducing inequalities in speech, language and communication
A coordinated local response
No child gets left behind
Promoting language and identifying need:Opportunities in the Healthy Child Programme and Early Years
21
Early language matters:
10 Top Tips
Talk to your baby everydayDescribe what you are doing with them throughout the day. For example, taking
a bath or when changing their nappy
Enjoy music togetherSing simple nursery rhymes with your baby. This helps them learn about the rhythm in
language. Actions are also important to help them understand the words
Gestures are important tooWaving, pointing, nodding and
shaking your head are all ways to communicate with your baby
Share books with your babyIt’s never too early to start enjoying books together. Talk about the pictures and point
to what your baby is interested in
See your baby’s point of viewGet down to your baby’s level when playing and talking. Make eye contact and give them
your full attention.
Follow your baby’s leadPlay with what they are interested in, join in with them and talk about what you are doing together – help them match words to objects
Respond to your babyWhen your baby gurgles, coos or
babbles, repeat it back to them and have a conversation together
Plan for quiet timeGive your baby chances to hear your voice and make noises without the TV, radio or other background noise
Talk to the bumpYour baby can hear you and will
recognise your voice once they are born
Interact with your babyBabies love it when you smile and make eye
contact with them. This helps them learn how to be sociable
22
Meeting Needs: • Integrated commissioning or
local agreements to ensure a
coordinated response to the
range of speech, language and
communication needs.
• Local pathways incorporate
health visiting, early years,
voluntary sector, speech and
language therapy and specialist
commissioning.
• Strategies start early in life and
continue throughout education.
• Parents are supported to
respond to their baby/ child and
build a language rich
environment.
• Interventions are proportionate
to need, evidence based and
targeted to those who need
them most to reduce inequalities
Actions for commissioners and provider leads
Targeted (selected):
Targeted:Small group additional intervention1:1 help from a trained volunteer
Universal
Promotion of early language.
Language rich early settings and home learning environment
Early identification of children with speech, language and
communication needs/ ongoing monitoring
Targeted
Small group intervention
1:1 help from a trained practitioner or volunteer.
Strategies to improve parental education and
responsive parenting.
Specialist
Intensive intervention with a
Speech and Language team
A continuum of response to a continuum of need
23
Workshop: Obstacles and
drivers for early language
24 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's
lives, London 2018
ChildHome &
family
Community,
services &
schools
Wider
society
Language
gap
Question One:
•What are the main obstacles and drivers to improve SLC
outcomes and social mobility for children under 5?
Question two: (What/ Who)
• Having identified the key drivers what are the actions we need at all levels of
the system to achieve these?
• And who are the key organisations that contribute to the action plan?
25 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
Questions?
26 Recent developments in language and inequality and why school readiness is a critical opportunity to change children's lives,
London 2018
For more information, contact: [email protected]
Links:
https://www.thecommunicationtrust.org.uk/media/540327/tct_talkingaboutageneration_repo
rt_online.pdf
http://www.eif.org.uk/publication/language-as-a-child-wellbeing-indicator/
https://educationendowmentfoundation.org.uk/resources/publications/early-language-
development
http://www.chimat.org.uk/
NHS Digital: ASQ preliminary data- See pilot study at bottom of attached page
http://content.digital.nhs.uk/maternityandchildren/CYPHSmonthly
Speech and language needs assessment reports for each upper tier local authority. The
current versions are available here -
http://atlas.chimat.org.uk/IAS/profiles/profile?profileId=7&geoTypeId=
