HOW I GROW UP AND DEVELOP
WHAT I NEED
FROM PEOPLE WHO LOOK AFTER ME
MY WIDER WORLD
SUPPORT
THE HEALTH VISITING PATHWAY
4 - 5.5 YEARS
NHS EDUCATION FOR SCOTLAND
SPEECH, LANGUAGE AND COMMUNICATION
GIVING CHILDREN THE BEST POSSIBLE START IN LIFE
A vocabulary of 3000 - 5000 words.
By 5 years a child can tell a story with a beginning, middle and end.
Can plan, question, negotiate, predict and reason.
Can use complex sentences.
Sentences generally grammatically correct.
Longer words may still be shortened.
Certain sounds eg ‘r’ ‘th’ are still developing.
Child’s speech can be understood by most people.
Using a fuller range of speech sounds and their speech is becoming clearer. however, the speech sound system and clarity is still developing at this stage.
Will take part in a sequence of pretend play and will make use of language as a commentary to this.
Is beginning to use language in different ways eg to relate past events as well as to comment, name or ask questions in relation to the here and now.
Will react to other people’s facial expressions and feelings.
Increasingly able to interact appropriately with a range of people. Starts to change the style of interaction depending on the situation.
Can show good conversational understanding.
Can show an understanding of concepts such as size, colour and position.
Shows abstract understanding and uses language to talk about things beyond the immediate situation.
Understands questions relating to past experiences.
Follows complex instructions.
Beginning to predict what might happen next.
Understands past and future time concepts.
Attends to activities with other children in a small group.
Can attend to activities for around 10 - 15 minutes.
Can take part in a conversation with adults or other children.
SPEECH, LANGUAGE AND COMMUNICATION DEVELOPMENT KEY
LOOK OUT FOR
- lack of eye contact
- extreme distractibility
- dysfluency (stammer)
- unable to follow instructions and respond appropriately within a simple conversation
- unable to put words into sentences or forms sentences that don’t make sense
- lack of flexibility, changes of routine are found to be a challenge
- play is repetitive or lacks imagination
- speech is frequently difficult to understand, even to close family.
- poor social skills with peers within play. Difficulty initiating or sustaining an interaction with peers or an adult
- hoarse voice or abnormal voice quality
- Parental concern
PROMOTING INTERACTION
- Encourage turn-taking and awareness of verbal turns in conversations
- Proximity: Children will communicate more when they are face to face with an adult
- Following a child’s interests encourages them to communicate about what is important to them.
- Waiting: Allowing time for children to process information and respond.
- Pace: Using a slow pace, allowing time for children to initiate and respond in interactions.
- Praising attempts at communication. Correcting a child’s speech may affect the interaction. Focus on what the child is saying, not how they are saying it. Provide a correct model for the child to hear.
PROMOTING LANGUAGE
- Expand: Repeat child’s words, add new information and model the correct grammar.
- Repeat the child’s words and add another idea or new vocabulary
- Extend thinking: Ask questions which develop child’s thinking, talk about ‘why’ things happen
- Encourage child to talk about events that have happened in the past.
- Use a variety of questions: Asking a variety of questions, avoiding ‘test’ questions e.g. ‘what colour is that?’
- Extend a child’s vocabulary- add news word, highlight and explain new vocabulary
- Develop awareness of rhyme and sounds
ENVIRONMENT
- Try to limit distractions such as tv, background noise
- Consider how screen time is influencing the child’s opportunities for interaction.
OPPORTUNITIES
- Play where an adult takes part in play as a partner and builds on the child’s interests and ideas.
- Opportunities for social interaction with peers
- Develop understanding through books: Talk about feelings and emotions, encourage prediction and inference
Communication capacity underpins realisation of wellbeing (SHANARRI)
Effective communication is vital in supporting informed choice: supporting children, young people and families in understanding what help is possible and what their choices may be
Pre-school into primary transitions are critical times of change for children and their families. Transitions can be particularly challenging for children and their families with Speech, Language and Communication Needs.
In some areas, particularly areas of social deprivation, between 40 and 50% of children are starting school with delayed language. (Law et al 2011)
Vocabulary at age five has been found to be the best predictor (from a range of measures at age five and ten) of whether children who experienced social deprivation in childhood were able to ‘buck the trend’ and escape poverty in later adult life. (Blanden 2006).
Health Visitors and Family Nurses play a key role in prevention and early identification of Speech, Language and Communication Needs. Below are some suggested ways of supporting families and signposting them to relevant support services:
- Consider any support a parent with Communication Support Needs may require. Parents with CSN may be less able to access additional supports and information that could assist with their child's development. Ensure you are aware of parents communication preferences and can respond appropriately to these.
- Ensure all information is ‘communication accessible.’
- Demonstrate and discuss positive interaction skills.
- Where there are capacity issues for parents, consider other family members who might be able to help – grandparents, older siblings – and give them key messages
- Signposting: Attending local Bookbug sessions, or other community resources can support the attachment and communication process.
- Tips and advice on effective strategies to promote language and social development for sharing or signposting with parents can be found on the bumps to bairns website
- Play, talk, Read website contains many ideas and examples of positive interaction.
- Use of evidence based tools to profile a child’s speech, language and communication abilities and needs. (eg ASQ 3)
- Effective multi-agency approach
- Consider Motivational Interviewing/ Health Coaching Strategies: Health Behaviour change e-learning suite
-
Using the elicit-provide-elicit model of sharing information and checking understanding.
- Elicit - what the parent/carer knows already
- Provide - fill in any gaps or misconceptions
- Elicit - Explore that fits with family life
- Using open-ended questions, active listening, reflecting back and summarising. (For more information on these techniques see NES Motivational Interviewing resource).
- Using a collaborative communication style - working in partnership with families, empowering them to solve issues and make decisions.
RESOURCES
Key features of successful transitions at all stages
- Effective multi-agency approach
- Involving parents and young people in planning,
- Building positive, trusting relationships
- Quality Communication
- Effective planning and organisation
- Effective identification of learning needs
- Involvement of parents and child
- Sustained monitoring and support post transition
FOR PROFESSIONALS
Further reading around effective transition to primary school
FOR PARENTS
Words Up – parent-friendly posters explaining development and key messages
Tips for parents and professionals in supporting children with their transition to primary school
REFERENCES
Blanden J (2006) Bucking the Trend – What enables those who are disadvantaged in childhood to succeed later in life? London: Department for Work and Pensions
Blaisdell C, Mountney K, McNair L. 2014 , Transition to primary school: What factors affect children’s transition to primary school, and are there factors which mean that some children manage better than others? What can help in managing transitions, and what are the barriers for services and families? Edinburgh: Evidence Request Bank
Buckley, B. 2003. Children’s communication skills from birth to five years. London: Routledge
Law J, McBean K, Rush R. 2011. Communication skills in a population of primary school-aged children raised in an area of pronounced social disadvantage. International Journal of Language and Communication Disorders, Vol. 46, No 6, pp 657 – 664
NES Motivational Interviewing resource
Sharma A., Cockerhill H. 2014. Mary Sheridan’s From Birth to Five Years: Children’s Developmental Progress. 4th Edn. London: Routledge
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