SPEECH, LANGUAGE AND COMMUNICATION

GIVING CHILDREN THE BEST POSSIBLE START IN LIFE

NHS EDUCATION FOR SCOTLAND

WHAT IS SPEECH, LANGUAGE AND COMMUNICATION?

Communication is the two way process in which individuals interact with others. Effective communication allows us to express our ideas, our wants and needs.

Children develop their speech, language and communication skills from birth and these skills develop through a child’s early years and beyond. The early years is a critical time for development of children’s speech, language and communication skills and is often referred to as a ‘window of opportunity’.

Children develop these skills gradually through interacting with others and the environment around them. Caregivers play a vital role in the development of children’s language and communication skills. Children learn at different rates and can vary considerably with regard to the rate at which they reach the various ‘milestones’.

 

Remember children do not always develop at the same time and in the same way. This guide describes how a child might develop speech, language and communication at different ages.

INTRODUCTION

Health visitors and Family Nurses play a key role in prevention, early identification and intervention for children through the early years of their lives in relation to Speech, Language and Communication.  This resource recognises the vital role of Health Visitors and Family Nurses in their ability to support families in relation to early speech, language and communication development.

Developed by NHS Education for Scotland to support the learning experiences of Health Visitors and Family Nurses in relation to speech, language and communication development, this resource complements wider learning experiences and signposts to relevant resources and further learning opportunities.

WHO IS THE RESOURCE FOR?

This resource has been developed for use by health visitors and family nurses in Scotland and acts as a guide from birth to five years. The Universal Pathway for Health Visiting is referred to during this resource as the key points of contact with children and their families.  This resource is intended for use to develop and extend the skills of both student learners and those who are seeking opportunities for continued professional development.

BACKGROUND

There is much evidence highlighting the importance of the early years of life in influencing outcomes in later life. The ambition in Scotland is to give all children the best possible start in life and for Scotland to be the best place for children to grow up.

The Early Years Framework (2008), Getting it Right for Every Child policy, the Universal Health Visiting Pathway and the duties and provisions set out in the Children and Young People (Scotland) Act 2014 all emphasise the importance of Health Visitors and Family Nurses in empowering parents/carers and supporting children aged 0-5 years achieve their optimum potential.

The All Party Parliamentary Group on Speech, Language and Communication difficulties (2013) highlighted a link between Speech, Language and Communication development and social disadvantage.  A link that is recurring and intergenerational in nature and has a profound impact on long term health and wellbeing of children and young people.

The importance of speech, language and communication development of children and young people is so significant that it is a feature of the Named Person role as defined in the Children and Young People (Scotland) Act 2014 with the Named Person Order (2016) requiring the Named Person to have had professional training in child development, and in assessing and profiling the speech, language and communication abilities of children, young people and their parents/carers.

This resource aims to guide the Named Person in the delivery of their public health role to children and their families in relation to speech, language and communication development Using the principles of GIRFEC and the Universal Health Visiting Pathway (Scottish Government) this resource aims to support Health Visitors and Family Nurses develop the skills and competence to work effectively in meeting the speech, language and communication components of the Named Person role.

LEARNING OUTCOMES

On completion of the resource (and undertaking other learning signposted in the resources) learners will be able to:

  • Describe normal speech, language and communication development in children aged 0-5 years, recognise abnormal speech, language and communication development and when there is a speech, language and communication needs.
  • Discuss factors impacting on the speech, language and communication development of children, their wellbeing and future outcomes and achievements.
  • Recognise speech, language and communication difficulties in parents/carers, as well as children and young people.
  • Discuss strategies to empower parents/carers to promote speech, language and communication development in children aged 0-5 years and to signpost to other services.
  • Describe their own role, and that of others, in promoting speech, language and communication development in children aged 0-5 years.

SPEECH, LANGUAGE AND COMMUNICATION DEVELOPMENT

The Pyramid below is often used to highlight the process of communication development in children.  The skills below have to be in place to act as a foundation for more complex skills to develop.  All these elements are important in order for children to communicate effectively. Each of these areas are multifaceted and multi-layered. Without aspects of any one of these elements, a child’s ability to communicate can be affected.

Click on each area to find out more about these skills.

  •  

    Speech refers to the sounds children use to build up words, saying sounds accurately and in the right places.  Children learn speech sounds by listening to the sounds they hear in languages around them. In each language there is a developmental order in which children typically develop sounds. (See linked Speech Sound Development guide.) Children develop their use of speech sounds over time. It is a gradual process and some children will progress more quickly than others.

    Speech can also refer to the ability to speak fluently, without hesitating, prolonging or repeating words or sounds.  Speaking with expression and a clear voice, using pitch, volume and intonation to support meaning.

    *SEE SPEECH SOUND DEVELOPMENT GUIDE

  •  

    Expressive language refers to a child’s ability to express their needs and wants. This includes having words to describe objects, actions and attributes. It is using these words to build sentences, conversations and narratives. It also refers to the ability to use the correct rules of grammar.

    It is important to consider all means a child uses to express themselves, including any non-verbal communication such as gestures, pointing or the use of any alternative/augmentative communication e.g. use of pictures, signs, communication books or high-tech communication aids.

     A child requires both opportunities in their environment to expressive themselves as well as reasons (a purpose) to communicate e.g. to express a choice, share their opinion etc.

  •  

    This refers to understanding of language. It is the ability to process and make sense of what people say. It is also how a child develops the understanding of non verbal behaviours and gestures. Children develop their understanding of words and also how to interpret the meaning of grammar.  Receptive language also includes the ability to follow instructions, understand concepts such as ‘on’ and ‘in’ and to interpret questions. A child’s receptive language skills are typically developed in advance of their expressive skills. As children grow they develop skills in their ability to reason, predict, draw inference and comparisons.

  •  

    Children learn to communicate by interacting with others. Recognising and responding to a child’s early attempts at communication are important as this re-enforces the value of communication. By interacting with others children learn the non-verbal rules of communication such as listening, looking and knowing how to take verbal turns. Children learn how to initiate interactions with others and take simple turns in an interaction. As children grow older they continue to learn through interacting with others. They being to learn how to change their language use to suit a given situation and to take into account other people’s perspectives and intentions.

    Play allows children to learn about the world around them. Learning through play is vital for the development of a child’s communication skills. Children need to have a variety of experiences to help them explore their world and practise skills which are important for learning, such as sharing and taking turns. There are several types of play which a child will learn gradually as he develops. In the second year of life children begin to engage in pretend play and then go on to develop more imaginative play. Pretend play is an important stage in supporting language development and often includes interaction with other adults and children.

  •  

    Attention and Listening skills are important for children to be able to make sense of words they hear, to respond to others and learn new skills such as developing their language skills.

    Children progress through stages of attention and listening development. They gradually learn how to focus on more than one task and shift their attention to and from tasks.

    Joint attention is one of the main building blocks for early interaction. Joint attention develops within the first year of life and is the basis of the development of effective communication skills. Joint attention is when the child responds to another persons’s focus of attention or seeks an other’s attention to share an interest or experience.

VIEW THESE GUIDES

FOR FURTHER INFORMATION ON THE GENERAL RANGE OF DEVELOPMENT FOR EACH AREA

SPEECH SOUND DEVELOPMENT GUIDE

EXPRESSIVE LANGUAGE DEVELOPMENT GUIDE

RECEPTIVE LANGUAGE DEVELOPMENT GUIDE

PLAY & INTERACTION DEVELOPMENT GUIDE

ATTENTION & LISTENING DEVELOPMENT GUIDE

BILINGUAL AND MULTILINGUAL DEVELOPMENT

 

Young children have the capacity to learn more than one language. Many children now grow up learning more than one language. Research has shown that being bilingual has many advantages such as being able to learn new words easily, being able to use information in new ways and developing solutions to problems.

Developing skills in two languages depends on the quality and amount of experience the child has using both languages. It is normal for bilingual children to mix rules from both languages or mix two languages in one sentences.

Growing up bilingual does not mean a child is more likely to have difficulties with their speech, language or communication.  If a child has a speech, language or communication need then this is likely to be evident across both languages.

Parents should be advised to speak the language they know best and feel most confident in so that children learn a good model of language. It is the quality of the parent-child communication that is important.

FOR MORE INFORMATION:

NHS Education for Scotland

102 Westport

Edinburgh

EH3 9DN

www.nes.scot.nhs.uk

OTHER LINKS

  • NES website
  • The Portal

©  NHS Education for Scotland 2018. You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes.  Use of this document for commercial purposes is permitted only with the written permission of NES.

BACKGROUND

There is much evidence highlighting the importance of the early years of life in influencing outcomes in later life. The ambition in Scotland is to give all children the best possible start in life and for Scotland to be the best place for children to grow up.

The Early Years Framework (2008), Getting it Right for Every Child policy, the Universal Health Visiting Pathway and the duties and provisions set out in the Children and Young People (Scotland) Act 2014 all emphasise the importance of Health Visitors and Family Nurses in empowering parents/carers and supporting children aged 0-5 years achieve their optimum potential.

The All Party Parliamentary Group on Speech, Language and Communication difficulties (2013) highlighted a link between Speech, Language and Communication development and social disadvantage.  A link that is recurring and intergenerational in nature and has a profound impact on long term health and wellbeing of children and young people.

The importance of speech, language and communication development of children and young people is so significant that it is a feature of the Named Person role as defined in the Children and Young People (Scotland) Act 2014 with the Named Person Order (2016) requiring the Named Person to have had professional training in child development, and in assessing and profiling the speech, language and communication abilities of children, young people and their parents/carers.

This resource aims to guide health visitors and family nurses in the delivery of their public health role to children and their families in relation to speech, language and communication development Using the principles of GIRFEC and the Universal Health Visiting Pathway (Scottish Government) this resource aims to support Health Visitors and Family Nurses develop the skills and competence to work effectively in meeting the speech, language and communication components of the Named Person role.

  •  

    Speech refers to the sounds children use to build up words, saying sounds accurately and in the right places.  Children learn speech sounds by listening to the sounds they hear in languages around them. In each language there is a developmental order in which children typically develop sounds. (See attached Speech Sound Development guide.) Children develop their use of speech sounds over time. It is a gradual process and some children will progress more quickly than others.

    Speech can also refer to the ability to speak fluently, without hesitating, prolonging or repeating words or sounds.  Speaking with expression and a clear voice, using pitch, volume and intonation to support meaning.

    *SEE SPEECH SOUND DEVELOPMENT GUIDE

  •  

    Expressive language refers to a child’s ability to express their needs and wants. This includes having words to describe objects, actions and attributes. It is using these words to build sentences, conversations and narratives. It also refers to the ability to use the correct rules of grammar.

    It is important to consider all means a child uses to express themselves, including any non-verbal communication such as gestures, pointing or the use of any alternative/augmentative communication eg use of pictures, signs, communication books or high-tech communication aids.

     A child requires both opportunities in their environment to expressive themselves as well as reasons (a purpose) to communicate eg to express a choice, share their opinion etc.

  •  

    This refers to understanding of language. It is the ability to process and make sense of what people say. It is also how a child develops the understanding of non verbal behaviours and gestures. Children develop their understanding of words and also how to interpret the meaning of grammar.  Receptive language also includes the ability to follow instructions, understand concepts such as ‘on’ and ‘in’ and to interpret questions. A child’s receptive language skills are typically developed in advance of their expressive skills. As children grow they develop skills in their ability to reason, predict, draw inference and comparisons.

  •  

    Children learn to communicate by interacting with others. Recognising and responding to a child’s early attempts at communication are important as this re-enforces the value of communication. By interacting with others children learn the non-verbal rules of communication such as listening, looking and knowing how to take verbal turns. Children learn how to initiate interactions with others and take simple turns in an interaction. As children grow older they continue to learn through interacting with others. They being to learn how to change their language use to suit a given situation and to take into account other people’s perspectives and intentions.

    Play allows children to learn about the world around them. Learning through play is vital for the development of a child’s communication skills. Children need to have a variety of experiences to help them explore their world and practise skills which are important for learning, such as sharing and taking turns. There are several types of play which a child will learn gradually as he develops. In the second year of life children begin to engage in pretend play and then go on to develop more imaginative play. Pretend play is an important stage in supporting language development and often includes interaction with other adults and children.

  •  

    Attention and Listening skills are important for children to be able to make sense of words they hear, to respond to others and learn new skills such as developing their language skills.

    Children progress through stages of attention and listening development. They gradually learn how to focus on more than one task and shift their attention to and from tasks.

    Joint attention is one of the main building blocks for early interaction. Joint attention develops within the first year of life and is the basis of the development of effective communication skills. Joint attention is when the child responds to another persons’s focus of attention or seeks an other’s attention to share an interest or experience.