Speech, Language and Communication Support for Children

Rebecca Pow Excerpts

Wednesday 4th July 2018 Westminster Hall

[Rebecca Pow (Taunton Deane) (Con)]

I beg to move,

That this House has considered speech, language and communication support for children.

It is a pleasure to serve under your chairmanship, Ms Dorries, especially given your own interest in communication, reading and writing.

[Ms Nadine Dorries (in the Chair)]

Order. I am sorry to interrupt, Ms Pow, but I notice that a lot of Members are wearing jackets. There is a temporary air conditioning unit in the room, but I am not sure how effective it will be. If anybody wishes to remove their jacket, they should feel free to do so.

[Rebecca Pow]

Thank you, Ms Dorries.

The most fundamental life skill for children is the ability to communicate, which has a direct impact on their ability to learn and develop friendships, and on their life chances. There are huge benefits to getting communication—speech and language development— right from birth, not just to the individual but to society and the economy as a whole. However, despite the best efforts of many involved in supporting children and young people, and some tremendous individual projects and programmes, such as the Royal College of Speech and Language Therapists, which I welcome here today, the communication champion Jean Gross, the Communication Council, the charity I CAN, and many more, including individual teachers and early years staff, awareness of the importance of children and young people’s speech, language and communication among the public and decision makers still seems sadly lacking. That has a serious impact on individuals and society, hence this debate.

Mr Speaker must be commended for his dedicated interest in this area, and for the Bercow report, a seminal piece of work that was carried out 10 years ago. It was an independent review of the state of provision for children with speech, language and communication needs—that is a bit of a mouthful, so I will refer to it as SLCN. Much good work flowed from that excellent report, including the better communication research programme, and the communication champion I mentioned. However, the recent follow-up report, “Bercow: Ten Years On”, which was published in March by the children’s communication charity I CAN and the Royal College of Speech and Language Therapists, and launched in style in Speaker’s House with, I am pleased to say, the Minister in attendance, revealed that despite pockets of great achievement, not enough progress has been made, and that it is a Cinderella sector.

I surmise that that may be linked to the fact that the whole area seems to fall between two stools: health and education. Somehow, it fails to be allotted the place it deserves in this country’s national policy. The second report highlights that, as a nation, we are yet to grasp the significance that not fully focusing on the importance of speech, language and communication has on younger generations and therefore on society as a whole. As a result, thousands of children and families suffer needlessly.

Evidence gathered in the report from thousands of contributors concluded that 1.4 million children and young people in the UK have SLCN. That is 10% of children and young people. Of those, 7.6% have developmental language disorder, which is a condition where children have problems understanding and/or using the spoken language and there is no obvious reason, such as a hearing problem or a physical disability, to explain those difficulties. The rest of that 10% have language disorders associated with other conditions, such as autism or a hearing impairment, plus other difficulties, including stammering. I will not address those conditions; this debate will concentrate on the 7.6% with developmental language disorder. Left untreated, it will adversely affect them for the rest of their lives.

I am interested in this area for a raft of reasons. Much of my career has been spent as a journalist and broadcaster, so communication has been a crucial part of my world and I appreciate how important it is. I also ran a small business. Even as MPs, we are employers, and when we are looking to take someone on, we are often looking for someone who can communicate—someone who is pleasant, amenable, good with words and able to converse and write clearly. Speech, language and communication skills are essential in our world. Most importantly, I am interested in this area as a parent. I have brought up three children with my husband, Charles, who I hope might be listening, so I am aware that parents can make a real contribution to helping their children develop their communication skills.

[Jeremy Quin (Horsham) (Con)]

My hon. Friend is making a powerful speech on an interesting topic. To pick up on her point about the value of communication in all professions, we should not forget teachers and the ability to train them through voice coaching. Two Essex multi-academy trusts have invested heavily in voice coaching for their teachers, and they have a much enhanced retention rate of 90%. Ensuring that teachers are educated, coached and assisted helps retention, and it provides a powerful example for the children in their care.

[Rebecca Pow]

I will move on to talk about teachers and their role, including the things they have noticed and how we might help them. It is such an important point. I am particularly interested in those voice coaching projects.

I mentioned the detrimental effect that poor communication skills can have on children. Affected children do less well at school. From the get-go, they make less academic progress in the early years foundation stage than their contemporaries, and when they leave primary school their attainment in reading, writing and mathematics is much lower than those without SLCN. The report states that only 15% of those identified reached the expected standards. Unsurprisingly, those children are also affected at GCSE level; only 20.3% of SLCN children gain a grade 4 or C or above in English and maths at GCSE, compared with an expected 63.9% of all pupils. The pattern is clear: poor SLCN attainment will directly affect their academic progress.

On top of that, unfortunately, there is a high chance that those children will develop mental health issues. In fact, young people referred to mental health services are three times more likely to have SLCN. There is also a strong correlation between emotional and behavioural disorders and language difficulties.

[Nick Smith (Blaenau Gwent) (Lab)]

I thank the hon. Lady for her leadership on this subject, and it is great that she has secured the debate. The report’s recommendations on youth justice are really important, and it is clear that speech and language therapists can play a big part in reducing the risk of reoffending. Does she agree that it is important that those services are provided as early as possible to young people in the youth justice system?

[Rebecca Pow]

I know that the hon. Gentleman is particularly interested in this area. He makes a valid point, which I will move on to, because it all links up.

Everything I have mentioned so far affects children’s life chances. As the hon. Gentleman just said, that is borne out by the fact that 60% of young offenders have unidentified speech, language and communication problems, so the link between the two is stark. Children with poor vocabulary skills are twice as likely to be unemployed in later life. Young offenders are often put on courses, such as anger management and drug rehabilitation, to try to help them, but if they do not have good reading, writing and communication skills, it is difficult for them to take advantage of those courses. I am sure that you will agree, Ms Dorries, that none of those things is desirable in a 21st-century society.

There is even more to these findings, because many of these children come from areas of social disadvantage. There is a very high prevalence of SLCN among vulnerable children, particularly looked-after children. Again, looked-after children are highly represented in the criminal justice system—the 60% figure emerges again. Unsurprisingly, many excluded children are also found to have SLCN, particularly boys—one study found that 100% of excluded boys had some sort of communication or behavioural disorder.

Unsurprisingly, the children of mothers who sadly have mental health issues, that develop just before or after birth, are often found to display SLCN, probably because as babies they did not receive the crucial stimulation they needed, which is so important from the absolute outset. Such children do not develop the essential language skills. Again, that highlights how important it is to pick up mental health issues in mums as early as possible, because they can have a knock-on effect on the babies.

Parenting is really important, so I will talk about that for a moment—it is not a digression, because it is all directly related. This issue affects not only people from disadvantaged areas, but all of us, wherever we come from. It was motherhood that prompted my interest in the importance of early communication. My sister is a speech, language and communication therapist specialising in early years children—I may have to register an interest. She made me aware of how I ought to engage with my babies from the word go. I do not think I had even held a baby before I had my own children, so I was pretty ignorant about children. I am not saying that my children are model success stories, but I have to say that the tips I was given really helped.

They were just simple things. For example, from birth to three months, parents should get very close to their baby, so that it has eye contact and starts to recognise the mouth, and learns that that is where sounds come from. If children are just sat down in front of a television or a laptop, they will not start to realise that. At six months, a baby starts to become very aware of its environment, so parents should start to talk about the things they are looking at. Obviously, they are not speaking at that point, but they are looking, so parents should start naming the object they think their baby is looking at, whether it is a dog, a cat, a mug or a cup. Then, from nine to 12 months, parents can start to expand on that. Their baby might be in a high chair and pointing at a cup, so the parent should say the word, and they should say it many times, because repetition is how our children learn. Many people think that children do not really communicate until they start talking, but of course they are; they are picking up all those vital signals that will help them to start forming words. It is an utterly fascinating subject.

I am told that dummies really are a no-no. Nursery staff I have spoken to have borne that out. If a dummy is put in a child’s mouth too often, it can affect the way the mouth develops. I discussed that only recently with a specialist facial consultant at Musgrove Park Hospital, and she agreed that we do not want to influence what happens in a baby’s mouth, because that has to grow and develop as well.

I will turn now to an area that I know is close to your heart, Ms Dorries: reading stories, poems and even songs. We can never do enough of that with our children, starting from the word go. I recently read an article by the author Philip Pullman, in which he bemoaned the fact that, sadly, not enough children are read to anymore and that the bedtime story is disappearing. Indeed, staff at a nursery in Taunton that I visited recently told me that many parents are ditching the bedtime story. The bedtime story is a crucial way for children to learn how to communicate, and again it is not to do with how wealthy someone is, or how smart they are. It is a cheap activity—almost free—that can help our children so much.

Some very interesting research on teaching effective vocabulary produced by A. Biemiller has shown that at age seven relatively high-performing children have an average of 7,100 words in their repertoire and that they can learn, on average, three words a day. However, relatively poor-performing children have an average of 3,000 words in their repertoire and learn, on average, one word a day. That is an enormous gap to fill if those relatively poor-performing children are to catch up when they get to school—I am told on good authority that it is almost impossible for them to catch up. Vocabulary at age five is the best predictor of a child’s outcomes at GCSE level.

[Ruth Smeeth (Stoke-on-Trent North) (Lab)]

I thank the hon. Lady for securing such an important debate. Stoke Speaks Out is one of the national exemplars of how to engage with this issue. Does she agree that we need sustained funding for such programmes? We have seen engagement in this work. In my constituency, 84% of children were 12 months behind in oral skills at the age of two. There was heavy investment and they eventually did well in their GCSEs, but funding was pulled for the children in the next years and we saw an exact inverse relationship in their long-term attainment. Does she agree that, in order to break the cycle, we need sustained funding for every year?

[Rebecca Pow]

I thank the hon. Lady for her intervention; she makes a good point. I have heard about that extremely good project, and there are others. I know that the matter is on the Minister’s agenda. I think that this is a process of joining up the dots, so that we can make good progress, because it is really coming to light how important this issue is for society as a whole. We cannot expect teachers to do it all. They must be able to pick up where they have to, and rightly so, but there is a lot that parents can do, and we could give them many more pointers when they have children. We must engage society on the whole issue

To pick up on the hon. Lady’s point, many nurseries and primary schools in Taunton Deane have joined me in supporting the idea that we ought to engage with parents to encourage them to do a little more. For example, staff at Topps Nursery at Musgrove Park Hospital, which I visited last week, are really concerned about the number of children arriving at their door who simply do not have the expected communication skills, whatever their age. Many of those children are not potty-trained, which is a problem, but many also lack basic communication skills. It was the staff at that nursery who mentioned dummies and said, “Please don’t use them.” They also expressed concern about too many children being dumped in front of gadgets, so that they are not stimulated and do not have normal levels of human contact.

I also met a couple of headteachers from two of my really excellent primary schools, St George’s Catholic School and Trull Church of England VA Primary School. When I mentioned that I had secured this debate, both of them said that they had experienced a marked rise in the number of children who do not talk when they start school, who cannot hold a conversation, who do not listen, who have speech problems and who therefore have poor social interaction skills. I was quite taken aback when they so quickly came up with this list of issues that our teachers are clearly facing. Of course, those issues put an added burden on our already hard-working and professional nursery and teaching staff and practitioners.

[Fiona Onasanya (Peterborough) (Lab)]

I thank the hon. Lady for securing this important debate. She is eloquently explaining the factors that inhibit our children’s development of communication skills. It is more than 10 years since Mr Speaker produced his first report, so does the hon. Lady agree that it is now time to implement its recommendations? In my constituency there is a lady called Helena, who was diagnosed with selective mutism and social anxiety. It is felt that if she had received the support she needed as a child, she would now, as an adult, be better able to contribute to society. However, she has great difficulty communicating and so is unable to work or go out alone. Does the hon. Lady agree that implementing the report’s recommendations would help such people?

--- Later in debate ---

[Rebecca Pow]

I thank the hon. Lady for that intervention. Of course I agree; early intervention is very much what we are talking about today. Intervention happens across the board in so many areas, but the earlier we can intervene to prevent an issue from escalating, the better—not only for the individual, but for society and the economy, because ultimately we will spend less money sorting it out. I spoke to one of my constituents, Clifford Mann. He heads up Musgrove Park Hospital A&E, but he is also the national clinical adviser for A&E. Although one might not think that this is his area, he expounded vociferously on the need for proactive pre-school engagement with this agenda—and others, such as tackling obesity—because it will pay dividends later for the NHS.

I do not want to be wholly negative, because there are already some exceptionally good programmes out there, doing good work and showing that we can improve in this area, not least the programme that my sister was involved in with Worcestershire Health and Care NHS Trust, which is quoted in the report as a model project. It references lots of other very good projects, such as the Time to Talk project in Warwickshire, the No Wrong Door project in North Yorkshire, and Better Start Southend. Another excellent project in my constituency is A.R.R.O.W. Tuition, run by Dr Colin Lane. It is a very good model that works really well: a multi-sensory blend of techniques combining established and innovative learning strategies, with the student’s own voice central to the approach. That touches on what my hon. Friend the Member for Horsham (Jeremy Quin) mentioned—using the voice to train and encourage—and it really does work.

Dr Lane has run a trial project—he has projects all over the place, but I suggested that he speak to Taunton Academy, which is in a very disadvantaged part of Taunton. The academy has its issues, but it is really turning things around. It got in touch with me the other day to say that they took on Dr Lane’s project and it is working absolute miracles in the school. I am going back next week to present some prizes to the children, who have made so much progress with their speech and language. This is a project to help children once they are in school, so there are good projects, and I would appreciate the Minister’s views about how more of these projects can be harnessed and how we might integrate this very good practice and make the most of it. We do not need to reinvent the wheel; we could just engage some more of these projects.

However, despite clear evidence of the huge benefits that improving children’s communication skills can bring, the second Bercow report highlighted that many parents and carers found it difficult to find help for their children. They were not sure where to go, and I have to admit that I had difficulties trying to find out where one would go in Somerset. When those parents and carers did get appointments, waiting times were long and many found the support wanting.

What needs to be done to tackle the clear communications crisis among our children, and thereby improve social mobility, health inequality and employment for so many people? There are some pretty straightforward steps, building on the good foundations that this Government have already put in place and are working on. First, there should be clear messages from the start, raising awareness of the real difference that addressing the issue could make. Secondly, simple guidance should be provided to parents. For example, I am going to put something on my website. How about writing to all parents who have just had babies, offering ideas and suggestions? I am sure that there are some simple things we could do.

As my hon. Friend the Member for Horsham mentioned, there should also be training for practitioners, including health visitors. Health visitors are so often the ones on the frontline who get sent in; it is largely they who spot the really difficult cases and deal with them. I recently spoke to Alison Kalwa, one of the wonderful health visitors in my constituency. She said, “Just give me a few more hours and a bit more time, and I could make so much difference with language development skills with the mum or dad and their baby.”

Having been to the launch of the Bercow report, I raised a lot of these issues in a letter to the Prime Minister, and I was really pleased with the interest she took in her response. She referenced the Department for Education’s plans to work with Public Health England to enable health visitors and early years practitioners to identify children’s SLCN early and put the right support in place. I would very much welcome the Minister saying a little more about that.

Overall, we need an overarching strategy with speech, language and communication at its core, and with a recognition that early identification is key. I very much welcome the recent announcement of an additional £20 billion for the NHS. One of the planks of that is mental health, so perhaps we have an opportunity to engage and harness some of that funding to work on communication needs so that we can prevent people from developing mental health issues in the first place. That is where it would be so important for health providers to link together, with all the public bodies playing their part, including Public Health England, NHS England, the Care Quality Commission, NHS Improvement, Ofsted and the Youth Justice Board, which brings in the point that the hon. Member for Blaenau Gwent (Nick Smith) made about offenders.

How about including children’s SLCN in those sustainability and transformation plans we keep hearing so much about? Of the 44 sustainability and transformation plans published in 2016, only three mention the issue. Surely there must be scope there. Perhaps Ofsted inspectors can be trained to ensure that children’s communication is part of everyday life. What is overridingly apparent to me is that the issue must be approached jointly by the health and social care sector and by the education sector—even in deciding which Minister we might like to answer us. It causes a slight dilemma: should it be the Department for Education or the Department of Health and Social Care? Who would it be better to raise the issue with? I am optimistic that this Minister has great links and communication skills and will hotfoot it to the Department for Education so that they can work jointly. I would love to hear his views on that.

I am optimistic that the Government can work on the issue, and it is brilliant that all these things are coming to light and so much work is being done. While I am at it, I have to put in a bid for something. In Parliament I often focus on issues relating to the environment, nature and the countryside, and one thing I have noticed is that many teachers and nursery practitioners have said how our children adore forest schools and getting outside to commune with nature. That is a great way to stimulate them and get their communication skills going, so let us work some of that into what we do as well. Things should not all be separate. Forest schools are a great way of engaging our children.

To sum up, if communication was given the priority it deserves, the 1 million-plus children in England who are suffering with communication problems could be helped. We should be thinking about the 7.6% whose life chances could be improved. Not addressing the issue will be a cost to society and the economy. If there are things out there that we can do to help, we must try to do them. If the issues are addressed, by engaging some of the excellent recommendations outlined in the second Bercow report, we will have wins for the individuals, for society and for the economy as a whole.

--- Later in debate ---

[Gareth Snell]

Yes, thank you—I was almost there.

That demonstrates to me that there are some wonderful ways in which we can start to tackle this problem, but the work has to be systemic and it has to be continued.

I will ask the Minister some important questions. How do the Government see early intervention work continuing, particularly for young people who are not in nursery provision before going to school?

[Rebecca Pow]

On the subject of different charities doing good work, in my constituency we have two really good branches of a charity called Read Easy, which work with adults on adult literacy. A lot of adults are scared to admit that they cannot read, but it is a really gentle, lovely way of engaging adults, because of course they cannot help their children if they cannot read properly themselves. The hon. Gentleman made a very good point about that.

[Gareth Snell]

Once again, the hon. Lady is absolutely right. The headteachers I have spoken to in Stoke-on-Trent say that once they can get parents, who may have had quite an unpleasant time at school themselves, into the school and show them that it is a safe environment for them as well as their children, the engagement levels with those parents increase. Suddenly, the child’s homework gets better, the reading diary is filled in, there is more interaction with the school for pastoral and social events, and the family becomes a much more engaged part of the school community rather than simply dropping their children off and picking them up in the afternoon.

I would be grateful if the Minister explained what the Government can do on early intervention, because it looks as if many of the future funding promises will be geared towards schools, which are already overstretched. If we can reach young people before school, we can close the gap and ensure that their opportunities for learning are increased.

I would also be grateful if the Minister, if he is unable to answer today, could at least think about longer-term aspirational plans. Stoke-on-Trent is an opportunity area, with two wonderful co-chairs, Professor Liz Barnes and Carol Shanahan, leading the way. They know that early intervention and breaking the cycle early on is important. Will the Minister tell us how he sees that programme being funded sustainably? The opportunity area is a three-year programme and they will do what they can in their three years, but that period will run out. How can we embed that work into our culture and society?

The schools in my constituency are working absolutely flat out to address this issue. I know that this is not a debate about fairer funding arrangements, but is there anything that the Minister could do to consider schools in areas such as Stoke-on-Trent, where deprivation levels are higher than we would like them to be on every metric? Might there be longer term intervention programmes for our city? We need to make sure that the generation of MPs who follow me and my hon. Friend the Member for Stoke-on-Trent North are not also discussing this issue.

--- Later in debate ---

[Rebecca Pow]

I thank the Minister, in particular for sharing his experience—I had no idea that he could not speak English until he was 11; it is remarkable how far one can go—and for his clear passion. I hope that stands us in good stead to answer some of the questions that have been raised. I hope that we can work together.

I thank all Members who took part in the debate: my hon. Friends the Members for Banff and Buchan (David Duguid) and for Horsham (Jeremy Quin), and the hon. Members for Stoke-on-Trent Central (Gareth Snell), for Stoke-on-Trent North (Ruth Smeeth)—Stoke had a good showing—and for Birmingham, Edgbaston (Preet Kaur Gill). There is clearly great interest in this area, and I hope that the debate has highlighted that there are far too many children with speech, language and communication disorders, which affect their life chances.

Too many children end up having mental health issues, being excluded from school and being young offenders—and ultimately, many end up unemployed. That is not good enough, and we ought to be able to address it. The debate, the Bercow report and, indeed, many of the excellent people watching the debate demonstrate that things do not have to be like this.

As the Minister outlined, a great deal of excellent work is in progress, and there is much more in the pipeline. I get the feeling from speaking to him and from what he said today that he is committed to improving the situation, and there are some simple steps that could improve it. I was pleased to hear that there will be a particular concentration on joint working and joint commissioning of services between health and education, which was one of the things I wanted to ensure came out of the debate.

The continuity of programmes and good projects is also important. I know—especially from my sister’s input—about the awful drama and time-wasting that is involved in having to keep reapplying for funding when people already have a good thing going. That wastes time and everybody’s effort. Perhaps we could try to smooth that out a little.

I am pleased that the all-important issue of parenting was raised. I touched on that because it is not only about very disadvantaged people; it is about everybody. If we engaged a little more on that front, we could make huge progress together. I am optimistic that, with the commitment of the Minister and his Department and of the Department of Health and Social Care, we can make a change.

Question put and agreed to.

Resolved,

That his House has considered speech, language and communication support for children.

[Nadine Dorries (in the Chair)]

Will Members please leave the Chamber quietly? The next debate is about to start.