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Speech and Language Therapy and Health Visiting

30th September 2016

A commitment to joint working by Speech and Language Therapy (SLT) and Health Visitor (HV) leaders in Leicester, Leicestershire and Rutland (Leicestershire Partnership Trust), led to a successful bid to DH which was the starting point for setting up a new pathway to get children talking and ready for school.

Any two-year old who is identified as being late to talk (often at the 2 year Healthy Child Programme universal contact) is now invited with their parents to a locally provided four-week group.

The ‘Let’s get Talking’ programme, written by the local SLT team, is led by a Community Nursery Nurse (CNN) who has received enhanced training in speech, language and communication. Each week a new idea is introduced to parents, for example to play face-to-face, to comment rather than to question, and to simplify their language. Parents are then given the opportunity to practise changing their style of interaction. Our goal is to support parents through this interaction to help their child to use more words and start to build sentences which a child needs in order to be able to communicate their needs, thoughts and ideas in readiness for school. The local Speech and Language Therapist attends one session of each group to continue to support the CNN and this helps joint decision-making about the most appropriate next steps for the child.

The pathway outcomes are very positive. At follow-up (2-3 months after the group) 63% of children who attended the group no longer required intervention.  Evaluation of parent confidence also showed a 60% increase.

A child’s story:

“I brought Mohammed along to see the health visitor because I was worried that he was only using about 6 words and not joining words together. The health visitor referred us to the Let’s Get Talking group which was starting 4 weeks later at the local children’s centre. I was a bit nervous about turning up at the group but it was very relaxed and friendly. There were 4 other families there and it was good to talk to other parents with children who were late talking.

At the first session the CNN told me how important it was to follow Mohammed’s lead and join in with his play, but I told her that Mohammed always runs off if I ever get down to play with him. While we were playing with Mohammed, I had a chat with the CNN about how I ask him lots of questions to try and get him to talk.  But she explained this might put him under too much pressure and what he needs is for me to just watch him and name the toys he is holding or say what he is doing.

I found it really difficult not to ask questions but then I started to realise that when I just said the name of the toy, Mohammed would look up at me and listen to me more. By the end of the group, Mohammed had started to like it when I got down to play with him and already he is saying some more words. I can see he’s learning now and I’m not so worried about when he starts nursery.”

Despite initial reservations about this new way of working, staff have seen the benefits, both for service users and also for working in partnership with their professional colleagues. This work has also acted as a catalyst for broader collaboration outside the health team. We are now working jointly with our local Higher Education Institute to co-deliver training to the next generation of HV and SLT students.

Liz Jackson and Louise Butchart, Speech and Languages Therapists

Nicy Turney, Professional Lead Health Visiting, FiHV