Universal co-ordinated model of play and communication services in children’s centres in Barking and Dagenham

Themes this local practice example relates to:

  • Early Years
  • General resources

Basic details

Organisation submitting example

The London Borough of Barking and Dagenham, Targeted Support Services, Children’s Services

Local authority/local area:

London Borough of Barking and Dagenham


The context and rationale

We developed a universal, coordinated model of play and communication services in children’s centres aimed at improving provision for children with speech, language and communication needs and including a programme of training and continuing professional development for those involved.

The idea:

To develop a universal, coordinated model of play and communication services in children’s centres (CCs) in the London Borough of Barking and Dagenham (LBBD) in order to:

• reduce the number of children, aged 0-5 years, in Barking and Dagenham with speech, language and communication needs (SLCN)
• prevent speech, language and communication delay
• identify early (pre-school, ideally before age 2 ) children with SLCN
• provide effective and appropriate early intervention for children with SLCN
• increase the percentage of children attending CCs in LBBD who achieve 6+ points in Communication, Language and Literacy (CLL) and Personal, Social and Emotional Development (PSED) in the Early Years Foundation Stage Profile (EYFSP).

Reason behind this initiative:

• high levels of children entering school with SLCN
• increasing levels of referrals to the Speech and Language Therapy (SLT) service
• high numbers of children of school age (4 years +) being referred to SLT, who would be at risk of poorer outcomes compared to children referred at an earlier age
• poorer EYFSP results compared to children in London and the United Kingdom, particularly in CLL and PSED
• local, national and international research evidence of the impact of early intervention in SLCN.

The practice

London Borough of Barking and Dagenham first developed a play and communication strategy and participated in several research projects, including: 

o Improving the Foundation Stage (2004–07)
o Interacting with Young Children, Parents as Partners in Early Learning (2006–08)
o Every Child a Talker (2009–11)
o Payment by Results trial (2011 – due to end 2013).

20 FTE (full time equivalent) Play and Communication Workers (PCWs) were recruited and provided with intensive specific training in speech, language and communication.
A coordinated programme of universal and targeted play and communication services for children and parents/carers was developed to be delivered from every children’s centre.
This included:
• six core universal services led by PCWs with specific aims and objectives in supporting speech, language and communication development (for example Infant Massage, Babbling Babes, Toddler Talk, Little Rhyme Makers)
• targeted support for children with additional needs, including Portage, and outreach programmes for children with SLCN who do not meet the criteria for referral to the Speech and Language Therapy Department
• outreach services (for example Little Rhyme Makers, Play with a Story) in schools, libraries, health centres and other venues, led by PCWs, with specific aims and objectives in supporting speech, language and communication development and sharing good practice with other early years practitioners
• a play and language workshop for parents and carers led by a speech and language therapist, comprising three 1 ½ hour weekly sessions: 
o Week one aims to give parents/carers an understanding of the development of children’s language and why communication is important. 
o Week two gives parents/carers practical ideas and strategies to support their children’s language development during play and everyday routines. 
o Week three focuses on sharing books and music to support language and communication. 
• tailored play and language workshops for parents of children with a language disorder or more complex difficulties and an ante-natal play and language workshop are also provided as required 
• monthly speech and language advice sessions led by a speech and language therapist in every children’s centre. Referral is not required and parents/carers can attend on a drop-in basis, though they are encouraged to make an appointment to avoid waiting. The speech and language therapist takes a structured case history and observes the child at play. Onward referrals are made as required, including to the speech and language therapy department, though many with a milder transient language delay are supported within children’s centre services. This service aims to:
o reduce referrals to the Speech and Language Therapy Department; 
o reduce waiting time for parents/carers and children requiring support and advice about language concerns.

A programme of professional development was designed and delivered for all children’s centre staff and early years practitioners from all agencies in LBBD, including health visitors, community nursery nurses, staff from social care, teachers and pre-school practitioners. This programme is based on findings from research carried out in LBBD over the years culminating in a structured training programme developed as part of the Every Child a Talker project. It is tailored to suit the needs of particular audiences, but includes some key principles:

• an understanding of speech, language and communication development
• 14 key interaction skills/strategies to support children’s language and communication development
• Creating a communication-friendly environment to support the development of children’s speech, language and communication. 

Universal systems were developed to:
• identify children with SLCN using a structured speech and language profile with all children who attend play and communication services
• monitor and track progress of any children identified with SLCN using profile and observation monitoring tool 
• implement early interventions according to varying and individual needs, following a structured care pathway.

Systems to ensure effective case supervision and consultation and communication with other agencies were developed, including:
• adhering to LBBD CAF (common assessment framework) guidance and protocols
• monthly group case discussion for PCWs led by speech and language therapist
• clear systems for case monitoring.

LBBD developed evaluation systems for all users that are fed into service files and SEF (self-evaluation forms) in order to inform planning and develop services, including:

• children: using photographs, symbols and objects to support children to evaluate the services they attend
• parents/carers: using specific evaluation tools for each service and other agencies (for example Portage, Speech and Language Therapy, Health team), using structured feedback forms,
• since 2009, working together with Schools’ data team to set up systems to analyse: 

o impact of CC attendance on children’s Foundation Stage Profile (FSP) attainment
o impact of individual services on FSP attainment
o results over time and compared with national, borough and statistical neighbours results
o impact of factors such as gender, ethnicity, Free School Meal entitlement on FSP achievement of children who have accessed CCs
o effects of sustained attendance at CCs on children’s FSP attainment.


In 2011, LBBD was selected as one of nine local authorities to be part of the Department for Education Payment by Results (PbR) trial. Play and communication was selected as one of five areas to be included in the trial. The PbR trial aim for play and communication is ‘to evaluate the effectiveness of play and communication services on FSP scores.’ 

Being part of the PbR trial has given LBBD the opportunity to improve on existing tools and design new systems to evaluate the impact of play and communication services and interventions on children’s attainment. 

Measuring outcomes

As well as assessing long-term outcomes using FSP attainment, LBBD is measuring short- and medium-term interim outcomes and have developed tools and an outcomes framework with which to do this. 

The following systems are currently being trialled:
• The PCW completes a speech and language profile with each parent/carer who accesses play and communication services, asking questions about the child’s communication in four defined areas. The PCW carries out a structured observation to gain additional information.
• Any child who is not at the expected level for his/her age in one or more of the defined areas is given a care plan. This is agreed at a monthly case discussion with the speech and language therapist. 
• Every child who is identified in this way is reviewed at 12- and 24-week periods using the speech and language profile and/or observation monitoring tool.
• According to the outcome, every child is assigned a level from 1–4. 
• Data is analysed for all children and for three targeted groups – boys, White British and those who would be eligible for Free School Meals, all of whom are at greater risk of speech and language delay in Barking and Dagenham compared to their peers.

Detailed analysis of 2012 Foundation Stage Profile results (as described above,) showing the impact of play and communication and other CC services on children’s attainment, particularly in Communication, Language and Literacy, will also be used.

A coordinated approach has been developed for the PbR trial in Barking and Dagenham; a similar outcome framework is being used in all five PbR trial areas of work, using a system tailored to each service, to evaluate interim outcomes at 12- and 24-week periods.

Evidencing your practice has made a difference to children, young people and families

The impact of attendance at CCs on children’s attainment in the Foundation Stage Profile – 2011

• 67% (2103/3159) of children in the 2011 FSP cohort had attended an LBBD Children’s Centre (CC), compared to 54% in 2010.
• 49% (254/521) of children eligible for FSM who accessed a CC achieved 6+ in CLLD in the FSP compared to 46% (80/175) who had not attended a CC and who achieved 6+ in CLLD.

Attendance at a CC had an impact on boys’ attainment:
• 66% (519/781) of boys in LBBD who achieved 78 points with 6+ in CLLD and PSED had attended a CC. 34% of boys in LBBD who achieved 78 points with 6+ in CLLD and PSED had not attended a CC.
• 67% (542/804) of boys in LBBD who achieved 6+ in CLLD had attended a CC. 33% of boys in LBBD who achieved 6+ in CLLD had not attended a CC.
• 74% (836/1129) of boys in LBBD who achieved 6+ in PSED had attended a CC. 26% of boys in LBBD who achieved 6+ in PSED had not attended a CC.
• 70% (154/219) of White British boys in LBBD who achieved 78 / 6+ / 6+ had attended a CC. 30% of White British boys in LBBD who achieved 78 / 6+ / 6+ had not attended a CC.

Attendance at a CC had an impact on the attainment of children with English as an Additional Language (EAL):
• 66% (520/782) of children with EAL in LBBD who achieved 78 / 6+ / 6+ had attended a CC. 34% (262/782) of children with EAL in LBBD who achieved 78 / 6+ / 6+ had not attended a CC.
• 67% (538/800) of children with EAL in LBBD who achieved 6+ in CLLD had attended a CC. 33% (262/800) of children with EAL in LBBD who achieved 6+ in CLLD had not attended a CC.
• 66% (742/1117) of children with EAL in LBBD who achieved 6+ in PSED had attended a CC. 34% (375/1117) of children with EAL in LBBD who achieved 6+ in PSED had not attended a CC.

Children who attended Play and Communication services in LBBD did better than children in the borough who had not attended a CC in the following areas of the FSP:
• 61% (165/271) of children who had attended Play and Communication services at a CC achieved 78 / 6+ / 6+, compared to 57% (603/1055) of children who had not attended a CC and achieved 78 / 6+ / 6+.
• 62% (167/271) of children who had attended Play and Communication services at a CC achieved 6+ in CLLD, compared to 57% (603/1055) of children who had not attended a CC and achieved 6+ in CLLD.
• 83% (226/271) of children who had attended Play and Communication services in a CC achieved 6+ in PSED, compared to 78% (826/1055) who had not attended a CC and achieved 6+ in PSED.

Children who had attended Baby Massage at a CC did better than those who had not in the following areas of the FSP:
• 71% (80/113) of children who had attended Baby Massage at a CC achieved 78 / 6+ / 6+. This compares with 57% (603/1056) of children who had not attended a CC and achieved 78 / 6+ / 6+.
• 73% (83/113) of children who had attended Baby Massage at a CC achieved 6+ points in CLLD. This compares with 57% (603/1056) of children who had not attended a CC and achieved 6+ in CLLD.
• 83% ((94/113) of children who had attended Baby Massage at a CC achieved 6+ points in PSED. This compares with 78% (826/1056) of children who had not attended a CC and achieved 6+ points in PSED.

Males who attended Baby Massage at a CC also did better than males who had not in the following areas of the FSP:
• 68% (42/62) of males who had attended Baby Massage at a CC achieved 78 / 6+ / 6+. This compares with 47% (262/556) of males who had not attended a CC and achieved 78 / 6+ / 6+.
• 71% (44/62) of males who had attended Baby Massage at a CC achieved 6+ points in CLLD. This compares with 47% (262/556) of males who had not attended a CC and achieved 6+ in CLLD.
• 79% (49/62) of males who had attended Baby Massage at a CC achieved 6+ points in PSED. This compares with 71% (393/556) of males who had not attended a CC and achieved 6+ points in PSED.

Results from Every Child a Talker (ECAT) project
The ECAT project in LBBD was graded as outstanding by the National Strategies. 540 early years practitioners, including members of the play and communication team, were trained to support speech, language and communication between 2009 and 2011. The speech, language and communication development of 1,328 children was monitored during the course of the project. Of these:
• 32% were assessed to be at risk of delay in their understanding of language at the beginning of the project (2009). This decreased to 17% at the end of the project following training of staff and intervention (2011).
• 18% were assessed to be ahead in their development of expressive language development at the beginning of the project (2009). This increased to 34% at the end of the project, following training of staff and intervention (2011).

Helping others to replicate your practice

Which service will we maintain?

• training programmes for all staff and continual professional development, including monthly supervision and structured observations of staff, all linked to the six-month appraisal review and annual appraisal
• core services run by PCWs, evaluated and developed as needed
• systems for identifying and monitoring progress
• evaluation systems to measure short- and medium-term interim outcomes and long-term outcomes using FSP data.

How will we do this?
• maintain current level of frontline staffing (PCWs) and train volunteers and other early years staff to support services
• continue partnership working with SLT Department
• continue training of staff from other agencies to ensure coordinated, holistic and consistent approach to supporting speech, language and communication development. 

Cost per annum

20 X Play and Communication Workers @ £23,277 each 465,540
1 X Early Communication Lead @ £43,368 43,368

Total cost: £508,908

Learning from the experience:

• A universal offer is essential to ensuring effective early identification, prevention and targeted early intervention.
• Standardised core services with clear established systems ensure coordinated approach to service delivery.
• Effective systems for sharing of good practice are necessary.
• Targeted services tailored to meet needs of individual children, families, CCs, localities and communities are required.
• Well-established evaluation systems at different levels (for example, parent, child, agency, service, CC, locality or borough) are essential.
• Good data support and aligned systems across services help to ensure:
o effective analysis and use of data
o ongoing development of systems and services.
• Co-ordinated approach to service delivery leads to most effective outcomes, so working in partnership with other services and agencies and aligning systems is important.
• Good leadership and support from and communication with senior management are essential. 
• Research helps to evaluate and develop services and practice. 
• The earliest interventions lead to the most effective outcomes.
• Sustained contact is important.
• Ongoing professional development for frontline staff is essential. 
• Working effectively with other CC staff and services leads to most successful outcomes for families – there is no single silver bullet. 

Golden threads

• Prove it – making change happen
• Unite to succeed – the right support at the right time

Additional documents available from the C4EO team:

• Play and communication profile template
• Play and communication monitoring tool
• Parent evaluation template
• Session evaluation template
• Summary evaluation template
• Payment by Results scoring tool

 

Contact Us

t. 020 7833 6825
e. contactus@C4EO.org.uk

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