Quality standard
Quality statement 2: Speech and language
Quality statement 2: Speech and language
Quality statement
Children have their speech and language skills assessed at their 2 to 2½ year integrated review.
Rationale
Children and young people with communication difficulties are at increased risk of social, emotional and behavioural difficulties and mental health problems. So identifying their speech and language needs early is crucial for their health and wellbeing. Many young children whose needs are identified early do catch up with their peers.
The 2 to 2½ year integrated review is a good time to assess speech and language skills because there is time to offer support before they start school.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that children's speech and language skills are assessed at their 2 to 2½ year integrated review.
Data source: Local data collection and the NHS Digital Community services data set.
Process
a) Proportion of children who have the 2 to 2½ year integrated review.
Numerator – the number in the denominator who have the 2 to 2½ year integrated review.
Denominator – the number of children aged 2 to 2½.
Data source: Office for Health Improvement and Disparities Health visitor service delivery metrics.
b) Proportion of children having the 2 to 2 ½ year integrated review who have their speech and language skills assessed.
Numerator – the number in the denominator who have their speech and language skills assessed.
Denominator – the number of children who have the 2 to 2½ year integrated review.
Data source: Local data collection and the NHS Digital Community services data set.
Outcome
a) Speech and language skills in children under 5.
Data source: Local data collection and the NHS Digital Community services data set.
b) School readiness of children under 5.
Data source: Local data collection.
c) Social, emotional and behavioural difficulties.
Data source: Local data collection.
d) Mental health difficulties.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers (such as health visiting services and early years providers) ensure that they put systems in place to assess speech and language skills at the 2 to 2½ year integrated review. Locally defined pathways and referral routes ensure that the appropriate services care for children who need support.
Health, social care and early years education practitioners (such as health visitors and pre-school education staff) ensure that they assess the speech and language skills of children at the 2 to 2½ year integrated review. Locally defined pathways ensure that the appropriate services care for children who need support.
Commissioners (such as clinical commissioning groups and local authorities) ensure that they commission services that assess speech and language skills at the 2 to 2½ year integrated review. Services have locally defined pathways so that the appropriate services care for children who need support.
Parents and carers are offered a review of their child's health and wellbeing when their child is aged 2 to 2½. During this review their child's speech and language is assessed. If their child needs help to develop these skills, they are offered care from the appropriate service.
Source guidance
Social and emotional wellbeing: early years. NICE guideline PH40 (2012), recommendation 2
Definitions of terms used in this quality statement
2 to 2½ year integrated review
The integrated review of children aged between 24 and 30 months incorporates the Healthy Child Programme assessments and the Early Years Progress Check (at age 2). The aim is to give parents a picture of their child's health and educational development. Depending on local protocols, the review may be carried out by a health visitor and an early years practitioner, or by a health visitor who will then share information with the early years practitioner.
The NHS Digital and Ofsted Ages and stages questionnaire is used to carry out the review.
[Adapted from Department of Health and Social Care and Public Health England Services for children aged 0 to 5: transfer to local authorities; and expert opinion]
Equality and diversity considerations
Practitioners should take into account cultural and language differences when carrying out the review with the child and discussing it with the child's parents and carers. If the child's first language is not English it may be necessary for a practitioner with the relevant experience to assess their speech and language skills.