Making a difference to children, young people and families

What now happens differently for children, young people and their families as a result of your actions?
What were the outcomes? This might refer to national indicators for example

A referral pathway has been established for the Ashford Better Communicators Service. This identifies the four children who enter the service every two terms. Once the children have been identified, a joint assessment by the Speech and Language Therapist and Early Years SENCO is undertaken. Joint targets are set in partnership with the parents. The child’s home nursery place is kept open and the child is offered a place for two terms at a specific nursery linked to a Children’s Centre, where the intensive intervention is offered. Parents receive regular support from the virtual team and a dedicated parent’s support group. Once the two terms are up, the child returns to his/her home nursery and the virtual team continues to offer the child and parent targeted support. This includes support in making the transition to the Reception class and follow-up support in the primary school until the end of Reception.

The principles of Early Support have been used to inform the model of reviewing the child’s needs. A ‘Team Around the Child’ meeting is used to co-ordinate and review the child’s progress. Parents play a key role in planning the support offered and reviewing the service as a whole. The practice has led to a marked increase in the children’s speech, language and communication skills, meaning that they are able to attend their local primary school and have the confidence to make new friends.

What now happens differently for the services involved?

The I CAN Early Talk Specialist Centre Accreditation Process provided an evidence based framework to improve local practice. Speech and Language Therapists and Specialist Teachers offer a more joint approach to assessment, interventions and providing training and advice to early years settings. Basing the service in a Children’s Centre enabled Kent County Council and its Primary Care Trust (PCT) partners to consider developing other Children’s Centres with an enhanced level of expertise in meeting the needs of a specific group of children and families.

A peripatetic approach to the specialist Early Talk service has been piloted for nine children in Thanet by NHS Eastern and Coastal Kent Community Services and Kent County Council. The pilot generated very positive outcomes. In this case the virtual team offers a joint specialist intervention in the child’s home and nursery (one session in the child’s home and one session in the nursery for two terms/12 weeks). The service is now seeking I CAN accreditation and this will impact on how Early Talk is rolled out across Kent.

Since the staffing levels in the virtual team are low, the service is cheap to run, compared to the savings that it generates. One child attending a specialist unit in a primary school for a year costs the Local Authority approximately £5,500. These costs include providing speech and language therapy, educational psychology and two custodial terms and compare with the cost of not intervening early to support a child’s speech, language and other educational and social needs at an early age, which can be as much as £153,687 once a child has reached 15.

Which of the changes will you maintain to sustain your achievements and how will you do this?

The Ashford Better Communicators Service was accredited by I CAN as an Early Talk Specialist Centre in December 2006. Since then, the Ashford Better Communicators Service has developed a joint approach to intervening early to offer specialist multi-agency interventions to a targeted group of children with speech language and communication needs.

The success of the Ashford Better Communicators Service has informed the development of a broader multi-agency specialist hub model that provides a multi-agency ‘one-stop-shop’ for disabled children, where they can receive a co-ordinated approach to having their needs assessed and supported, receive timely information, a co-ordinated approach to accessing a short break, and a joint approach to delivering training and advice to promote their inclusion in everyday activities.

The Ashford Better Communicators Service has also led to a new partnership agreement between Kent County Council, the NHS and I CAN to roll out the full Early Talk model to three other parts of Kent.

The practice enhances the evidence base for delivering early interventions within a “continuum of services around the family – universal, targeted and specialist services” required to meet the range of speech, language and communication needs identified within the Bercow Review. It can be used to inform how Children’s Centres can effectively support children with speech, language and communication needs. The practice can also be used to support the development of Early Years Networks as defined by the Childcare Act 2006.

Offering to keep the home nursery placement open for two terms, by paying for specialist nursery sessions is an expensive option and may not be sustainable in the long term. A peripatetic service in the child’s home nursery – bypassing the need to attend the specialist nursery – has been very positively received by the child, parent and home nursery.

If you are not yet sure what difference has been made, what new measures could be introduced, or what could be improved, to allow you to determine the difference made?

Evaluation

How have you evaluated progress against outcome measures?
How have you evaluated the improvement in outcomes for children, young people and/or families?
Do you have any information on the cost of your programme? This would be really useful information for other areas who might wish to implement a similar programme.

Please provide evidence of the learning that has occurred, of how systems have changed as a result of the practice being implemented, and of how outcomes have improved.
We are interested to hear about how you have evaluated the practice and how you have encouraged feedback from children, young people and their families. The results of this feedback and evaluation can include external evaluation reports, internal reviews, children, youth or parent feedback surveys, other surveys/data, anecdotal evidence, budgetary and/or statistical information, and plans/timelines.

What ‘hot tips’ do you have from your experience for others?

We are particularly interested in any barriers you encountered and how you overcame these and in your views regarding the potential for replicability of your practice example.

The Ashford Better Communicators Service has been externally accredited by I CAN. The accreditation process and subsequent annual reviews have informed the development of the model. Parental evaluation and evaluations from key stakeholders such as nurseries have also been used to inform the development of the model.

Ashford Better Communicators Service
In 2008-2009:
• 92% of the children supported were able to attend their local primary school and made good progress. Historically, children with similar needs would have needed to access a specialist language provision.
• 70% of children demonstrated a marked increase in their understanding of language.
• 80% of children showed an increase in their use of language.
• Only one child out of 12 needed a Statement of Special Educational Need.
• In some cases the child’s receptive and expressive language scores increased by such a large extent that they would no longer be classified as having a speech and language disorder.
• Parental questionnaires returned evidenced a very high parental satisfaction rate for the service as a whole, and the support offered concerning the transition to Reception class.
• All the children supported made progress above expectation. Improvement in their speech and language skills had a positive impact on the progress they made across other areas of the Early Years Foundation Stage Curriculum. The children showed greater self confidence and demonstrated reduced levels of frustration to those previously shown when interacting with others.
• Home nurseries reported an increase in their knowledge base in supporting children with severe speech, language and communication impairments.

Thanet pilot
• 90% of the children supported were able to attend their local primary school.
• Children demonstrated marked improvements in their use of language and understanding of language.
• The intensive intervention model led to an increase in parent’s confidence in meeting their child’s speech, language and communication needs.

Hot Tips:
• Identify dedicated resources for the scheme and have a contingency for staff vacancies.
• Establish a joint approach to meeting a child’s specific needs, which includes recognising that parents need to play a crucial role in improving the outcomes for the child.
• Establishing a close partnership working model between the virtual team, parents, the specialist nursery, and the home nursery/primary school is crucial.
• Transition meetings are very positively received by both parents and teachers.
• A strategic level commitment to mainstream an effective service once it has gone beyond the pilot phase is key, as is a commitment for dedicated staffing from all agencies and, potentially, a pooled or aligned budget.