Parents hold the key to preventing speech delay. Anne Wiltsher reports on what childcare professionals are doing to empower them
Toddlers' speech mistakes make us laugh - and nursery teacher Esther Thomas' recollections of her daughter's early efforts are certainly hilarious.
'Resipippies' were Ricekrispies, 'cray-boop' was playgroup and lippies were slippers. Big Ben was, more sensibly, 'Big Bong'.
'Appydong' was harder to interpret. But Esther got to the bottom of it. 'I had often responded to demands for jam by getting off a chair saying, "You're always making me get up and down". My toddler thought "up and down" was what I was getting, not where I was going.'
It is worth telling this story to remind us that children have their own idiosyncratic ways of learning to talk and we should take care not to overlay the process with adult anxiety. Some childcare practitioners told Nursery World they believe speech delay is on the increase, but, as yet, this seems unproven.
Even the percentage of children who suffer from it is uncertain.
Poverty link Dr James Law, head of language and communication sciences at City University, London, recently carried out a systematic review of all research papers on children aged nought to seven with primary speech delays - that is, those which are not caused by disabilities - and found that the prevalence estimates ranged from 0.06 to 33.2 per cent. Dr Law states that this is partly a result of the difficulty in establishing what 'normal' speech development is.
However, Shivani Chotai, co-ordinator of speech and language therapy at the Sure Start Project in Tower Hamlets, London, believes there is evidence that speech delay is getting worse in inner city areas. 'It appears to be linked to an increase in poverty,' she says. 'Interaction between adult carers and a young child is essential for language development, and when a parent's priority is "Have I got enough food on the table?" they are hardly likely to be spending a lot of time playing with a child. There is also inadequate provision of nursery and other childcare, which could support children's language development.'
In addition, the effects of television have led to a decrease in children's concentration skills which impact on language development, believes Ms Chotai.
'Children just sit in front of the TV rather than interacting with someone. Sometimes this is because parents feel that TV can be educational.'
Turn off the telly Dr Sally Ward became famous for saying, 'Turn off your telly, please' with her W.I.L.S.T.A.A.R. early intervention programme to combat speech delay The programme is often known as BabyTalk, as Dr Ward has written a book of the same name.
Prior to writing BabyTalk, Dr Ward was principal speech and language therapist at the Mancunian Community NHS Trust, but she now works in private practice. She is also advisor in developmental language disability to the Royal College of Speech and Language Therapists.
From 1984-87, Dr Ward carried out a study in inner city Manchester with her colleague Deirdre Birkett to map out a means of detecting infants at risk of language delay in the first year of life. This was followed up by a further three-year study from 1990-93 designed to test the BabyTalk programme which the two therapists developed during clinic work.
In the two studies - the first involved 373 ten-month-old babies, the second 140 (although half in the second study were a control group) - television was on loudly in the homes they visited. 'In many homes the television would be turned on by the first person up in the morning and off by the last to bed at night,' says Dr Ward.
Dr Ward explains that babies cannot 'tune out' background noise in the same way that adults can, and that in order to develop language they need time listening to one parent talking in a quiet place. Dr Ward asked mothers to turn off the TV for at least half an hour and talk to their babies; they discussed ways to talk to infants and how often.
Those with speech delay made startling progress, catching up after only four months. At three years the children were almost all up to standard, many above their age level, while in the control group 85 per cent still suffered speech delay. At seven it was a similar story. BabyTalk is now used in 40 local authorities, many of which have Sure Start projects.
Nursery service Shivani Chotai has also developed an intervention service to use in social services nurseries. The Riverside Early Years Intervention Service was set up in 1996 with her colleague Louise Habgood when they both worked for the Riverside Community Health Care NHS Trust in London. Figures for speech and language delay in the ten social services day centres were comparable to national research showing that 23 to 50 per cent of children at such nurseries have speech difficulties.
The service includes a two-day initial training programme and speech and language therapists also work alongside staff. Parent workshops are run regularly and attendance has been encouraging.
Two-day training packages are now available to all nurseries in the Riverside locality, including private ones, and to playgroups. Sixty-five other Community Trusts have expressed interest in starting similar schemes.
However, it is with parents that the prevention of speech delay mainly lies. Rosie Roberts, director of Peers Early Education Partnership (PEEP), points out that three-quarters of children aged nought to three are mainly cared for by their mother at home.
PEEP was set up in 1995 to improve the educational attainment of children in a deprived area of Oxford. A Sure Start project operates in one third of the area and a second PEEP scheme is to be set up in Birkenhead Sure Start. Next year PEEP plans to publish its programme material nationally.
In Oxford, every new baby in the area is visited at four weeks and parents told about weekly group sessions where families can support each other, sing songs and rhymes, listen to a story and take home the 'Learning together pack' which has ideas for play activities to do at home. Local families speak 20 different languages and many of the staff are bi-lingual.
Dr Ward recommends that parents always speak to babies in their own language as it is difficult to speak 'Motherese' - that high-pitched, tuneful voice that a baby automatically triggers in us, which has been shown to be most helpful to their language development - in a second language.
Reaching and sharing Parents usually enjoy the BabyTalk and PEEP programmes. But aren't the ones who need it most the least likely to take part? Rosie Roberts admits that the most difficult task is encouraging 'hard to reach' families. Only about half the babies visited at four weeks come to the weekly sessions, but the rest have follow-up visits at home. In Sure Start areas it is health visitors who usually introduce BabyTalk to mothers. In both programmes the approach is one of 'sharing', 'empowering' and 'offering ideas' to parents, rather than 'telling' them what to do.
Sure Start's target is for at least 90 per cent of children to have normal speech and language development at 18 months and three years, so these schemes and others like them are natural allies and should be encouraged.
Speaking at a recent conference organised by the National Literacy Trust, Councillor Rita Stringfellow, leader of North Tyneside Council, recalled being shocked at meeting a nursery child who could only grunt. 'How could this have happened?' she asked.
'Children are citizens with rights,' she said. 'They have a right to language and literacy skills - and it is our responsibility to empower parents to enhance those skills.'
Contacts:
- BabyTalk programme: 01625 252 4490. BabyTalk is published by Century at 12.99.
- Riverside Early Years Intervention Service: Louise Habgood 0208 746 5770. n PEEP: 01865 779779. PEEP is looking for co-ordinators with early years experience.
- Read Esther Thomas' account of her daughter's language development in the Early Education Autumn 2000 newsletter.
