Introduction:
Karen is a specialist Speech and Language Therapist with 25 years’ experience in early years. Following a 19 year career in the NHS in Northamptonshire, she has worked independently supporting children and families in their homes and helping practitioners and children in Early Years settings through government funding.
I am fortunate to work with many Early Years Practitioners across Northamptonshire and Leicestershire. The practitioners I meet have a strong foundational knowledge of speech, language and communication development. The activities they plan and prepare offer language rich opportunities for the range of children in their care.
Many practitioners are keen to access additional CPD opportunities and are aware of high quality programmes and resources available from organisations such as Elklan, ICAN and Speech and Language UK, which offer training and tools to support the professional development of nursery staff, teachers and childminders. This desire to improve their knowledge and skills has developed in response to the growing needs of children in settings and a reduction in outside professional support. During my visits to settings, it is common to hear that children are waiting for professional appointments and that they are unlikely to be seen before they start school. Practitioners often feel anxious about this as they strive to make sure children are ready for school.
The practitioners I work with are experienced at providing the language rich environments and interaction that children require when they need a “boost” with their language development. These children respond quickly and consistently to high quality interactions with sensitive adults during play. Increasingly, the question that practitioners are asking is how to differentiate and provide time and support to so many children with so many different presenting needs.
Why have speech, language and communication needs continued to rise since the end of pandemic restrictions?
As our first cohort of “Covid babies” start school, as Early Years professionals we are reflecting on why there is an increase in children’s speech and language needs, and why this is not decreasing as children’s lives return to normal following the pandemic.
A report by Speech and Language UK (1-3) estimates that 1.9 million children are behind with their talking and/or understanding of words - the highest number ever recorded. This is 1 in 5 children. This has increased since 2022 when the estimate was 1.7 million.
Recent research from the National Institute for Health and Care Research (NIHR) has shown that, in England, 14% of two-year-old children are failing to meet the communication level expected for their age. In disadvantaged communities this rises to 40%. Around 50% of children with language and communication needs are never referred for help. Socially disadvantaged and minority ethnic families are least likely to access support (4). Speech and language therapy services are in crisis with high referral rates, long waiting lists and high levels of vacancies (5).
What is the expectation of the EYFS?
“The development of children’s spoken language underpins all seven areas of learning and development. The number and quality of the conversations they have with adults and peers throughout the day in a language-rich environment is crucial. By commenting on what children are interested in or doing, and echoing back what they say with new vocabulary added; practitioners will build children's language effectively. Reading frequently to children….will give children the opportunity to thrive” (ref 6 page 9).
Why are there so many more children who are not responsive to adult interactions, therefore making it difficult to build language in this way? In a setting recently, a practitioner told me “the children don’t expect to be spoken to”. Another said “when I sit alongside her she moves away, she is suspicious, like I am a stranger sitting next to her on an empty bus”.
As Early Years professionals we are trying to navigate and understand some fundamental changes in how young children are developing.
The way we interact and connect with other people is changing
During the pandemic, children were exposed to technology more frequently and for longer than at any other time in history. The world moved online; work and school were conducted virtually at home. Parents used technology to entertain young babies, using tablets and phones much sooner than they may have thought about previously as they tried to navigate work and supporting online learning for older children. It became the norm. One study from this time actually showed an increase in children’s vocabulary development during the pandemic. This was attributed to the fact that parents shared screen time with their young children as they were together more at home (7).
As the world returned to normal, parents have continued to use technology as a way for their babies and children to learn, possibly with less interaction from adults. The use of phones and tablets has increased with younger children having access to their own devices. With the release of dopamine, the effects of prolonged screen time can act like a digital drug, which desensitises the brain’s reward system. Children need more and more access to get a response and this can lead to difficulties removing or limiting the devices. Children are happy to watch media sources, becoming absorbed in the virtual world of content designed especially for them.
Children are engrossed and quiet when watching programmes; therefore parents have been able to work from home more easily. This has led to children attending fewer sessions at nursery or starting late and finishing early as parents can work with them at home and save child care costs.
A recent article has summarised the growing body of research into the impact of technology on child behaviour, including: less parent-child reciprocity, fewer verbal interactions, fewer learning opportunities and a narrowing and decreased responsiveness to external cues (i.e. less likely to pick up on what is going on around them) (8). Whereas television exposure was previously a focal point for the whole family, it has become increasingly common for both children and adults to rely on handheld devices.
The American Academy of Pediatrics (AAP) advises a common sense approach to screen time, with under 18 month olds limited to video chatting and parental involvement essential for children from 18 to 24 months (9).
Parents often do not have access to information and professional support to understand the impact of unlimited screen time on brain development. Life is fast paced and there are many pressures on today’s families. The importance of play has reduced and many parents value the perceived educational benefits of technology and are impressed by their child’s skill to work devices, unaware of the effect it can have on joint attention, interaction and concentration.
The long term impact of the rise in technology (particularly individual hand held devices) is not yet known and we will have to wait for the research to confirm what we are witnessing in our early years settings – children are developing differently and we need to alter the way we teach children in order to help them to learn.
What can we do to help?
If many of the challenges that children face are due to the world around them (rather than genetic differences) then we can help them by making changes to the environment. Early Years Professionals have a hugely important role to play. You can and do make the difference.
My experience over the last two years has made me reflect on my own practice and the need to take more time when working with a child; going slowly and at their pace and allowing them space and time to think and opportunities to play and investigate a variety of resources.
When I visit settings, I work with practitioners to embed the principles of VERVE – developing communication through natural interaction (10). We look closely at the child’s interests and do not interrupt their deep level learning. This means sitting quietly with the child and waiting for them to “make the first move” by looking up, smiling or showing. This is our invitation to join in sensitively.
This approach works for all children with communication challenges. It aims to reset the balance of turns – ensuring that there is an equal amount of “serve and return” interactions. It focuses on slowing down and making connections. It has been successful for a range of children I have worked with; those with social communication difficulties, developmental delays, limited understanding and reduced vocabularies, stammers, selective mutism and unclear speech.
The world is fast paced and frenetic but children should be allowed a slower, more thoughtful, less rushed childhood in order to build secure relationships and embed the brain connections needed for successful future learning.
References:
https://speechandlanguage.org.uk/wp-content/uploads/2024/02/1.7-million-young-futures-FINAL.pdf
https://speechandlanguage.org.uk/the-issue/our-campaigns/speaking-up-for-the-covid-generation/
https://www.fundingawards.nihr.ac.uk/award/NIHR156329
https://www.rcslt.org/news/rcslt-workforce-and-vacancy-survey/
https://warwick.ac.uk/newsandevents/pressreleases/impact_of_covid-19/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820972
https://www.commonsensemedia.org/articles/how-much-screen-time-is-ok-for-my-kids
VERVE interaction: http://www.keenacummins.co.uk/