Summary of the impact

Research at Newcastle on speech language and communication needs (SLCN) has significantly extended the range and quality of evidence in this field. The research is significantly informing high level policy makers, and has been used to set up an accessible database which is having impact on the practice of a range of different professionals. It has contributed to a new programme of work which has produced positive outcomes for schools, children and young people and has been used as an evidence base to secure charity funding for a third sector organisation.

Underpinning research

Delayed language development is common in young children, affecting up to 20% of children at school entry, rising to a figure of 40% in the most disadvantaged populations (1). Many of these children go on to struggle with reading and writing and consequently other academic subjects. As a result, many underachieve throughout their schooling and into the work force.

Since joining Newcastle, James Law (Professor of Speech and Language Science, 2010-present) has built on his ESRC funded project work (funding but not publications outwith the current REF period) which looked at adult outcomes for school entry language delays (1). This project was among the first to confirm the long term consequences of such early delays in a very large populations over a long period of time (18,000 between 5 and 34 years in the British Cohort Study 1970) (2). Social disadvantage is one of the main predictors of change in the early years from an analysis of the Millennium Cohort Study (3), although comparable work on Avon Longitudinal Study of Parents and Children showed that for very young children what parents do to promote their child's readiness for school is more important that social disadvantage per se (4). With the exception of (4) Law led each of these studies, writing the original proposals, contributing to the analyses and authoring reports and papers.

Equally important is the development of well evaluated interventions. Before being employed at Newcastle, Law was the first author of an internationally recognised review of speech and language therapy interventions published by the Cochrane Collaboration, which can be accessed at http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004110/pdf. It is very widely cited and contributed to Law's role as PI in a major £1.5m research programme funded by the Department for Education in England, called the Better Communication Research Programme (BCRP), 2009-2012 and commissioned as a response to the Bercow review of services for children with speech, language and communication needs (SLCN). One aspect of this work was identifying the `best evidence' for oral language programmes. The research examined the intervention literature related to children with primary speech and language difficulties. The evidence was drawn together and led to the production of the report, What works: Interventions for Children with Speech Language and Communication Needs, one of a number of reports from the BCRP project (5). The main findings were that whilst over 60 evidence-based interventions are available to practitioners, many are not being used in the UK, with some practitioners commonly relying on interventions with little underpinning evidence. Independently Law has also been contributing to the development of the primary evidence base both in the UK and in Australia (6).

References to the research

All the papers cited have substantive international reach. (2) and (3) are being submitted in REF2; (1) and (6) are in important professional journals; and (4) and (5) are reports which have received government scrutiny and are published on government websites.

Key Grant information:

Principal Investigator	Grant Title	Sponsor	Period	Value to Newcastle
James Law	Better Communication Research Programme (BCRP)	Department for Education	2009-2012	£76,000
James Law	Centre of Research Excellence in Childhood Language	National Health and Medical Research Council (Australia)	2012-2017	£23,000
James Law	Early Language Delays in the UK	Save the Children	2012-2013	£10,000

Details of the impact

The research has informed the direction and focus of a parliamentary inquiry, the All Party Parliamentary Group (APPG) on Speech and Language, chaired by Lord Ramsbotham. Lord Ramsbotham who led a parliamentary discussion on the issue on January 29^th 2013, also confirmed: "In addition to his willingness to advise, based on his deep knowledge and understanding of the subject, he (Law) was able to suggest people from whom we ought to seek evidence, and topics that we could pursue with advantage. We could not have completed our work without him...I can think of no better example of how research can be used to impact on policy" (IMP1). Law presented research evidence to the APPG and he was identified as a key contributor by the Royal College of Speech and Language Therapists (RCSLT). As a result, the underpinning research is cited multiple times in the final report (IMP2). The underpinning research output (2) was also cited in the RCSLT's response to the House of Commons Education Committee in October 2012, to highlight the relationship between language delays in children and social disadvantage (IMP3). The significance of the RCRP and APPG reports are highlighted by Lord Ramsbotham: "[the reports] were published in time to inform debate on the Children and Families Bill...if successfully enacted, these will change the life prospects of many young people, for which there is no doubt that much of the credit will be due to Professor Law for educating members of both Houses of Parliament" (IMP1).

The Communication Trust, an umbrella organisation representing more than 40 charities which have speech and language as a focus of their activities, drew directly on the BCRP evidence to develop an interactive online database, `What Works'
www.thecommunicationtrust.org.uk/schools/what-works. The Director of The Communication Trust, said; "This landmark research is to be welcomed by all those committed to supporting children and young people who struggle with communication...The Trust and our Communication Consortium is fully committed to ensuring all those who work with children and young people with SLCN know how to support them and have practical tools to do this... We're working with the Department and the research team to disseminate the resources and outcomes of the research, including an online database of evidenced interventions to support children's communication" (IMP4).

The database has also been endorsed by the RCSLT and the organisation's Chief Executive was quoted in a Communication Trust Newsletter as saying: "The RCSLT is delighted to have had the opportunity to work with partners at The Communication Trust to support the evaluation and development of the What Works website. At a time when commissioning of services is becoming more complex, any resource that supports this process is going to be vital" (IMP5). Indicating the significance of the database, RCSLT's Chief Executive has also confirmed that feedback from the membership (12,201 people in the UK) has been positive and that "we believe that the database, to which James Law has been so instrumental, has the potential to make a major contribution to the development of evidence based services across the UK and beyond" (IMP6).

The online database aims to support a range of users, including speech and language therapists (SLTs), commissioners, teachers, practitioners and other specialist staff and draws together the best available evidence in an accessible form. It was launched March 2013 and by the 31^st of July 2013, it had been accessed by a total of 22,700 visitors, with 49,500 page views (IMP7). 4,200 professionals are already registered to use the database. The Professional Director of the Communication Trust states that "The data base is a direct result of the research and we have worked closely [with Law] to ensure the research information is accessible to the widest audience while not losing the robust nature of the content. The data base has been important to our sector in providing up to date information on evidenced interventions that can apply positively on outcomes for children and young people with speech, language and communication needs...the what works data base has been incredibly well received across our sector" (IMP7). Feedback from users is positive, and comments left by professionals who have accessed the database include:

"I've already used information I have found on the database to discuss interventions with parents, schools and speech and language therapists. I have also found the links to various websites extremely useful and have recommended some to parents and EY [early years] practitioners. Thank you!" (Educational Psychologist)

"[The database] helps influence our service delivery design; supports advocating to commissioners/our managers for evidence of why we need Speech Language Therapy" (SLT)

"Although we have always strived to be evidence based as a profession, in the day to day job of a Speech & Language Therapist, there is not often time to find this research. Having a database will be a fantastic resource when sharing with parents and professionals why we have chosen an intervention (or why we have chosen NOT to use something!)" (SLT) (IMP7).

Significantly the database is funded by the Department of Education through to 2017 and the moderating group of which Law is a key member will continue to monitor its quality.

The Communication Trust also cited the research findings as corroborating evidence in their case for support for an Early Endowment Foundation grant of £967,780, which is funding a new trial based on their programme, Talk of the Town (IMP8). The programme "was developed with the aim of providing a framework where evidenced approaches and interventions could be dropped into place within the early years, primary and secondary school in one community...We were able to take this approach and the What Works data base as a foundation to seek further funding to test out the approach more robustly and have recently secured a significant grant from the Educational Endowment Foundation to run a randomised control trial on the approach in 64 primary schools across three areas of the country" (IMP7). In the `Latest News' section of their website the Communication Trust noted that: "the underlying interventions supported as part of Talk of the Town are those that have been identified through the Better Communication Research Programme as having good evidence of impact" (IMP9).

The comprehensive review of the relevant research literature in the BCRP research also produced a `Communication Supporting Classrooms (CsC) Observation Tool' (with supporting guidance) — one of few such tools that are evidence-based (IMP10). The Tool provides professionals with the means of profiling the ways in which oral language is supported in Reception and Key Stage 1 and 2 classrooms. It has been published on The Communication Trust website `Resources for Practitioners'.

In summary, the underpinning research has significantly informed and influenced high level policy makers and professional organisations. In particular, the BCRP research was (i) instrumental in placing SLCN on the political and policy agenda, and (ii) led directly to the introduction of a database of evidenced interventions, aimed at supporting practitioners, and a new programme which has produced positive outcomes for schools, children and young people.

Sources to corroborate the impact

(IMP1) Factual statement from Lord Ramsbotham, Chair of the APPG for Speech & Language.

(IMP2) APPG on Speech and Language Difficulties (2013) The Links Between Speech, Language and Communication Needs and Social Disadvantage. London: RCSLT (pages 8-13, 15-16, 18-19, 21, 27, 32, 34-37). Available at:
http://www.rcslt.org/governments/docs/all_party_parliamentary_group_on_slcn_inquiry_report.

(IMP3) RCSLT (2012) Evidence to the House of Commons Education Committee on the Government's Proposed Reform of SEN Provision (page 2). Available at:
http://www.rcslt.org/governments/docs/sen_provision_evidence.

(IMP4) The Communication Trust, Press Release (December 2012). Available at:
www.thecommunicationtrust.org.uk/media/29329/bcrp_dec2012.doc.

(IMP5) The Communication Trust, Newsletter — March 2013. Available at:
http://www.thecommunicationtrust.org.uk/media/50829/march_2013.html.

(IMP6) Factual statement from Chief Executive, RCSLT.

(IMP7) Factual statement from Professional Director, The Communication Trust.

(IMP8) Education Endowment Foundation Projects (Talk of the Town). Available at:
http://educationendowmentfoundation.org.uk/projects/the-communications-trust-talk-of-the-town.

(IMP9) The Communication Trust, News Item `The Education Endowment Foundation award a grant to The Communication Trust to test a school-wide approach to improving speech, language and communication support'. Available at:
http://www.thecommunicationtrust.org.uk/about-the-trust/what-do-we-do/latest-news.aspx.

(IMP10) BCRP (2012) Communication Supporting Classrooms Observation Tool. Available at:
www.thecommunicationtrust.org.uk/media/93866/tct_bcrp_csc_final.pdf.