The health visiting pathway: 4-5 years
How I grow up and develop
ATTENTION AND LISTENING
- Attends to activities with other children in a small group.
- Can attend to activities for around 10 -15 minutes.
- Can listen whilst also completing another activity such as playing.
PLAY AND INTERACTION
- Can take part in a conversation with adults or other children.
- Plays together with others with shared aims.
- Begins taking turns and negotiating.
- Will take part in a sequence of pretend play and will make use of language as a commentary to this.
- 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.
RECEPTIVE LANGUAGE (UNDERSTANDING)
- Can show good conversational understanding.
- Can show an understanding of describing words and 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 longer, more complex instructions.
- Beginning to predict what might happen next.
- Understands past and future time concepts.
- Is beginning to use language in different ways e.g. to relate past events as well as to comment, name or ask questions in relation to the here and now.
EXPRESSIVE LANGUAGE (USE)
- By 5 years a child can tell a story with a beginning, middle and end.
- Can tell you what happened in the past and what is about to happen next.
- Has developed a vocabulary of 3000-5000 words.
- Can use longer, more complex sentences.
- Sentences are generally grammatically correct.
- Beginning to plan, question, negotiate, predict and reason.
SPEECH SOUNDS
- 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.
- Longer words may still be shortened.
- Certain sounds eg ‘r’ ‘th’ are still developing.
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.
What I need from people who look after me
Promoting Interaction
- Encourage turn-taking and awareness of verbal turns in conversations.
- 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.
- Allowing time for children to process information and respond.
- Using a slower pace can be helpful in allowing time for children to initiate and respond in interactions.
- Avoid correcting a child’s speech. 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
- Repeat child’s words, adding new information to expand their ideas and model the correct grammar.
- Repeat the child’s words and add another idea or new vocabulary.
- Ask questions which develop and extend a child’s thinking, talk about ‘why’ things happen.
- Encourage children to talk about events that have happened in the past.
- Use a variety of questions: Asking a variety of open 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 to allow for a quiet, distraction free time for communication and interaction.
- Consider how screen time is influencing the child’s opportunities for interaction, ensuring there are lots of opportunities for talking and interacting together.
Opportunities
- Play provides lots of opportunities to build communication skills, especially 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 will support communication skills.
- Play board games that involve turn taking encouraging listening, concentration and discussions.
- Develop understanding through books: Talk about feelings and emotions, encourage prediction and inference.
- Go out a daily walk and talk about what your child is seeing, adding new words to their vocabulary through synonyms and antonyms.
My wider world
- Communication capacity underpins realisation of wellbeing (SHANARRI).
- Effective communication is vital in supporting informed choice and upholding children’s rights to express their views (UNCRC): supporting children, young people and families in understanding what help is possible and what their choices may be.
- In some areas, particularly areas of social deprivation, between 40 and 50% of children are starting school with delayed language.
- Which factors are associated with better and poorer SLC outcomes? | Early Speech, Language and Communication Development: Which Factors are Associated with Better or Poorer Outcomes? | Resources | Education Scotland.
- 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.
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.
Resources
For professionals
- Parent Club website is the host for the Chatting Together messages for bumps to babies, and toddlers to young children and has accompanying videos to share with families.
- Chatting Together Messages | National Early Language and Communication (NELC) Project.
- Bookbug for the Home training: Fully funded training available for midwives and health visitors who are working closely with families and would like to use stories songs and rhymes on a one-to-one basis to support families.
- Dolly Parton’s Imagination Library: If children are Looked After when they are born or are care-experienced at any point between birth and 5 years, they will be eligible for Dolly Parton’s Imagination Library. Professionals can make families/carers aware or ensure that children are signed up through their local social work department.
- The Scottish model of infant participation: Key Messages for Best Practice: 2 - Voice of the Infant: best practice guidelines and infant pledge - gov.scot.
For parents
- Parent Club website is the host for the Chatting Together messages for bumps to babies, and toddlers to young children and has accompanying videos to share with families.
- Chatting Together Messages | National Early Language and Communication (NELC) Project
- CBeebies Parenting Activities for babies, toddlers and children.
- You can also find books and resources in the baby bookbug bag and many recordings of popular songs and rhymes on the free Bookbug app.
- Ready Steady Baby has lots of information and resources to support early development.
- Solihull free resources for parents (using code TARTAN) inourplace | Solihull Approach – Scotland | inourplace.
- Understanding your baby
- Understanding your child: from toddler to teenager
- Understanding your child with additional needs
- Understanding your child's feelings
- Understanding your child's mental health and wellbeing
- Understanding the impact of the pandemic on your child