Toddler toolkit which can identify speech and language problems to be rolled out

Health visitors across England are to be trained to use a toolkit which can identify very young children with speech, language and communication problems.

They will use a simple word list and child observation - known as the Early Language Identification Measure (ELIM)- during routine home visits when children are aged two and two-and-a-half.

Research led by Newcastle University with the University of Aberdeen, published in a new Public Health England report, shows the ELIM can identify 94% of toddlers with early language needs.

Numerous research studies have shown that children with delayed language development do worse at school and have poorer outcomes later in life. It can also signal other developmental conditions such as autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD).

University of Aberdeen Professor of Primary Care and Rural Health, Phil Wilson, said: “Early language problems are strongly associated with a range of developmental problems in childhood. They are also a powerful predictor of poor physical and mental health later in life, so it is important to pick them up in a reliable way. 

“The results from this research programme will soon make a difference to every child in England because we now have both an effective way for health visitors to identify children at risk and a robust pathway for these children to get the right kind of help. Hopefully a similar approach will be adopted in Scotland before long.”

James Law, Professor of Speech and Language Sciences at Newcastle University’s School of Education, Communication and Language Sciences, who led the study, said: “Early speech and language delays can be a worry for parents and professionals alike and researchers have been looking for ways to accurately identify children who would benefit from help. The research suggests the Early Language Identification Measure does just this and more accurately than others.

“Once the right children have been identified the key is for parents and other professionals, such as health visitors and early years practitioners, to work together to find out what would most help the child. For children with the most marked difficulties this may be speech and language therapy but it may be finding out more about the languages the child uses or pointing them to resources that help them better understand their child’s needs.”

In 2018 a team led by Professor Law was commissioned by Public Health England (PHE) and the Department for Education (DfE) to develop a measure of language skills and an accompanying intervention for children attending their health visitor review at 24 and 30 months of age.

The project ran between January 2019 and July 2020 and involved health visitors, early educators and speech and language therapists in five areas  - Derbyshire, Middlesbrough, Newham, Wakefield and Wiltshire.  More than 800 children were assessed and the ELIM identified 94% of youngsters who needed support.

When a child was identified as needing support, the health visitors would talk with their families to discuss the best ways to help the youngster. Support offered ranged from  using online resources to including exercises in everyday life.

“As every family’s needs are different what is required is a carefully constructed conversation looking to match the child and families’ needs with the resources that are available. Every conversation is different,” explains Professor Law. “The key thing is for the practitioners and parents to work together to provide solutions so that the child can be ready for school when the time comes.”

The health visitor training programme will begin in January 2021.

The research was carried out by researchers at Newcastle and Aberdeen Universities, the Bristol Speech and Language Therapy Unit, the Institute of Health Visitors and Robert Rush, an independent education researcher.